A unique combination of stem cell therapy and surgery may effectively treat lower-limb paralysis in spina bifida before birth
In a collaboration between fetal surgeons, led by Diana Farmer, and stem cell bioengineers, led by Aijun Wang (both from UC Davis), placental stem cells have been tested as a potential treatment for the paralysis associated with spina bifida.
Farmer helped pioneer in utero surgery for spina bifida as part of the landmark Management of Myelomeningocele Study (MOMS). However, the revolutionary technique has limitations, as she explained: “prenatal surgery revolutionized spina bifida treatment by improving brain development, but it didn’t benefit motor function as much as we hoped”. The most common and disabling form of spina bifida is known as myelomeningocele. In this form, the spinal cord emerges through the back, often pulling brain tissue into the spinal column and causing cerebrospinal fluid to fill the interior of the brain, resulting in a need for permanent shunts to drain excess fluid.
Farmer and Wang have become the first group to combine fetal surgery with placental stem cell treatment in an animal model with the aim of reducing the effects of spina bifida. In the study, lambs with myelomeningocele received fetal surgery to return exposed tissue to the spinal canal. Human placenta-derived mesenchymal stromal cells were preserved in hydrogel and applied to the site of the lesion. A scaffold was added to hold the hydrogel in place and the repair was completed by surgical closures.
Of the six animals that received stem cell treatment, all were able to walk without observable disability within a few hours of birth. In contrast, six control animals that received just the hydrogel and scaffold remained unable to stand.
Summarizing the group’s work, Farmer stated: “fetal surgery provided hope that most children with spina bifida would be able to live without shunts. Now, we need to complete that process and find out if they can also live without wheelchairs.”
— Written by Hannah Wilson
Sources: Wang A, Brown EG, Lankford L et al. Tissue Engineering and Regenerative Medicine: Placental Mesenchymal Stromal Cells Rescue Ambulation in Ovine Myelomeningocele. Stem Cells Trans. Med. doi:10.5966/sctm.2014-0296 (2015) (Epub ahead of print); UC Davis News Release: https://ucdmc.ucdavis.edu/publish/news/newsroom/9953/?WT.rss_f=UC%20Davis%20Health%20System%20news&WT.rss_ev=a&WT.rss_a=Article_9953