Therapeutic evidence of umbilical cord-derived mesenchymal stem cell transplantation for cerebral palsy: a randomized, controlled trial.
BACKGROUND
Cerebral palsy (CP) is a syndrome of childhood movement and posture disorders. Clinical evidence is still limited and sometimes inconclusive about the benefits of human umbilical cord mesenchymal stem cells (hUC-MSCs) for CP. We conducted a randomized trial to evaluate the safety and efficacy of hUC-MSC transplantation concomitant with rehabilitation in patients with CP.


METHODS
Eligible patients were allocated into the hUC-MSC group and control group. In addition to rehabilitation, the patients in the hUC-MSC group received four transfusions of hUC-MSCs intravenously, while the control group received a placebo. Adverse events (AEs) were collected for safety evaluation in the 12-month follow-up phase. Primary endpoints were assessed as activities of daily living (ADL), comprehensive function assessment (CFA), and gross motor function measure (GMFM) scales. In addition, cerebral metabolic activity was detected by 18F-FDG-PET/CT to explore the possible mechanism of the therapeutic effects. Primary endpoint data were analyzed by ANOVA using SPSS version 20.0.


RESULTS
Forty patients were enrolled, and 1 patient withdrew informed consent. Therefore, 39 patients received treatments and completed the scheduled assessments. No significant difference was shown between the 2 groups in AE incidence. Additionally, significant improvements in ADL, CFA, and GMFM were observed in the hUC-MSC group compared with the control group. In addition, the standard uptake value of 18F-FDG was markedly increased in 3 out of 5 patients from the hUC-MSC group at 12 months after transplantation.


CONCLUSIONS
Our clinical data showed that hUC-MSC transplantation was safe and effective at improving the gross motor and comprehensive function of children with CP when combined with rehabilitation. Recovery of cerebral metabolic activity might play an essential role in the improvements in brain function in patients with CP. The therapeutic window, transfusion route, and dosage in our study were considerable for reference in clinical application.


TRIAL REGISTRATION
Chictr.org.cn, ChiCTR1800016554. Registered 08 June 2018-retrospectively registered. The public title was "Randomized trial of umbilical cord-derived mesenchymal stem cells for cerebral palsy."
['Gu|Jiaowei|J|', 'Huang|Li|L|', 'Zhang|Che|C|', 'Wang|Yong|Y|', 'Zhang|Ruibo|R|', 'Tu|Ziliang|Z|', 'Wang|Hengdong|H|', 'Zhou|Xihui|X|', 'Xiao|Zhousheng|Z|', 'Liu|Zegan|Z|', 'Hu|Xiang|X|', 'Ke|Zunchen|Z|', 'Wang|Dabin|D|', 'Liu|Li|L|0000-0003-1200-3068']
D000203:Activities of Daily Living D002547:Cerebral Palsy D002675:Child, Preschool D004311:Double-Blind Method D005260:Female D006801:Humans D008297:Male D045164:Mesenchymal Stem Cell Transplantation D059630:Mesenchymal Stem Cells
Mesenchymal stem cells Cell transplantation Cerebral palsy Umbilical cord Activities of daily living Clinical trial