Human intracerebroventricular (ICV) injection of autologous, non-engineered, adipose-derived stromal vascular fraction (ADSVF) for neurodegenerative disorders: results of a 3-year phase 1 study of 113 injections in 31 patients.

We have chosen to test the safety of human intracerebroventricular (ICV) brain injections of autologous non-genetically-modified adipose-derived stromal vascular fraction (ADSVF). In this IRB-approved trial, 24 patients received ICV ADSVF via an implanted reservoir between 5/22/14 and 5/22/17. Seven others were injected via their ventriculo-peritoneal shunts. Ten patients had Alzheimer's disease (AD), 6 had amyotrophic lateral sclerosis (ALS), 6 had progressive multiple sclerosis (MS-P), 6 had Parkinson's "Plus" (PD+), 1 had spinal cord injury, 1 had traumatic brain injury, and 1 had stroke. Median age was 74 (range 41-83). Injections were planned every 2-3 months. Thirty-one patients had 113 injections. Patients received SVF injection volumes of 3.5-20 cc (median:4 cc) containing 4.05 × 105 to 6.2 × 107 cells/cc, which contained an average of 8% hematopoietic and 7.5% adipose stem cells. Follow-up ranged from 0 to 36 months (median: 9.2 months). MRIs post injection(s) were unchanged, except for one AD patient whose hippocampal volume increased from < 5th percentile to 48th percentile (NeuroQuant® volumetric MRI). Of the 10 AD patients, 8 were stable or improved in tests of cognition. Two showed improvement in P-tau and ß-amyloid levels. Of the 6 MS-P patients all are stable or improved. Four of 6 ALS patients died of disease progression. Twelve of 111 injections (11%) led to 1-4 days of transient meningismus, and mild temperature elevation, which resolved with acetaminophen and/or dexamethasone. Two (1.8% of injections) required hospitalization for these symptoms. One patient (0.9% of injections) had his reservoir removed and later replaced for presumed infection. In this Phase 1 safety trial, ADSVF was safely injected into the human brain ventricular system in patients with no other treatment options. Secondary endpoints of clinical improvement or stability were particularly promising in the AD and MS-P groups. These results will be submitted for a Phase 2 FDA-approved trial.

Iron loading into ferritin can be stimulated or inhibited by the presence of cations and anions: a specific role for phosphate.

Phosphate and other oxo-anions have been shown to stimulate the rate of iron loading into ferritin (J. Polanams, A.D. Ray, R.K. Watt, Inorg. Chem. 44 (2005) 3203-3209). This study was undertaken to determine if accelerated iron loading was a specific effect for phosphate and closely associated oxo-anions or if it was a general anion effect. Controls were also performed with mono-valent cations to determine the effect of these cations on iron loading into ferritin. Cations were shown to slow the rate of iron loading into ferritin. Fluoride and iodide were shown to slow the iron loading process of ferritin. Sulfate was also shown to slow iron loading into ferritin to a more significant extent than the cations or halides tested. The trigonal planar oxo-anions, carbonate and nitrate, did not inhibit or stimulate iron loading. We conclude that the increased rate of iron loading into ferritin is specific to phosphate and other closely associated tetrahedral oxo-anion analogs, that the effect is driven by the insolubility of the iron and anion complex, and that in general, cations and anions slow the rate of iron loading into ferritin.