Kotowski M, Litwinska Z, Klos P, Pius-Sadowska E, Zagrodnik-Ulan E, Ustianowski P, Rudnicki J, Machalinski B
Department of General Pathology, Pomeranian Medical University, Szczecin, Poland.
Department of Clinical Anesthesiology and Intensive Therapy for Adult and Children, Pomeranian Medical University, Szczecin, Poland.
J Physiol Pharmacol. 2017 Dec;68(6):921-927.
Umbilical cord blood (UCB), rich in stem/progenitor cells, is partially eliminated from the bloodstream during childbirth because the cord is immediately clamped. We hypothesize that transfusion of autologous UCB to premature infants after delivery could serve as an adjuvant modality for preventing the development of prematurity-related complications. We randomly enrolled 20 preterm infants born before 32 weeks of gestational age (GA), all of whom developed anemia, necessitating transfusion of red blood cells (RBCs). Two groups, matched for GA, were selected: (1) infants (n = 5) who underwent UCB transfusion once within 5 days of birth (mean ± standard deviation, 3.2 ± 1.9 days) and (2) infants (n = 15) from whom UCB was not collected (e.g., lack of consent). The latter served as controls and received allogeneic RBC transfusions (7.8 ± 3.9 days after birth). Selected prematurity-related complications were monitored. Two weeks after UCB/RBC transfusion, peripheral blood samples were collected, and the concentrations of 41 selected growth factors and their receptors were analyzed using a multiplex protein array. UCB transfusions were found to be both feasible and tolerable. Intraventricular haemorrhage was diagnosed in two of five (40%) UCB recipients, but was found in thirteen of fifteen RBC recipients (86.7%). Twenty-two plasma proteins (e.g., insulin-like growth factors, stem cell factor, epidermal growth factors) were found with significantly different concentrations in UCB recipients compared to controls. Results demonstrate safety and feasibility of UCB transfusion in a small group of very premature neonates and should be interpreted as preliminary speculation. Transfusion of UCB could induce a specific humoral effects, and this could serve as an adjuvant modality for prevention of prematurity complications.
脐带血富含干/祖细胞，在分娩过程中，由于脐带被立即夹紧，部分脐带血会从血流中被清除。我们推测，分娩后给早产儿输注自体脐带血可作为预防早产相关并发症的辅助手段。我们随机招募了20名孕周小于32周（GA）的早产儿，所有这些婴儿均出现贫血，需要输注红细胞（RBC）。选择了两组GA匹配的婴儿：（1）出生后5天内接受一次脐带血输注的婴儿（n = 5）（平均±标准差，3.2±1.9天），以及（2）未采集脐带血的婴儿（n = 15）（例如，缺乏同意）。后者作为对照，接受异体红细胞输注（出生后7.8±3.9天）。监测选定的早产相关并发症。在脐带血/红细胞输注两周后，采集外周血样本，并使用多重蛋白质阵列分析41种选定生长因子及其受体的浓度。发现脐带血输注既可行又可耐受。5名脐带血接受者中有2名（40%）被诊断为脑室内出血，但在15名红细胞接受者中有13名（86.7%）出现脑室内出血。与对照组相比，在脐带血接受者中发现22种血浆蛋白（例如，胰岛素样生长因子、干细胞因子、表皮生长因子）的浓度存在显著差异。结果表明，在一小群极早产儿中进行脐带血输注具有安全性和可行性，应将其解释为初步推测。脐带血输注可诱导特定的体液效应，这可作为预防早产并发症的辅助手段。
