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脐带间充质干细胞植入治疗视网膜色素变性:一项3期试验的6个月随访结果

Umbilical cord derived mesenchymal stem cell implantation in retinitis pigmentosa: a 6-month follow-up results of a phase 3 trial.

作者信息

Kahraman Neslihan Sinim, Oner Ayse

机构信息

Department of Ophthalmology, Kayseri Acibadem Hospital, Kayseri 38030, Turkey.

出版信息

Int J Ophthalmol. 2020 Sep 18;13(9):1423-1429. doi: 10.18240/ijo.2020.09.14. eCollection 2020.

Abstract

AIM

To investigate the efficacy and the safety of umbilical cord derived mesenchymal stem cell (UC-MSC) implantation in patients with retinitis pigmentosa (RP).

METHODS

This prospective, single-center, phase 3 clinical study enrolled 124 eyes of 82 RP patients. The patients received 5 million UC-MSCs to the suprachoroidal area with a surgical procedure. Patients were evaluated on the 1 day, 1, and 6 months postoperatively. Best corrected visual acuity (BCVA), anterior segment and fundus examinations, color photography, optical coherence tomography (OCT), and visual field (VF) tests were carried out at each visit. Fundus fluorescein angiography (FFA) and multifocal electroretinography (mfERG) recordings were performed at the end of the 6 month. Ocular and systemic adverse events of the surgical procedure were also noted.

RESULTS

All of the 82 patients completed the 6-month follow-up period. None of them had any serious systemic or ocular complications. There were statistically significant improvements in BCVA and VF during the study (all <0.05). The amplitudes of the P1 waves in the central areas showed significant improvements in mfERG recordings. There were also significant increases in implicit times of P1 waves in the central areas.

CONCLUSION

Suprachoroidal administration of UC-MSCs has beneficial effect on BCVA, VF, and mfERG measurements during the 6-month follow-up period. Cell mediated therapy based on the secretion of growth factors (GFs) seems to be an effective and safe option for degenerative retinal diseases.

摘要

目的

探讨脐带间充质干细胞(UC-MSC)植入治疗视网膜色素变性(RP)患者的疗效和安全性。

方法

这项前瞻性、单中心、3期临床研究纳入了82例RP患者的124只眼。患者通过手术将500万个UC-MSC注入脉络膜上腔。在术后1天、1个月和6个月对患者进行评估。每次随访时进行最佳矫正视力(BCVA)、眼前节和眼底检查、彩色照相、光学相干断层扫描(OCT)和视野(VF)测试。在6个月末进行眼底荧光血管造影(FFA)和多焦视网膜电图(mfERG)记录。还记录了手术的眼部和全身不良事件。

结果

82例患者均完成了6个月的随访期。他们均未出现任何严重的全身或眼部并发症。研究期间BCVA和VF有统计学意义的改善(均P<0.05)。mfERG记录中中央区域P1波的振幅有显著改善。中央区域P1波的隐含时间也有显著增加。

结论

在6个月的随访期内,脉络膜上腔注射UC-MSC对BCVA、VF和mfERG测量有有益作用。基于生长因子(GFs)分泌的细胞介导疗法似乎是治疗视网膜退行性疾病的一种有效且安全的选择。

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