Efficacy of Human Umbilical Cord Blood-Mononuclear Cell Transplantation for MSA Treatment and Its Effects on Changes in T-Cell Subsets in Peripheral Blood and Inflammatory Factors

Abstract

Objective. This study is aimed at examining the efficacy of human umbilical cord blood-mononuclear cell (hUCB-MNCs) transplantation through lateral atlanto-occipital space puncture in multiple system atrophy (MSA) treatment and investigating changes in T-cell subsets in peripheral blood and inflammatory factors in patients before and after treatment. Methods. A total of 20 patients with MSA who underwent hUCB-MNC transplantation through lateral atlanto-occipital space puncture in the Liaocheng People’s Hospital were enrolled. Patients were followed up at 0, 1, 3, and 6 months after treatment, and the Unified Multiple System Atrophy Rating Scale (UMSARS) scores, TNF-α in the peripheral blood, IL-6, percentage of CD4, and CD4/CD8 ratio were evaluated and compared for each follow-up point; any adverse effects were recorded. Results. UMSARS Part I scores were $20.55\pm 3.80$ , $19.20\pm 3.78$ , and $19.40\pm 4.11$ , 1, 3, and 6 months, respectively, after treatment and were significantly lower as compared to that before treatment ( $23.50\pm 4.72$ ; $P<0.05$ ). Similarly, UMSARS Part II scores 1, 3, and 6 months after treatment were $25.50\pm 5.01$ , $24.05\pm 5.01$ , and $24.25\pm 5.05$ , respectively, significantly lower as compared to that before treatment ( $30.15\pm 5.63$ ; $P<0.05$ ). The IL-6 values in the peripheral blood 1, 3, and 6 months after treatment were $5.25\pm 2.70\text{pg}/\text{m}$ , $2.96\pm 1.75\text{pg}/\text{m}$ , and $3.31\pm 1.62\text{pg}/\text{m}$ , respectively, which were significantly lower ( $P<0.05$ ) than that before treatment ( $8.22\pm 4.69$ ) pg/m. The TNF-α levels at 3 and 6 months after treatment were $13.08\pm 6.13\text{pg}/\text{m}$ and $12.24\pm 4.76\text{pg}/\text{m}$ , respectively, which were significantly lower than that before treatment ( $22.99\pm 13.30$ ; $P<0.01$ ). The CD4/CD8 ratios in the peripheral blood 1, 3, and 6 months after treatment were $1.09\pm 0.25$ , $1.30\pm 0.24$ , and $1.43\pm 0.22$ , respectively, which were significantly different than that before treatment ( $0.81\pm 0.24$ , $P<0.01$ ). Similarly, the CD4 percentages 1, 3, and 6 months after treatment were $34.09\pm 1.79$ , $36.05\pm 1.50$ , and $36.47\pm 1.47$ , respectively, which were significantly different than that before treatment ( $0.81\pm 0.24$ ; $P<0.01$ ). Conclusion. hUCB-MNC transplantation through lateral atlanto-occipital space puncture could significantly improve the symptoms and signs in patients with MSA and delay the disease progression. Thus, hUCB-MNCs may modulate immune activity and reduce the inflammatory response.