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OBJECTIVE: In this study, we used autologous bone marrow aspirate concentrate (BMAC) transplantation to treat children with cerebral palsy (CP) to improve their motor and cognitive functions.
PATIENTS AND METHODS: Forty-two patients with CP received BMAC. The transplantation of stem cells via the intrathecal route includes three BMAC applications....
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... Moreover, the isolation process of these mononuclear cells is more convenient in clinical settings [73]. The incorporation of a customized rehabilitation program alongside stem cell therapy resulted in a synergistic enhancement of motor and cognitive functions in children with CP [74]. This finding implies that a combined treatment approach involving both stem cell therapy and tailored physical rehabilitation programs may offer a more effective therapeutic strategy. ...
Pediatric neurological diseases refer to a group of disorders that affect the nervous system in children. These conditions can have a significant impact on a child’s development, cognitive function, motor skills, and overall quality of life. Stem cell therapy is a new and innovative approach to treat various neurological conditions by repairing damaged neurons and replacing those that have been lost. Mesenchymal stem cells (MSCs) have gained significant recognition in this regard due to their ability to differentiate into different cell types. MSCs are multipotent self-replicating stem cells known to render promising results in the treatment of stroke and spinal cord injury in adults. When delivered to the foci of damage in the central nervous system, stem cells begin to differentiate into neural cells under the stimulation of paracrine factors and secrete various neurotrophic factors (NTFs) like nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and neurotrophin-3 (NT-3) that expedite the repair process in injured neurons. In the present review, we will focus on the therapeutic benefits of the MSC-based therapies in salient pediatric neurological disorders including cerebral palsy, stroke, and autism.
... While a few clinical trials and case studies have explored the effects of intrathecal bone marrow aspirate concentrate (BMAC) administration in ASD patients and demonstrated encouraging improvements in symptoms and severity of ASD, our study is the first to examine correlations between patients' cerebrospinal fluid (CSF) cytokine profiles before and after BMAC therapy and their subsequent therapeutic outcomes [27][28][29][30][31]. We suppose that BMAC's therapeutic effects may be attributed to the modulation of cytokine networks, which could make cytokine levels valuable biomarkers. ...
... The procedural specifics entailed positioning patients prone, making a precise incision on their right anterior iliac crest, and aspirating bone marrow through the iliac crest using a specialized 22G harvest needle. To anticoagulate the bone marrow, we utilized the Acid Citrate Dextrose (ACD) formula A in a 7:1 ratio [31]. The Angel whole blood separation system (Arthrex, Naples, FL, USA) was instrumental in processing bone marrow. ...
... Previous studies have confirmed the positive healing promise and safety of cell therapies in ASD patients (Table 9) [27,31,[45][46][47][48][49][50]. However, it is hard to qualitatively compare the results between the studies due to the deployment of different evaluation metrics, cell therapy protocols, and cultural and post-treatments rehabilitation differences that may influence the results between the follow-up periods. ...
Autism spectrum disorder (ASD) has recently been linked to neuroinflammation and an aberrant immune response within the central nervous system. The intricate relationship between immune response and ASD remains elusive, with a gap in understanding the connection between specific immune mechanisms and neural manifestations in autism. In this study, we employed a comprehensive statistical approach, fusing both overarching and granular methods to examine the concentration of 16 cytokines in the cerebrospinal fluid (CSF) across each autologous bone marrow aspirate concentrate (BMAC) intrathecal administration in 63 male and 17 female autism patients. Following a six-month period post the third administration, patients were stratified into three categories based on clinical improvement: Group 1-no/mild (28 subjects), Group 2-moderate (16 subjects), and Group 3-major improvement (15 subjects). Our integrated analysis revealed pronounced disparities in CSF cytokine patterns and clinical outcomes in autism subjects pre-and post-BMAC transplantation. Crucially, our results suggest that these cytokine profiles hold promise as predictive markers, pinpointing ASD individuals who might not exhibit notable clinical amelioration post-BMAC therapy.
Cell therapies are an emergent treatment for cerebral palsy (CP) with promising evidence demonstrating efficacy for improving gross motor function. However, families value improvements in a range of domains following intervention and the non-motor symptoms, comorbidities and complications of CP can potentially be targeted by cell therapies. We conducted a scoping review to describe all outcomes that have been reported in cell therapy studies for CP to date, and to examine what instruments were used to capture these. Through a systematic search we identified 54 studies comprising 2066 participants that were treated with a range of cell therapy interventions. We categorized the reported 53 unique outcome instruments and additional descriptive measures into 10 categories and 12 sub-categories. Movement and Posture was the most frequently reported outcome category, followed by Safety, however Quality of Life, and various prevalent comorbidities and complications of CP were infrequently reported. Notably, many outcome instruments used do not have evaluative properties and thus are not suitable for measuring change following intervention. We provide a number of recommendations to ensure that future trials generate high-quality outcome data that is aligned with the priorities of the CP community.
