My experience using UC-MSCs in autism
My name is Dr. Fermín Celma. I am a general surgeon whose work focuses on stem cell therapy and its clinical applications. One of the areas I have focused on is the use of umbilical cord-derived mesenchymal stromal cells (UC-MSCs) in children and adults on the autism spectrum. I have treated more than 1,000 children and adults on the autism spectrum with stem cell therapy.
In my clinical experience, the areas in which I have observed improvements include language development, communication, eye contact, calmness, motor skills and coordination.
I do not consider stem cells a complete cure for autism. Autism is a complex neurodevelopmental condition, and every individual has their own strengths, difficulties and developmental needs.
My interest is in improving the areas of functioning that present challenges for autistic children and adults, particularly communication, social engagement, motor coordination and the ability to remain calm and regulated. These are important areas to assess when evaluating an individual's progress after treatment.
I believe the potential of UC-MSCs deserves serious attention because of their biological properties and their relationship with immune regulation and cellular signalling. I see favourable results, and I have written about some of my patients and their progress. Because of the results my patients have, I continue this protocol.
Donor selection and laboratory screening
The laboratory is responsible for screening donors and assessing the suitability of donated material before UC-MSCs are released for use. I consider donor selection and the quality of the cellular product extremely important parts of the treatment process.
- Vaccination records. The laboratory checks donor vaccination records. Donors must not have received influenza vaccinations or COVID-19-related vaccines.
- Spike protein testing. The laboratory tests donor blood for spike protein. Results are interpreted according to the testing method used.
- Medical history. The laboratory reviews the donor's medical records for previous illnesses, underlying conditions and anything else that could affect donor suitability or the characteristics of the donated material.
- General health assessment. Donors must meet the laboratory's rigorous eligibility requirements, and their medical history and laboratory findings are assessed.
- Quality control of the cells. The final UC-MSC product undergoes quality-control procedures, including cell identity, viability, purity and sterility, alongside the required manufacturing and release checks.
The laboratory carries out this screening and testing. My role as a general surgeon is the clinical application of the treatment and the assessment and care of the patient. See the full list of laboratory tests.
Why I use umbilical cord-derived mesenchymal stromal cells
UC-MSCs are obtained from umbilical cord tissue, usually from Wharton's jelly, the connective tissue surrounding the cord's blood vessels. They are studied for their ability to release biological signalling molecules and to interact with immune cells.
Their properties include immunomodulatory activity and paracrine signalling: they release molecules that influence the activity of other cells without necessarily becoming part of the tissue they affect. These properties interest me because the immune system, inflammatory signalling and neurological function are interconnected, and my approach focuses on the potential of UC-MSCs to influence the cellular environment and support improvements in everyday functioning.
The cells used must be properly identified and characterised. UC-MSCs are distinct from other preparations obtained from umbilical cord blood, and their source, viability, purity and manufacturing quality are very important.
The areas of improvement I observe
When I assess someone after UC-MSC treatment, I look at language, communication, eye contact, calmness, motor skills and coordination. These functions matter for everyday life, learning, relationships and independence.
Language development
Language is a fundamental part of communication, but progress looks different for each individual. Some children begin using more words, while others improve their ability to express needs, respond to questions or communicate in other ways.
Communication
Communication involves more than spoken words. It includes understanding instructions, expressing needs, responding to others, using gestures and taking part in meaningful exchanges. I consider functional communication one of the most important outcomes.
Eye contact and social engagement
Eye contact varies naturally between individuals, and autistic people should not be judged solely on how often they make eye contact. When I assess social engagement, I also consider attention to others, responsiveness, shared activities and how comfortable the person is during interaction.
Calmness and regulation
Some autistic children and adults find emotional regulation, sensory overload or transitions difficult. I pay attention to whether a person appears calmer, more settled and better able to take part in everyday activities.
Motor skills and coordination
Motor development affects balance, posture, hand movements, physical confidence and everyday tasks, so I assess coordination and motor function alongside communication and social engagement.
Results should be documented over time, using observations from parents, caregivers, therapists and clinicians wherever possible.
The treatment schedule I use
The protocol I have found to give the best outcome consists of three intravenous administrations of 35 million UC-MSCs, three months apart: 105 million cells in total.
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Month 0: first administration
Before treatment, baseline assessments record communication, language, social engagement, motor skills, coordination, adaptive functioning and general health.
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Month 3: second administration
Progress is reviewed, evaluated and recorded.
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Month 6: third administration
Followed by continued clinical monitoring and assessment.
Each visit takes two to four hours in total.
The dose and schedule have to be considered in relation to the particular cell product, the individual's circumstances and appropriate medical oversight. This schedule should not be assumed to be a universally validated regimen for autism.
Immune modulation and the neurological environment
The immune system and the nervous system communicate through many biological pathways. Cytokines and other signalling molecules influence cellular activity, and researchers continue to investigate the role of immune regulation in neurological development.
Studies have found immune differences in some groups of autistic people. Autism is not simply an inflammatory condition, and there is no single biological explanation for every autistic person's experiences.
UC-MSCs can influence immune-cell activity and inflammatory signalling by releasing regulatory molecules that interact with other cells. I consider this relevant to understanding how cellular therapy affects the biological environment in which the nervous system works. In my clinical work, I focus on observable changes in communication, engagement, calmness and coordination rather than relying only on laboratory measurements.
The brain and the areas I assess
Microglia
Microglia are the resident immune cells of the central nervous system. They help maintain the brain's cellular environment, remove cellular debris and regulate aspects of synaptic development and neural connectivity. The relationship between these processes and autism is complex and can differ between individuals. What I look for is whether treatment is associated with practical changes in how a person communicates, engages with others and manages everyday activities.
The arcuate fasciculus
The arcuate fasciculus is a white matter pathway connecting the frontal and temporal regions of the brain involved in understanding and producing language. Language depends on coordinated activity across many brain regions, and neuroplasticity, the nervous system's ability to change its connections, is central to development and learning.
Broca's area: producing speech
Broca's area, in the frontal lobe, contributes to speech production, language planning and grammar. Some autistic people understand more language than they can express in words; others communicate through gestures, signs or communication devices. I value functional communication, not only spoken words. After treatment, changes in spontaneous speech, comprehension, functional communication and social engagement should be documented, rather than assuming that a particular brain region has been repaired.
Wernicke's area: understanding language
Wernicke's area is a traditional term for a region associated with understanding language, although modern neuroscience recognises that comprehension involves a wider network. Receptive and expressive language can develop differently in autistic children and adults, so I assess how a person understands language, follows instructions, expresses needs and communicates day to day.
The default mode network
The default mode network is a group of connected brain regions involved in memory, self-reflection and aspects of social understanding. Social communication involves several networks, not one. When I evaluate social engagement, I consider responsiveness, shared attention, taking part in activities and interaction with familiar people. Eye contact is only one part of this.
Neuroplasticity
Researchers are investigating how the signalling molecules released by UC-MSCs influence neuronal survival, synaptic function and the cellular environment. UC-MSCs should not be assumed to become working neurons or to rebuild language pathways directly after an intravenous infusion; their effects are different from replacing neurons. What matters clinically is how a person functions over time, measured consistently.
Safety, cell quality and monitoring
The laboratory is responsible for donor screening and for the quality-control checks on the cells, including identity, viability, purity, sterility and manufacturing consistency. Donor vaccination records, medical history and spike protein results are part of that screening.
Intravenous cell treatment for a child requires informed parental consent, careful assessment and continued follow-up. All reported improvements are documented, and the child's existing developmental, educational and communication support should continue.
Written by Dr. Fermín Celma, general surgeon focusing on stem cell therapy. If you feel others may benefit from this information, please share it.