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Published in: Journal of Translational Medicine 1/2014

Open Access 01-12-2014 | Research

Clinical observation of umbilical cord mesenchymal stem cell transplantation in treatment for sequelae of thoracolumbar spinal cord injury

Authors: Hongbin Cheng, Xuebin Liu, Rongrong Hua, Guanghui Dai, Xiaodong Wang, Jianhua Gao, Yihua An

Published in: Journal of Translational Medicine | Issue 1/2014

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Abstract

Background

Umbilical cord mesenchymal stem cells (UCMSCs) have a considerable advantage and potential in treating for central nervous system diseases and have become a novel alternative treatment for spinal cord injury. This study aims to compare the neurological function outcome of stem cell transplantation, rehabilitation therapy, and self-healing for sequelae of spinal cord injury.

Methods

Thirty-four cases of thoracolumbar spinal cord injury were randomly divided into three groups: the stem cell transplantation group was given CT-guided UCMSC transplantation twice; the rehabilitation group received rehabilitation therapy; and the blank control group did not receive any specific treatment. AIS grading, ASIA scoring, the manual muscle strength and muscle tension scale, and the Barthel index were used to evaluate the clinical outcome. Urodynamic examination was also performed for patients in the UCMSC group and the rehabilitation therapy group.

Results

Seven of the ten patients in the UCMSC group had significant and stable improvement in movement, self-care ability, and muscular tension; five of the forteen patients (36%) in the rehabilitation group also had certain improvement in these aspects. Urodynamic examination demonstrated that patients in the UCMSC group exhibited an increase in maximum urinary flow rate and maximum bladder capacity, as well as a decrease in residue urine volume and maximum detrusor pressure. The rehabilitation group exhibited decreased maximum bladder capacity, but no perceptible change in maximum urinary flow rate, residue urine volume or maximum detrusor pressure.

Conclusions

UCMSC transplantation can effectively improve neurological functional recovery after spinal cord injury, and its efficacy is superior to that of rehabilitation therapy and self-healing.

Trial registration

The present clinical study was registered at chictr.org (registration number: NCT01393977).
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Literature
1.
go back to reference Li J, Liu G, Zheng Y, Hao C, Zhang Y, Wei B, Zhou H, Wang D: The epidemiological survey of acute traumatic spinal cord injury (ATSCI) of 2002 in Beijing municipality. Spinal Cord. 2011, 49: 777-782. 10.1038/sc.2011.8.CrossRefPubMed Li J, Liu G, Zheng Y, Hao C, Zhang Y, Wei B, Zhou H, Wang D: The epidemiological survey of acute traumatic spinal cord injury (ATSCI) of 2002 in Beijing municipality. Spinal Cord. 2011, 49: 777-782. 10.1038/sc.2011.8.CrossRefPubMed
2.
go back to reference Reitz A: Afferent pathways arising from the lower urinary tract after complete spinal cord injury or cauda equina lesion: clinical observations with neurophysiological implications. Urol Int. 2012, 89: 462-467. 10.1159/000342815.CrossRefPubMed Reitz A: Afferent pathways arising from the lower urinary tract after complete spinal cord injury or cauda equina lesion: clinical observations with neurophysiological implications. Urol Int. 2012, 89: 462-467. 10.1159/000342815.CrossRefPubMed
3.
go back to reference Zhang S, Wadhwa R, Haydel J, Toms J, Johnson K, Guthikonda B: Spine and spinal cord trauma: diagnosis and management. Neurol Clin. 2013, 31: 183-206. 10.1016/j.ncl.2012.09.012.CrossRefPubMed Zhang S, Wadhwa R, Haydel J, Toms J, Johnson K, Guthikonda B: Spine and spinal cord trauma: diagnosis and management. Neurol Clin. 2013, 31: 183-206. 10.1016/j.ncl.2012.09.012.CrossRefPubMed
4.
go back to reference Ibarra A, Martinon S: Pharmacological approaches to induce neuroregeneration in spinal cord injury: an overview. Curr Drug Discov Technol. 2009, 6: 82-90. 10.2174/157016309788488320.CrossRefPubMed Ibarra A, Martinon S: Pharmacological approaches to induce neuroregeneration in spinal cord injury: an overview. Curr Drug Discov Technol. 2009, 6: 82-90. 10.2174/157016309788488320.CrossRefPubMed
5.
go back to reference Kwon BK, Okon E, Hillyer J, Mann C, Baptiste D, Weaver LC, Fehlings MG, Tetzlaff W: A systematic review of non-invasive pharmacologic neuroprotective treatments for acute spinal cord injury. J Neurotrauma. 2011, 28: 1545-1588. 10.1089/neu.2009.1149.PubMedCentralCrossRefPubMed Kwon BK, Okon E, Hillyer J, Mann C, Baptiste D, Weaver LC, Fehlings MG, Tetzlaff W: A systematic review of non-invasive pharmacologic neuroprotective treatments for acute spinal cord injury. J Neurotrauma. 2011, 28: 1545-1588. 10.1089/neu.2009.1149.PubMedCentralCrossRefPubMed
6.
go back to reference Ditunno JF, Cardenas DD, Formal C, Dalal K: Advances in the rehabilitation management of acute spinal cord injury. Handb Clin Neurol. 2012, 109: 181-195. 10.1016/B978-0-444-52137-8.00011-5.CrossRefPubMed Ditunno JF, Cardenas DD, Formal C, Dalal K: Advances in the rehabilitation management of acute spinal cord injury. Handb Clin Neurol. 2012, 109: 181-195. 10.1016/B978-0-444-52137-8.00011-5.CrossRefPubMed
7.
go back to reference van Hedel HJ, Dietz V: Rehabilitation of locomotion after spinal cord injury. Restor Neurol Neurosci. 2010, 28: 123-134.PubMed van Hedel HJ, Dietz V: Rehabilitation of locomotion after spinal cord injury. Restor Neurol Neurosci. 2010, 28: 123-134.PubMed
8.
go back to reference Beck KD, Nguyen HX, Galvan MD, Salazar DL, Woodruff TM, Anderson AJ: Quantitative analysis of cellular inflammation after traumatic spinal cord injury: evidence for a multiphasic inflammatory response in the acute to chronic environment. Brain. 2010, 133: 433-447. 10.1093/brain/awp322.PubMedCentralCrossRefPubMed Beck KD, Nguyen HX, Galvan MD, Salazar DL, Woodruff TM, Anderson AJ: Quantitative analysis of cellular inflammation after traumatic spinal cord injury: evidence for a multiphasic inflammatory response in the acute to chronic environment. Brain. 2010, 133: 433-447. 10.1093/brain/awp322.PubMedCentralCrossRefPubMed
9.
go back to reference Ghasemlou N, Bouhy D, Yang J, Lopez-Vales R, Haber M, Thuraisingam T, He G, Radzioch D, Ding A, David S: Beneficial effects of secretory leukocyte protease inhibitor after spinal cord injury. Brain. 2010, 133: 126-138. 10.1093/brain/awp304.PubMedCentralCrossRefPubMed Ghasemlou N, Bouhy D, Yang J, Lopez-Vales R, Haber M, Thuraisingam T, He G, Radzioch D, Ding A, David S: Beneficial effects of secretory leukocyte protease inhibitor after spinal cord injury. Brain. 2010, 133: 126-138. 10.1093/brain/awp304.PubMedCentralCrossRefPubMed
10.
go back to reference Hernandez J, Torres-Espin A, Navarro X: Adult stem cell transplants for spinal cord injury repair: current state in preclinical research. Curr Stem Cell Res Ther. 2011, 6: 273-287. 10.2174/157488811796575323.CrossRefPubMed Hernandez J, Torres-Espin A, Navarro X: Adult stem cell transplants for spinal cord injury repair: current state in preclinical research. Curr Stem Cell Res Ther. 2011, 6: 273-287. 10.2174/157488811796575323.CrossRefPubMed
11.
go back to reference Komuta Y, Teng X, Yanagisawa H, Sango K, Kawamura K, Kawano H: Expression of transforming growth factor-beta receptors in meningeal fibroblasts of the injured mouse brain. Cell Mol Neurobiol. 2010, 30: 101-111. 10.1007/s10571-009-9435-x.CrossRefPubMed Komuta Y, Teng X, Yanagisawa H, Sango K, Kawamura K, Kawano H: Expression of transforming growth factor-beta receptors in meningeal fibroblasts of the injured mouse brain. Cell Mol Neurobiol. 2010, 30: 101-111. 10.1007/s10571-009-9435-x.CrossRefPubMed
12.
go back to reference Lee SH, Chung YN, Kim YH, Kim YJ, Park JP, Kwon DK, Kwon OS, Heo JH, Ryu S, Kang HJ, Paek SH, Wang KC, Kim SU, Yoon BW: Effects of human neural stem cell transplantation in canine spinal cord hemisection. Neurol Res. 2009, 31: 996-1002. 10.1179/174313209X385626.CrossRefPubMed Lee SH, Chung YN, Kim YH, Kim YJ, Park JP, Kwon DK, Kwon OS, Heo JH, Ryu S, Kang HJ, Paek SH, Wang KC, Kim SU, Yoon BW: Effects of human neural stem cell transplantation in canine spinal cord hemisection. Neurol Res. 2009, 31: 996-1002. 10.1179/174313209X385626.CrossRefPubMed
13.
go back to reference Park SS, Byeon YE, Ryu HH, Kang BJ, Kim Y, Kim WH, Kang KS, Han HJ, Kweon OK: Comparison of canine umbilical cord blood-derived mesenchymal stem cell transplantation times: involvement of astrogliosis, inflammation, intracellular actin cytoskeleton pathways, and neurotrophin-3. Cell Transplant. 2011, 20: 1867-1880. 10.3727/096368911X566163.CrossRefPubMed Park SS, Byeon YE, Ryu HH, Kang BJ, Kim Y, Kim WH, Kang KS, Han HJ, Kweon OK: Comparison of canine umbilical cord blood-derived mesenchymal stem cell transplantation times: involvement of astrogliosis, inflammation, intracellular actin cytoskeleton pathways, and neurotrophin-3. Cell Transplant. 2011, 20: 1867-1880. 10.3727/096368911X566163.CrossRefPubMed
14.
go back to reference Ra JC, Shin IS, Kim SH, Kang SK, Kang BC, Lee HY, Kim YJ, Jo JY, Yoon EJ, Choi HJ, Kwon E: Safety of intravenous infusion of human adipose tissue-derived mesenchymal stem cells in animals and humans. Stem Cells Dev. 2011, 20: 1297-1308. 10.1089/scd.2010.0466.CrossRefPubMed Ra JC, Shin IS, Kim SH, Kang SK, Kang BC, Lee HY, Kim YJ, Jo JY, Yoon EJ, Choi HJ, Kwon E: Safety of intravenous infusion of human adipose tissue-derived mesenchymal stem cells in animals and humans. Stem Cells Dev. 2011, 20: 1297-1308. 10.1089/scd.2010.0466.CrossRefPubMed
15.
go back to reference Kaner T, Karadag T, Cirak B, Erken HA, Karabulut A, Kiroglu Y, Akkaya S, Acar F, Coskun E, Genc O, Colakoglu N: The effects of human umbilical cord blood transplantation in rats with experimentally induced spinal cord injury. J Neurosurg Spine. 2010, 13: 543-551. 10.3171/2010.4.SPINE09685.CrossRefPubMed Kaner T, Karadag T, Cirak B, Erken HA, Karabulut A, Kiroglu Y, Akkaya S, Acar F, Coskun E, Genc O, Colakoglu N: The effects of human umbilical cord blood transplantation in rats with experimentally induced spinal cord injury. J Neurosurg Spine. 2010, 13: 543-551. 10.3171/2010.4.SPINE09685.CrossRefPubMed
16.
go back to reference Shang AJ, Hong SQ, Xu Q, Wang HY, Yang Y, Wang ZF, Xu BN, Jiang XD, Xu RX: NT-3-secreting human umbilical cord mesenchymal stromal cell transplantation for the treatment of acute spinal cord injury in rats. Brain Res. 2011, 1391: 102-113. 10.1016/j.brainres.2011.03.019.CrossRefPubMed Shang AJ, Hong SQ, Xu Q, Wang HY, Yang Y, Wang ZF, Xu BN, Jiang XD, Xu RX: NT-3-secreting human umbilical cord mesenchymal stromal cell transplantation for the treatment of acute spinal cord injury in rats. Brain Res. 2011, 1391: 102-113. 10.1016/j.brainres.2011.03.019.CrossRefPubMed
17.
go back to reference Cao FJ, Feng SQ: Human umbilical cord mesenchymal stem cells and the treatment of spinal cord injury. Chin Med J (Engl). 2009, 122: 225-231. Cao FJ, Feng SQ: Human umbilical cord mesenchymal stem cells and the treatment of spinal cord injury. Chin Med J (Engl). 2009, 122: 225-231.
18.
go back to reference Hu SL, Luo HS, Li JT, Xia YZ, Li L, Zhang LJ, Meng H, Cui GY, Chen Z, Wu N, Lin JK, Zhu G, Feng H: Functional recovery in acute traumatic spinal cord injury after transplantation of human umbilical cord mesenchymal stem cells. Crit Care Med. 2010, 38: 2181-2189. 10.1097/CCM.0b013e3181f17c0e.CrossRefPubMed Hu SL, Luo HS, Li JT, Xia YZ, Li L, Zhang LJ, Meng H, Cui GY, Chen Z, Wu N, Lin JK, Zhu G, Feng H: Functional recovery in acute traumatic spinal cord injury after transplantation of human umbilical cord mesenchymal stem cells. Crit Care Med. 2010, 38: 2181-2189. 10.1097/CCM.0b013e3181f17c0e.CrossRefPubMed
19.
go back to reference Liao W, Xie J, Zhong J, Liu Y, Du L, Zhou B, Xu J, Liu P, Yang S, Wang J, Han Z, Han ZC: Therapeutic effect of human umbilical cord multipotent mesenchymal stromal cells in a rat model of stroke. Transplantation. 2009, 87: 350-359. 10.1097/TP.0b013e318195742e.CrossRefPubMed Liao W, Xie J, Zhong J, Liu Y, Du L, Zhou B, Xu J, Liu P, Yang S, Wang J, Han Z, Han ZC: Therapeutic effect of human umbilical cord multipotent mesenchymal stromal cells in a rat model of stroke. Transplantation. 2009, 87: 350-359. 10.1097/TP.0b013e318195742e.CrossRefPubMed
20.
go back to reference Malgieri A, Kantzari E, Patrizi MP, Gambardella S: Bone marrow and umbilical cord blood human mesenchymal stem cells: state of the art. Int J Clin Exp Med. 2010, 3: 248-269.PubMedCentralPubMed Malgieri A, Kantzari E, Patrizi MP, Gambardella S: Bone marrow and umbilical cord blood human mesenchymal stem cells: state of the art. Int J Clin Exp Med. 2010, 3: 248-269.PubMedCentralPubMed
21.
go back to reference Zhang L, Zhang HT, Hong SQ, Ma X, Jiang XD, Xu RX: Cografted Wharton's jelly cells-derived neurospheres and BDNF promote functional recovery after rat spinal cord transection. Neurochem Res. 2009, 34: 2030-2039. 10.1007/s11064-009-9992-x.CrossRefPubMed Zhang L, Zhang HT, Hong SQ, Ma X, Jiang XD, Xu RX: Cografted Wharton's jelly cells-derived neurospheres and BDNF promote functional recovery after rat spinal cord transection. Neurochem Res. 2009, 34: 2030-2039. 10.1007/s11064-009-9992-x.CrossRefPubMed
22.
go back to reference Dai GH, Liu XB, Zhang Z, Wang XD, Li M, Cheng HB, Hua RR, Shi J, Wang RZ, Qin C, Gao JH, An YH: Comparative analysis of curative effect of CT-guided stem cell transplantation and open surgical transplantation for sequelae of spinal cord injury. J Transl Med. 2013, 11: 315-325. 10.1186/1479-5876-11-315.PubMedCentralCrossRefPubMed Dai GH, Liu XB, Zhang Z, Wang XD, Li M, Cheng HB, Hua RR, Shi J, Wang RZ, Qin C, Gao JH, An YH: Comparative analysis of curative effect of CT-guided stem cell transplantation and open surgical transplantation for sequelae of spinal cord injury. J Transl Med. 2013, 11: 315-325. 10.1186/1479-5876-11-315.PubMedCentralCrossRefPubMed
23.
go back to reference Putz C, Schuld C, Akbar M, Grieser T, Wiedenhofer B, Furstenberg CH, Gerner HJ, Rupp R: Neurological and functional recovery in multiple injured patients with paraplegia: outcome after 1 year. J Trauma. 2011, 70: 1078-1085. 10.1097/TA.0b013e3181e73fa0.CrossRefPubMed Putz C, Schuld C, Akbar M, Grieser T, Wiedenhofer B, Furstenberg CH, Gerner HJ, Rupp R: Neurological and functional recovery in multiple injured patients with paraplegia: outcome after 1 year. J Trauma. 2011, 70: 1078-1085. 10.1097/TA.0b013e3181e73fa0.CrossRefPubMed
24.
go back to reference de Groat WC, Yoshimura N: Plasticity in reflex pathways to the lower urinary tract following spinal cord injury. Exp Neurol. 2012, 235: 123-132. 10.1016/j.expneurol.2011.05.003.PubMedCentralCrossRefPubMed de Groat WC, Yoshimura N: Plasticity in reflex pathways to the lower urinary tract following spinal cord injury. Exp Neurol. 2012, 235: 123-132. 10.1016/j.expneurol.2011.05.003.PubMedCentralCrossRefPubMed
25.
go back to reference Hadiji N, Miri I, Ben Salah FZ, Rahali H, Koubaa S, Lebib S, Dziri C: [Neurogenic urinary bladder in patients with spinal cord injury. Protocol of surveillance and management]. Tunis Med. 2009, 87: 137-143.PubMed Hadiji N, Miri I, Ben Salah FZ, Rahali H, Koubaa S, Lebib S, Dziri C: [Neurogenic urinary bladder in patients with spinal cord injury. Protocol of surveillance and management]. Tunis Med. 2009, 87: 137-143.PubMed
26.
go back to reference Chen Z, Sun S, Deng R, Cai D, Yuan X, Du G, Yang W, Ye Z: The assessment of bladder and urethral function in spinal cord injury patients. J Huazhong Univ Sci Technolog Med Sci. 2009, 29: 609-613. 10.1007/s11596-009-0515-4.CrossRefPubMed Chen Z, Sun S, Deng R, Cai D, Yuan X, Du G, Yang W, Ye Z: The assessment of bladder and urethral function in spinal cord injury patients. J Huazhong Univ Sci Technolog Med Sci. 2009, 29: 609-613. 10.1007/s11596-009-0515-4.CrossRefPubMed
Metadata
Title
Clinical observation of umbilical cord mesenchymal stem cell transplantation in treatment for sequelae of thoracolumbar spinal cord injury
Authors
Hongbin Cheng
Xuebin Liu
Rongrong Hua
Guanghui Dai
Xiaodong Wang
Jianhua Gao
Yihua An
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Translational Medicine / Issue 1/2014
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/s12967-014-0253-7

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