Lee Hoon-Bum, Park Si-Woon, Kim Il-Kwon, Kim Jae-Hyung, Kim Doo Young, Hwang Ki-Chul
Department of Plastic and Reconstructive Surgery.
Department of Rehabilitation Medicine.
Medicine (Baltimore). 2020 Aug 21;99(34):e21846. doi: 10.1097/MD.0000000000021846.
Stroke often causes residual hemiparesis, and upper extremity motor impairment is usually more disabling than lower extremity in those who are suffering from post-stroke hemiparesis. Cell therapy is one of the promising therapies to reduce post-stroke disability.
Three male participants were included in the study to investigate the feasibility and tolerability of autologous adipose tissue derived stromal vascular fraction.
All participants had hemiparesis after 1st-ever stroke longer than 6 months previously.
Under general anesthesia, liposuction of abdominal subcutaneous fat was performed. Stromal vascular fraction freshly isolated from the adipose tissue extract was injected into the muscles of paretic upper extremity. All participants received inpatient stroke rehabilitation consisted of physical and occupational therapy more than 3 hours a day for 2 months or more.
The whole procedure did not produce any significant adverse event in all participants. Adipose tissue extracts yielded sufficient stromal cells. One participant showed clinically important change in upper extremity Fugl-Meyer assessment after the injection and it lasted up to 6 months. Functional magnetic resonance imaging showed concomitant increase in ipsilesional cortical activity. The other 2 participants did not show remarkable changes.
Intramuscular injection of autologous adipose tissue derived stromal vascular fraction seems to be a safe and tolerable procedure in subjects with chronic stroke, and its utility in rehabilitation needs further investigation.
中风常导致残留偏瘫，在中风后偏瘫患者中，上肢运动障碍通常比下肢更具致残性。细胞治疗是减少中风后残疾的一种有前景的治疗方法。
本研究纳入了三名男性参与者，以调查自体脂肪组织来源的基质血管成分的可行性和耐受性。
所有参与者均在首次中风后超过6个月出现偏瘫。
在全身麻醉下，进行腹部皮下脂肪抽脂。从脂肪组织提取物中新鲜分离出的基质血管成分被注射到患侧上肢的肌肉中。所有参与者均接受住院中风康复治疗，包括每天超过3小时的物理治疗和职业治疗，持续2个月或更长时间。
整个过程在所有参与者中均未产生任何重大不良事件。脂肪组织提取物产生了足够的基质细胞。一名参与者在注射后上肢Fugl-Meyer评估中出现了临床上重要的变化，且持续了6个月。功能磁共振成像显示同侧皮质活动同时增加。另外两名参与者未显示出明显变化。
对于慢性中风患者，肌肉注射自体脂肪组织来源的基质血管成分似乎是一种安全且可耐受的方法，其在康复中的效用需要进一步研究。
