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Dr. Shahrokh Yousefzadeh-ChabokAssociate Professor of Neurosurgery,
Guilan Road Trauma Research Center, Guilan University
Comparing GCSF and Stem Cells Obtained
From Mesenchymal Cells
in Healing of Spinal Cord Injured of Rat
LOGOStudy Design
Sham
•Alone Laminec-tomy, Without SCI
Control
•Laminec-tomy
LOGOStudy Design
Stem CellInteratecal Injection SCI Surgery
- - - Laminectomy Sham
- Distilled water + Laminectomy Control
- GCSF + Laminectomy GCSF
+ - + Laminectomy MSC
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Within 14 injury day
Acute:
Between 14 days and 8 weeks.
Sub acute:
More than 8 weeks.
Chronic:
SCI
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Muscles complications
Neuropathic Pain
Complication of BMSCT
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GM- CSF (Grunulocyte macrophaye-colony stimulating factor)
G-CSF (Grunulocyte-colony stimulating factor)
Erythropoitin
Hematopoietic Cytokine
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Decrease apoptosis an improvement of Neurologic
Function (Neuroprotective Effect)
GCSF Effect
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Fever > 390C
Cord Transection MRI
Ventilator assisted Breathing
(ASIA) grade A, B
Exclusion Criteria of GCSF
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as a growth Factor for hematopoitic progenitor cells to Treat of Nentopenia
Hematopoietic:
mobilization of peripheral blood-drieved hematopoeitic stem cells for
transplantation to treat of Neuronal Injury & Stork
Nonhematopoitic :
GCSF (Granulocyte-colony Stimulating Factor) Function
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5 mg/kg/ Day for 5 days
10 mg/kg/ Day for 5 days
Dose of GCSF
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GCSF in Acute Phase of SCI
Mobilization of bone-marrow derived cell to injury site of spinal cord
Suppresses Neuronal Apoptosis
Suppresses the death of Oligodendrocyte
Protect myelin
Suppresses the expression of cytokine such as TNF-α and IL-1B
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GCSF in Subacute Phase of SCI
Neuroprotective effects via
angiogenesis after SCI
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Exclusion Criteria
16 years old < age < 75 years old
High dose MPss (solumedrol)
Intracerebral Pathology (Tumor, Ischemia, Infections)
History of major bleeding requiring transfusion
History of leukopenia, thrombocytopenia hepatic or renal
dysfunction, sever heart failure, splenomegaly
Malignance
pregnancy
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Hematopoietic Stem Cell
Mesenchymal Stem Cell
Endothelial Progenitor Cell
Macrophage
lymphocyte
BMC Sources
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fever twice daily for 7 days
CBC once daily for 7 days
ASI Score
ASI impairment score(AIS)
Post Operative Exam
LOGOMild Complication
Pneumonia ,Peptic Ulcer, Hepatopathy
Fever, Headache, Nausea Vomiting
Low Back Pain, Pelvic Pain
LOGOSever Complication
MI
CVA
Spleen rupture
LOGOMesenchymal Stem Cell Effects
Neroprotection
Neurogenesis
Neuroplasticity
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Bone marrow
umbilical cord
Aniniotic fluid
Addipose tissure
Mesenchymal Stem Cell Sources
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Decreased apopetotic cell death
Increase of Neurogeneration
Synaptogenesis
Remyelination
Angiogenesis
Re-formation of BBB
The Effects of MSC
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In Experimental Study of MSC in Rat
Increase in axonal fiber density synaptogenesis and myelination
Secretion of trophic factor (BDNF…..)
Decrease glial scar thickness
Enhance annual growth in the penumbra
Anti inflammation by suppression of T-cell ,inhabit of B-cell and
IgG Production
LOGOAdvantage of Cell Transplant
Easily localized the treatment of affected site
supply a variety of trophic factor
Persistence of long time to affect the environment injured tissue
Increased the host cell
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