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造血干细胞和间充质干细胞移植作为多发性硬化症有效治疗方法的发展。

The development of hematopoietic and mesenchymal stem cell transplantation as an effective treatment for multiple sclerosis.

作者信息

Holloman Jameson P, Ho Calvin C, Hukki Arushi, Huntley Jennifer L, Gallicano G Ian

机构信息

Department of Biochemistry and Molecular & Cellular Biology, Georgetown University School of Medicine 3900 Reservoir Rd. NW, Washington DC 20057, USA.

出版信息

Am J Stem Cells. 2013 Jun 30;2(2):95-107. Print 2013.

Abstract

This article examines the current use and future implications of stem cell therapy in treating Multiple Sclerosis (MS). MS is the most common neurological disease in young adults, affecting approximately two million people worldwide. Currently there is no cure for MS. The standard treatment of MS involves disease-modifying drugs, which work to alleviate the symptoms of MS. However, these drugs carry adverse side effects and are ineffective in preventing disease progression in many MS patients. Hematopoietic stem cell transplantation (HSCT) was first used in 1995 to treat patients with severe rapidly progressing MS. The HSCT treatment protocol has evolved into a less intense conditioning regimen that is currently demonstrating efficacy in treating patients with variable disease severity-with best results in early-stage rapidly progressing MS patients with active CNS inflammation. Mesenchymal stem cell therapy (MSCT) is an experimental stem cell therapy currently undergoing clinical trials. Animal models and early clinical trials have shown promise that MSCT might be a low risk treatment to precipitate neuroregeneration and immunomodulation in MS patients. Specifically, neuroprogenitor and placental-derived mesenchymal stem cells offer the best hope for a practical treatment for MS. Stem cell therapy, and perhaps a combinatorial therapeutic approach, holds promise for a better treatment for MS.

摘要

本文探讨了干细胞疗法在治疗多发性硬化症(MS)中的当前应用及未来意义。MS是年轻成年人中最常见的神经疾病,全球约有200万人受其影响。目前MS无法治愈。MS的标准治疗包括疾病修正药物,其作用是缓解MS症状。然而,这些药物有不良副作用,且对许多MS患者预防疾病进展无效。造血干细胞移植(HSCT)于1995年首次用于治疗严重快速进展型MS患者。HSCT治疗方案已演变为强度较低的预处理方案,目前在治疗不同疾病严重程度的患者中显示出疗效,在早期快速进展且伴有中枢神经系统炎症的MS患者中效果最佳。间充质干细胞疗法(MSCT)是一种正在进行临床试验的实验性干细胞疗法。动物模型和早期临床试验表明,MSCT可能是一种低风险的治疗方法,可促进MS患者的神经再生和免疫调节。具体而言,神经祖细胞和胎盘来源的间充质干细胞为MS的实际治疗提供了最大希望。干细胞疗法,或许还有联合治疗方法,有望为MS带来更好的治疗效果。

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