Lee Hee Song, Song Junyoung, Min Kyunghoon, Choi Yong-Soo, Kim Sun-Mi, Cho Sung-Rae, Kim MinYoung
Department of Rehabilitation Medicine, CHA University, Gyeonggi-do, South Korea.
Yonsei Stem Cell Research Center, Avison Biomedical Research Center, Seoul, South Korea.
Brain Dev. 2014 Oct;36(9):764-9. doi: 10.1016/j.braindev.2013.11.002. Epub 2013 Dec 4.
Cerebral palsy (CP) is a disabling condition characterized by the motor impairment, which is difficult to be ameliorated. In the brain of infants with CP, there are persistent pathomechanisms including accentuated neuroinflammation. Since erythropoietin was demonstrated to have neuroprotective effect via anti-inflammatory and anti-apoptotic properties, we hypothesized that the administration of recombinant human EPO (rhEPO) could help children with CP, especially young infants.
We investigated the therapeutic efficacy of rhEPO for infants with CP, who had been undergoing active rehabilitation in hospitalized setting to eliminate treatment bias. Twenty infants with CP were randomly divided into EPO or control group equally. We compared the changes in the Gross Motor Function Measure (GMFM) and the Bayley Scales of Infant Development-II (BSID-II) scores during one month of hospitalization between two groups.
The improvements after 1 month on the GMFM A and GMFM total scores differed significantly between the groups (p = 0.003, p = 0.04, respectively). However, the changes after 6 months were not different between the two groups. The scores of BSID-II did not show any differences at 1-month and 6-months post-treatment.
These results indicated that rhEPO could have therapeutic efficacy for infants with CP during the active rehabilitation and anti-inflammation was suggested to be one of its therapeutic mechanisms.
脑性瘫痪(CP)是一种以运动功能障碍为特征的致残性疾病,难以改善。在患有CP的婴儿大脑中,存在包括神经炎症加剧在内的持续病理机制。由于促红细胞生成素已被证明通过抗炎和抗凋亡特性具有神经保护作用,我们推测给予重组人促红细胞生成素(rhEPO)可能有助于患有CP的儿童,尤其是幼儿。
我们研究了rhEPO对在住院环境中接受积极康复治疗的CP婴儿的治疗效果,以消除治疗偏倚。20名CP婴儿被随机平均分为EPO组或对照组。我们比较了两组在住院1个月期间粗大运动功能测量(GMFM)和贝利婴儿发育量表第二版(BSID-II)评分的变化。
两组在GMFM A和GMFM总分上1个月后的改善情况有显著差异(分别为p = 0.003,p = 0.04)。然而,6个月后的变化在两组之间没有差异。治疗后1个月和6个月时,BSID-II评分没有显示出任何差异。
这些结果表明,rhEPO在积极康复期间对患有CP的婴儿可能具有治疗效果,并且抗炎作用被认为是其治疗机制之一。