Baumgartner Linda S, Moore Ernest, Shook David, Messina Steven, Day Mary Clare, Green Jennifer, Nandy Rajesh, Seidman Michael, Baumgartner James E
Little HEARoes & Clarke Schools for Hearing and Speech, Orlando, FL, USA.
Department of Audiology and Speech-Language Pathology, University of North Texas, Denton, TA, USA.
J Audiol Otol. 2018 Oct;22(4):209-222. doi: 10.7874/jao.2018.00115. Epub 2018 Aug 22.
Sensorineural hearing loss (SNHL) in children is associated with neurocognitive morbidity. The cause of SNHL is a loss of hair cells in the organ of Corti. There are currently no reparative treatments for SNHL. Numerous studies suggest that cord blood mononuclear cells (human umbilical cord blood, hUCB) allow at least partial restoration of SNHL by enabling repair of a damaged organ of Corti. Our objective is to determine if hUCB is a safe treatment for moderate to severe acquired SNHL in children. Subjects and.
Eleven children aged 6 months to 6 years with moderate to severe acquired SNHL were treated with intravenous autologous hUCB. The cell dose ranged from 8 to 30 million cells/kg body weight. Safety was assessed by measuring systemic hemodynamics during hUCB infusion. Infusion-related toxicity was evaluated by measuring neurologic, hepatic, renal and pulmonary function before and after infusion. Auditory function, auditory verbal language assessments and MRI with diffusion tensor imaging (DTI) were obtained before and after treatment.
All patients survived, and there were no adverse events. No infusionrelated changes in hemodynamics occurred. No infusion-related toxicity was recorded. Five subjects experienced a reduction in auditory brainstem response (ABR) thresholds. Four of those 5 subjects also experienced an improvement in cochlear nerve latencies. Comparison of MRI with DTI sequences obtained before and after treatment revealed increased fractional anisotropy in the primary auditory cortex in three of five subjects with reduced ABR thresholds. Statistically significant (p<0.05) reductions in ABR thresholds were identified.
TIntravenous hUCB is feasible and safe in children with SNHL.
儿童感音神经性听力损失（SNHL）与神经认知疾病相关。SNHL的病因是柯蒂氏器中的毛细胞丢失。目前尚无针对SNHL的修复性治疗方法。大量研究表明，脐血单个核细胞（人脐带血，hUCB）可通过修复受损的柯蒂氏器使SNHL至少部分恢复。我们的目的是确定hUCB对儿童中度至重度获得性SNHL是否为安全的治疗方法。对象与方法：11例年龄在6个月至6岁之间的中度至重度获得性SNHL儿童接受了静脉自体hUCB治疗。细胞剂量范围为每千克体重800万至3000万个细胞。通过在hUCB输注期间测量全身血流动力学来评估安全性。通过在输注前后测量神经、肝、肾和肺功能来评估输注相关毒性。在治疗前后进行听觉功能、听觉言语语言评估以及磁共振成像（MRI）和弥散张量成像（DTI）。结果：所有患者均存活，且无不良事件发生。未出现与输注相关的血流动力学变化。未记录到与输注相关的毒性。5名受试者的听觉脑干反应（ABR）阈值降低。这5名受试者中有4名的蜗神经潜伏期也有所改善。对治疗前后获得的MRI与DTI序列进行比较，发现5名ABR阈值降低的受试者中有3名的初级听觉皮层各向异性分数增加。确定ABR阈值有统计学意义（p<0.05）的降低。结论：静脉注射hUCB对SNHL儿童是可行且安全的。
