Spinal cord injury (SCI) involves damage to the area that can cause an impairment of loss of muscle control, movement and sensation. Currently, patients with injury to the spinal cord are managed with physical therapy, occupation therapy and other rehabilitation methods to cope with the physical changes.
However, stem cell research may present a new approach to the management of this patient group, allowing for a potential improvement in the symptoms of the condition, such as incontinence, muscular control and sexual function.
Types of Stem Cells
Stem cells used in the treatment of SCI may come from various sources, including autologous mesenchymal CD34+ cells from own bone marrow, allogeneic mesenchymal cells from the human umbilical cord tissue or adipose tissue.
The bone marrow cells are taken from both hips of the patient, who is sedated with light general anesthetic. The cells are then tested for quality and bacterial contamination before they can be used in the research. Likewise, cells from umbilical cords are taken from healthy births and must pass rigorous screening prior to being passed for use in trials.
Scientific research conducted in animals with spinal cell injury has investigated the utility of stem cells in the repair of the injury. As a result of this research, a general understanding of the role that stem cells could play has been established. This includes:
- Replacement of necrotic nerve cells following the injury.
- Generation of supporting cells for the myelin nerve sheath and stimulate growth of damaged axons.
- Protection of nearby cells from further damage with the release of growth factors and other substances.
- Prevention of spread due to anti-inflammatory action
Clinical Trials of Mesenchymal Stem Cells
Mesenchymal stem cells, also known as stromal stem cells, are a topic of interest in the research for treatment of spinal cord injury. The theory is for the stem cells to provide protection to and aid growth of the cells in the region of the injured spinal cord.
The safety and efficacy of different stem cell types have been investigated in several different studies. Various methods of administration have been trialed, including injection into the spine, the vein or the skin.
Clinical Trials of Embryonic Stem Cells
There has also been some research focused on embryonic stem cells in the management following spinal cord injury.
One study observed the effect of an injection of precursors of oligodendrocytes, to form the myelin sheath around the axons. However, after four patients were treated with the cells and observed for signs of restored nerve signaling, the study was discontinued. The belief that embryonic stem cells may be promising for spinal cord injury was not tainted.
Another study investigated the effect of hES cell-derived oligodendrocyte progenitor cells when injected into the site of thoracic spinal cord injury. Of five patients, none experienced serious side effects, and imaging tests revealed that the volume of injury was reduced in 80% of patients.
At this point in time, there is insufficient scientific evidence to recommend the used of stem cells for spinal cord injury as a routine practice. The technique is promising, however, offering the possibility of healing and the improvement of the symptoms, which is in contrast to the current practice that recommends coping mechanisms without a definitive cure or improvement.
For this reason, scientific research is likely to continue in the future in the hope of finding a suitable method to improve the quality of life for patients with spinal cord injury.
By Yolanda Smith, BPharm