Clinical experience: Outcomes of mesenchymal stem cell transplantation in five stroke patients

Nesrin Ercelen; Nilgun Karasu; Bulent Kahyaoglu; Onder Cerezci; Rana Cagla Akduman; Defne Ercelen; Gizem Erturk; Gokay Gulay; Nagihan Alpaydin; Gizem Boyraz; Berrin Monteleone; Zekiye Kural; Hakan Silek; Sibel Temur; Canan Aykut Bingol

doi:10.3389/fmed.2023.1051831

Clinical experience: Outcomes of mesenchymal stem cell transplantation in five stroke patients

Front Med (Lausanne). 2023 Jan 19:10:1051831. doi: 10.3389/fmed.2023.1051831. eCollection 2023.

Authors

Nesrin Ercelen¹, Nilgun Karasu¹, Bulent Kahyaoglu², Onder Cerezci^{3

4}, Rana Cagla Akduman⁵, Defne Ercelen⁶, Gizem Erturk^{2

7}, Gokay Gulay⁸, Nagihan Alpaydin⁸, Gizem Boyraz⁹, Berrin Monteleone¹⁰, Zekiye Kural², Hakan Silek⁵, Sibel Temur¹¹, Canan Aykut Bingol⁵

Affiliations

¹ Department of Medical Genetics, Faculty of Medicine, Üsküdar University, Istanbul, Türkiye.
² Department of Neurology, American Hospital, Istanbul, Türkiye.
³ Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Üsküdar University, Istanbul, Türkiye.
⁴ Department of Physical Medicine and Rehabilitation, American Hospital, Istanbul, Türkiye.
⁵ Department of Neurology, Faculty of Medicine, Yeditepe University, Istanbul, Türkiye.
⁶ Computational and Systems Biology Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, United States.
⁷ Department of Healthcare Management, Faculty of Health Sciences, Üsküdar University, Istanbul, Türkiye.
⁸ ATIGEN-CELL/Cell and Tissue Center, Trabzon, Türkiye.
⁹ Geneis Genetic System Solutions, Istanbul, Türkiye.
¹⁰ Department of Pediatrics at NYU Long Island School of Medicine, Medical Genetics, Langone Hospital, New York University, Long Island, NY, United States.
¹¹ Department of Anesthesia and Reanimation, Faculty of Medicine, Yeditepe University, Istanbul, Türkiye.

Abstract

Stem cell therapy, which has promising results in acute disorders such as stroke, supports treatment by providing rehabilitation in the chronic stage patients. In acute stroke, thrombolytic medical treatment protocols are clearly defined in neurologic emergencies, but in neurologic patients who miss the "thrombolytic treatment intervention window," or in cases of hypoxic-ischemic encephalopathy, our hands are tied, and we are still unfortunately faced with hopeless clinical implementations. We consider mesenchymal stem cell therapy a viable option in these cases. In recent years, novel research has focused on neuro-stimulants and supportive and combined therapies for stroke. Currently, available treatment options are limited, and only certain patients are eligible for acute treatment. In the scope of our experience, five stroke patients were evaluated in this study, who was treated with a single dose of 1-2 × 10⁶ cells/kg allogenic umbilical cord-mesenchymal stem cells (UC-MSCs) with the official confirmation of the Turkish Ministry of Health Stem Cell Commission. The patients were followed up for 12 months, and clinical outcomes are recorded. NIH Stroke Scale/Scores (NIHSS) decreased significantly (p = 0.0310), and the Rivermead Assessment Scale (RMA) increased significantly (p = 0.0234) for all patients at the end of the follow-up. All the patients were followed up for 1 year within a rehabilitation program. Major clinical outcome improvements were observed in the overall clinical conditions of the UC-MSC treatment patients. We observed improvement in the patients' upper extremity and muscle strength, spasticity, and fine motor functions. Considering recent studies in the literature together with our results, allogenic stem cell therapies are introduced as promising novel therapies in terms of their encouraging effects on physiological motor outcomes.

Keywords: UC-MSC transplantation; regenerative medicine; rehabilitation; stem cell therapy; stroke recovery.