Cell therapy effects portrayed on positron emission tomography of the brain serve as a new dimension for autism

Abstract

Cell therapy offers a promising premise in alleviating complex neurological disorders. Autologous bone marrow mononuclear cells (BMMNCs) have been used in many studies and have been documented to have a safe and ethical profile. These cells have shown angiogenetic and immunomodulatory properties in addition to other neuroprotective effects. Precisely, these may serve to address a disorder at a neurophysiological level and thus, hold gratifying results in autism. The literature suggests hypoperfusion and immune alteration as major underlying pathogenetic mechanisms in autism. Herewith, we present a case of autism treated with intrathecal administration of autologous BMMNCs. Results were documented objectively on Indian Scale for Assessment of Autism (ISAA), Childhood Autism Rating Scale (CARS), Clinical Global Impression (CGI) scores and positron emission tomography computerized tomography (PET-CT) scan. On regular follow-up assessment of the patient at 3 mo, at 6 mo (pre 2nd dose) and at 9 mo (i.e., 3 mo post 2nd dose), significant clinical improvement was noted in social relationship, communication and behavior. On the outcome measure, his ISAA score improved from 132 (moderate autism) to 103 (mild autism). On comparison of the PET-CT scan, changes in metabolism correlated with the clinical improvements. On the CGI scores, he showed improvement in all the three domains, with a decrease in the severity of illness and with partial remission of symptoms. This case provides a useful insight into the clinical effects of autologous BMMNCs in autism and guides us to plan future studies and offers a promising premise in alleviating complex neurological disorders.