Stem Cell Treatment and Cerebral Palsy: A Systematic Review and Meta-Analysis

  • Authors: Motavaf M.1, Dehghan S.2, Ghajarzadeh M.3, Ebrahimi N.4, Zali A.5, Safari S.6, Mirmosayyeb O.7
  • Affiliations:
    1. Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence,, Shahid Beheshti University of Medical Sciences
    2. Stem cell and Regeneration Medicine Research Center, Iran University of Medical Sciences
    3. Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN),, Tehran University of Medical Sciences
    4. School of medicine, Isfahan University of Medical Sciences
    5. Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence,, , Shahid Beheshti University of Medical Sciences
    6. Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shahid Beheshti University of Medical Sciences
    7. Isfahan Neurosciences Research Center, Isfahan University of medical sciences
  • Issue: Vol 19, No 2 (2024)
  • Pages: 210-219
  • Section: Medicine
  • URL: https://cijournal.ru/1574-888X/article/view/645693
  • DOI: https://doi.org/10.2174/1574888X18666221201114756
  • ID: 645693

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Abstract

Objective:We designed this systematic review and meta-analysis to estimate the pooled efficacy and safety profile of different types of stem cells in treating patients with cerebral palsy (CP).

Methods:We systematically searched PubMed, Scopus, EMBASE, Web of Science, Google Scholar, and also gray literature, including references of the included studies which were published before November 2021. We extracted data regarding the total number of participants, first author, publication year, country of origin, mean age, cell type, cell dose, cell source, method of transplantation, duration of follow-up, Gross motor function, Ashworth scale, and adverse events.

Results:We found 2073 articles by literature search; after deleting duplicates, 1194 remained. Nine articles remained for meta-analysis. The SMD of GMF-66 score (after-before) treatment was 1.5 (95% CI:0.7-2.3) (I2 = 89.9%, p < 0.001). The pooled incidence of Gastrointestinal (GI) complications after transplantation was 21% (95% CI:9-33%) (I2 = 56%, P = 0.08). The pooled incidence of fever after transplantation was 18 % (95% CI:6-30%) (I2 = 87.9%, P = 0.08 < 0.001)

Conclusion:The result of this systematic review and meta-analysis show that stem cell therapy in cerebral palsy has neuroprotective properties from anti-inflammatory and anti-apoptotic activities. Stem cell therapy seems to be a promising adjunct to traditional therapies for cerebral palsy patients.

About the authors

Mahsa Motavaf

Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence,, Shahid Beheshti University of Medical Sciences

Email: info@benthamscience.net

Samaneh Dehghan

Stem cell and Regeneration Medicine Research Center, Iran University of Medical Sciences

Email: info@benthamscience.net

Mahsa Ghajarzadeh

Universal Council of Epidemiology (UCE), Universal Scientific Education and Research Network (USERN),, Tehran University of Medical Sciences

Email: info@benthamscience.net

Narges Ebrahimi

School of medicine, Isfahan University of Medical Sciences

Email: info@benthamscience.net

Alireza Zali

Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence,, , Shahid Beheshti University of Medical Sciences

Email: info@benthamscience.net

Saeid Safari

Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Comprehensive Center of Excellence, Shahid Beheshti University of Medical Sciences

Author for correspondence.
Email: info@benthamscience.net

Omid Mirmosayyeb

Isfahan Neurosciences Research Center, Isfahan University of medical sciences

Email: info@benthamscience.net

References

  1. Jones MW, Morgan E, Shelton JE, Thorogood C. Cerebral palsy: introduction and diagnosis (part I). J Pediatr Health Care 2007; 21(3): 146-52. doi: 10.1016/j.pedhc.2006.06.007 PMID: 17478303
  2. Odding E, Roebroeck ME, Stam HJ. The epidemiology of cerebral palsy: Incidence, impairments and risk factors. Disabil Rehabil 2006; 28(4): 183-91. doi: 10.1080/09638280500158422 PMID: 16467053
  3. Liu X, Fu X, Dai G, et al. Comparative analysis of curative effect of bone marrow mesenchymal stem cell and bone marrow mononuclear cell transplantation for spastic cerebral palsy. J Transl Med 2017; 15(1): 48. doi: 10.1186/s12967-017-1149-0 PMID: 28235424
  4. Sharma A, Sane H, Gokulchandran N, et al. A clinical study of autologous bone marrow mononuclear cells for cerebral palsy patients: a new frontier. Stem Cells Int 2015; 2015: 905874. doi: 10.1155/2015/905874
  5. Nelson KB, Blair E. Prenatal factors in singletons with cerebral palsy born at or near term. N Engl J Med 2015; 373(10): 946-53. doi: 10.1056/NEJMra1505261 PMID: 26332549
  6. Pharoah PO, Cooke T, Cooke RW, Rosenbloom L. Birthweight specific trends in cerebral palsy. Arch Dis Child 1990; 65(6): 602-6. doi: 10.1136/adc.65.6.602 PMID: 2378516
  7. Rah WJ, Lee YH, Moon JH, et al. Neuroregenerative potential of intravenous G-CSF and autologous peripheral blood stem cells in children with cerebral palsy: a randomized, double-blind, cross-over study. J Transl Med 2017; 15(1): 16. doi: 10.1186/s12967-017-1120-0 PMID: 28109298
  8. Levitt S, Addison A. Treatment of cerebral palsy and motor delay. (6th ed.), Hoboken: John Wiley & Sons 2018. doi: 10.1002/9781119373902
  9. Andrzejewska A, Dabrowska S, Lukomska B, Janowski M. Mesenchymal stem cells for neurological disorders. Adv Sci (Weinh) 2021; 8(7): 2002944. doi: 10.1002/advs.202002944 PMID: 33854883
  10. Liu J, Lv Z-Y, Li Y. Progress in clinical trials of stem cell therapy for cerebral palsy. Neural Regen Res 2021; 16(7): 1377-82. doi: 10.4103/1673-5374.300979 PMID: 33318421
  11. Boncoraglio GB, Ranieri M, Bersano A, Parati EA, Del Giovane C. Stem cell transplantation for ischemic stroke. Cochrane Database Syst Rev 2019; 5: 195. doi: 10.1002/14651858.CD007231.pub3
  12. Nguyen LT, Nguyen AT, Vu CD, Ngo DV, Bui AV. Outcomes of autologous bone marrow mononuclear cells for cerebral palsy: an open label uncontrolled clinical trial. BMC Pediatr 2017; 17(1): 104. doi: 10.1186/s12887-017-0859-z PMID: 28403842
  13. Cox CS Jr, Baumgartner JE, Harting MT, et al. Autologous bone marrow mononuclear cell therapy for severe traumatic brain injury in children. Neurosurgery 2011; 68(3): 588-600. doi: 10.1227/NEU.0b013e318207734c PMID: 21192274
  14. McDonald CA, Fahey MC, Jenkin G, Miller SL. Umbilical cord blood cells for treatment of cerebral palsy; timing and treatment options. Pediatr Res 2018; 83(1-2): 333-44. doi: 10.1038/pr.2017.236 PMID: 28937975
  15. Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928. doi: 10.1136/bmj.d5928 PMID: 22008217
  16. Sun JM, Case LE, Mikati MA, et al. Sibling umbilical cord blood infusion is safe in young children with cerebral palsy. Stem Cells Transl Med 2021; 10(9): 1258-65. doi: 10.1002/sctm.20-0470 PMID: 34085782
  17. Thanh LN, Trung KN, Duy CV, et al. Improvement in gross motor function and muscle tone in children with cerebral palsy related to neonatal icterus: an open-label, uncontrolled clinical trial. BMC Pediatr 2019; 19(1): 290. doi: 10.1186/s12887-019-1669-2 PMID: 31438885
  18. Fu X, Hua R, Wang X, et al. Synergistic improvement in children with cerebral palsy who underwent double-course human wharton’s jelly stem cell transplantation. Stem Cells Int 2019; 2019: 7481069. doi: 10.1155/2019/7481069
  19. Nguyen TL, Nguyen HP, Nguyen TK. The effects of bone marrow mononuclear cell transplantation on the quality of life of children with cerebral palsy. Health Qual Life Outcomes 2018; 16(1): 164. doi: 10.1186/s12955-018-0992-x PMID: 30107811
  20. Chernykh ER, Kafanova MY, Shevela EY, et al. Clinical experience with autologous M2 macrophages in children with severe cerebral palsy. Cell Transplant 2014; 23 (Suppl. 1): 97-104. doi: 10.3727/096368914X684925 PMID: 25302537
  21. Wang X, Cheng H, Hua R, et al. Effects of bone marrow mesenchymal stromal cells on gross motor function measure scores of children with cerebral palsy: A preliminary clinical study. Cytotherapy 2013; 15(12): 1549-62. doi: 10.1016/j.jcyt.2013.06.001 PMID: 24100132
  22. Chen L, Huang H, Xi H, et al. Intracranial transplant of olfactory ensheathing cells in children and adolescents with cerebral palsy: a randomized controlled clinical trial. Los Angeles, CA: SAGE Publications Sage CA 2010.
  23. Paprocka J, Kaminiów K, Kozak S, Sztuba K, Emich-Widera E. Stem cell therapies for cerebral palsy and autism spectrum disorder-A systematic review. Brain Sci 2021; 11(12): 1606. doi: 10.3390/brainsci11121606 PMID: 34942908
  24. Alessandrini M, Preynat-Seauve O, De Briun K, Pepper MS. Stem cell therapy for neurological disorders. S Afr Med J 2019; 109 (Suppl. 1): 70-7. doi: 10.7196/SAMJ.2019.v109i8b.14009 PMID: 31662153
  25. Novak I, Walker K, Hunt RW, Wallace EM, Fahey M, Badawi N. Concise review: Stem cell interventions for people with cerebral palsy: Systematic review with meta‐analysis. Stem Cells Transl Med 2016; 5(8): 1014-25. doi: 10.5966/sctm.2015-0372 PMID: 27245364
  26. Huang L, Zhang C, Gu J, et al. A randomized, placebo-controlled trial of human umbilical cord blood mesenchymal stem cell infusion for children with cerebral palsy. Cell Transplant 2018; 27(2): 325-34. doi: 10.1177/0963689717729379 PMID: 29637820
  27. Luan Z, Liu W, Qu S, et al. Effects of neural progenitor cell transplantation in children with severe cerebral palsy. Cell Transplant 2012; 21 (Suppl. 1): 91-8. doi: 10.3727/096368912X633806 PMID: 22507684

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