Stem-cell transplantation into the frontal motor cortex in amyotrophic lateral sclerosis patients

2009, Vol. 11, No. 1 , Pages 26-34 (doi:10.1080/14653240802644651)
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1Servicio de Neurologia, Hospital Universitario UANL
2Hospital San Jose Tec de Monterrey, Servicio de Neurologia
3Tecnologico de Monterrey, School of Medicine, Servicio de Terapia Celular, CITES
4Servicio de Neurocirugia, Hospital San Jose Tec de Monterrey, Monterrey, Mexico
Correspondence: Hector R. Martinez, FACP, Escuela de Medicina, CITES, 3a Piso, Morones Prieto 3000 Pte, Col. Doctores, CP 64710, Monterrey, NL, Mexico



Background aims

Amyotrophic lateral sclerosis (ALS) is characterized by the selective death of motor neurons. CD133+ stem cells are known to have the capacity to differentiate into neural lineages. Stem cells may provide an alternative treatment for ALS and other neurodegenerative diseases.

Methods

Five men and five women (aged 38–62 years) with confirmed ALS were included in this study. Our institutional ethics and research committees approved the protocol. After informed consent was obtained, patients underwent Hidrogen-Magnetic Resonance Imaging (H-MRI) spectroscopy and were given scores according to an ALS functional rating scale, Medical Research Council power muscle scale and daily living activities. Bone marrow was stimulated with 300 µg filgrastim subcutaneously daily for 3 days. Peripheral blood mononuclear cells were obtained after admission by leukapheresis. The cell suspension was conjugated with anti-human CD133 superparamagnetic microbeads, and linked cells were isolated in a magnetic field. The isolated cells (2.5–7.5×105) were resuspended in 300 µL of the patient's cerebrospinal fluid, and implanted in motor cortexes using a Hamilton syringe. Ten patients with confirmed ALS without transplantation were used as a control group. Patients were followed up for a period of 1 year.

Results

The autologous transplantation of CD133+ stem cells into the frontal motor cortex is a safe and well-tolerated procedure in ALS patients. The survival of treated patients was statistically higher (P=0.01) than untreated control patients.

Conclusions

Stem-cell transplantation in the motor cortex delays ALS progression and improves quality of life.