Author Login

Correspondence to Author: E.C. Savrunlu¹, S. Kabatas^1,2,3,E. Civelek^1,3,N. Kaplan¹, Joel Nguemo Tetio⁴,Osman Boyali¹,M. Bozkurt⁵,N. Kucukcakir⁶,Erdal Karaoz ⁷. 

Eyup Can Savrunlu, Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Gaziosmanpasa 34255, Istanbul, Turkey.
Serdar Kabatas, Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Gaziosmanpasa 34255, Istanbul, Turkey.
Serdar Kabatas, Center for Stem Cell & Gene Therapy Research and Practice, University of Health Sciences Turkey, Gaziosmanpasa 34255, Istanbul, Turkey.
Serdar Kabatas, Institude of Health Sciences, Pediatric Allergy-Immunology Programme, Marmara University, Istanbul, Turkey.
Erdinc Civelek, Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Gaziosmanpasa 34255, Istanbul, Turkey.
Erdinc Civelek, Institude of Health Sciences, Pediatric Allergy-Immunology Programme, Marmara University, Istanbul, Turkey.
Necati Kaplan, Department of Neurosurgery, Istanbul Rumeli University, corlu Reyap Hospital, corlu 59860, Tekirdag, Turkey.
Osman Boyali, Department of Neurosurgery, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Gaziosmanpasa 34255, Istanbul, Turkey.
Mehmet Bozkurt, Department of Plastic Reconstructive and Aesthetic Surgery, Private Practice, Sisli 34367, Istanbul, Turkey
Nurten Kucukcakir, Department of Physical Medicine and Rehabilitation, Romatem Bursa Hospital, Osmangazi 16080, Bursa, Turkey
Erdal Karaoz, Liv Hospital, Center for Regenerative Medicine and Stem Cell Research & Manufacturing (LivMedCell), Besiktas 34340, Istanbul, Turkey

DOI: 10.52338/joct.2025.5082

Abstract:

Backgroud:Traumatic spinal cord injury (SCI) is a pathological condition characterized by neurological impairments, the severity of which is contingent upon the level and extent of the injury. In addition to these impairments, SCI is frequently associated with autonomic dysfunctions and complications affecting the cardiovascular and gastrointestinal systems, leading to debilitating consequences such as urinary and bowel incontinence and spasticity, significantly diminishing patients quality of life.
Aim:This study aimed to evaluate the safety and therapeutic efficacy of mesenchymal stem cell-derived exosomes (MSCdE) in patients with SCI.
Methods:Sixteen patients (mean age: 26.25 + 4.89 years) with SCI resulting from combat-related injuries were enrolled. Of these, 2 patients (12.5%) had lumbar injuries, 11 (68.75%) had thoracic injuries, and 3 (18.75%) had cervical injuries. Exosome administration was performed in 6 treatment cycles over a 4.5-month period. Each cycle involved the intrathecal injection of 3 ml (30 billion) and intramuscular injection of 10 ml (30 billion) of exosomes. Patients were monitored for 1 year following the intervention. Adverse events were assessed according to the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0). Neurological function was evaluated using the American Spinal Injury Association Impairment Scale (ASIA), spasticity using the Modified Ashworth Scale (MAS), motor and cognitive function using the Functional Independence Measure (FIM), and urinary and bowel incontinence using the Wexner Incontinence Score and Qualiveen Short Form (SFQ). All assessments were conducted by a multidisciplinary team comprising a neurosurgeon and a specialist in physical therapy and rehabilitation.
Results:No serious adverse events were reported throughout the treatment and follow-up period. Minor side effects, such as low-grade fever and localized pain, were observed, classified as CTCAE v5.0 Grade 1, and resolved spontaneously within 24 hours without medical intervention. Statistically significant improvements were noted in all clinical parameters. FIM motor scores increased from 26.75 + 9.81 pre-treatment to 43.88 ± 17.01 post-treatment (p < 0.01). ASIA motor scores improved significantly from 47.00 ± 21.15 to 56.00 ± 18.74 (p < 0.001), and ASIA sensory scores (light touch/pin-prick) increased from 66.06/66.25 to 77.56/79.75 (p < 0.001). MAS values (right/left) decreased from 7.00/6.94 .

Citation:

Dr., S. Kabatas ,Efficacy and Safety of Exosomes from Whartons Jelly-Derived Mesenchymal Stem Cells in Patients with Spinal Cord Injury. Journal of Clinical Transplantation 2025.