Published online Mar 20, 2021. doi: 10.5493/wjem.v11.i2.17
Peer-review started: December 24, 2020
First decision: January 18, 2021
Revised: February 19, 2021
Accepted: March 12, 2021
Article in press: March 12, 2021
Published online: March 20, 2021
To date, hypoxic ischemic encephalopathy (HIE) is refractory, including after cardiopulmonary resuscitation, hemorrhagic shock and cerebral infarction etc.
Limited treatment options exist for patients with HIE and substantial functional deficits. Thus, further clinical research investigations on this subject could be valuable.
The current study examined safety and preliminary efficacy estimates of allogeneic mesenchymal stem cells (MSCs) in this population.
Entry criteria included HIE ≥ 6 mo prior, substantial impairment and disability. Enrollees received intrathecal, intramuscular, and intravenous administrations of Wharton’s jelly–derived MSCs at a target dose of 1 × 106/kg for each application route (twice a month for 2 mo).
Treatment was safe based on serial neurological and functional exams, laboratory tests, electroencephalographies, and magnetic resonance imaging.
Therapeutic administration of stem cells has a theoretical role in the treatment of HIE. Although promising results from many publications have been reported, there is still no consensus on which cellular therapy should be administered to which patient at what time after HIE. There seems to be a need for a tremendous amount of work to elucidate the underlying mechanisms of how MSCs interact with damaged host tissues and how this interaction results in a cascade of events that lead to some functional neuronal recovery.
These findings suggest that quality of the cells, optimization of the cell dose, standardization of the cell processing, the timing, route of administration and patient selection as well as the role of clinical experience of the physcisian are critical to the success of stem cell therapy in HIE patients.