Cerebral palsy is a collective term describing permanent and non-progressive neurological disorders that affect the development of movement and posture. It can occur due to injury from malformation, stroke, or infection in the brain before, during, or after birth. The brain is unable to repair the injury, which negatively impacts its communication with the body. The disorder manifests as loss of movement in limbs accompanied by deficits in cognitive and visual functions. The treatment modalities are limited in their effects, propelling extensive research in this field for a cure that can grant better functional outcomes. Stem cell therapy has emerged as the newest treatment for cerebral palsy that can cause functional recovery.
Treatment of Cerebral Palsy
The treatments for cerebral palsy do not act on the disorder but rather focus on mitigating symptoms. For instance, anti-inflammatory medications for pain, baclofen to treat muscle stiffness, carbidopa-levodopa for muscle contractions, and abnormal posture. Surgical options include hip surgery, rhizotomy, spinal fusion, etc. However, these modalities have certain limitations:
- They do not act on the underlying mechanisms of the disorder.
- The modalities are only symptom-driven.
- The medications can cause adverse effects from long-term use.
- The effects of medications vary with the severity and symptoms of the disorder.
- Surgical options are not applicable to all patients.
Additionally, rehabilitative therapies like physical therapy, speech therapy, cardio training, gait training, and assistive devices have been employed to improve the quality of life, but show little efficacy.
Stem Cells for Cerebral Palsy Treatment
The constraints of the standard treatment options have redirected the efforts to alternatives. Cell therapy, especially stem cell therapy, has fascinated scientists. Their therapeutic properties has the potential for treating neurological disorders. Restoring neuronal networks and cell replenishment is the main objective of this therapy in order to promote functional recovery. It is helpful in cerebral palsy treatment, which has cell death, inflammation, oxidative stress, and impaired microenvironment as the underlying disease processes. The preclinical research has produced some interesting results:
Neurogenesis: Stem cell infusion resulted in an increased number of neural progenitors and also induced proliferation of neural precursors already present in the tissue.
Neuroprotection: Studies have shown a higher amount of mature nerve cells after stem cell treatment, evident of the protective action of these cells. An increment of 15% in the level of trophic factors have been noticeable after this treatment. These factors prolong nerve cell survival and protect them from damage.
Neuroinflammation: According to research data, stem cells decrease the immune cell recruitment into the brain and alleviate the levels of proinflammatory mediators, thus modulating the immune response that worsens the disorder.
Angiogenesis: Blood vessel obstruction and consequent disruption of blood supply, eventually leads to nerve cell death. Stem cells increase the quantity of blood vessels by angiogenesis. Scientific research has indicated that the effects either occur due to their transformation into vessel cells or they secrete angiogenesis-inducing growth factors like VEGF.
Neural Network: A neural network is formed by nerve cells and their elongated processes, named axons. Stem cell administration has shown a considerable increase in the axons at the injury site, demonstrating the organization of the neural connections.
Types of Stem Cells
For translating the research data, the choice of stem cells is essential. For cerebral palsy, three candidates are suitable-
- Mesenchymal stem cells (MSCs): They can be obtained from different sources.
- Neural stem cells: They have a high propensity to form nerve cells.
- Induced pluripotent stem cells: They can be obtained from normal tissue cells and converted into neural cells outside the body.
Among all the possible candidates, MSCs derived from umbilical cord (UCMSCs) are the most commonly used candidate, with bone marrow MSCs (BMMSCs) ranking a close second. Both MSCs have fewer ethical implications and have defined the collection process. UCMSCs are present in abundant amounts and use painless extraction methods. Autologous transplant (injecting the patient’s cells) and allogeneic transplant (injecting someone else’s cells into the patient) is another debate for therapy. To reduce trauma to the children by BMMSCs, allogeneic transplant is a recommended choice.
Clinical Evidence
Several clinical trials have and are still assessing the efficacy of the stem cell treatment.
- A clinical trial by Chahine et al. with 17 patients of cerebral palsy was administered bone marrow stem cells. About 73% patients showed significant progress with improvements in motor functions up to 1.3 points on a scale of 0 to 3. The symptoms, like muscle stiffness, bowel and bladder control, motility, independent functioning, and cognitive functions, showed positive improvements.
The preference of UCMSCs arises from a low immune rejection rate and higher regeneration potential. Currently, over 22 clinical trials are using UCMSCs for treatment.
- A randomized trial by Li et al. analyzed the therapeutic efficacy of UCMSCs in 39 patients in terms of motor skills, cognitive function, sensory processing, communication, and daily activities. The treatment showed improvement in all aspects. Imaging studies also demonstrated an increase in brain metabolic activity, which could be responsible for the favorable results.
Cerebral Palsy Treatment Success Stories
Safety of Stem Cell Treatment
The evaluation of adverse effects due to stem cell therapy is necessary. Therefore, many studies have analysed the same, including the ones mentioned above. The only reported complications were fever, headaches, and vomiting. Complications such as seizures or meningitis were absent. A comprehensive analysis of five clinical trials also exhibited a lack of any serious adverse events. Many such trials have shown no difference in adverse effects occurring in the stem cell therapy group and the group that didn’t employ the treatment. The mounting evidence shows that stem cell therapy is essentially safe. However, a trial for a longer time period might assess the risks in the long term. Still, the early trials only favor the efficacy and safety of stem cell treatment.
In Conclusion
Cerebral palsy has multiple causative factors and a complex mechanism. The disorder goes untreated, resulting in a low quality of life, as the current treatments focus on addressing the symptoms. Regenerative medicine includes stem cell therapy, which attempts to return organs to their initial, healthy state. It also treats the various signaling pathways underlying the disorder to mitigate symptoms from the root level through its diverse therapeutic properties. Therefore, clinical trials have employed revolutionary therapy for cerebral palsy. Early findings show a notable improvement in cognitive and motor skills, which is encouraging. The trials even showed that there were no notable side effects from this medication. Among the many stem cells, UCMSCs have drawn the interest of researchers due to their accessibility and effectiveness for treatment. At Advancells, we care for you and deliver top-notch quality UCMSCs to ensure the best cerebral palsy treatment in India.
FAQs:
Q – What are the standard treatment options for cerebral palsy?
The standard treatment includes mitigating the symptoms through medication and posture through surgery to provide relief and improve the quality of life.
Q – Why are stem cells better than the current treatment interventions?
These cells address the lacunae of the current interventions for not treating the disorder. These cells act on the cellular level mechanisms to eliminate the disorder at its root.
Q – How does stem cell therapy work?
The therapy regenerates nerve cells, reorganizes neural networks, alleviates inflammation, and drives vessel remodeling to treat cerebral palsy.
Q – Which stem cells are used for cerebral palsy treatment?
Mesenchymal stem cells (MSCs), neural stem cells, and induced pluripotent stem cells have been researched for the disorder. However, most clinical trials have used umbilical cord MSCs and shown positive results.
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