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两名接受面部移植脂肪来源的基质血管成分细胞的帕金森病患者的持续临床改善。

Sustained clinical improvement of Parkinson's disease in two patients with facially-transplanted adipose-derived stromal vascular fraction cells.

机构信息

Wake Forest University Institute of Regenerative Medicine, Winston-Salem, NC, USA; Department of Plastic Surgery, Hospital Escuela Oscar Danilo Rosales Argüello, Leon, Nicaragua.

Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA.

出版信息

J Clin Neurosci. 2020 Nov;81:47-51. doi: 10.1016/j.jocn.2020.09.001. Epub 2020 Sep 25.

Abstract

Cell-based therapy has been studied as an alternative for Parkinson's Disease (PD), with different routes of administration. The superficial fascia and facial muscles possess a rich blood supply, while venous and lymphatic access via the orbit and the cribriform plate provide a route to cerebral circulation. We here document positive clinical effects in two patients with PD treated with autologous adipose-derived stromal vascular fraction (SVF) cell preparation, implanted into the face and nasal cavity. Two patients with PD were transplanted with 60 million total nucleated cells in processed SVF into the facial muscles and nose. Serial evaluations were carried out up to 5 years (patient 1) and 1 year (patient 2), using the PDQ-39, the UPDRS, and serial videos. Video scoring was reviewed in a blinded fashion. Both patients reported qualitative improvement in motor and nonmotor symptoms following injection. Quantitatively, PDQ-39 scores decreased in all categories for both. On-medication UPDRS motor scores decreased in both (20 to 4 in patient 1, 18 to 3 in patient 2) despite taking the same or less medication (LEDD 350 to 350 in patient 1, LEDD 1175 to 400 in pt2). Both subjects had off-medication UPDRS scores similar to their pretreatment on-medication scores (20 to 14 in patient 1, 18 to 23 in patient 2). These preliminary findings describe local facial and nasal injections of SVF preparation followed by prolonged clinical benefit in two patients. Despite an unknown mechanism of action, this potential therapy warrants careful verification and investigation.

摘要

细胞疗法已被研究作为帕金森病(PD)的替代疗法,具有不同的给药途径。浅筋膜和面肌具有丰富的血液供应,而通过眶和筛板的静脉和淋巴通路提供了通往大脑循环的途径。我们在此记录了两名接受自体脂肪衍生基质血管部分(SVF)细胞制剂治疗的 PD 患者的阳性临床效果,将其植入面部和鼻腔。两名 PD 患者共植入 6000 万个处理后的 SVF 中的总核细胞,植入面肌和鼻腔。使用 PDQ-39、UPDRS 和连续视频对两名患者进行了长达 5 年(患者 1)和 1 年(患者 2)的连续评估。视频评分以盲法进行回顾。两名患者均报告注射后运动和非运动症状有定性改善。定量方面,PDQ-39 评分在所有类别中均下降。两名患者的服药 UPDRS 运动评分均下降(患者 1 从 20 降至 4,患者 2 从 18 降至 3),尽管服用相同或更少的药物(患者 1 的 LEDD 从 350 降至 350,患者 2 的 LEDD 从 1175 降至 400)。两名患者在停药期间的 UPDRS 评分与治疗前服药时的评分相似(患者 1 为 20 至 14,患者 2 为 18 至 23)。这些初步发现描述了 SVF 制剂的局部面部和鼻腔注射,随后两名患者获得了长期的临床获益。尽管作用机制未知,但这种潜在的治疗方法值得仔细验证和研究。

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