Meta-Analysis of Cord Blood for Cerebral Palsy November 2023
Megan Finch-Edmondson, PhD, on behalf of the study team Megan Finch-Edmondson, PhD, lead author Introduction to cerebral palsy: Cerebral palsy is an umbrella term that describes a group of disorders affecting a person’s movement and posture. Cerebral palsy is a life-long condition that arises from injury to the brain during development, usually before, during or shortly after birth. Cerebral palsy is a highly variable condition. Symptoms may include difficulties in walking, balance and motor control, eating, swallowing, speech or coordination of eye movements. Cerebral palsy can vary in the way it affects an individual’s movement (type), the part of the body affected (topography) and by how severe the symptoms are (severity), which can be measured using the Gross Motor Function Classification System (GMFCS). In addition, people with cerebral palsy may also experience other impairments or co-occurring conditions such as epilepsy, behaviour disorders, or vision or hearing impairments. What treatments exist? Numerous interventions exist that help people with cerebral palsy to develop and maintain their functional skills as well as reduce the symptoms of cerebral palsy. These include various rehabilitative and medical interventions such as physical, occupational, and speech therapies, as well as botox injections, oral or intrathecal baclofen and even surgery to manage muscle stiffness and contractures. Currently there are no available treatments that directly target the underlying brain injury to improve function and quality of life. Why cell therapies? There is significant interest in investigating cell therapies such as umbilical cord blood as a treatment for cerebral palsy. This is because umbilical cord blood contains a variety of stem and progenitor cells that have been shown to be beneficial following a brain injury in laboratory research. These benefits include reducing inflammation and cell death, and promoting repair following a brain injury, mainly via release of cellular factors (“trophic mechanisms”). This may help to reduce the size or severity of an injury, and/or improve the connections within the brain. Cord blood for cerebral palsy: The earliest reported infusions of umbilical cord blood for cerebral palsy date back nearly 20 years. This was included in a paper published by Sun et al. in 2010 in which 140 children with cerebral palsy received autologous (their own) umbilical cord blood from March 2004 to December 20093. Since then, numerous studies have been published, with a 2021 review finding nearly 800 individuals with cerebral palsy had been treated with umbilical cord blood across all phases of clinical studies, including six medium/large randomised placebo-controlled trials. A 2016 systematic review concluded that cord blood treatment is safe and more effective than rehabilitation alone in improving gross motor function. Τhe study also suggested that umbilical cord blood treatment in children with cerebral palsy improved gross motor skills more than controls, and that higher cell dose and repeated treatments are likely beneficial, with data presented for the 6-month follow up timepoint.
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