Review Article

Umbilical Cord as Prospective Source for Mesenchymal Stem Cell-Based Therapy

Table 6

Clinical studies regarding the use of UC-MSCs.

Disease 
Number of clinical trials (NCT)
The number of recipients (age) 
The number of transplanted UC-MSCs 
The route of administration 
The frequency of administration
Main resultsReference

Type 1 diabetes mellitus 
NCT01219465
15 (≤25 years) 
2,6 ± 1,2 × 106
i.v.
Twice, 4-week interval
() During the whole study (24 months), there was no statistical difference between treatment and control groups in mean fasting plasma glucose (FPG) and results of glutamic acid decarboxylase antibody (GADA) test 
In treatment group compared to control group: 
() Mean postprandial plasma glucose (PPG) levels and glycated hemoglobin HbA1c levels were lower since month 9 
() Fasting C-peptide levels and mean C-peptide/glucose ratio (CPGR) levels were higher since month 6 
() The dosage of insulin per day was progressively reduced since month 6. In 8 patients, the daily insulin dosage was reduced by more than 50% of the baseline, and in 3 patients insulin was discontinued.
() No adverse reactions and no ketoacidosis appeared in treatment group, while in control group ketoacidosis appeared in 3 patients
[32]

Systemic lupus erythematosus 
NCT01741857
Six (15–60 years) 
1 × 106 per 1 kg 
i.v.
Once
One month after transplantation:  
() Serum indoleamine 2,3-dioxygenase (IDO) activity increased 
() Percentages of peripheral blood CD3+CD4+ T-cells decreased
[33]

Systemic lupus erythematosus 
NCT00698191
16 (17–55 years) 
1 × 106 per 1 kg 
i.v.
Once
() Significant improvements in the SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) score in all patients 3 months after transplantation and in 2 patients 24 months after transplantation 
() In all patients with lupus nephritis (), proteinuria reduced 3 months after transplantation, 6 months after in 8 patients; 12 months after in 2 patients; 18 months after in 1 patient 
() In 13 patients with hypoproteinemia, serum albumin levels increased 
() In 6 patients with refractory cytopenias, the platelet count increased 
() The percentage of CD4+FoxP3+ T-cells (Treg cells) in peripheral blood increased 
() Serum levels of TGFβ increased, and serum levels of IL-4 decreased 3 months after transplantation 
() There was no significant difference in IL-10 levels between treatment and comparison groups
[34]

Bronchopulmonary dysplasia 
NCT01297205
Nine (preterm infants with birth weight of 630–1030 g) 
10–20 × 106 per 1 kg 
Intratracheally 
Once
() There were no significant differences in the duration of intubation between treatment and comparison groups 
() BPD severity was lower in treatment group, regression coefficient 1.7 
() In treatment group, levels of IL-1β, IL-6, IL-8, IL-10, MMP-9, TNFα, and TGFβ1 in tracheal aspirates at day 7 were significantly reduced compared with those at baseline or at day 3 posttransplantation
[35]

HIV-1 
NCT01213186
Seven (26–49 years) 
0,5 × 106 per 1 kg 
i.v.
Three transfusions at 1-month interval
() CD4 T-cell counts and CD4/CD8 ratio increased after 6 months of treatment compared with the individual baseline data as well as with controls 
() No significant alterations in counts of CD3 and CD8 T-cells, CD19+ B cells, CD3−CD56+ NK cells, CD3+CD56+NK T-cells, Lin-1−HLA-DR+CD11c+ mDCs, Lin-1−HLA-DR+CD123+ pDCs, and γδT cells were observed 
() The percentages of naive and central memory T-cells subsets were gradually increased, whereas the effector memory and terminally differentiated effector T-cells subsets were gradually decreased 
() Significantly decreased PD-1 (programmed cell death 1) expression on total CD4, CD8 T-cells, and HIV-1-specific pentamer + CD8 T-cells at months 6, 9, and 12, and significantly increased BTLA (B-lymphocyte attenuator and T-lymphocyte attenuator) expression levels on total CD4 and CD8 T-cells were found at months 9 and 12  
() Plasma levels of proinflammatory cytokines IFN-α2, TNF-α, IFN-γ, IL-9 (month 6), IL-1ra, IL-12p70, and IL-6 (months 6 and 12), chemokines MIP-1β, IP-10, IL-8, MCP-1, and RANTES (months 6 and 12), growth factors PDGF-BB (month 6), and G-CSF and VEGF (months 6 and 12) levels were significantly reduced
[36]

Primary biliary cirrhosis
NCT01662973
Seven (33–58 years) 
0,5 × 106 per 1 kg 
i.v.  
Three transfusions at 4-week interval
() There was a significant decrease in serum alkaline phosphatase and γ-glutamyltransferase levels at the end of the follow-up period (48 weeks) as compared with baseline 
() No significant changes were observed in serum alanine aminotransferase, aspartate aminotransferase, total bilirubin, albumin, prothrombin time activity, international normalized ratio, or immunoglobulin M levels
[37]

Acute-on-chronic liver failure
NCT01218464
24 (24–59 years) 
0,5 × 106 per 1 kg 
i.v.
Three transfusions at 4-week interval
() The survival rates in patients were significantly increased during the 48-week follow-up period 
() There were increased levels of serum albumin and cholinesterase (12 weeks after the first transfusion), prothrombin activity (1 week after the first transfusion), hemoglobin level, and platelet counts (36 weeks after the first transfusion) 
() Serum total bilirubin (1 week after the first transfusion) and alanine aminotransferase (throughout the 48 weeks of follow-up) levels were significantly decreased
[38]

Myocardial infarction 
NCT01291329
58 (18–80 years) 
6 × 106
Intracoronary infusion 
Once
() The absolute increase in the myocardial viability and perfusion within the infarcted territory was significantly greater than in the placebo group at four months.
() The absolute increase in the global left ventricular ejection fraction at 18 months was significantly greater than that in the placebo group.
() The absolute decreases in left ventricular end-systolic volumes and end-diastolic volumes at 18 months were significantly greater than those in the placebo group
[39]