Commentary on “Possible induction of acute disseminated encephalomyelitis (ADEM)-like demyelinating illness by intrathecal mesenchymal stem cell injection”

• Published in: Journal of clinical neuroscience Vol. 20; no. 2; pp. 312 - 313
• Main Author: Butzkueven, Helmut
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.02.2013
• Subjects: Adult; Autografts; Case reports; Cerebellum; Demyelination; Encephalomyelitis; Encephalomyelitis, Acute Disseminated - diagnosis; Encephalomyelitis, Acute Disseminated - etiology; Female; Humans; Inflammation; Injections, Spinal; Magnetic resonance imaging; Mesenchymal stem cell therapy; Mesenchymal Stem Cell Transplantation - adverse effects; Mesenchyme; Multiple sclerosis; Myelitis; Nervous system; Neurology; Serious adverse event; Stem cells; Transplantation, Autologous - adverse effects; Mesenchymal stem cell therapy; Multiple sclerosis; Serious adverse event
• ISSN: 0967-5868; 1532-2653; 1532-2653
• DOI: 10.1016/j.jocn.2012.06.003

The case report that is the subject of this Commentary describes a 27-year-old woman, who, 3 months after a devastating low cervical myelitis, underwent intrathecal mesenchymal stem cell (MSC) infusions. Six hours after the third infusion, she became unconscious, febrile and cerebral MRI showed acute bitemporal and left cerebellar lesions, consistent with an acute disseminated encephalomyelitis. It is likely that this is the first reported patient with neuroinflammatory exacerbation after MSC therapy. This case suggests that, in addition to their malignant potential, autologous MSC expanded in vitro can exhibit immune-activating properties leading to autoimmune exacerbation.