Traumatic brain injuries (TBI) are a devastating injury. According to some estimates, traumatic brain injuries contribute to approximately 30% of all injury-related deaths in the United States. When patients suffer from traumatic brain injuries, tissue, cells, and neurons in the brain die. If this cell and tissue death does not lead to patient death, then patients can be left with debilitating disabilities, such as lack of motor function and cognitive abilities.
There are currently no effective therapies that address the underlying conditions of TBI. Stem cells are a promising alternative therapy for patients who suffer from TBI. A study, Cell-Based therapy for traumatic brain injury, looked into the various medical studies on stem cell therapy and TBI and the process of traumatic brain injuries. The study has found that stem cells may be an effective therapy for TBI patients.
Background on Traumatic Brain Injuries
Traumatic brain injuries result from a direct hit to the head or extreme acceleration and deceleration and rotational forces. This type of injury occurs in two phases. The first phase occurs when the patient first suffers from the injury. There is immediate damage to the central nervous system which releases a number of inflammatory neurotransmitters. Additionally, the injury can disrupt the blood brain barrier and can cause a cerebral hemorrhage and fluid retention. These issues can increase pressure in the brain and lead to a lack of blood flow to the brain.
The second phase of the injury begins a few hours after the initial injury and can last hours or days. There are multiple bodily processes that occur, such as mitochondrial dysfunction, that leads to brain cell and tissue death. The loss of neurons in the brain is a result of the first and secondary phases of the injury. Patients continue to experience neuron death in the brain even up to 12 months after the original injury. The TBI creates an acute inflammatory environment that leads to neuron death and prevents the body from repairing the damage in the brain.
The body does attempt to build new blood vessels and neurons after suffering from a traumatic brain injury. However, the reparative mechanisms are often overwhelmed by the inflammatory environment, hemorrhage and increased pressure. Stem cells may be able to help improve this condition in the brain.
Originally, the medical community thought that stem cells may directly create new neurons. Researchers now believe that stem cells create paracrine and system effects in the brain. Stem cells release anti-inflammatory and growth factors, decrease pressure and inflammation, create new neurons, blood vessels, and capillaries. The researchers wanted to look into all of the studies performed on TBI and stem cells.
Clinical Studies of Stem Cell Therapy for TBI
The researchers looked into all relevant medical trials of stem cell therapy and traumatic brain injuries. At the time this study was published, there were two clinical trials using stem cells as a treatment for traumatic brain injury.
The first study looked at 10 children aged five to fourteen who had suffered from TBIs. In the study, the researchers administered autologous bone marrow derived mononuclear cells within 48 hours of the original injury and followed the patients over the course of six months. There were no episodes of post-injury seizures, increased brain pressure, or restriction of blood flow to the brain. Every patient showed neurological improvement, but only three patients completely recovered.
The other study investigated the use of stem cells on 97 patients who were in the second phase of their TBI. The patients were given a mean dose of 4×106 autologous bone marrow derived mononuclear cells within two months of the original injury and patients were followed for 40 days. There were no serious complications or adverse events. 27 patients showed improvements in motor function and 11 out of 24 vegetative state patients showed improvements in conscientiousness. This study found that stem cells were more effective on younger patients and patients who received the stem cells closer to the date they were affected by the original injury.
There are other clinical trials that are looking into the potential of stem cell therapy on traumatic brain injuries. The early clinical trials are encouraging and have shown that stem cells are safe for TBI patients. The study concluded that more research is needed into TBI and stem cells, but the future looks promising.
The medical community needs to understand the optimal delivery of stem cells and when patients should receive stem cells after their injury. The researchers believe that stem cell therapy is an effective therapy for traumatic brain injuries. Stem cells will likely play an important role in treatment for TBI in the future.
