Duke study for ASD children’s with allogenic and autologous cord blood

“In a subanalysis of children without intellectual disability (ID), allogeneic, but not autologous, CB was associated with improvement in a larger percentage of children on the clinician-rated Clinical Global Impression-Improvement scale”

And: “Children without ID treated with CB showed significant improvements in communication skills (VABS-3 Communication Domain), and exploratory measures including attention to toys and sustained attention (eye-tracking) and increased alpha and beta electroencephalographic power.”

“The rationale is that CB CD14+ monocytes act through paracrine signaling to modulate brain inflammation and/or immune abnormalities, improving brain function and behavior.”

“One hundred eighty children, aged 2-7 years (mean ± SD, 5.47 ± 1.65) who met DSM-5 criteria for ASD participated. Diagnosis was based on the Autism Diagnostic Observation Schedule-217 and Autism Diagnostic Interview, Revised.18 Participants were screened for a genetic cause of ASD with testing for Fragile X and chromosomal microarray. Inclusion criteria included (1) negative genetic testing, (2) qualified CB unit with a minimum banked total nucleated cell dose of ≥2.5 × 107 cells/kg or ≥4/6 HLA-matched allogeneic unrelated CB unit, (3) stable on medications for ≥2 months, (4) ability to travel to study site twice, (5) English speaking, and (6) normal absolute lymphocyte count (≥1500/μL).”

But : “Infused dose was not associated with the primary and secondary outcomes, with the exception of the CGI. The allogeneic cohort received a higher TNC dose compared with the autologous cohort (3.8 × 107/kg vs 2.7 × 107/kg) making it impossible to determine whether the effect in the allogeneic group was due to the higher cell dose or to CB type.”

“When participants with NVIQ ≥70 were analyzed separately, the results indicated that participants without ID who were treated with CB exhibited significantly increased relative alpha powerposterior/toys (P = .02) and significantly increased relative beta1 powerall brain regions/social (P = .02) compared with the placebo group (Figure 5). No main effects were found for theta or gamma power.”

“However, for children without ID, clinician CGI ratings indicated that children treated with allogeneic CB, but not those treated with autologous CB, showed improvement over placebo. Children without ID also showed significantly greater improvement in a prespecified secondary outcome measure of VABS Communication SS when treated with CB compared with placebo.”

https://www.jpeds.com/article/S0022-3476(20)30334-6/pdf

Laisser un commentaire

Votre adresse de messagerie ne sera pas publiée. Les champs obligatoires sont indiqués avec *