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心脏骤停后儿童缺氧缺血性脑损伤所致脑瘫的首例自体细胞治疗——脐带血个体化治疗

First autologous cell therapy of cerebral palsy caused by hypoxic-ischemic brain damage in a child after cardiac arrest-individual treatment with cord blood.

作者信息

Jensen A, Hamelmann E

机构信息

Campus Clinic Gynecology, Ruhr-University Bochum, Universitätsstrasse 140, 44799 Bochum, Germany.

出版信息

Case Rep Transplant. 2013;2013:951827. doi: 10.1155/2013/951827. Epub 2013 May 15.

DOI:10.1155/2013/951827
PMID:23762741
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3671311/
Abstract

Each year, thousands of children incur brain damage that results in lifelong sequelae. Therefore, based on experimental evidence, we explored the therapeutic potential of human cord blood, known to contain stem cells, to examine the functional neuroregeneration in a child with cerebral palsy after cardiac arrest. The boy, whose cord blood was stored at birth, was 2.5 years old and normally developed when global ischemic brain damage occurred resulting in a persistent vegetative state. Nine weeks later, he received autologous cord blood (91.7 mL, cryopreserved, 5.75 × 10e8 mononuclear cells) intravenously. Active rehabilitation (physio- and ergotherapy) was provided daily, follow-up at 2, 5, 12, 24, 30, and 40 months. At 2-months follow-up the boy's motor control improved, spastic paresis was largely reduced, and eyesight was recovered, as did the electroencephalogram. He smiled when played with, was able to sit and to speak simple words. At 40 months, independent eating, walking in gait trainer, crawling, and moving from prone position to free sitting were possible, and there was significantly improved receptive and expressive speech competence (four-word sentences, 200 words). This remarkable functional neuroregeneration is difficult to explain by intense active rehabilitation alone and suggests that autologous cord blood transplantation may be an additional and causative treatment of pediatric cerebral palsy after brain damage.

摘要

每年都有成千上万的儿童遭受脑损伤,从而导致终身后遗症。因此,基于实验证据,我们探索了已知含有干细胞的人类脐带血在一名心脏骤停后患有脑瘫的儿童中促进功能性神经再生的治疗潜力。这个男孩出生时储存了脐带血,2.5岁,在发生全脑缺血性脑损伤导致持续植物状态之前发育正常。九周后,他静脉输注了自体脐带血(91.7毫升,冷冻保存,5.75×10⁸个单核细胞)。每天进行积极的康复治疗(物理治疗和职业治疗),并在2、5、12、24、30和40个月时进行随访。在2个月的随访中,男孩的运动控制能力有所改善,痉挛性麻痹大幅减轻,视力恢复,脑电图也恢复正常。玩耍时他会微笑,能够坐起来并说出简单的词语。在40个月时,他能够独立进食、在步态训练器中行走、爬行以及从俯卧位转为自由坐立,并且接受性和表达性语言能力有了显著提高(能说四字句子,掌握200个单词)。这种显著的功能性神经再生仅靠积极的康复治疗很难解释,这表明自体脐带血移植可能是小儿脑损伤后脑瘫的一种额外的病因性治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da2/3671311/e65108fb6296/CRIM.TRANSPLANTATION2013-951827.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da2/3671311/b8d97449001a/CRIM.TRANSPLANTATION2013-951827.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da2/3671311/1adb899dda61/CRIM.TRANSPLANTATION2013-951827.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da2/3671311/e65108fb6296/CRIM.TRANSPLANTATION2013-951827.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da2/3671311/b8d97449001a/CRIM.TRANSPLANTATION2013-951827.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da2/3671311/1adb899dda61/CRIM.TRANSPLANTATION2013-951827.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da2/3671311/e65108fb6296/CRIM.TRANSPLANTATION2013-951827.003.jpg

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