Accidents happen and sometimes really bad accidents happen; especially if they injure your head. Traumatic brain injuries or TBIs can result from automobile accidents, explosions or other events that result from severe blows to the head. TBIs an adversely affect a patient and his/her family for long periods of time. TBI patients can experience cognitive deficits that prevent them from thinking or speaking straight, and sensory deficits that prevent them from seeing, hearing or smelling properly. Psychological problems can also result. Essentially, TBIs represent a major challenge for modern medicine.
According to data from the Centers for Disease Control (CDC), 1.7 million Americans suffer from TBIs each year (of varying severity). Of these, 275,000 are hospitalized for their injuries and approximately 52,000 of these patients die from their injuries. In fact, TBIs contribute to one-third of all injury-related deaths in the United States each year. More than 6.5 million patients are burdened by the deleterious effects of TBIs, and this leads to an economic burden of approximately $60 billion each year.
Currently, treatments for TBI are few and far between. Neurosurgeons can use surgery to repair damaged blood vessels and tissues, and diminish swelling in the brain. Beyond these rather invasive techniques, the options for clinicians are poor.
A new study by Charles S. Cox, professor of Pediatric Surgery and co-director of the Memorial Hermann Red Duke Trauma Institute, and his colleagues suggest that stem cell treatments might benefit TBI patients. The results of this study were published in the journal Stem Cells.
This study enrolled 25 TBI patients. Five of them received no treatment and served as controls, but the remaining 20 received gradually increasing dosages of their own bone marrow stem cells. The harvesting, processing and infusion of the bone marrow cells occurred within 48 hours of injury. Functional and cognitive results were measured with standard tests and brain imaging with magnetic resonance imaging and diffusion tensor imaging.
This work is an extension of extensive preclinical work done by Cox and his coworkers in laboratory animals and a phase I study that established that such stem cell transplantation are safe for human patients. The implanted stem cells seem to quell brain inflammation and lessen the damage to the brain by the TBI.
Despite the fact that those TBI patients who received the stem cell treatments had greater degrees of brain damage, the treatment group showed better structural preservation of the brain and better functional outcomes than the control group. Of particular interest was the decrease in indicators of inflammation as a result of the bone marrow cell-based infusions.
Cox said of this trial, “The data derived from this trial moves beyond just testing safety of this approach.” He continued: “We now have a hint of a treatment effect that mirrors our pre-clinical work, and were are now pursuing this approach in a phase IIb clinical trial sponsored by the Joint Warfighter Program within the US Army Medical Research Acquisition Activity, as well as our ongoing phase IIb pediatric severe TBI clinical trial; both using the same autonomous cell therapy.”
This an exciting study, but it is a small study. While the safety of this procedure has been established, the precise dosage and long-term benefits will require further examination. However it is a fine start to what may become the flowering of new strategies to treat TBI patients.