Zeira Offer, Asiag Nimrod, Aralla Marina, Ghezzi Erica, Pettinari Letizia, Martinelli Laura, Zahirpour Daniele, Dumas Maria Pia, Lupi Davide, Scaccia Simone, Konar Martin, Cantile Carlo
San Michele Veterinary Hospital, Via Primo Maggio 37, 26838, Tavazzano con Villavesco, Italy.
Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56124, Pisa, Italy.
J Neuroinflammation. 2015 Sep 29;12:181. doi: 10.1186/s12974-015-0402-9.
Non-infectious inflammatory diseases of the canine central nervous system (CNS) are common idiopathic disorders grouped under the term meningoencephalomyelitis of unknown origin (MUO). Ante mortem diagnosis is achieved via assessment of clinical signs, magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) analysis, but the definitive diagnosis needs histopathological examination. MUO are mostly considered as autoimmune CNS disorders, so that suppressing the immune reaction is the best management method for patients. Mesenchymal stem cells (MSCs) are under investigation to treat autoimmune and degenerative disorders due to their immunomodulatory and regenerative properties. This study aims to verify the safety, feasibility, and efficacy of MSCs treatment in canine idiopathic autoimmune inflammatory disorders of the CNS.
Eight dogs presented with acute onset and rapid progression of multifocal neurological signs were selected to the study. In all patients' physical and neurological examinations, MRI and CSF analyses were performed. Clinical diagnosis in all cases was MUO. All selected dogs responded initially to immunosuppressive drugs (prednisone and a combination of prednisolone and cytosine arabinoside) but developed undesirable side effects. For all eight dogs, the owners considered euthanasia but accepted cell therapy as a last possibility. Autologous bone marrow MSCs (BMMSCs), isolated, cultured, and expanded, were administered by intrathecal (IT) injection in the cisterna magna intravenously (IV) and by intra-arterial (IA) injection in the right carotid artery. Adverse effects and clinical response were monitored for 6 months up to 2-year follow-up.
The use of autologous BMMSCs in dogs with MUO was safe for IT, IV, and IA injections. No major short- or long-term adverse effects were registered. All the dogs presented early improvement in their general and neurological conditions, with particular effect on cervical pain. The group of dogs treated by IT+IA administration showed a shorter time of reaction to therapy compared to the group treated by IT+IV administration.
MSCs treatment in dogs affected by MOU is safe and feasible. A larger group of dogs is needed to confirm these results as well as CNS histology in order to better understand the underlying mechanisms.
犬中枢神经系统(CNS)的非感染性炎症性疾病是一组常见的特发性疾病,统称为不明原因的脑膜脑脊髓炎(MUO)。生前诊断通过评估临床症状、磁共振成像(MRI)和脑脊液(CSF)分析来实现,但确诊需要组织病理学检查。MUO大多被认为是自身免疫性中枢神经系统疾病,因此抑制免疫反应是患者的最佳治疗方法。间充质干细胞(MSCs)因其免疫调节和再生特性,正在被研究用于治疗自身免疫性和退行性疾病。本研究旨在验证MSCs治疗犬特发性自身免疫性中枢神经系统炎症性疾病的安全性、可行性和有效性。
选择8只出现急性发作且多灶性神经症状迅速进展的犬进行研究。对所有患者进行体格和神经检查、MRI和CSF分析。所有病例的临床诊断均为MUO。所有入选的犬最初对免疫抑制药物(泼尼松以及泼尼松龙和阿糖胞苷的联合用药)有反应,但出现了不良副作用。对于所有8只犬,其主人考虑实施安乐死,但接受细胞治疗作为最后的可能性。分离、培养和扩增的自体骨髓间充质干细胞(BMMSCs)通过在枕大池鞘内(IT)注射、静脉内(IV)注射以及在右颈动脉内动脉(IA)注射的方式给药。在长达2年的随访中,对不良反应和临床反应进行了6个月的监测。
在患有MUO的犬中使用自体BMMSCs进行IT、IV和IA注射是安全的。未记录到重大的短期或长期不良反应。所有犬的一般状况和神经状况均出现早期改善,对颈部疼痛有特别的效果。与IT + IV给药治疗组相比,IT + IA给药治疗组的犬对治疗的反应时间更短。
MSCs治疗受MUO影响的犬是安全可行的。需要更大数量的犬来证实这些结果以及中枢神经系统组织学,以便更好地理解潜在机制。