Biomedical Engineering Reference
In-Depth Information
cord implantation of autologous mesenchymal stem cells (MSCs) in a few well-
monitored patients with ALS. For the treatment, bone marrow collection was
performed according to the standard procedure by aspiration from the posterior iliac
crest. Ex vivo expansion of MSC was induced according to Pittenger's protocol.
The cells were suspended in 2 ml of autologous cerebrospinal fluid and transplanted
into the spinal cord by a micrometric pump injector. No patient manifested major
adverse events such as respiratory failure or death [
79
]. Minor adverse events were
intercostal pain irradiation (four patients) which was reversible after a mean period
of 3 days after surgery, and leg sensory dysesthesia (five patients) which was reversible
after a mean period of 6 weeks after surgery. No modification of the spinal cord
volume or other signs of abnormal cell proliferation were observed. They concluded
that results appear to demonstrate that the procedures of ex vivo expansion of autol-
ogous MSCs and of transplantation into the spinal cord of humans are safe and well
tolerated by ALS patients.
The success of cell-replacement therapy in ALS will depend a lot on preclinical
evidence, because of the complexity and precision of the pattern of connectivity that
needs to be restored in degenerating motorneurons. It is probably that adult stem-
cell therapy will need to be used with other drugs or treatments, such as antioxidants
and/or infusion of trophic molecules.
Cambria Biosciences, LLC is the recipient of a grant from the ALS Association
supporting research to identify new drug candidates for the treatment of ALS. The
research initiative, Translational Research Advancing Therapy for ALS (TREAT
ALS), aims to accelerate the process of moving good ideas from the research arena
into clinical trials and then patients.
Cellular Transplantation Strategies for Spinal Cord Injury
The spinal cord connects the brain with the rest of the body by sending out millions
of electrical signals. When there is injury to the spinal cord and this connection
breaks paralysis occurs. As of now, spinal cord damage is irreversible, leaving
approximately 250,000 Americans in a devastating position. However, in the past
10 years, as stem cell research has developed, new exciting possibilities have
arisen for people suffering from spinal cord injury. Crush injuries to the spinal cord
are common, as opposed to clean cuts that sever the cord without any damage to
overlying tissue and bone. Crush injuries usually result in low blood flow to the
affected area, producing an ischemic condition. Fluid buildup often results, leading
to compression from swelling and secondary ischemia. This damage can exceed
the amount produced from the primary injury. A whole host of toxic conditions
lead to the production of molecules that recruit glial cells to infiltrate the site in an
effort to affect repair; unfortunately however, poor design of the system leads to
reactive gliosis, which basically means the glial cells are looking to “plug the hole”
instead of forming a nice, stable tube to guide the damaged axon back to its target.
This glial scarring is an enormous barrier to regeneration of the spinal cord and
recovery of function.
