Combined protocol of cell therapy for chronic spinal cord injury. Report on the electrical and functional recovery of two patients.
BACKGROUND
This is a preliminary report on successful results obtained during treatment of two patients with chronic spinal cord injury. The therapeutic approach was based on the generation of controlled inflammatory activity at the injury site that induced a microenvironment for the subsequent administration of autologous, BM-driven transdifferentiated neural stem cells (NSC).


METHODS
BM mesenchymal stem cells (MSC) were cocultured with the patient's autoimmune T (AT) cells to be transdifferentiated into NSC. Forty-eight hours prior to NSC implant, patients received an i.v. infusion of 5 x 10(8) to 1 x 10(9) AT cells. NSC were infused via a feeding artery of the lesion site. Safety evaluations were performed everyday, from the day of the first infusion until 96 h after the second infusion. After treatment, patients started a Vojta and Bobath neurorehabilitation program.


RESULTS
At present two patients have been treated. Patient 1 was a 19-year-old man who presented paraplegia at the eight thoracic vertebra (T8) with his sensitive level corresponding to his sixth thoracic metamere (T6). He received two AT-NSC treatments and neurorehabilitation for 6 months. At present his motor level corresponds to his first sacral metamere (S1) and his sensitive level to the fourth sacral metamere (S4). Patient 2 was a 21-year-old woman who had a lesion that extended from her third to her fifth cervical vertebrae (C3-C5). Prior to her first therapeutic cycle she had severe quadriplegia and her sensitive level corresponded to her second cervical metamere (C2). After 3 months of treatment her motor and sensitive levels reached her first and second thoracic metameres (T1-T2). No adverse events were detected in either patient.


CONCLUSIONS
The preliminary results lead us to think that this minimally invasive approach, which has minor adverse events, is effective for the repair of chronic spinal cord lesions.
Moviglia
G A
GA
Instituto Regina Mater, Paraguay 2452, Buenos Aires, 1121 ABL, Argentina. gmoviglia@reginamater.com
Fernandez Viña
R
R
Brizuela
J A
JA
Saslavsky
J
J
Vrsalovic
F
F
Varela
G
G
Bastos
F
F
Farina
P
P
Etchegaray
G
G
Barbieri
M
M
Martinez
G
G
Picasso
F
F
Schmidt
Y
Y
Brizuela
P
P
Gaeta
C A
CA
Costanzo
H
H
Moviglia Brandolino
M T
MT
Merino
S
S
Pes
M E
ME
Veloso
M J
MJ
Rugilo
C
C
Tamer
I
I
Shuster
G S
GS
D000328:Adult; D000690:Amyotrophic Lateral Sclerosis / Q000276:immunology; D015703:Antigens, CD / Q000032:analysis; D017252:CD3 Complex / Q000032:analysis; D018929:Cell Culture Techniques / Q000379:methods; D002454:Cell Differentiation; D002469:Cell Separation / Q000379:methods; D017690:Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D018920:Coculture Techniques; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D059630:Mesenchymal Stem Cells / Q000737:chemistry / Q000166:cytology; D009416:Nerve Regeneration; D009419:Nerve Tissue Proteins / Q000276:immunology; D009474:Neurons / Q000166:cytology; D020127:Recovery of Function; D013119:Spinal Cord Injuries / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D013234:Stem Cells / Q000166:cytology; D013601:T-Lymphocytes / Q000737:chemistry / Q000276:immunology / Q000637:transplantation*; D016896:Treatment Outcome
D015703:Antigens, CD; D017252:CD3 Complex; D009419:Nerve Tissue Proteins