How effective is stem cell treatment of frostbite?
2020-08-13
What is frostbite?
Gradual freezing disease (also known as amyotrophic lateral sclerosis) is a fatal neurodegenerative disease. Theoretical physicist Stephen Hawking and American baseball star Lou Glick also unfortunately contracted the disease (hence the name Rick’s disease”). In the early stage, the patient may only feel weakness, muscle jumping, and easy fatigue. It gradually progresses to general muscle atrophy, muscle strength decline, difficulty in voluntary activities, and finally develops difficulty in swallowing and breathing, until respiratory failure.
90% of cases of amyotrophic lateral sclerosis are considered to be sporadic, while the remaining 10% of patients are related to familial inheritance, of which about 20% are encoded by superoxide dismutase 1 (SOD1) on chromosome 21q Caused by gene mutations; there are also some factors that are thought to be involved in the occurrence and development of frostbite, such as mitochondrial dysfunction, glutamate excitotoxicity, oxidative stress and neuroinflammation.
Mechanism of stem cell treatment of frostbite
Stem cell therapy, as a potentially effective treatment method for gradual freezing, has appeared intraspinal, intrathecal, intramuscular, intracerebral or intravenous administration routes. Some cases have also shown human mesenchymal stem cells from different sources ( MSCs) (bone marrow, cord blood, fat, etc.) can get better results.
Known mechanisms of stem cell therapy include immune regulation, anti-inflammatory effects, effective homing, and promotion of exosomes to secrete growth factors such as brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF) and insulin-like growth factor- 1 (IGF-1). The second study showed that the neuronal cells differentiated from stem cells can replace the neuron population lost in gradual freezing; the transplanted stem cells prevent existing motor neurons by releasing neuroprotective nutritional factors and regulating immunity The degeneration of the disease, changes the toxic microenvironment inflammation of gradual freezing disease, and improves the survival rate of neurons.
Clinical efficacy of stem cells in the treatment of frostbite
A prospective, non-randomized, open phase I/IIa clinical trial evaluated the safety and efficacy of stem cell therapy in 23 patients. After intrathecal injection of bone marrow mesenchymal stem cells (BM-MSC), about 30% of patients experienced mild to moderate headache, similar to headaches after standard lumbar puncture, and no suspected serious adverse reactions were observed.
The data showed that the amyotrophic lateral sclerosis function score scale (FRS) decreased significantly after 3 months of treatment; the disease was significantly reduced at 3, 6, 9 and 12 months after treatment. In about 80% of patients, the spirometry (FVC) value remained stable within 9 months; 75% of the patients had a stable WS value after 3 months of medication, and then decreased within 12 months of the follow-up period.
The results of this study show that stem cell therapy is safe to treat gradual freezing and can at least slow the progression of the disease.
