Case Report

A Case of Non-Progressive Congenital Myopathy: Efficacy and Clinical Outcomes of the Wharton's Jelly Derived Mesenchymal Stem Cell Transplantation

Abstract

Non-Progressive Congenital Myopathy is a disease characterized by muscle weakness, and unfortunately, there is no conventional treatment. In the last decade, regenerative medicine practices have become a rising value, and Mesenchymal Stem Cells (MSCs) have fascinating outcomes in regenerative medicine with their high regenerative capacities, their ability to regulate with paracrine secretions, and their immunological properties. Based on our experience in our previous clinical studies, Wharton's-Jelly-derived (WJ-)MSCs are the most suitable source for muscle diseases among all MSC sources. In this study, we evaluated the outcomes of 10 doses of WJ-MSC transplantation to the patient diagnosed with Non-Progressive Congenital Myopathy. A 17-year-old female with a SPEN-1 mutation, Non-Progressive Congenital Myopathy patient received 10 times as 1×10⁶/kg in the intra-arterial, intramuscular and intravenous administration of allogenic WJ-MSC. Before and after the treatment, the patient was followed-up with the upper extremity scale, Vignos lower extremity scale, muscle strength scale, functional independence measure, and evaluation of Serum creatine kinase (CK) levels. Improvement in both upper extremity scale and Vignos lower extremity scales, increasing in muscle strength, and decreasing in CK-level were detected. Although transplantation of WJ-MSC cannot treat any genetic-based diseases, they may benefit in alleviating clinical outcomes of disease. More importantly, WJ-MSC transplantation may offer a better quality of life by alleviating the symptoms of this rare disease with no treatment option that can be provided in conventional methods.

1. North KN, Wang CH, Clarke N, Jungbluth H, Vainzof M, Dowling JJ, et al. Approach to the diagnosis of congenital myopathies. Neuromuscul Disord. 2014;24(2):97–116.
2. Karaoz E, Cetinalp Demircan P, Erman G, Gungorurler E, Eker Sariboyaci A. Comparative Analyses of Immunosuppressive Characteristics of Bone-Marrow, Wharton’s Jelly, and Adipose Tissue-Derived Human Mesenchymal Stem Cells. Turkish J Haematol Off J Turkish Soc Haematol. 2017;34(3):213–25.
3. Wang Q, Yang Q, Wang Z, Tong H, Ma L, Zhang Y, et al. Comparative analysis of human mesenchymal stem cells from fetal-bone marrow, adipose tissue, and Warton’s jelly as sources of cell immunomodulatory therapy. Hum Vaccines Immunother. 2016;12(1):85–96.
4. Qazi TH, Duda GN, Ort MJ, Perka C, Geissler S, Winkler T. Cell therapy to improve regeneration of skeletal muscle injuries. J Cachexia Sarcopenia Muscle. 2019;10(3):501–16.
5. Gang EJ. Skeletal Myogenic Differentiation of Mesenchymal Stem Cells Isolated from Human Umbilical Cord Blood. Stem Cells. 2004 Jul 1;22(4):617–24.
6. Dai A, Baspinar O, Yesilyurt A, Sun E, Inci Aydemir C, Oztel ON, et al. Efficacy of stem cell therapy in ambulatory and nonambulatory children with Duchenne muscular dystrophy – Phase I–II. Degener Neurol Neuromuscul Dis. 2018;8:63–77.
7. Kuroda K, Han H, Tani S, Tanigaki K, Tun T, Furukawa T, et al. Regulation of marginal zone B cell development by MINT, a suppressor of Notch/RBP-J signaling pathway. Immunity. 2003;18(2):301–12.
8. Vajsar J, Gonorazky HD, Dowling JJ. Myopathies and myotonic disorders. In: Pediatric Electromyography: Concepts and Clinical Applications. Springer International Publishing; 2017. p. 327–54.
9. Benchaouir R, Meregalli M, Farini A, D’Antona G, Belicchi M, Goyenvalle A, et al. Restoration of Human Dystrophin Following Transplantation of Exon-Skipping-Engineered DMD Patient Stem Cells into Dystrophic Mice. Cell Stem Cell. 2007 Dec 13;1(6):646–57.
10. Das AK, Abdullah BJJ Bin, Dhillon SS, Vijanari A, Anoop CH, Gupta PK. Intra-arterial allogeneic mesenchymal stem cells for critical limb ischemia are safe and efficacious: Report of a phase i study. World J Surg. 2013;37(4):915–22.
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IssueVol 60, No 4 (2022) QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/acta.v60i4.9270
Keywords
Non-progressive congenital myopathy Mesenchymal stem cells Muscle fibrosis Muscle-fiber regeneration

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How to Cite
1.
Azeri R, Sun E, Karaoz E. A Case of Non-Progressive Congenital Myopathy: Efficacy and Clinical Outcomes of the Wharton’s Jelly Derived Mesenchymal Stem Cell Transplantation. Acta Med Iran. 2022;60(4):249-253.