Summary of types of cells and the results of associated published or ongoing clinical research into their use for the treatment of spinal cord injury
| Type of cell | Clinical studies published or underway | Patient population and time of cell administration | Results |
|---|---|---|---|
| Bone marrow–derived stem cells | Geffner et al. 200840 Autologous cells given via intraspinal injection, IV or topically | 8 patients: 4 with acute injury (5 d–6 mo), 4 with chronic injury (5–21 yr) | No major adverse events; improvements in quality of life as measured by Barthel scale* and bladder function (quantitative results not reported) |
| Yoon 200741 Autologous cells with GM-CSF injected at site of lesion | 35 patients: 17 acute (< 2 wk), 6 subacute (2–8 wk), 12 chronic (> 8 wk) | No major adverse events in patients given implants; at least 1-grade improvement in AIS† in 30.4% of patients v. 0% in historical cohort | |
| Sykova 200642 Autologous cells given IA or IV | 20 patients: 7 acute (10–30 d), 13 chronic (2–17 mo) | No major adverse events; 5/7 acute patients and 1/13 chronic patients underwent neurologic improvement | |
| Deda 200843 Autologous cells via intraspinal injection | 9 patients with chronic complete injury | All patients improved by at least 1 AIS grade; no complications reported | |
| Olfactory ensheathing cells | Mackay-Sim 200844 Autologous cells injected intraspinally | 6 patients with chronic (> 6 mo) complete thoracic injury | No adverse events; no functional improvement; 1 patient had sensory improvement |
| Lima 201045 Olfactory mucosa containing cells injected intraspinally | 20 patients with chronic (18–89 mo) complete injury | 1 case of aseptic meningitis; at least 1-grade improvement in AIS 55% of patients | |
| Schwann cells | Saberi 200846 Autologous cells obtained from sural nerve and injected intraspinally | Interim safety report of 4/33 patients with chronic (28–80 mo) thoracic injury | No major adverse events; transient paresthesia and muscle spasms noted in all 4 patients |
| Activated autologous macrophages | Knoller 200547 Cells injected intraspinally immediately caudal to lesion | 8 patients with acute (< 14 d) complete injury | No major adverse events related to implantation; at least 2-grade improvement in AIS in 3 patients (38%) |
| Lammertse 201248 Cells injected intraspinally immediately caudal to lesion | 43 patients (26 treatment, 17 control) with acute (< 14 d) complete injury | At least 1-grade improvement in AIS in 7 patients in treatment group (27%) and 10 patients in control group (59%); 1 case of postoperative spinal instability, 1 case of postoperative atelectasis attributed to treatment | |
| Human embryonic stem cells | Geron Corp., Menlo Park, CA Cells injected intraspinally | Target enrolment of 8 patients with acute (7–14 d) complete thoracic injury | Trial stopped before completion after implantation in 4 patients |
| Tissue-derived adult neural stem cells | Curt (ongoing) Allogeneic cells injected intraspinally | Target enrolment of 12 patients with chronic (> 6 wk) thoracic injury | Currently enrolling, no data reported |
Note: AIS = American Spinal Injury Association Injury Scale, GM-CSF = granulocyte macrophage colony-stimulating factor, IA = intraarterial, IV = intravenous.
↵* Ordinal scale between 1 and 10. A high score suggests a high likelihood of living at home and functioning independently.
↵† Scale with 5 levels ranging from grade A (most severe) to E (perfect neurologic status).