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脊髓损伤中的自体骨髓源性干细胞

Autologous Bone Marrow-Derived Stem Cells in Spinal Cord Injury.

作者信息

Bansal Himanshu, Verma Poonam, Agrawal Anupama, Leon Jerry, Sundell I Birgitta, Koka Prasad S

机构信息

Mother Cell, Anupam Hospital, Rudrapur, Uttarakhand, India.

RegennMed Research and Therapeutics, New Delhi, India.

出版信息

J Stem Cells. 2016;11(1):51-61.

Abstract

INTRODUCTION

Spinal cord injury is a traumatic neurological condition which makes the patient disable. Its management still remains challenging but advancements in the regenerative medicine have changed the approach of treating this serious debilitating condition of the central nervous system. Cell based therapies can restore function in spinal cord injury by replacing the lost neural tissue. These therapies also rejuvenate the existing intact neurons by facilitating remyelination and by repairing and reducing progressive tissue damage and scarring.

METHODS

Autologous bone marrow stem cells were collected from the patients. 5 ml of the processed sample was injected back into the patients via lumbar puncture at L1/L2 level. The bone marrow harvesting and administration was repeated every 4 weeks 3 times (12 weeks).

RESULTS

Significant improvements were noticed following the injections into the patients with the duration of injury less than 6 months. ASIA grade improvements were observed in 6 out of 10 patients. VTC and walking, at least with the support, was restored in eight patients. Bladder control and sexual functions improved in three and five patients respectively. Eight patients exhibited decreased spasticity.

DISCUSSION

We believe that autologous bone marrow stem cells contributed towards the neuroplaticity and/or paracrine effect due to which we observed the considerable improvements in the conditions of the patients.

CONCLUSION

This preliminary proof of patient improvement reinforces the potential of autologous bone marrow stem cell treatment in the patients suffering from Spinal Cord Injury. Although the results are encouraging further studies are needed to substantiate the claims.

摘要

引言

脊髓损伤是一种创伤性神经疾病,会导致患者致残。其治疗仍然具有挑战性,但再生医学的进展改变了治疗这种严重的中枢神经系统衰弱病症的方法。基于细胞的疗法可以通过替换丢失的神经组织来恢复脊髓损伤后的功能。这些疗法还通过促进髓鞘再生、修复和减少进行性组织损伤及瘢痕形成,使现有的完整神经元恢复活力。

方法

从患者体内采集自体骨髓干细胞。将5毫升处理后的样本通过L1/L2水平的腰椎穿刺重新注入患者体内。骨髓采集和给药每4周重复一次,共3次(12周)。

结果

对受伤时间少于6个月的患者进行注射后,观察到显著改善。10名患者中有6名患者的美国脊髓损伤协会(ASIA)分级得到改善。8名患者的肺活量和行走能力(至少在有支撑的情况下)得以恢复。3名和5名患者的膀胱控制和性功能分别得到改善。8名患者的痉挛程度减轻。

讨论

我们认为自体骨髓干细胞促成了神经可塑性和/或旁分泌效应,因此我们观察到患者的病情有了相当大的改善。

结论

患者病情改善的这一初步证据强化了自体骨髓干细胞治疗脊髓损伤患者的潜力。尽管结果令人鼓舞,但仍需要进一步研究来证实这些说法。

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