Experience of Application of Embryonic Stem Cells in Amyotrophic Lateral Sclerosis

A.I.Smikodub, Cell Therapy Clinic of  National Medical University and Embryonic Tissues Center EmCell , Kiev, Ukraine

Analyzed is the experience of 61 ALS patients (38 men and 23 women), mean age being 48,4±16,3; duration of the disease before the initial treatment was as follows: up to 1 year – 10 patients, up to 2 years – 18 patients, up to 3 years – 29 patients, over 3 years – 4 patients, 41% with classical ALS with affected upper and lower motor neurons, 13% with primary sclerosis, 20%  with progressing bulbar palsy, 7% with progressive muscular atrophy, 8% with combined form, and 11% with family ALS.   Course of treatment presupposed administration of 4 cell suspensions containing mesenchymal, ectodermal, and endodermal stem cells obtained from growth zones of 4-8 weeks old cadaverous embryos’ systems and organs; amounts administered varied from 0,5 to 3 ml, cell count - from 0,1 to 100x10⁵/ml.  In early post-transplant period (1-2 weeks after the treatment), 67% of patients reported decreased weakness, fasciculations, spasticity, improved appetite, and less manifestations  of depression.  In the course of the first 2 months, 34% of patients observed increased range of motions in the extremities, decreased muscular rigidity, lower hyperreflexia, decreased number of fasciculating muscle zones, better endurance of daily loads, less expressed dysphagia and dysarthria.   In 3-6 months after the first course of treatment, 58% of patients reported aggravation of condition and reversion of relevant symptoms, though less expressed than prior to the treatment.   II treatment was performed in 24 cases, in 12,8±4,3 months, III course – in 8 cases, in 10,6±3,9 months, IV course – in 3 cases, in 9,2±4,1 months.   Repeated courses of treatment also allow for reduced weakness, fasciculations, spasticity, increased range of motions, improved speech and swallowing quality. Conclusions: embryonic stem cells do not terminate degenerative process in motor neurons, but provide for palliation of the disease course; the best results were achieved in the group where ALS duration did not exceed 1 year, and where neurological symptoms were not as markedly expressed as in patients at later stages.