Chronic Spinal Cord Injury (SCI) can lead to significant motor and sensory deficits. However, recent advances in medical research have explored the potential of Mesenchymal Stem Cells (MSCs) as a promising treatment option for SCI patients. This article presents a case study showcasing the positive outcomes of MSC therapy in reversing motor and sensory impairments.

What is Spinal Cord Injury?

SCI occurs when the tightly packed bundle of cells and nerves responsible for transmitting signals to and from the brain sustains injury. The spinal cord extends from the lower brain down to the lower back, and the severity of SCI can vary, ranging from minor impairment to near-total nerve fiber damage. Fortunately, complete recovery is possible in cases with minimal nerve cell death. An incomplete injury allows for some sensory function and muscle control below the injury site, while a complete injury results in the loss of both sensory and motor functions below the injury site.

Symptoms of Spinal Cord Injury:

• Numbness, tingling, or changes in sensation in the hands and feet.
• Paralysis, which may occur immediately after SCI or develop over time due to swelling and bleeding.
• Pain or pressure in the head, neck, or back.
• Loss of movement and the inability to move certain body parts.
• Weakness or inability to move specific body parts.
• Difficulty breathing.
• Unnatural positions of the spine or head.

Causes of Spinal Cord Injury:

Motor vehicle accidents and catastrophic falls are the most common causes of SCI. Other contributing factors include violence, sports injuries, medical or surgical complications, industrial accidents, and diseases that damage the spinal cord. Risk factors such as age (leading to dangerous falls), alcohol use, and the lack of protective equipment during high-risk activities can also increase the likelihood of SCI.

Treatment of Spinal Cord Injury:

• Physical treatment involves realigning the spine using rigid braces or mechanical force as soon as possible to stabilize it and prevent further damage.
• Surgery may be necessary to remove fractured vertebrae, bone fragments, herniated discs, or other objects pressing on the spinal column. Early surgery is associated with better functional recovery, as suggested by neurosurgical studies.
• A new treatment approach involves injecting mesenchymal stem cells, which shows promise in promoting neuroprotection during secondary injury.

Therapeutic Efficacy of MSCs:

MSCs exert their therapeutic effects by producing juxtacrine or paracrine factors that enhance regeneration from endogenous stem cells. This effect depends on the migration of MSCs to the diseased organ or tissue. At the injury site, MSCs differentiate into different functional neuronal cell subtypes, making them valuable for regenerating damaged central neuronal areas. Additionally, MSCs support revascularization, modulate inflammatory responses, and protect vulnerable cells from oxidative stress-induced apoptosis. These unique characteristics have led to suggestions of renaming MSCs to medicinal signaling cells (MSCs) by Caplan.

Case Study:

The article presents a case study of a 43-year-old male patient, a long-term smoker with no diagnosed illnesses. The patient suffered a complete SCI after falling a significant distance, resulting in an almost complete transection of the spinal cord. He underwent stem cell treatment using intrathecal injections of Wharton’s Jelly-derived MSCs. The treatment led to significant improvements in both sensory and motor functions, as indicated by the American Spinal Injury Association (ASIA) grades and scores over a 25-month follow-up period.

Conclusion:

The case study demonstrates the potential of MSC therapy in reversing motor and sensory deficits caused by chronic spinal cord injuries. As research continues to progress, a similar protocol of allogeneic MSCs can be explored in future clinical trials to treat patients with severe spine damage, offering hope for enhanced quality of life and functional recovery.

References 

• Caplan, A.I. (2017). Mesenchymal stem cells: Time to change the name! Stem Cells Transl. Med, (6), 1445–1451. 
•  Dominici, M., Le Blanc, K., Mueller, I., Slaper-Cortenbach, I., Marini, F. C., Krause, D. S., Deans, R. J. & Horwitz, E. M. (2006). Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. International Society Cell & Gene Therapy, 8(4), 315–317, https://doi.org/10.1080/14653240600855905 
• Jamali, F., Alqudah, M., Rahmeh, R., Bawaneh, R., Al-Shudifat, A., Samara, O. & Awidi, A. (2023). Safe reversal of motor and sensory deficits by repeated high doses of mesenchymal stem cells in a patient with chronic complete spinal cord injury. American Journal of Case Reports, https://doi.org/10.12659/AJCR.938576 
• Krupa, P., Vackova, I. & Ruzicka, J. (2018). The effect of human mesenchymal stem cells derived from Wharton’s Jelly in spinal cord injury treatment is dosedependent and can be facilitated by repeated application. Int J Mol Sci, 19(5):1503 
• National Institute of Neurological Disorders and Stroke. (2023). Spinal cord injury. National Institutes of Health (NIH). https://www.ninds.nih.gov/health-information/disorders/spinal-cord-injury 
• Sohni, A. & Verfaillie, C. M. (2013). Mesenchymal stem cells migration homing and tracking. Hindawi Publishing Corporation, Stem Cell International, 1–8, http://dx.doi.org/10.1155/2013/130763 
• Sykova, E., Cizkova, D. & Kubinova, S. (2021). Mesenchymal stem cells in treatment of spinal cord injury and amyotrophic lateral sclerosis. Fontiers in Cell and Developmental Biology, (9), 1–17, https://doi.org/10.3389/fcell.2021.695900