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Open-labeled study of unilateral autologous bone-marrow-derived mesenchymal stem cell transplantation in Parkinson's disease

Published:August 07, 2009DOI:https://doi.org/10.1016/j.trsl.2009.07.006
      Parkinson's disease (PD) is a progressive neurodegenerative disease for which stem cell research has created hope in the last few years. Seven PD patients aged 22 to 62 years with a mean duration of disease 14.7±7.56 years were enrolled to participate in the prospective, uncontrolled, pilot study of single-dose, unilateral transplantation of autologous bone-marrow-derived mesenchymal stem cells (BM-MSCs). The BM-MSCs were transplanted into the sublateral ventricular zone by stereotaxic surgery. Patients were followed up for a period that ranged from 10 to 36 months. The mean baseline “off” score was 65±22.06, and the mean baseline “on” score was 50.6±15.85. Three of 7 patients have shown a steady improvement in their “off”/“on” Unified Parkinson's Disease Rating Scale (UPDRS). The mean “off” score at their last follow-up was 43.3 with an improvement of 22.9% from the baseline. The mean “on” score at their last follow-up was 31.7, with an improvement of 38%. Hoehn and Yahr (H&Y) and Schwab and England (S&E) scores showed similar improvements from 2.7 and 2.5 in H&Y and 14% improvement in S&E scores, respectively. A subjective improvement was found in symptoms like facial expression, gait, and freezing episodes; 2 patients have significantly reduced the dosages of PD medicine. These results indicate that our protocol seems to be safe, and no serious adverse events occurred after stem-cell transplantation in PD patients. The number of patients recruited and the uncontrolled nature of the trial did not permit demonstration of effectiveness of the treatment involved. However, the results encourage future trials with more patients to demonstrate efficacy.

      Abbreviations:

      7-AAD (7- amino actinomycin D), ADL (activities of daily living), bFGF (basic fibroblast growth factor), BM-MSC (bone-marrow-derived mesenchymal stem cell), COA (certificate of analysis), CT (computed tomography), DA (dopamine), DBS (deep brain stimulation), DPBS (Dulbecco's phosphate buffered saline), EDTA (ethylenediaminetetraacetic acid), FBS (fetal bovine serum), H&Y (Hoehn and Yahr), IEC (Institutional Ethics Committee), KO-DMEM (Knockout Dulbecco's Modified Eagle's Medium), MNC (mononuclear cell), PET (positron emission tomography), PD (Parkinson's disease), RT-PCR (reverse transcriptase-polymerase chain reaction), S&E (Schwab and England), SVZ (subventricular zone), UPDRS (Unified Parkinson Disease Rating Scale)
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