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Spinal Cord Injury

Spinal Cord Injury

A spinal cord injury is damage to the spinal cord that causes temporary or permanent changes in its function.

The spinal cord is a bundle of nerve fibers that connects nearly all parts of the body to the brain. Brain cells (neurons) send and receive messages in the brain and spinal cord while nerve cells (axons) carry instructions to the rest of the body. Oligodendrocytes are tasked with producing the myelin sheath that protects these critical axons. Astrocytes are responsible for ensuring that the central nervous system remains free of toxins and potentially harmful proteins while microglia are the immune cells of the brain.

There are two parts to a spinal cord injury.

The initial physical trauma is a stretch (traction) injury that causes the nerves fibers to either partially or completely sever. This gap, in what is essentially the communication super corridor of the body, hampers the ability of the brain to send instructions to the rest of the body. 

The secondary injury is the inflammation caused by the gap in the spinal cord. Inflammation causes astrocytes, oligodendrocytes and microglia to kick into action and seal the hole in the myelin sheath by forming glial scar tissue. This serves to stabile the fragile tissue of the central nervous system, repair the blood-brain barrier (BBB), prevent an overwhelming inflammatory response and limit cellular degeneration after the injury. However, all this occurs before axons are able to get in and bridge the gap in the spinal cord thereby hindering the recovery process.

As parts of the spinal cord remain unused for extended periods of time, they begin to waste away (atrophy) while neurons and axons continue to die naturally (apoptosis) before they are able to fix the injury and fail to adapt to the highly inflamed environment. 

 

How Our Products Can Treat Spinal Cord Injury

We use products derived from human baby umbilical cord tissues in all our therapy programs - Wharton's Jelly MSCs (wjMSCs). 

A major hurdle in spinal cord regeneration is inhibition of axonal regeneration, glial scar formation, lesions and the inability of existing cells to adapt to the injured environment (neuroplasticity) [1,2]. Any treatment involving the human brain has to overcome the blood-brain barrier (BBB). This is a strictly regulated 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 [3,4,5].
  • migrate to sites of injury (chemotaxis) [6,7].
  • communicate with and alter nearby cells (paracrine effect) [8,9,10].
  • encourage existing cells to self-repair (autocrine effect) [10,11,12].
  • prevent rejection by regulating the immune system (immunomodulation) [6,7,13,14,15,16,17,18,19,29].
  • reduce inflammation [7,18,19,20,21,22,23,24,25,26,29].
  • prevent cells from dying (apoptosis) [6,7,8,24,27,28,29,30].
  • transform into neurons [22,27,31,32,33,34].
  • promote the formation of axons (axogenesis) [23,25,29,35,36,37,38].
  • incapable of forming tumours [6,15,16,39,40].
  • release neuroprotective factors [8,21,30,41].
  • encourage existing cells to adapt (neuroplasticity) [42,43,44].

 

Treating A Spinal Cord Injury

There are currently 5 clinical trials exploring the use of wjMSCs in the treatment of spinal cord injury. These have been registered but results and findings have yet to be posted [45,46,47,48,49].

Studies have found that neurotrophin-3 (NT-3) and bFGF are capable of exerting protective and regenerative action in spinal cord lesions [50,51]. A collaborative Chinese study transplanted wjMSCs into rats whose spinal cords had been transacted. Three weeks into the study, they discovered an overexpression of NT-3 and bFGF in the animals. This led to a reduction in glial scar formation, promotion of axonal regrowth and increased neurofilament-positive fibers as well as significant functional improvement [52].

A 2013 Chinese study noted an 81.25% response to treatment in patients with incomplete spinal cord injury while no response in patients with complete spinal cord injury. Out of 16 patients with incomplete spinal cord injury, 13 experienced improvements in motor or sensory functions, or both, as well as improved bowel and bladder control ability. One month post-therapy, sensitivity to pain (algesia), tactile sensation, motion and activity of daily living were found to have significantly improved [53].

wjMSCs were found to hold the promise of restoration of lost tissue and improvement of function in an evaluation of 100 patients. The study, published in 2014, demonstrated that wjMSCs were able to inhibited cell death (apoptosis) and encourage expression of critical enzymes that trigger modification of extracellular-signal-regulated kinase [54].

A clinical trial conducted by the General Hospital of Chinese People’s Armed Police Forces treated 10 patients with wjMSCs while 24 other patients either underwent rehabilitation only or did not receive any treatment at all. Of the 10 patients in this 2014 trial, seven had significant and stable improvement in movement, self-care ability and muscular tension. The 10 patients also exhibited an increase in maximum urinary flow rate and maximum bladder capacity, as well as a decrease in residue urine volume and maximum detrusor pressure. The clinical trial concluded that wjMSC transplantation can effectively improve neurological functional [55].

Two years later, researcher from the same hospital examined the effects of wjMSC transplantation in a patient with a two-year history of complete cervical spinal cord injury. The patient was evaluated using somatosensory evoked potential (SSEP), pain rating index (PRI) and clinical presentations. SSEP is a test that shows the electrical signals of sensation going from the body to the brain. It is combined with an electromyogram (EMG) to measure how well the nerve roots leaving the spine are working [56]. PRI was performed using the McGill Pain Questionnaire [57], an international standard scale for description and evaluation. It was used to evaluate the patient’s neuropathic pain. After therapy, the patient was seen to have increased SSEP motor scores on left and right sides (5 and 4 points respectively) while PRI had reduced by 16 points. Prior to receiving wjMSCs, the patient had lost all sensation below the injury point. One year after SCT, the patient felt strong palpation on the abdomen although no sensation in the feet [58].

Most recently in 2017, researchers at the Chinese Academy of Sciences and the Affiliated Hospital of Logistics University of CAPF employed a new treatment methodology. They operated on eight patients with complete spinal cord injury to remove the glial scar before implanting NeuroRegen scaffolds, functionalized with wjMSCs, in the lesion. Patients then underwent six months of rehabilitation therapy. One year of observation showed that five patients demonstrated expansion of sensation levels and three showed increased finger flexibility. Analysis of motor-evoked potentials (MEPs) showed improvement in seven of the patients. This indicated partial recovery of neurological function. Two patients reported defecation sensation but not sphincter control while some of them reported increased stability and trunk equilibrium in the sitting position and autonomic neural function recovery (such as sweating) [59].

 

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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