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人胎脑源性神经干细胞/祖细胞移植治疗创伤性颈脊髓损伤患者的临床试验

Clinical Trial of Human Fetal Brain-Derived Neural Stem/Progenitor Cell Transplantation in Patients with Traumatic Cervical Spinal Cord Injury.

作者信息

Shin Ji Cheol, Kim Keung Nyun, Yoo Jeehyun, Kim Il-Sun, Yun Seokhwan, Lee Hyejin, Jung Kwangsoo, Hwang Kyujin, Kim Miri, Lee Il-Shin, Shin Jeong Eun, Park Kook In

机构信息

Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea ; Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea.

Department of Neurosurgery, Yonsei University College of Medicine, Seoul 120-752, Republic of Korea.

出版信息

Neural Plast. 2015;2015:630932. doi: 10.1155/2015/630932. Epub 2015 Oct 11.

Abstract

In a phase I/IIa open-label and nonrandomized controlled clinical trial, we sought to assess the safety and neurological effects of human neural stem/progenitor cells (hNSPCs) transplanted into the injured cord after traumatic cervical spinal cord injury (SCI). Of 19 treated subjects, 17 were sensorimotor complete and 2 were motor complete and sensory incomplete. hNSPCs derived from the fetal telencephalon were grown as neurospheres and transplanted into the cord. In the control group, who did not receive cell implantation but were otherwise closely matched with the transplantation group, 15 patients with traumatic cervical SCI were included. At 1 year after cell transplantation, there was no evidence of cord damage, syrinx or tumor formation, neurological deterioration, and exacerbating neuropathic pain or spasticity. The American Spinal Injury Association Impairment Scale (AIS) grade improved in 5 of 19 transplanted patients, 2 (A → C), 1 (A → B), and 2 (B → D), whereas only one patient in the control group showed improvement (A → B). Improvements included increased motor scores, recovery of motor levels, and responses to electrophysiological studies in the transplantation group. Therefore, the transplantation of hNSPCs into cervical SCI is safe and well-tolerated and is of modest neurological benefit up to 1 year after transplants. This trial is registered with Clinical Research Information Service (CRIS), Registration Number: KCT0000879.

摘要

在一项I/IIa期开放标签、非随机对照临床试验中,我们试图评估将人神经干细胞/祖细胞(hNSPCs)移植到创伤性颈脊髓损伤(SCI)后的损伤脊髓中的安全性和神经学效应。在19例接受治疗的受试者中,17例感觉运动完全性损伤,2例运动完全性损伤且感觉不完全性损伤。源自胎儿端脑的hNSPCs培养成神经球并移植到脊髓中。对照组未接受细胞植入,但在其他方面与移植组密切匹配,包括15例创伤性颈脊髓损伤患者。细胞移植后1年,没有脊髓损伤、空洞或肿瘤形成、神经功能恶化以及神经病理性疼痛或痉挛加重的证据。19例移植患者中有5例美国脊髓损伤协会损伤分级(AIS)得到改善,2例(A→C),1例(A→B),2例(B→D),而对照组只有1例患者有所改善(A→B)。改善包括移植组运动评分增加、运动水平恢复以及电生理研究反应。因此,将hNSPCs移植到颈脊髓损伤中是安全且耐受性良好的,并且在移植后1年内具有适度的神经学益处。该试验已在韩国临床研究信息服务中心(CRIS)注册,注册号:KCT0000879。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5299/4619963/198d6b242093/NP2015-630932.001.jpg

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