Significant Improvement of Acute Complete Spinal Cord Injury Patients Diagnosed by a Combined Criteria Implanted with NeuroRegen Scaffolds and Mesenchymal Stem Cells

Abstract

Stem cells and biomaterials transplantation hold a promising treatment for functional recovery in spinal cord injury (SCI) animal models. However, the functional recovery of complete SCI patients was still a huge challenge in clinic. Additionally, there is no clinical standard procedure available to diagnose precisely an acute patient as complete SCI. Here, two acute SCI patients, with injury at thoracic 11 (T11) and cervical 4 (C4) level respectively, were judged as complete injury by a stricter method combined with American Spinal Injury Association (ASIA) Impairment Scale, magnetic resonance imaging (MRI) and nerve electrophysiology. Collagen scaffolds, named NeuroRegen scaffolds, with human umbilical cord mesenchymal stem cells (MSCs) were transplanted into the injury site. During 1 year follow up, no obvious adverse symptoms related to the functional scaffolds implantation were found after treatment. The recovery of the sensory and motor functions was observed in the two patients. The sensory level expanded below the injury level, and the patients regained the sense function in bowel and bladder. The thoracic SCI patient could walk voluntary with the hip under the help of brace. The cervical SCI patient could raise his lower legs against the gravity in the wheelchair and shake his toes under control. The injury status of the two patients was improved from ASIA A complete injury to ASIA C incomplete injury. Furthermore, the improvement of sensory and motor functions was accompanied with the recovery of the interrupted neural conduction. These results showed that the supraspinal control of movements below the injury was regained by functional scaffolds implantation in the two patients who were judged as the complete injury with combined criteria, it suggested that functional scaffolds transplantation could serve as an effective treatment for acute complete SCI patients.

Advances in Tissue Engineering and Innovative Fabrication Techniques for 3-D-Structures: Translational Applications in Neurodegenerative Diseases

“…After SCI was induced, the protocol required the injection of biomaterials (made of diblock copolypeptide hydrogels) delivering fibroblast growth factor 2, EGF, glial cell-derived neurotrophic factor (GDNF), and integrin-blocking antibody [ 170 ]. Other than compounds, bio-scaffolds can also in this case be used to deliver stem cells, most frequently human mesenchymal stem cells, widely used in the treatment of the disease [ 269 , 270 , 271 ], but scaffolds complexed with NPCs have also been developed [ 166 , 272 , 273 ]. It is worth mentioning that in the case of SCI, biomaterials (in particular the Neuro-Spinal Scaffold - InVivo Therapeutics Corp.) have also been used in clinical practice [ 167 , 168 ].…”

Current Status and Future Strategies to Treat Spinal Cord Injury with Adult Stem Cells

“…These combination therapies improved axonal regeneration, stem cell differentiation, and functional improvement, and decreased scar formation 6,31,48) . In a recent human clinical trial, combination treatment with a collagen scaffold and UC-MSCs in the acute phase of SCI improved the AIS grade from A to C in one patient with cervical SCI and one patient with thoracic SCI after 1 year of followup 61) .…”

Challenges With the Development of Biomaterials for Sustainable Tissue Engineering

“…Once again, results with natural polymers have generally proven to be better. Dai and colleagues have worked with bovine collagen scaffolds, showing good results in a chronic SCI canine model when seeded with umbilical cord mesenchymal stem cells (Li et al, 2017), and then in human clinical trials with both acute (Xiao et al, 2018) and chronic (Xiao et al, 2016) spinal cord injuries.…”