Stem Cell in Management of Children With Cerebral Palsy

 In Cerebral Palsy

Stem Cell in Management of Children With Cerebral Palsy

Cerebral palsy is a condition which affects not only a person but the whole family for lifelong. The family wants a cure at any cost they can afford. But we know that brain damage is permanent and cannot be cured with the present techniques available. People are using stem cell technique at some centers in some parts of the world. But we need to understand before deciding to choose it as a treatment option.

What is stem cell treatment and how it works?

Stem cells are multipotential cells that exist in both developing and adult tissue. Their key unifying characteristics are their ability to self-renew. In the brain, as we know neuron cells are responsible for all the signals and control of body functions. These are very vulnerable cells and another cell called oligodendrocytes make a covering over these neurons with fat called myelin. These oligodendrocytes die in cerebral palsy especially in case of hypoxic-ischemic insult. Once these cells die unprotected neurons also die eventually. If this myelin could be replaced before neurons die, damage of the neurons can be lessened. But these stem cells are unspecialized and during the process of proliferation, they can either remain unspecialized or under the right condition become specialized cells. (Stem cell treatments for cerebral palsy: fact sheet for patient and families, February 2011 by Crystal Ruff, Jared Wicox, Michael Fehlings)

Even the authors ( Iona Novak, Karen Walker, Rod W. Hunt, Euan M. Wallace, Michael Fahey, Nadia Badawia ) of article “Concise Review: Stem Cell Interventions for People with Cerebral Palsy: Systematic Review With Meta-Analysis” published in Stem Cell Translational Medicine, 2016;5:10141025 accept that stem cell therapy is promising but not yet proven for cure. Rehabilitation, orthopedic surgery and pharmacology are the current standards of care. According to Bernard Dan (editorial: stem cell therapy for cerebral palsy, Journal of developmental medicine and child neurology, 2016)” Stem cells are promising but clearly not even ready to be assessed for their potential contribution to the management of the individual with CP”

Because of lack of transparency and unwarranted media hype there is the development of stem cell tourism and many clinics in some countries of the world offer stem cell treatment but are unregulated, lack legitimate affiliation or accountability and use technologies without solid scientific foundation. The individuals utilizing such clinics expose themselves to a lack of success, exclusion from legitimate trials, false hope, complications, and financial hardships. (Crystal A Ruff, Stuart D Faulkner, Michael G Fehling. The potential for stem cell therapies to have an impact on Cerebral palsy: opportunities and limitations, Developmental Medicine and child neurology, 2013, 55: 689697)

It is clear from above discussion and evidences that although the research is going on the use of stem cells as treatment of cerebral palsy but it would take a long time to come it up as a promising cure or may not even be proved. Role of parents is to be aware and not get into the trap before such evidences come.

Dr. Michael Fehlings and colleagues at the University of Toronto have published an online newsletter, aimed at a non-scientific or health professional audience, on stem cell treatments for cerebral palsy. More detail can be obtained at that website. Here are some of the key points:

  1. Transplanting stem cell into the brain could support and/or replace brain tissue during the process of white matter damage in cerebral palsy.

  2. Animal models used in research on cerebral palsy have shown that many types of stem cells can be used to reduce damage and return motor function after brain injury.

  3. New technological improvements make it possible for skin cells to be taken from a patient and turned into the exact cell needed to repair injured tissue, getting rid of the need for tissue donor waiting lists and anti-rejection drugs.

  4. Once stem cells are put in, they can never be removed.

  5. There are no proven stem cell treatments available for patients with cerebral palsy right now, and it will take a number of years for safe and effective therapies to make it to the clinic.

  6. Unregulated clinics outside of North America are offering stem cell transplants; however, these clinics have shown no scientific proof that their procedures offer any effect beyond placebo effects and/or normal development.

  7. Stem cell transplantation would probably have to be performed within the window of the time between the first appearance of injury and irreparable loss of neurons.

You can get Lots of information on stem cell research on the following site—

  1. International society for stem cell research( ISSCR). http://www.isscr.org

  2. U.S. National Institutes of Health research. http://www.ninds.nih.gov/disorders/cerebral_palsy/detail_cerebral_palsy.htm

  1. A government-sponsored initiative providing up-to-date information on stems cells in regenerative medicine. http://stemcells.nih.gov/

  1. Current North American Clinical Trials on stem cells for cerebral palsy

  1. Duke University http://clinicaltrials.gov/ct2/show/NCT01147653

  2. Canadian Institutes of Health Research: The CIHR Stem Cell Research page provides up-to-date information on stem cell governance and legislature in Canada. http://www.cihr-irsc.gc.ca/e/15255.html
  1. Current information on registered clinical trials: http://clinicaltrials.gov/ct2/results?term=cerebral+palsy+AND+stem+cells

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