Korean J Pediatr.  2007 Sep;50(9):882-890. 10.3345/kjp.2007.50.9.882.

A pilot study of neuroprotection with umbilical cord blood cell transplantation for preterm very low birth weight infants

Affiliations
  • 1Department of Pediatrics, Pochon CHA University, Korea. barnabas@cha.ac.kr
  • 2Department of Pediatrics, Korea University, Korea.
  • 3Department of Pediatrics, Inje University, Korea.
  • 4Institute for Clinical Research, Korea.

Abstract

PURPOSE: Preterm very low birth weight infant have high rate of adverse neurodevelopmental sequale. Recently, there have been lots of reports that human umbilical cord blood transplantation ameliorates functional deficits in animal models as hypoxic ischemic injury. This pilot study was undertaken to determine the clinical efficacy and safety of autologous umbilical cord blood cell transplantation for preventing neurodevelopmental sequale in perterm VLBW.
METHODS
Subjects were 26 preterm infants whose birth weight are less than 1,500 g and delivered under the intrauterine period 34 weeks. Autologous umbilical mononuclear cells (about 5.87x10(7)/kg) were injected to neonate via the umbilical vein on the postnatal 24-48 hour. The therapeutic efficacy was assessed by numbers of nucleated RBC, urinary uric acid/creatinine ratio, concentration of neuron specific enolase (NSE), interleukin 6 (IL6), interleukin-1beta (IL-1beta), and glial cell derived neurotrophic factor (GDNF) in serum and cerebrospinal fluid on day 1 and 7.
RESULTS
There were no significant differences in the numbers of the nucleated RBC, urinary uric acid/creatinine ratio, concentration of creatine kinase between the transplanted infants and controls. But the nucleated RBC is more likely to be rapidly discharged in the transplanted group. In the transplanted group, the concentrations of IL6, IL-1beta, and GDNF were no significant difference between day 1 and 7, although GDNF seemed to be elevated. Serum NSE concentration was significantly elevated after transplantation, but not in CSF.
CONCLUSION
It is suggested that autologous umbilical cord blood transplantation in preterm very low birth weight infant is safe to apply clinical practice. Long term follow up study should be needed to evaluate the potential therapeutic effect of umbilical cord blood transplantation for neuroprotection.

Keyword

Umbilical cord blood transplantation; Preterm; Neuroprotection

MeSH Terms

Birth Weight
Cell Transplantation
Cerebrospinal Fluid
Creatine Kinase
Fetal Blood*
Glial Cell Line-Derived Neurotrophic Factor
Humans
Infant*
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight*
Interleukin-1beta
Interleukin-6
Models, Animal
Neuroglia
Phosphopyruvate Hydratase
Pilot Projects*
Transplants
Umbilical Cord*
Umbilical Veins
Creatine Kinase
Glial Cell Line-Derived Neurotrophic Factor
Interleukin-1beta
Interleukin-6
Phosphopyruvate Hydratase
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