Human embryonic olfactory ensheathing cell transplantation for treating the sequel of myelitis: A self-control study of 32 cases using American Spinal Injury Association Scoring Standard / 中国组织工程研究

ABSTRACT

BACKGROUND: Animal experimental studies have confirmed that cell transplantation, neurotrophic factor infusion or transplantation as well as other methods can alter the local environment of injured spinal cord and promote its partial function recovery.OBJECTIVE: This study aimed to assess the clinical efficacy of olfactory ensheathing cell transplantation for the treatment of the sequel of myelitis, and to explore whether it would promote the recovery of the spinal cord function.DESIGN: A non-randomized self-control study.SETTING: Ward of Second Department of Surgery of Taian Disabled Soldiers Hospital of Shandong Province.PARTICIPANTS: Thirty-two patients with obsolete myelitis, who come from all over China and suffered from disease for 0.5 to 7 years, admitted to our hospital between June 2004 and July 2007 were recruited in this study. The involved patients, including 21 males and 11 females, were aged 5-48 years. Their neurological functions were not obviously improved after various conventional treatments and limb function exercise. Meanwhile, various sensorimotors and autonomic nerve functional impairments were left. Among the patients, 18 suffered from acute viral myelitis, 8 from acute purulent myelitis and 6 from tuberculous myelitis. After onset, they were all given large doses of radiosonde,dexamethasone, anti-inflammatory and immunomodulatory drugs and various neurotrophic drugs. Twenty-six patients presented complete injury and six patients incomplete injury. Informed consent of treatment was obtained from each patient. The therapeutic protocol was approved by the Ethics Committee of the hospital. Embryonic olfactory bulbs were harvested from aborted embryo, which was donated voluntarily by the patients or their relatives.METHODS: Cells were isolated from embryonic olfactory bulbs, cultured and purified for 7 to 14 days, and finally they were digested into single-cell suspension. Under the surgical miscroscope, the cells were transplanted onto the regions which were above or below the spinal cord injury site. Two weeks to 2 months postoperatively, neurological function of spinal cord was assessed by using the American Spinal Injury Association (ASIA) Scoring Standard formulated in 2000, and was compared to pre-operation function.MAIN OUTCOME MEASURES: ①Sensory function change. ②Motor function change.RESULTS: Half a year to 2 years after olfactory ensheathing cell transplantation, the sensory and motor functions of 32 patients were all obviously improved (motor function 55.72±10.50 vs. 51.53±13.41; light touch69.53±11.68 vs.63.06±15.98; pain sense 69.50±12.20 vs. 64.03±15.0, all P ＜ 0.01 ).CONCLUSION: Olfactory ensheathing cell transplantation can help to promote the neurological function recovery of patients with the sequel of myelitis. However, its long-term curative effect needs to be further investigated.