Study of the Diffusion Tensor Imaging for Preclinical Therapeutic Efficacy of Umbilical Cord Mesenchymal Stem Cell Transplantation in the Treatment of Spinal Cord Injury

Zhao, Ying; Yao, Liqing; Li, Ao; Ou, Jibing; Ying, Hanjie; Shang, Yunyun

doi:10.2147/ijgm.s326023

Cited by 6 publications

(2 citation statements)

References 16 publications

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“…420,421 Combined transplantation of different types of cells, transplantation of MSCs combined with biomaterials, and comprehensive rehabilitation may be strategies to improve the effect of MSCs in clinical trials. [422][423][424][425] A phase 1/2 clinical trial of cell transplantation combining human autologous Schwann cells and BMSCs was carried out in subacute complete SCI patients and revealed statistically significant improvements in sensory and neurological functions (Table 3). 422 Bone marrow mononuclear cells (BMMCs) and umbilical cord blood-derived mononuclear cells (UCB-MNCs) are both useful cell types for repairing SCI, and their function has been verified in clinical research on SCI (Table 3).…”

Section: Advanced Technology In Clinical Trialsmentioning

confidence: 99%

Spinal cord injury: molecular mechanisms and therapeutic interventions

Ren

et al. 2023

Sig Transduct Target Ther

165

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Spinal cord injury (SCI) remains a severe condition with an extremely high disability rate. The challenges of SCI repair include its complex pathological mechanisms and the difficulties of neural regeneration in the central nervous system. In the past few decades, researchers have attempted to completely elucidate the pathological mechanism of SCI and identify effective strategies to promote axon regeneration and neural circuit remodeling, but the results have not been ideal. Recently, new pathological mechanisms of SCI, especially the interactions between immune and neural cell responses, have been revealed by single-cell sequencing and spatial transcriptome analysis. With the development of bioactive materials and stem cells, more attention has been focused on forming intermediate neural networks to promote neural regeneration and neural circuit reconstruction than on promoting axonal regeneration in the corticospinal tract. Furthermore, technologies to control physical parameters such as electricity, magnetism and ultrasound have been constantly innovated and applied in neural cell fate regulation. Among these advanced novel strategies and technologies, stem cell therapy, biomaterial transplantation, and electromagnetic stimulation have entered into the stage of clinical trials, and some of them have already been applied in clinical treatment. In this review, we outline the overall epidemiology and pathophysiology of SCI, expound on the latest research progress related to neural regeneration and circuit reconstruction in detail, and propose future directions for SCI repair and clinical applications.

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Section: Advanced Technology In Clinical Trialsmentioning

confidence: 99%

Spinal cord injury: molecular mechanisms and therapeutic interventions

Ren

et al. 2023

Sig Transduct Target Ther

165

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“…The follow-up period ranged from 6 to 60 months. The basic information of the included studies is shown in Additional file 1 : Table S2 [ 23 – 84 ].…”

Section: Resultsmentioning

confidence: 99%

Clinical translation of stem cell therapy for spinal cord injury still premature: results from a single-arm meta-analysis based on 62 clinical trials

Shang

Wang

Zhang

et al. 2022

BMC Med

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Background How much scientific evidence is there to show that stem cell therapy is sufficient in preclinical and clinical studies of spinal cord injury before it is translated into clinical practice? This is a complicated problem. A single, small-sample clinical trial is difficult to answer, and accurate insights into this question can only be given by systematically evaluating all the existing evidence. Methods The PubMed, Ovid-Embase, Web of Science, and Cochrane databases were searched from inception to February 10, 2022. Two independent reviewers performed the literature search, identified and screened the studies, and performed a quality assessment and data extraction. Results In total, 62 studies involving 2439 patients were included in the analysis. Of these, 42 were single-arm studies, and 20 were controlled studies. The meta-analysis showed that stem cells improved the ASIA impairment scale score by at least one grade in 48.9% [40.8%, 56.9%] of patients with spinal cord injury. Moreover, the rate of improvement in urinary and gastrointestinal system function was 42.1% [27.6%, 57.2%] and 52.0% [23.6%, 79.8%], respectively. However, 28 types of adverse effects were observed to occur due to stem cells and transplantation procedures. Of these, neuropathic pain, abnormal feeling, muscle spasms, vomiting, and urinary tract infection were the most common, with an incidence of > 20%. While no serious adverse effects such as tumorigenesis were reported, this could be due to the insufficient follow-up period. Conclusions Overall, the results demonstrated that although the efficacy of stem cell therapy is encouraging, the subsequent adverse effects remain concerning. In addition, the clinical trials had problems such as small sample sizes, poor design, and lack of prospective registration, control, and blinding. Therefore, the current evidence is not sufficiently strong to support the clinical translation of stem cell therapy for spinal cord injury, and several problems remain. Additional well-designed animal experiments and high-quality clinical studies are warranted to address these issues.

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Umbilical Cord Blood Transplantation: Connecting Its Origin to Its Future

Sanchez‐Petitto

Rezvani

Daher

et al. 2023

Stem Cells Translational Medicine

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Transplantation of umbilical cord blood (UCB) is an attractive alternative source of hematopoietic stem cells (HSCs). The unique properties of cord blood and its distinct immune tolerance and engraftment kinetics compared to bone marrow (BM) and peripheral blood progenitor cells, permit a wider disparity in human leukocyte antigen levels between a cord blood donor and recipient after an unrelated umbilical cord blood transplant (UCBT). In addition, it is readily available and has a lowered risk of graft-versus-host disease (GvHD), with similar long-term clinical outcomes, compared to BM transplants. However, the relatively low number of cells administered by UCB units, as well as the associated delayed engraftment and immune reconstitution, pose limitations to the wide application of UCBT. Research into several aspects of UCBT has been evaluated, including the ex vivo expansion of cord blood HSCs and the process of fucosylation to enhance engraftment. Additionally, UCB has also been used in the treatment of several neurodegenerative and cardiovascular disorders with varying degrees of success. In this article, we will discuss the biology, clinical indications, and benefits of UCBT in pediatric and adult populations. We will also discuss future directions for the use of cord blood.

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Study of the Diffusion Tensor Imaging for Preclinical Therapeutic Efficacy of Umbilical Cord Mesenchymal Stem Cell Transplantation in the Treatment of Spinal Cord Injury

Cited by 6 publications

References 16 publications

Spinal cord injury: molecular mechanisms and therapeutic interventions

Spinal cord injury: molecular mechanisms and therapeutic interventions

Clinical translation of stem cell therapy for spinal cord injury still premature: results from a single-arm meta-analysis based on 62 clinical trials

Umbilical Cord Blood Transplantation: Connecting Its Origin to Its Future

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