Role of bone marrow‐derived mesenchymal stem cells in recovery following cervical spinal hemisection

Abstract

Following spinal cord hemisection at C2 (C2SH), removal of descending excitatory drive to phrenic motoneurons results in ipsilateral diaphragm muscle (DIAm) paralysis. Over time, there is partial recovery of rhythmic phrenic activity post‐C2SH. Intrathecal delivery of brain‐derived neurotrophic factor (BDNF) enhances this functional recovery, with 100% of rats displaying rhythmic phrenic activity at 14 days (14D) post‐C2SH; but in humans intrathecal BDNF is associated with adverse effects that limit application. Stem cell transplantation may facilitate a targeted BDNF delivery and minimize side effects. In adult rats, bilateral DIAm EMG activity was chronically monitored before and after C2SH to assess recovery. Wild type, GFP‐expressing bone‐marrow derived mesenchymal stem cells (MSC‐wt) or BDNF‐GFP expressing MSC (MSC‐BDNF) were injected at C2. Seventy % of MSC‐BDNF treated rats displayed functional recovery at 7D and 100% at 14D post‐C2SH. Functional recovery in BDNF‐wt treated C2SH rats was not different from untreated C2SH controls (~10% at 7D and ~40% at 14D). Cellular incorporation of MSC into the spinal cord was evident by GFP immunoreactivity in both MSC groups. We conclude that targeted MSC‐based delivery of BDNF enhances functional recovery of DIAm respiratory activity following an upper cervical spinal cord injury.Supported by NIH grant HL096750 and Mayo Clinic.