Allogeneic mesenchymal stem cells may be a viable treatment modality in cerebral palsy

Osman Boyalı; Serdar Kabatas; Erdinç Civelek; Omer Ozdemir; Yeliz Bahar-Ozdemir; Necati Kaplan; Eyüp Can Savrunlu; Erdal Karaöz

doi:10.12998/wjcc.v12.i9.1585

Allogeneic mesenchymal stem cells may be a viable treatment modality in cerebral palsy

World J Clin Cases. 2024 Mar 26;12(9):1585-1596. doi: 10.12998/wjcc.v12.i9.1585.

Authors

Osman Boyalı¹, Serdar Kabatas^{2

3}, Erdinç Civelek², Omer Ozdemir², Yeliz Bahar-Ozdemir⁴, Necati Kaplan⁵, Eyüp Can Savrunlu⁶, Erdal Karaöz^{7

8

9}

Affiliations

¹ Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Turkey. drosmanboyali@gmail.com.
² Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Istanbul 34360, Turkey.
³ Center for Stem Cell & Gene Therapy Research and Practice, University of Health Sciences Turkey, Istanbul 34360, Turkey.
⁴ Department of Physical Medicine and Rehabilitation, Health Sciences University Sultan Abdulhamid Han Training and Research Hospital, Istanbul 34668, Turkey.
⁵ Department of Neurosurgery, Istanbul Rumeli University, Çorlu Reyap Hospital, Tekirdağ 59860, Turkey.
⁶ Department of Neurosurgery, Nevşehir State Hospital, Nevşehir 50300, Turkey.
⁷ Center for Regenerative Medicine and Stem Cell Research & Manufacturing (LivMedCell), Liv Hospital, Istanbul 34340, Turkey.
⁸ Department of Histology and Embryology, Istinye University, Faculty of Medicine, İstanbul 34010, Turkey.
⁹ Center for Stem Cell and Tissue Engineering Research and Practice, Istinye University, Istanbul 34340, Turkey.

Abstract

Background: Cerebral palsy (CP) describes a group of disorders affecting movement, balance, and posture. Disturbances in motor functions constitute the main body of CP symptoms. These symptoms surface in early childhood and patients are affected for the rest of their lives. Currently, treatment involves various pharmacotherapies for different types of CP, including antiepileptics for epilepsy and Botox A for focal spasticity. However, none of these methods can provide full symptom relief. This has prompted researchers to look for new treatment modalities, one of which is mesenchymal stem cell therapy (MSCT). Despite being a promising tool and offering a wide array of possibilities, mesenchymal stem cells (MSCs) still need to be investigated for their efficacy and safety.

Aim: To analyze the efficacy and safety of MSCT in CP patients.

Methods: Our sample consists of four CP patients who cannot stand or walk without external support. All of these cases received allogeneic MSCT six times as 1 × 10⁶/kg intrathecally, intravenously, and intramuscularly using umbilical cord-derived MSCs (UC-MSC). We monitored and assessed the patients pre- and post-treatment using the Wee Functional Independence Measure (WeeFIM), Gross Motor Function Classification System (GMFCS), and Manual Ability Classification Scale (MACS) instruments. We utilized the Modified Ashworth Scale (MAS) to measure spasticity.

Results: We found significant improvements in MAS scores after the intervention on both sides. Two months: Right χ² = 4000, P = 0.046, left χ² = 4000, P = 0.046; four months: Right χ² = 4000, P = 0.046, left χ² = 4000, P = 0.046; 12 months: Right χ² = 4000, P = 0.046, left χ² = 4000, P = 0.046. However, there was no significant difference in motor functions based on WeeFIM results (P > 0.05). GMFCS and MACS scores differed significantly at 12 months after the intervention (P = 0.046, P = 0.046). Finally, there was no significant change in cognitive functions (P > 0.05).

Conclusion: In light of our findings, we believe that UC-MSC therapy has a positive effect on spasticity, and it partially improves motor functions.

Keywords: Cerebral palsy; Mesenchymal stem cell; Muscle spasticity; Transplantation; Wharton’s jelly.

Publication types

Clinical Trial