Imaging reveals new findings from a major stem cell trial for stroke

Researchers led by Sean I. Savitz, MD, reported today in the newspaper Stem cells The bone marrow cells used to treat ischemic stroke in an expanded phase I trial were not only safe and feasible, but also provided improved recovery over a matched prior control group.

In addition, through the serial imaging of the diffusion tensor, the repair of motor nerve pathways from the brain to the spinal cord was first captured by study participants, according to the center team. Health Sciences University of Texas at Houston (UTHealth). ).

"In the typical stroke injury, you can see the degeneration of nerve pathways where it contracts," said Savitz, director of the Institute of Cerebrovascular Disease and professor of neurology at McGovern Medical School of UTHealth. "What surprised us was that after three to six months we were able to see the pathways thicken in some patients." We do not usually see the same level of response in patients have had a stroke so severe, but further research will be needed to determine whether the return of nerve pathways is due to cellular processing or some of the natural recovery. "

The team also reported that patients in the cell-treated group had a 1-point improvement in the modified 90-day Rankin score, a 6-point scale considered the gold standard for assessing recovery and recovery. disability after a stroke. Patients in the study were compared to a matched control group based on the propensity score to estimate the size of the effect size.

Farhaan S. Vahidy, Ph.D., MBBS, MPH, Director of Population Health at the Institute of Cerebrovascular and Cerebrovascular Diseases and Associate Professor of Neurology at McGovern Medical School of UTHealth, was the first author of document and performed the analyzes.

The pilot study, which began in 2009, was the first of its kind to use a patient's own bone marrow cells. The results of the first 10 patients were published in 2011 in Annals of Neurology.

The last article included the results of 25 patients, who received an intravenous dose of their own bone marrow cells within 72 hours of the first symptoms of stroke. They were followed for one year after treatment and the results were compared to those of a control group of 185 patients with acute ischemic stroke who received only conventional treatment. Research has shown that no serious adverse events related to the procedures have been observed.

The authors wrote that the regenerative potential of bone marrow mononuclear cells is attributed to various mechanisms that influence stroke recovery and is supported by numerous preclinical studies analyzed by Vahidy in a study published in the journal American Heart Association, Stroke, in 2016. Cells migrate to the site of injury and release proteins that decrease inflammation preventing the healing process. Bone marrow cells also lend themselves easily to autologous perfusion, eliminating the need for immunosuppressive drugs.

"According to our findings, it is possible to perform a bone marrow sample and then infuse the cells into a wide range of stroke patients," Savitz said. "Well-designed randomized clinical trials are needed to further evaluate the safety and effectiveness of this new approach to improving stroke recovery."

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