574.3.1.5 Spinal Cord Injury (SCI)
Spinal cord injury is a chronic debilitating condition that results in loss of sensory-
motor and other neurological functions such as bowel and bladder control. A wide
variety of medical and surgical treatments have been tried to aim at restoring the
morphological structure of the spinal cord and to restore its function. Due to their
ability to rapidly proliferate and differentiate into several different cell lines, stem
cell therapy has been tried in altering the course of symptoms in patients with spinal
cord injury. Several parameters such as clinical neurologic improvement, motor and
sensory evoked potentials, bladder urodynamic testing have been studied following
stem cell therapy in SCI patients and have shown promising results [ 19 ].
4.3.2 Musculoskeletal System
4.3.2.1 Osteoarthritis
Osteoarthritis is a progressive degenerative disorder, often affecting large weight
bearing joints such as hips and knees. Prior trauma or altered mechanics due to vari-
ous factors may accelerate this process. Several experimental treatments to reduce
cartilage damage and slow progression of cartilage loss including micro fracture
and autologous chondrocyte implantation have been described [ 20 ]. However, due
to their unique ability to rapidly proliferate and differentiate into chondrocytes,
mesenchymal stem cell implants have been studied for their potential role in manag-
ing osteoarthritis and may have a role in halting progression of osteoarthritis [ 21 ].
In addition, mesenchymal stem cells produce several cytokines and growth fac-
tors, the paracrine effect of which helps in tissue regeneration and angiogenesis [ 22 ].
Recent studies in patients treated with autologous mesenchymal stem cells for
cartilage defects have shown promising results with improved arthroscopic and his-
tologic grading when compared to un-treated patients [ 23 – 25 ]. Largest of these was
a study of 56 patients who underwent intra articular injection of a combination of
autologous mesenchymal stem cells and hyaluronic acid versus hyaluronic acid
alone 3 weeks following high tibial osteotomy and microfracture for osteoarthritis.
Improved clinical outcome as well as MRI appearance was observed in the treated
group of patients as measured using IKDC (International Knee Documentation
Committee) score at 6 months, 1 and 2 years and MOCART (Magnetic Resonance
Observation of Cartilage Repair Tissue) scores at 1 year respectively [ 25 ].
4.3.2.2 Rheumatoid Arthritis
Rheumatoid arthritis is a chronic synovial inflammatory arthritis mediated by acti-
vated T lymphocytes, eventually resulting in cartilage loss and joint destruction.
Due to their ability to suppress the proliferation of activated T lymphocytes,
4 Clinical Applications of Stem Cell Transplant in Treating Non-Hematologic...