Major Points and Findings:
- Objective: The review aims to present the current understanding of the clinical use of umbilical cord blood based on articles from PubMed and clinical trials registered on ClinicalTrials.gov.
- Potential of Cord Blood: There's growing evidence suggesting that cord blood might be useful for both early diagnostics and treatment of cerebral palsy. The acidity of CB and its biochemical parameters, including various cytokines, growth factors, and other metabolites, are potential predictors of future neurodevelopment.
- Clinical Studies: Several clinical studies have affirmed the safety and efficacy of CB administration in both autologous (from the patient) and allogeneic (from a donor) models. A meta-analysis of five clinical trials involving 328 participants was mentioned. At the time of the report, nine clinical trials were assessing the use of autologous umbilical CB in children diagnosed with hypoxic-ischemic encephalopathy or cerebral palsy, involving over 2500 patients.
- Cerebral Palsy Background: The etiology of 70% of CP cases remains unknown. In 20% of children, it might be linked to prematurity, perinatal trauma, or brain hypoxia. The frequency of CP varies, with estimates ranging from 1.24 to 3.8 per 1000 live-born children.
- Cord Blood in Diagnostics: Cord blood has diagnostic value, with around 90 CB proteins being predictors of disorders diagnosed in adults, such as cancer, cardiovascular diseases, and neurodegenerative diseases. A meta-analysis of 51 articles showed that CB acidity was significantly associated with neonatal mortality, hypoxic-ischemic encephalopathy, cerebral palsy, and other neonatal complications.
- Cord Blood Composition: Cord blood contains stem cells, anti-inflammatory cytokines, and proinflammatory cytokines. Various cell populations in CB have potential neuroregenerative properties. These cells secrete immunomodulatory and neurotrophic factors that can aid in central nervous system repair. The mechanisms for the neuroprotective effect of CB stem cells include neural differentiation, anti-apoptotic and anti-inflammatory actions, stimulation of angiogenesis, and production of trophic factors.
- Extracellular Vesicles: Scientists have shown increased interest in extracellular vesicles (EVs), which are micro- or nanoparticles carrying mRNA, microRNA, and proteins. EVs have been effective in treating animal models of various diseases, including liver diseases, myocardial infarction, and brain injuries.