Moviglia G A, Fernandez Viña R, Brizuela J A, Saslavsky J, Vrsalovic F, Varela G, Bastos F, Farina P, Etchegaray G, Barbieri M, Martinez G, Picasso F, Schmidt Y, Brizuela P, Gaeta C A, Costanzo H, Moviglia Brandolino M T, Merino S, Pes M E, Veloso M J, Rugilo C, Tamer I, Shuster G S
Instituto Regina Mater, Paraguay 2452, Buenos Aires, 1121 ABL, Argentina.
Cytotherapy. 2006;8(3):202-9. doi: 10.1080/14653240600736048.
This is a preliminary report on successful results obtained during treatment of two patients with chronic spinal cord injury. The therapeutic approach was based on the generation of controlled inflammatory activity at the injury site that induced a microenvironment for the subsequent administration of autologous, BM-driven transdifferentiated neural stem cells (NSC).
BM mesenchymal stem cells (MSC) were cocultured with the patient's autoimmune T (AT) cells to be transdifferentiated into NSC. Forty-eight hours prior to NSC implant, patients received an i.v. infusion of 5 x 10(8) to 1 x 10(9) AT cells. NSC were infused via a feeding artery of the lesion site. Safety evaluations were performed everyday, from the day of the first infusion until 96 h after the second infusion. After treatment, patients started a Vojta and Bobath neurorehabilitation program.
At present two patients have been treated. Patient 1 was a 19-year-old man who presented paraplegia at the eight thoracic vertebra (T8) with his sensitive level corresponding to his sixth thoracic metamere (T6). He received two AT-NSC treatments and neurorehabilitation for 6 months. At present his motor level corresponds to his first sacral metamere (S1) and his sensitive level to the fourth sacral metamere (S4). Patient 2 was a 21-year-old woman who had a lesion that extended from her third to her fifth cervical vertebrae (C3-C5). Prior to her first therapeutic cycle she had severe quadriplegia and her sensitive level corresponded to her second cervical metamere (C2). After 3 months of treatment her motor and sensitive levels reached her first and second thoracic metameres (T1-T2). No adverse events were detected in either patient.
The preliminary results lead us to think that this minimally invasive approach, which has minor adverse events, is effective for the repair of chronic spinal cord lesions.
本文是关于两名慢性脊髓损伤患者治疗取得成功结果的初步报告。治疗方法基于在损伤部位产生可控的炎症活动，从而为后续自体骨髓来源的转分化神经干细胞（NSC）的施用营造微环境。
将骨髓间充质干细胞（MSC）与患者的自身免疫性T（AT）细胞共培养，使其转分化为NSC。在植入NSC前48小时，患者静脉输注5×10⁸至1×10⁹个AT细胞。通过损伤部位的供血动脉输注NSC。从首次输注当天至第二次输注后96小时，每天进行安全性评估。治疗后，患者开始进行vojta和Bobath神经康复计划。
目前已治疗两名患者。患者1为19岁男性，第八胸椎（T8）水平截瘫，感觉平面相当于第六胸节（T6）。他接受了两次AT-NSC治疗及6个月的神经康复治疗。目前其运动平面相当于第一骶节（S1），感觉平面相当于第四骶节（S4）。患者2为21岁女性，损伤范围从第三颈椎至第五颈椎（C3-C5）。在第一个治疗周期前，她患有严重四肢瘫，感觉平面相当于第二颈椎节（C2）。经过3个月治疗，其运动和感觉平面达到第一和第二胸节（T1-T2）。两名患者均未检测到不良事件。
初步结果使我们认为，这种微创方法不良事件较少，对慢性脊髓损伤的修复有效。
