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采用自体间充质干细胞治疗难治性癫痫患者可降低癫痫发作频率:一项开放标签研究。

Treatment of refractory epilepsy patients with autologous mesenchymal stem cells reduces seizure frequency: An open label study.

作者信息

Hlebokazov Fedor, Dakukina Tatiana, Ihnatsenko Svetlana, Kosmacheva Svetlana, Potapnev Michael, Shakhbazau Antos, Goncharova Natalia, Makhrov Michael, Korolevich Pavel, Misyuk Nikolai, Dakukina Victoria, Shamruk Irina, Slobina Elena, Marchuk Sergei

机构信息

Republican Scientific and Practical Center for Mental Health, Minsk, Belarus.

Republican Scientific and Practical Center for Transfusion and Medical Biotechnology, Minsk, Belarus.

出版信息

Adv Med Sci. 2017 Sep;62(2):273-279. doi: 10.1016/j.advms.2016.12.004. Epub 2017 May 10.

Abstract

PURPOSE

Existing anti-epileptic drugs (AED) have limited efficiency in many patients, necessitating the search for alternative approaches such as stem cell therapy. We report the use of autologous patient-derived mesenchymal stem cells (MSC) as a therapeutic agent in symptomatic drug-resistant epilepsy in a Phase I open label clinical trial (registered as NCT02497443).

PATIENTS AND METHODS

The patients received either standard treatment with AED (control group), or AED supplemented with single intravenous administration of undifferentiated autologous MSC (target dose of 1×10cells/kg), followed by a single intrathecal injection of neurally induced autologous MSC (target dose of 0.1×10cells/kg).

RESULTS

MSC injections were well tolerated and did not cause any severe adverse effects. Seizure frequency was designated as the main outcome and evaluated at 1 year time point. 3 out of 10 patients in MSC therapy group achieved remission (no seizures for one year and more), and 5 additional patients became responders to AEDs, while only 2 out of 12 patients became responders in control group (difference significant, P=0.0135).

CONCLUSIONS

MSC possess unique immunomodulatory properties and are a safe and promising candidate for cell therapy in AED resistant epilepsy patients.

摘要

目的

现有的抗癫痫药物(AED)对许多患者的疗效有限,因此需要寻找如干细胞治疗等替代方法。我们在一项I期开放标签临床试验(注册号为NCT02497443)中报告了使用自体患者来源的间充质干细胞(MSC)作为有症状药物抵抗性癫痫的治疗剂。

患者和方法

患者接受AED标准治疗(对照组),或接受AED治疗并补充单次静脉注射未分化的自体MSC(目标剂量为1×10细胞/千克),随后单次鞘内注射神经诱导的自体MSC(目标剂量为0.1×10细胞/千克)。

结果

MSC注射耐受性良好,未引起任何严重不良反应。癫痫发作频率被指定为主要结局,并在1年时间点进行评估。MSC治疗组的10名患者中有3名实现缓解(无癫痫发作一年及以上),另有5名患者对AED有反应,而对照组的12名患者中只有2名有反应(差异显著,P = 0.0135)。

结论

MSC具有独特的免疫调节特性,是AED抵抗性癫痫患者细胞治疗的安全且有前景的候选者。

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