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A pilot study of neuroprotection with umbilical cord blood cell transplantation for preterm very low birth weight infants

Korean Journal of Pediatrics 2007;50(9):882-890.
Published online September 15, 2007.
A pilot study of neuroprotection with umbilical cord blood cell transplantation for preterm very low birth weight infants
Kyu Young Chae1, Kyu Hyung Lee1, So-Hee Eun2, Byung Min Choi2, Baik-Lin Eun2, Hoon-Chul Kang2, Myung Jae Chey2, Nam Keun Kim3, Doyeun Oh3
1Department of Pediatrics, Pochon CHA University, Korea
2Department of Pediatrics, Korea University, Korea
3Institute for Clinical Research, Pochon CHA University, Korea
극소 저 출생체중 미숙아에서 자가 제대혈 줄기세포 이식을 통한 신경 손상 방지 연구
채규영1, 이규형1, 은소희2, 최병민2, 은백린2, 강훈철2, 최명재2, 김남근3, 오도연3
1포천중문의대 소아과학교실
2고려대학교 의과대학 소아과학교실
3포천중문의대 임상의학연구소
Correspondence: 
Kyu Young Chae, Email: barnabas@cha.ac.kr
Abstract
Purpose
: Preterm very low birth weight infant have high rate of adverse neurodevelopmental sequale. Recently, there have been lots of reports that human umbilical cord blood transplantation ameliorates functional deficits in animal models as hypoxic ischemic injury. This pilot study was undertaken to determine the clinical efficacy and safety of autologous umbilical cord blood cell transplantation for preventing neurodevelopmental sequale in perterm VLBW.
Methods
: Subjects were 26 preterm infants whose birth weight are less than 1,500 g and delivered under the intrauterine period 34 weeks. Autologous umbilical mononuclear cells (about 5.87×107/kg) were injected to neonate via the umbilical vein on the postnatal 24-48 hour. The therapeutic efficacy was assessed by numbers of nucleated RBC, urinary uric acid/creatinine ratio, concentration of neuron specific enolase (NSE), interleukin 6 (IL6), interleukin-1β (IL-1β), and glial cell derived neurotrophic factor (GDNF) in serum and cerebrospinal fluid on day 1 and 7.
Results
: There were no significant differences in the numbers of the nucleated RBC, urinary uric acid/creatinine ratio, concentration of creatine kinase between the transplanted infants and controls. But the nucleated RBC is more likely to be rapidly discharged in the transplanted group. In the transplanted group, the concentrations of IL6, IL-1β, and GDNF were no significant difference between day 1 and 7, although GDNF seemed to be elevated. Serum NSE concentration was significantly elevated after transplantation, but not in CSF.
Conclusion
: It is suggested that autologous umbilical cord blood transplantation in preterm very low birth weight infant is safe to apply clinical practice. Long term follow up study should be needed to evaluate the potential therapeutic effect of umbilical cord blood transplantation for neuroprotection.
Key Words: Umbilical cord blood transplantation, Preterm, Neuroprotection


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