title: Intraspinal delivery of bone marrow stromal cell-derived neural stem cells in patients with amyotrophic lateral sclerosis: A safety and feasibility study.
abstract: BACKGROUND
  Stem cells have been used in several studies with different methodologies to treat patients with ALS.
  
  
  METHODS
  In this safety and feasibility study, 11 patients with definite or probable ALS according to El Escorial criteria were selected. 3 patients were excluded due to inadequate bone marrow or safety measures after acquisition of bone marrow. Bone marrow stromal cell-derived neural stem cells were injected in C7-T1 spinal cord under general anesthesia. Patients were followed for 12months after injection with manual muscle testing, ALSFRS-R, quality of life changes, pulmonary function test and electromyography.
  
  
  RESULTS
  None of the patients had perioperative mortality or major morbidity. One patient had temporary deterioration in lower extremities after injection which improved after a few weeks. In the 12months post-injection, only one patient died due to pulmonary embolism. From the remaining 7 patients, all had a stable course after 4months and 5 were stable for the first 8months post-injection and deteriorated afterwards.
  
  
  CONCLUSIONS
  In this study, intraspinal injection of bone marrow derived neural stem cells appears to be safe. Patients experienced a temporary stabilization for the first few months post-injection and then gradually deteriorated.
authors.affiliation: Shefa Neuroscience Research Center, Khatam-Alanbia Hospital, Tehran, Iran; Iranian Center of Neurological Research, Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: nafisi@sina.tums.ac.ir.
authors.forename: Shahriar
authors.initials: S
authors.lastname: Nafissi
authors.affiliation: Shefa Neuroscience Research Center, Khatam-Alanbia Hospital, Tehran, Iran; Faculty of Medicine, Shahed University, Tehran, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Kazemi
authors.affiliation: Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran.
authors.forename: Taki
authors.initials: T
authors.lastname: Tiraihi
authors.affiliation: Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: Beladi-Moghadam
authors.affiliation: Department of Biostatistics and Epidemiology, School of Medicine, Zanjan University of Medical Science, Zanjan, Iran.
authors.forename: Soghrat
authors.initials: S
authors.lastname: Faghihzadeh
authors.affiliation: Immunoregulation Research Center, Shahed University, Tehran, Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Faghihzadeh
authors.affiliation: Department of Infectious Disease, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Davoud
authors.initials: D
authors.lastname: Yadegarynia
authors.affiliation: Department of Anesthesiology, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Sadeghi
authors.affiliation: Reproductive Biotechnology Research Center, Avicenna Research Institute, Tehran, Iran.
authors.forename: Leili
authors.initials: L
authors.lastname: Chamani-Tabriz
authors.affiliation: Department of Spinal Cord Injury, Shefa Neuroscience Research Center, Khatam-Alanbia Hospital, Tehran, Iran.
authors.forename: Abdollah
authors.initials: A
authors.lastname: Khanfakhraei
authors.affiliation: Department of Spinal Cord Injury, Shefa Neuroscience Research Center, Khatam-Alanbia Hospital, Tehran, Iran.
authors.forename: Taher
authors.initials: T
authors.lastname: Taheri
mesh_terms: D000328:Adult; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000628:therapy*; D001854:Bone Marrow Cells / Q000502:physiology*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength
keywords: Amyotrophic lateral sclerosis; Cervical cord; Intraspinal injection; Neural stem cells