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Stem cells can potentially provide trophic support to the injured spinal cord microenvironment by modulating the inflammatory response, increasing vascularization and suppressing cystic change. After the primary injury, microenvironmental changes inhibit axonal regeneration. Spinal cord injury has a complex pathophysiology. "Our patient also reported a strong improvement with his grip and pinch strength, as well as range of motion for shoulder flexion and abduction," Dr. Clinical signs of efficacy in both motor and sensory function were observed at three, six, 12 and 18 months following the stem cell injection. Stem cells were injected nearly a year after his injury and several months after his improvement had plateaued. But that progress plateaued six months after the injury. As described in the February 2020 issue of Mayo Clinic Proceedings, the neurological examination at the time of the injury revealed complete loss of motor and sensory function below the level of injury.Īfter undergoing urgent posterior cervical decompression and fusion, as well as physical and occupational therapy, the patient demonstrated improvement in motor and sensory function. The initial participant in CELLTOP phase 1 sustained a C3-4 ASIA grade A spinal cord injury. The spinal cord injuries must be American Spinal Injury Association (ASIA) grade A or B. Study participants must be age 18 or older and have experienced traumatic spinal cord injury within the past year. Patients randomized to the medical management arm will eventually cross over to the stem cell arm. In CELLTOP phase 2, 40 patients will be randomized to receive stem cell treatment or best medical management. "One objective in our future studies is to delineate the optimal treatment protocols and understand why patients respond differently." Among the 10 participants in our phase 1 study, we had some nonresponders and moderate responders," Dr. "Not every patient who receives stem cell treatment is going to be a superresponder.
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#Stem cell treatment for spinal cord injury trial#
The first participant in the phase 1 trial was a superresponder who, after stem cell therapy, saw significant improvements in the function of his upper and lower extremities. Bydon examining patient #1 in the CELLTOP phase 1 trial In the future, emerging cell types, scaffolding, and cell engineering might improve cell survival, integration, and therapeutic efficiency.Dr. This crucial milestone has paved the way to consider refinements and combined therapies, such as the use of biomaterials to augment the effects of cell transplantation. Nevertheless, in the past decade, clinical trials have shown the feasibility and long-term safety of cell transplantation into the injured spinal cord. However, no trials of these therapies in patients have yet provided reproducible evidence for clinical efficacy, challenged by small effect sizes, low immune suppression, and low sensitivity study designs. Cell-based and stem-cell-based therapies are recognised as promising candidates to promote functional recovery. Although some neurological function might be regained, most patients with initially complete lesions have severe, irreversible neurological impairment.
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Patients need appropriate timely surgical and critical care, followed by neurorehabilitation to facilitate neuronal reorganisation and functional compensation. Most often, a single traumatic event, such as a traffic or recreational accident, leads to primary spinal cord damage through compression and laceration, followed by secondary damage consisting of inflammation and ischaemia, and culminating in substantial tissue loss. Spinal cord injury is a severely disabling neurological condition leading to impaired mobility, pain, and autonomic dysfunction.