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Traumatic Brain Injury (TBI)

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Traumatic Brain Injury (TBI)

TBI can occur as a result of direct impact, extreme acceleration and deceleration and / or rotational forces that damage the brain on a cellular level. There are two parts to the injury.

The initial first stage involves damage to the central nervous system due to a change in the electric charge within brain cells (depolarisation of neurons) as well as inflammation in the brain. This leads to widespread neuronal impairment, disruption of the blood-brain barrier (BBB) and what is known as membrane attack complex (MAC). This occurs when complement proteins create a hole in the membrane of a cell allowing extracellular fluids to flood it. This causes neurons to disintegrate (lysis) and eventually die (apoptosis).

The second stage of the injury occurs when inflammation in the brain persists for weeks, months and even years after the initial injury. This means that neurons continue to disintegrate and die even years after the initial injury. Over time, calcium begins seeping into neurons causing the accumulation of free radicals. This disrupts their ability to convert energy efficiently (mitochrondrial dysfunction) causing even more neurons to die and further diminish the brain’s ability to heal itself.

The human brain already has naturally occurring progenitor cells that replace dead neurons and repair injuries as and when needed. But a prolonged and acute inflammatory environment prevents these cells from doing their job.

 

How Our Products Can Treat A Traumatic Brain Injury

We use products derived from human baby umbilical cord tissues in all our therapy programs - Wharton's Jelly MSCs (wjMSCs). The human brain is strictly regulated by the blood-brain barrier (BBB). This is a semipermeable endothelial membrane that separates blood from cerebrospinal fluid. It is a highly selective mechanism that allows only a select few types of cells, particles and molecules enter the brain. Our products are special because they can:

  • cross the endothelial brain barrier [1,2,3,4].
  • migrate to sites of injury (chemotaxis) [5,6].
  • communicate with and alter nearby cells (paracrine effect) [7,8,9].
  • encourage existing cells to self-repair (autocrine effect) [9,10,11].
  • prevent rejection by regulating the immune system (immunomodulation) [5,6,12,13,14,15,16,17,18].
  • reduce inflammation [6,17,18,19,20,21,23].
  • prevent cells from dying (apoptosis) [5,6,8,19,24,30].
  • transform into neurons and glia [20,24,25,26,27,28].
  • promote the formation of nerve cell axons (axogenesis) [21,22].
  • promote the formation of neurons and astrocytes (neurogenesis) [30].
  • incapable of forming tumours [5,14,15,29].
  • release neuroprotective factors [8,30].
  • encourage existing cells to adapt (neuroplasticity) [31,32,33].
  • survive and differentiate in low oxygen environments [34,35,36,37,38].

 

Treating A Traumatic Brain Injury

When an injury occurs to the brain, it leaves certain parts oxygen-deprived making the environment hostile to the survival of cells. Experiments have been conducted to see the effects of different levels of oxygen on MSC performance. In these experiments, MSCs were allowed to differentiate under normoxic and hypoxic conditions.

  • Normoxia: 10 to 21% oxygen [39].
  • Hypoxia: 1 to 5% oxygen [39].

Astonishingly, numerous experiments systematically found that wjMSCs not only survived but differentiated better and faster under hypoxic conditions [34,35,36,37,38]. This would indicate that wjMSCs are ideal in the treatment of traumatic brain injury.

A combined 2013 study by the General Hospital of Chinese People’s Armed Police Forces and Harbin Medical University transplanted wjMSCs in patients with sequelae of traumatic brain injury that had been sustained more than one year previously. Patients were evaluated with Fugl-Meyer Assessment (FMA) scoring and Functional Independence Measure (FIM) scoring. FMA is a 226-point multi-item scale that assesses motor function, sensory function, balance, joint range of motion and joint pain [40] while FIM is an 18-item rating scale that assesses self-care, bowel and bladder management, mobility, communication, cognition, and psychosocial adjustment [41]. The study found that after 6 months of wjMSCs implantation, FMA indicated an improvement in upper extremity, lower extremity, sensation and balance sub-scores while FIM noted a significant improvement in self-care, sphincter, mobility, locomotion, communication and social cognition sub-scores [42].

Two years later, another Chinese study intrathecally administered wjMSCs to 100 patients with various neurological conditions. They were assessed one year later with the Hauser Ambulation Index (HAI), an assessment that measures the time and degree of assistance required to walk 25 feet [43]. One year after the treatment, functional indices improved in 47 patients: of which nine patients had post-traumatic brain syndrome. Intrathecal administration of wjMSCs indicated the potential of restoration of lost tissue and improvement of function in patients with profound neurological defects and inefficient conventional cure [44].

Researchers at Renmin Hospital of Wuhan University combined wjMSC transplantation with hyperbaric oxygen treatment (HBOT) in rat models of traumatic brain injury. The study determined that the wjMSCs and HBOT group had the least neurological deficits. This group also exhibited lower latency scores as early as two days post-implantation and the best learning and memory scores. An analysis of their brains four weeks later found it filled with glial cells and glial fibers, an increased number of neuraxon-like structures, a lack of softening foci (first sign of a developing lesion) and only a small amount of scar tissue remaining [45]

 

Cyrona’s Program

Achieving high standards in our work is of paramount importance to us. Depending on a patient’s needs, we combine our premium grade Passage 2 wjMSCs with physiotherapy, occupational therapy, speech and language therapy and/or rehabilitative medicine. 

Learn more about our Products and Programs.

 

Why Choose Cyrona?

  • Latest cellular research and technology.
  • Unique, tailored therapy outlines.
  • Products that meet international standards.
  • Microbiology & clinical team with extensive experience in advanced medicine.
  • Board-certified physicians geared towards patient safety.
  • Fact-based information from clinical studies and trials.
  • No outlandish promises of a one-stop-cure or false improvement rates.

 

Therapy Packages

All our therapy packages come inclusive of:

 

INTERNATIONAL PATIENTS

  • Premium grade Passage 2 wjMSCs.
  • Treatment by qualified specialist(s).
  • Certificate of Analysis (CoA).
  • Airport transfer.
  • Transportation to & from therapy session(s).
  • Accommodation.
  • Hospital room for therapy.

 

LOCAL PATIENTS

  • Premium grade Passage 2 wjMSCs.
  • Treatment by qualified specialist(s).
  • Certificate of Analysis (CoA).
  • Transportation to & from therapy session(s).
  • Hospital room for therapy.

 

How Do We Proceed

All our therapies are charged based on the number of wjMSCs and supplementary infusions required for the patient’s specific condition. As no two people are alike, our specialists review each patient’s medical reports before tailoring a therapy catered to addressing his or her individual needs.

You may chat with one of our Customer Care Representatives or send an e-mail detailing the patient’s condition to one of our Liaison Officers. It would expedite the process if you can provide us with:

  • Imaging results (MRI scan / CT scan / X-Ray).
  • Hematology reports (blood test).
  • Doctor’s assessment reports.
  • Pictures or videos of the patient (if relevant).

Upon getting in touch with us, a Liaison Officer evaluates and assigns the case to the specialist best equipped to treat the condition. A therapy, unique only to the patient, is drawn up and a price quoted accordingly.

Should you decide to proceed with therapy, our specialists require that all patients have Cancer Marker Screening performed in their country of residence before travelling to us for therapy. If the patient has had Cancer Marker Screening within the last 3 months, you may e-mail those results to us. In the event that the patient’s Cancer Marker Screening results are not satisfactory, our specialists will refuse to proceed with therapy. It is for this reason that we requests that patients have Cancer Marker Screening performed in their country of residence prior to travelling to us.

One week prior to arrival, a deposit payment is required in order to arrange accommodation and transportation.

Full payment is required to be made one-day prior to therapy commencement.

Post-treatment, our specialist will provide the patient with a post-treatment protocol as well as what to expect on his or her journey towards a better, and hopefully, healthier new life.

 

Kindly get in touch with us for the sources listed throughout this article.

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