LOGO Dr. Shahrokh Yousefzadeh-Chabok Associate Professor of Neurosurgery, Guilan Road Trauma Research Center, Guilan University Comparing GCSF and Stem.

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Dr. Shahrokh Yousefzadeh-ChabokAssociate Professor of Neurosurgery,

Guilan Road Trauma Research Center, Guilan University

Comparing GCSF and Stem Cells Obtained

From Mesenchymal Cells

in Healing of Spinal Cord Injured of Rat

LOGOStudy Design

Sham

•Alone Laminec-tomy, Without SCI

Control

•Laminec-tomy

LOGOStudy Design

Stem CellInteratecal Injection SCI Surgery

- - - Laminectomy Sham

- Distilled water + Laminectomy Control

- GCSF + Laminectomy GCSF

+ - + Laminectomy MSC

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Within 14 injury day

Acute:

Between 14 days and 8 weeks.

Sub acute:

More than 8 weeks.

Chronic:

SCI

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Muscles complications

Neuropathic Pain

Complication of BMSCT

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GM- CSF (Grunulocyte macrophaye-colony stimulating factor)

G-CSF (Grunulocyte-colony stimulating factor)

Erythropoitin

Hematopoietic Cytokine

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Decrease apoptosis an improvement of Neurologic

Function (Neuroprotective Effect)

GCSF Effect

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Fever > 390C

Cord Transection MRI

Ventilator assisted Breathing

(ASIA) grade A, B

Exclusion Criteria of GCSF

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as a growth Factor for hematopoitic progenitor cells to Treat of Nentopenia

Hematopoietic:

mobilization of peripheral blood-drieved hematopoeitic stem cells for

transplantation to treat of Neuronal Injury & Stork

Nonhematopoitic :

GCSF (Granulocyte-colony Stimulating Factor) Function

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5 mg/kg/ Day for 5 days

10 mg/kg/ Day for 5 days

Dose of GCSF

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GCSF in Acute Phase of SCI

Mobilization of bone-marrow derived cell to injury site of spinal cord

Suppresses Neuronal Apoptosis

Suppresses the death of Oligodendrocyte

Protect myelin

Suppresses the expression of cytokine such as TNF-α and IL-1B

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GCSF in Subacute Phase of SCI

Neuroprotective effects via

angiogenesis after SCI

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Exclusion Criteria

16 years old < age < 75 years old

High dose MPss (solumedrol)

Intracerebral Pathology (Tumor, Ischemia, Infections)

History of major bleeding requiring transfusion

History of leukopenia, thrombocytopenia hepatic or renal

dysfunction, sever heart failure, splenomegaly

Malignance

pregnancy

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Hematopoietic Stem Cell

Mesenchymal Stem Cell

Endothelial Progenitor Cell

Macrophage

lymphocyte

BMC Sources

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fever twice daily for 7 days

CBC once daily for 7 days

ASI Score

ASI impairment score(AIS)

Post Operative Exam

LOGOMild Complication

Pneumonia ,Peptic Ulcer, Hepatopathy

Fever, Headache, Nausea Vomiting

Low Back Pain, Pelvic Pain

LOGOSever Complication

MI

CVA

Spleen rupture

LOGOMesenchymal Stem Cell Effects

Neroprotection

Neurogenesis

Neuroplasticity

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Bone marrow

umbilical cord

Aniniotic fluid

Addipose tissure

Mesenchymal Stem Cell Sources

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Decreased apopetotic cell death

Increase of Neurogeneration

Synaptogenesis

Remyelination

Angiogenesis

Re-formation of BBB

The Effects of MSC

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In Experimental Study of MSC in Rat

Increase in axonal fiber density synaptogenesis and myelination

Secretion of trophic factor (BDNF…..)

Decrease glial scar thickness

Enhance annual growth in the penumbra

Anti inflammation by suppression of T-cell ,inhabit of B-cell and

IgG Production

LOGOAdvantage of Cell Transplant

Easily localized the treatment of affected site

supply a variety of trophic factor

Persistence of long time to affect the environment injured tissue

Increased the host cell

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