Characteristics Medical Center of the Chinese People's Armed Police Forces (CAPF), Tianjin, 300162, China.
Fourth Medical Center of People's Liberation Army (PLA) General Hospital, Beijing, 100048, China.
Sci China Life Sci. 2022 May;65(5):909-926. doi: 10.1007/s11427-021-1985-5. Epub 2021 Aug 16.
Spinal cord injury (SCI) often results in an inhibitory environment at the injury site. In our previous studies, transplantation of a scaffold combined with stem cells was proven to induce neural regeneration in animal models of complete SCI. Based on these preclinical studies, collagen scaffolds loaded with the patients' own bone marrow mononuclear cells or human umbilical cord mesenchymal stem cells were transplanted into SCI patients. Fifteen patients with acute complete SCI and 51 patients with chronic complete SCI were enrolled and followed up for 2 to 5 years. No serious adverse events related to functional scaffold transplantation were observed. Among the patients with acute SCI, five patients achieved expansion of their sensory positions and six patients recovered sensation in the bowel or bladder. Additionally, four patients regained voluntary walking ability accompanied by reconnection of neural signal transduction. Among patients with chronic SCI, 16 patients achieved expansion of their sensation level and 30 patients experienced enhanced reflexive defecation sensation or increased skin sweating below the injury site. Nearly half of the patients with chronic cervical SCI developed enhanced finger activity. These long-term follow-up results suggest that functional scaffold transplantation may represent a feasible treatment for patients with complete SCI.
脊髓损伤(SCI)常导致损伤部位出现抑制性环境。在我们之前的研究中,已证实支架结合干细胞移植可诱导完全性 SCI 动物模型中的神经再生。基于这些临床前研究,将负载患者自身骨髓单核细胞或人脐带间充质干细胞的胶原支架移植到 SCI 患者中。共纳入 15 例急性完全性 SCI 患者和 51 例慢性完全性 SCI 患者,并随访 2 至 5 年。未观察到与功能性支架移植相关的严重不良事件。在急性 SCI 患者中,5 例患者的感觉位置扩大,6 例患者的肠或膀胱感觉恢复。此外,4 例患者恢复了自主行走能力,并伴有神经信号转导的重新连接。在慢性 SCI 患者中,16 例患者的感觉水平扩大,30 例患者出现反射性排便感觉增强或损伤部位以下皮肤出汗增加。近一半的慢性颈 SCI 患者手指活动增强。这些长期随访结果表明,功能性支架移植可能是完全性 SCI 患者的一种可行治疗方法。