alexa Intrathecal Autologous Bone Marrow Mononuclear Cell Transplantation in a Case of Adult Autism
ISSN: 2165-7890

Autism-Open Access
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Case Report

Intrathecal Autologous Bone Marrow Mononuclear Cell Transplantation in a Case of Adult Autism

Alok Sharma1, Nandini Gokulchandran1, Hemangi Sane2, Pooja Kulkarni2*, Nancy Thomas3, Amruta Paranjape3 and Prerna Badhe1

1Department of Medical Services and Clinical Research, NeuroGen Brain and Spine Institute, India

2Department of Research and Development, NeuroGen Brain and Spine Institute, India

3Department of Neuro Rehabilitation, NeuroGen Brain and Spine Institute, India

*Corresponding Author:
Pooja Kulkarni
Department of Research and Development
NeuroGen Brain and Spine Institute
Surana Sethia Hospital and Research Centre
Mumbai-400071, India
Tel: +9122-25281610/ +9122-25283706
E-mail: [email protected]

Received date June 25, 2013; Accepted date September 01, 2013; Published date September 06, 2013

Citation: Sharma A, Gokulchandran N, Sane H, Kulkarni P, Thomas N, et al. (2013) Intrathecal Autologous Bone Marrow Mononuclear Cell Transplantation in a Case of Adult Autism. Autism 3:113. doi:10.4172/2165-7890.1000113

Copyright: © 2013 Sharma A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



 

Abstract

Autism is a complex neurodevelopmental disorder with a worldwide prevalence of 1 in 88. With greater understanding of mechanism of action of cellular therapy it is now possible to address the pathogenesis of autism. Recent findings of cellular therapy offering immunomodulatory, angigogenetic and paracrine effects make it a lucrative option for treatment of autism. We administered a 33 year old adult patient of autism intrathecally, with autologous bone marrow mononuclear cells (BMMNCs), twice with an interval of six months. On follow up at 3, 6 and 9 months post first intervention, he was re-evaluated clinically and no major or minor side effects were observed. At 6 and 9 months objective outcome measures of Indian Scale for Assessment of Autism (ISAA) and Clinical Global Impression (CGI) were used and they showed significant improvement. At the end of 9 months, on ISAA, the score improved from 94 to 64. The CGI showed improvement by change in severity of illness from 3 (Mildly ill) to 1 (Borderline mentally ill). Global improvement on CGI was scored 2 (much improved) with an efficacy index of 5 (moderate therapeutic effect). PET CT scan was repeated at 6 months which showed a balancing effect in the metabolism of affected areas. The changes observed on the PET CT scan correlated with clinical improvements. MRI remained same at 6 months thereby, indicating that PET CT scan may serve as a better monitoring tool for effects of cellular therapy. In this case study, we hypothesize that cellular therapy has repaired the neural connections and achieved balance in the excitatory and inhibitory neuronal cells by various mechanisms of neuroprotection, neuromodulation and neurorestoration. Cell therapy holds great potential and randomized controlled trials may be conducted to study their long term effects in treating autism.

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