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Vol. 61. Issue 3.
Pages 183-190 (May - June 2019)
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Vol. 61. Issue 3.
Pages 183-190 (May - June 2019)
Radiology today
Neuroimaging and clinical trials with stem cells in amyotrophic lateral sclerosis: Present and future perspectives
Neuroimagen y ensayos clínicos con células madre en la esclerosis lateral amiotrófica: perspectivas de presente y futuro
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J.M. García Santosa,b,
Corresponding author
josem.garcia11@carm.es

Corresponding author.
, M. García Martínez-Lozanob, C. Vázquez Olmosa, M. Blanquerc
a Servicio de Radiología, Hospital General Universitario Morales Meseguer, Murcia, Spain
b Facultad de Medicina, Universidad de Murcia, Murcia, Spain
c Unidad de Trasplante Hematopoyético y Terapia Celular, Servicio de Hematología, Hospital Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biomédica (IMIB), Campus Mare Nostrum, Universidad de Murcia, Murcia, Spain
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Abstract

Amyotrophic lateral sclerosis is a rare neurodegenerative disease with a rapid fatal course. The absence of effective treatments has led to new lines of research, some of which are based on stem cells. Surgical injection into the spinal cord, the most common route of administration of stem cells, has proven safe in trials to test the safety of the procedure. Nevertheless, challenges remain, such as determining the best route of administration or the way of checking the survival of the cells and their interaction with the therapeutic target. To date, the mission of neuroimaging techniques has been to detect lesions and complications in the spine and spinal cord, but neuroimaging also has the potential to supplant histologic study in analyzing the relations between the implanted cells and the therapeutic target, and as biomarkers of the disease, by measuring morphological and functional changes after treatment. These developments would increase the role of radiologists in the clinical management of patients with amyotrophic lateral sclerosis.

Keywords:
Central nervous system
Amyotrophic lateral sclerosis
Adult stem cells
Research with stem cells
Surgical interventions
Spinal cord
Magnetic resonance imaging
Neuroimaging
Analyzing patient outcomes
Resumen

La esclerosis lateral amiotrófica es una enfermedad neurodegenerativa rara con un curso rápido y fatal. La ausencia de tratamientos efectivos ha hecho surgir nuevas líneas de investigación, entre ellas las basadas en células madre. La inyección quirúrgica intramedular, que ha sido la principal vía de administración, ha demostrado ser segura en los ensayos de seguridad del procedimiento. Sin embargo, persisten desafíos como la mejor vía de administración o el modo de comprobar la supervivencia de las células y su interacción con la diana terapéutica. La misión de las técnicas de neuroimagen ha sido hasta ahora la detección de lesiones y complicaciones espinales y medulares, pero tienen potencial para sustituir al estudio anatomopatológico, analizando la relación de las células implantadas con la diana terapéutica, y como biomarcadores de la enfermedad, midiendo cambios morfológicos y funcionales postratamiento, lo que implicará más a los radiólogos en el manejo clínico de estos enfermos.

Palabras clave:
Sistema nervioso central
Esclerosis lateral amiotrófica
Células madre adultas
Investigación con células madre
Intervenciones quirúrgicas
Médula espinal
Imagen por resonancia magnética
Neuroimagen
Análisis del resultado en el paciente

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