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Published on: July 24, 2016
Intraventricular administration of SHED-derived mesenchymal stem cells in neonatal post- infectious hydrocephalus: a
Noushin Pouryazdanpanah1, Zahra Jamali2, Homa Ghabeli3
1Department of Hematology & Medical Laboratory Sciences, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Insights
This study explores stem cell therapy for neonatal post-infectious hydrocephalus (PIH). Intraventricular mesenchymal stem cells showed potential safety and clinical benefits in a preterm infant with severe PIH.
Area of Science:
- Neonatal Neurology
- Regenerative Medicine
- Pediatric Neurosurgery
Background:
- Post-infectious hydrocephalus (PIH) in neonates causes significant neurodevelopmental issues.
- Current treatments like cerebrospinal fluid diversion do not fully address brain injury.
- Mesenchymal stem cells (SHED) have neurotrophic and immunomodulatory potential.
Purpose of the Study:
- To assess the safety and feasibility of intraventricular stem cell therapy in a neonate with severe PIH.
- To evaluate preliminary clinical and imaging outcomes following SHED administration.
- To explore a novel therapeutic approach for inflammatory brain conditions in neonates.
Main Methods:
- A preterm neonate with Acinetobacter-associated PIH received intraventricular allogeneic SHED under a compassionate-use protocol.
- Concurrent ventriculoperitoneal shunt placement was performed.
- Clinical and neuroimaging follow-up was conducted.
Main Results:
- The intraventricular SHED administration was technically feasible and well-tolerated.
- No immediate procedure-related adverse events were observed.
- Follow-up showed reduced ventricular size, cortical mantle thickening, and improved clinical status.
Conclusions:
- This first-in-human case suggests short-term safety for intraventricular SHED therapy in neonatal PIH.
- Concurrent CSF diversion is a confounder, limiting causal inference.
- Further controlled studies are warranted to investigate SHED therapy efficacy in neonatal PIH.
Abstract:
Post-infectious hydrocephalus (PIH) in neonates is associated with substantial neurodevelopmental morbidity, and cerebrospinal fluid diversion alone does not address the underlying inflammatory and parenchymal injury. Mesenchymal stem cells derived from human exfoliated deciduous teeth (SHED) exhibit neurotrophic and immunomodulatory properties with potential translational relevance in inflammatory brain conditions. We report a preterm neonate with severe Acinetobacter-associated PIH requiring ventriculoperitoneal shunt placement who concurrently received intraventricular administration of allogeneic SHED under a compassionate-use framework. The procedure was technically feasible and well tolerated, without immediate procedure-related adverse events. Follow-up neuroimaging demonstrated reduced ventricular size and progressive cortical mantle thickening, accompanied by clinical gains in alertness, feeding, and motor function. Although causal inference cannot be established from a single observation and concurrent cerebrospinal fluid diversion represents a major confounder, this first-in-human experience suggests short-term procedural safety and supports further controlled clinical investigation of intraventricular SHED therapy in neonatal post-infectious hydrocephalus.
