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通过多种途径将自体骨髓干细胞给予脊髓损伤患者是安全的,并能改善其生活质量:综合病例研究。

Administration of autologous bone marrow stem cells into spinal cord injury patients via multiple routes is safe and improves their quality of life: comprehensive case studies.

作者信息

Geffner L F, Santacruz P, Izurieta M, Flor L, Maldonado B, Auad A H, Montenegro X, Gonzalez R, Silva F

机构信息

Hospital Luis Vernaza, JBGYE, Guayaquil, Ecuador.

出版信息

Cell Transplant. 2008;17(12):1277-93. doi: 10.3727/096368908787648074.

Abstract

Presently, there is no cure or effective treatment for spinal cord injury (SCI). Studies in SCI patients have shown that for a treatment to be effective it must primarily improve their quality of life. Numerous studies have shown that stem cells represent an alternative treatment for various disorders and have shown promise in several disease/trauma states. For instance, the use of autologous CD34+ stem cells has been shown to ameliorate symptoms of several disorders such as leukemia, cardiomyopathy, diabetes, and several autoimmune diseases, including multiple sclerosis. For the first time, we report eight case studies of SCI (four acute, four chronic) with approximately 2 years of follow-up that were administered bone marrow stem cells (BMSCs) via multiple routes: directly into the spinal cord, directly into the spinal canal, and intravenous. Magnetic resonance imaging illustrated morphological changes in the spinal cord of some of the patients following BMSCs administration. Comprehensive evaluations demonstrate improvements in ASIA, Barthel (quality of life), Frankel, and Ashworth scoring. Moreover, in order to assess bladder function, we designed a simple numerical clinical scoring system that demonstrates significant changes in bladder function following BMSCs administration. To date, we have administration BMSCs into 52 patients with SCI and have had no tumor formations, no cases of infection or increased pain, and few instances of minor adverse events. These studies demonstrate that BMSCs administration via multiple routes is feasible, safe, and may improve the quality of life for patients living with SCI.

摘要

目前,脊髓损伤(SCI)尚无治愈方法或有效的治疗手段。对脊髓损伤患者的研究表明,一种治疗方法若要有效,必须首先改善他们的生活质量。大量研究表明,干细胞是治疗各种疾病的一种替代方法,并且在几种疾病/创伤状态下已显示出前景。例如,使用自体CD34+干细胞已被证明可改善多种疾病的症状,如白血病、心肌病、糖尿病以及包括多发性硬化症在内的几种自身免疫性疾病。我们首次报告了8例脊髓损伤病例研究(4例急性,4例慢性),随访约2年,这些患者通过多种途径接受了骨髓干细胞(BMSC)治疗:直接注入脊髓、直接注入椎管以及静脉注射。磁共振成像显示了部分患者在接受骨髓干细胞治疗后脊髓的形态变化。综合评估表明美国脊髓损伤协会(ASIA)、巴氏指数(生活质量)、弗兰克指数和阿什沃思评分均有改善。此外,为了评估膀胱功能,我们设计了一个简单的数字临床评分系统,该系统显示在接受骨髓干细胞治疗后膀胱功能有显著变化。迄今为止,我们已对52例脊髓损伤患者进行了骨髓干细胞治疗,未出现肿瘤形成、感染病例或疼痛加剧的情况,仅有少数轻微不良事件。这些研究表明,通过多种途径给予骨髓干细胞是可行、安全的,并且可能改善脊髓损伤患者的生活质量。

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