Sharma Alok, Sane Hemangi, Kulkarni Pooja, Yadav Jayanti, Gokulchandran Nandini, Biju Hema, Badhe Prerna
Department of Medical Services and Clinical research, NeuroGen Brain & Spine Institute, Stem Asia Hospital and Research Centre, Sector - 40, Plot No. 19, Palm Beach Road, Seawood (W), New Mumbai, 400706 India.
Department Of Research & Development, NeuroGen Brain & Spine Institute, Stem Asia Hospital and Research Centre, Sector - 40, Plot No. 19, Palm Beach Road, Seawood (W), New Mumbai, 400706 India.
Springerplus. 2015 Jan 17;4:26. doi: 10.1186/s40064-015-0794-0. eCollection 2015.
Traumatic brain injury is an injury to the brain parenchyma resulting from external factors such as vehicular accidents, falls, or sports injuries. Its outcome involves primary insult followed by a cascade of secondary insult, resulting in diffuse axonal injury further causing white matter damage. Surgical intervention targets the primary damage, whereas only few treatment alternatives are available to treat the secondary damage. Cellular therapy could be one of the prospective therapeutic options, as it has the potential to arrest the degeneration and promote regeneration of new cells in the brain. We conducted a pilot study on 14 cases who were administered with autologous bone marrow mononuclear cells, intrathecally. The follow up was done at 1 week, 3 months and 6 months after the intervention. The Functional Independence Measure scale, the SF-8 Health Survey Scoring and the disability rating scale were used as outcome measures. These scales showed a positive shift in scores at the end of 6 months. Improvements were observed in various symptoms, along with activities of daily living. Improvement in PET CT scan performed before and 6 months after the intervention in 3 patients corresponded to the clinical and functional improvements observed in these patients. The results of this study suggest that cell therapy may promote functional recovery leading to an improved quality of life in chronic TBI. Although the results are positive, the improvements after cell therapy are not optimal. Hence, additional multicenter, controlled studies are required to establish cell therapy as a standard therapeutic approach.
创伤性脑损伤是由外部因素如交通事故、跌倒或运动损伤导致的脑实质损伤。其结果包括原发性损伤,随后是一系列继发性损伤,导致弥漫性轴索损伤,进而引起白质损伤。手术干预针对原发性损伤,而治疗继发性损伤的治疗选择很少。细胞治疗可能是一种有前景的治疗选择,因为它有潜力阻止退变并促进大脑中新细胞的再生。我们对14例接受鞘内注射自体骨髓单个核细胞的患者进行了一项初步研究。在干预后1周、3个月和6个月进行随访。使用功能独立性测量量表、SF-8健康调查评分和残疾评定量表作为结果指标。这些量表在6个月末显示出分数的正向变化。在各种症状以及日常生活活动方面都观察到了改善。对3例患者在干预前和干预后6个月进行的PET CT扫描的改善与在这些患者中观察到的临床和功能改善相对应。本研究结果表明,细胞治疗可能促进功能恢复,从而改善慢性创伤性脑损伤患者的生活质量。虽然结果是积极的,但细胞治疗后的改善并不理想。因此,需要进行更多的多中心、对照研究,以将细胞治疗确立为一种标准治疗方法。