immunomodulation, chronic muscular atrophy, muscular progenitor cells, spinal cord injury
Objectives:Restore muscular trophism and voluntary contractile capacity through cell therapy in atrophied muscles in SCI patients.Setting:Out Patient Treatment, Universidad Maimonides, Buenos Aires, Argentina.Methods:After receiving spinal cord cell therapy and intensive rehabilitation, 7 chronic complete spinal cord injury (SCI) patients (4 people with paraplegia and 3 people with quadriplegia) regained muscular electrical activity in previously denervated territories. However, signs of severe muscular atrophy persisted. Looking to reverse chronic muscular atrophy, atrophied muscles with electrical activity were implanted with autologous type 1 macrophages (Mo1) and autologous tissue-specific T helper 1 Cells (Th1) associated with autologous muscular progenitor cells (MPC). The Mo1 and Th1 used cells were named Effector Cells (EC). Each muscle received between 6 to 8 implants, one every 6 weeks. Cellular therapy was combined with intensive rehabilitation program.Results:Sonogram and histological signs of recovery started eight weeks after the first implant. Sonograms showed progressively muscle volume increasing and gradually replacement of hyperechogenic muscle tissue by hypoechogenic muscle bands (resembling normal muscular structure). New bands were distributed parallel to the main muscle axis, along the entire muscular length. Histological samples of hypoechogenic bands showed new and normal muscular tissue. Changes were seen in 7/7 patients. Non-significant side events were detected in any patient over the 24 months of follow up.Conclusions:The results presented here suggest that the combination of immune and regenerative cell therapy may play an important therapeutic role in clinical and histological recovery of chronic muscular atrophy.
Tsinghua University Press
Gustavo A. Moviglia, M. Teresita Moviglia Br, olino et al. Local immunomodulation and muscle progenitor cells induce recovery in atrophied muscles in spinal cord injury patients. Journal of Neurorestoratology 2018, 6(1): 136-145.