Portas M, Mansilla E, Drago H, Dubner D, Radl A, Coppola A, Di Giorgio M
Hospital de Quemados del Gobierno de la Ciudad de Buenos Aires, Buenos Aires, Argentina.
Servicio de Ingeniería Tisular, Medicina Regenerativa y Terapias Celulares del Centro Único de Ablación e Implantes de la provincia de Buenos Aires (CUCAIBA), Buenos Aires, Argentina.
Radiat Prot Dosimetry. 2016 Sep;171(1):99-106. doi: 10.1093/rpd/ncw206. Epub 2016 Aug 29.
Acute and late radiation-induced injury on skin and subcutaneous tissues are associated with substantial morbidity in radiation therapy, interventional procedures and also are of concern in the context of nuclear or radiological accidents. Pathogenesis is initiated by depletion of acutely responding epithelial tissues and damage to vascular endothelial microvessels. Efforts for medical management of severe radiation-induced lesions have been made. Nevertheless, the development of strategies to promote wound healing, including stem cell therapy, is required. From 1997 to 2014, over 248 patients were referred to the Radiopathology Committee of Hospital de Quemados del Gobierno de la Ciudad de Buenos Aires (Burns Hospital) for the diagnosis and therapy of radiation-induced localized lesions. As part of the strategies for the management of severe cases, there is an ongoing research and development protocol on 'Translational Clinical Trial phases I/II to evaluate the safety and efficacy of adult mesenchymal stem cells from bone marrow for the treatment of large burns and radiological lesions'. The object of this work was to describe the actions carried out by the Radiopathology Committee of the Burns Hospital in a chronic case with more than 30 years of evolution without positive response to conventional treatments. The approach involved the evaluation of the tissular compromise of the lesion, the prognosis and the personalized treatment, including regenerative therapy.
皮肤和皮下组织的急性和晚期辐射损伤在放射治疗、介入手术中会导致相当高的发病率,在核事故或放射性事故中也备受关注。其发病机制始于急性反应性上皮组织的耗竭以及血管内皮微血管的损伤。人们已努力对严重的辐射诱导损伤进行医学处理。然而,仍需要制定促进伤口愈合的策略,包括干细胞疗法。1997年至2014年期间,超过248名患者被转诊至布宜诺斯艾利斯市烧伤医院(Burns Hospital)放射病理学委员会,以诊断和治疗辐射诱导的局部损伤。作为重症病例管理策略的一部分,正在开展一项关于“评估骨髓来源的成人间充质干细胞治疗大面积烧伤和放射性损伤的安全性和有效性的转化临床试验I/II期”的研发方案。这项工作的目的是描述烧伤医院放射病理学委员会对一例病程超过30年、对传统治疗无阳性反应的慢性病患所采取的措施。该方法包括评估损伤的组织损伤情况、预后以及个性化治疗,包括再生治疗。