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神经修复支架移植治疗急性、慢性完全性脊髓损伤患者的长期临床观察。

Long-term clinical observation of patients with acute and chronic complete spinal cord injury after transplantation of NeuroRegen scaffold.

机构信息

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.

出版信息

Sci China Life Sci. 2022 May;65(5):909-926. doi: 10.1007/s11427-021-1985-5. Epub 2021 Aug 16.

DOI:10.1007/s11427-021-1985-5
PMID:34406569
Abstract

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.

摘要

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。

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本文引用的文献

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Cell Therapies for Spinal Cord Injury: Trends and Challenges of Current Clinical Trials.脊髓损伤的细胞治疗:当前临床试验的趋势和挑战。
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Spinal cord lesions.脊髓损伤
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The Efficacy of Different Material Scaffold-Guided Cell Transplantation in the Treatment of Spinal Cord Injury in Rats: A Systematic Review and Network Meta-analysis.不同材料支架引导细胞移植治疗大鼠脊髓损伤的疗效:系统评价和网络荟萃分析。
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How much time is necessary to confirm the diagnosis of permanent complete cervical spinal cord injury?确认永久性完全性颈脊髓损伤的诊断需要多长时间?
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Different functional bio-scaffolds share similar neurological mechanism to promote locomotor recovery of canines with complete spinal cord injury.不同功能的生物支架通过相似的神经机制促进完全性脊髓损伤犬的运动功能恢复。
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Pre-Clinical Evaluation of CBD-NT3 Modified Collagen Scaffolds in Completely Spinal Cord Transected Non-Human Primates.完全性脊髓横断的非人灵长类动物中 CBD-NT3 修饰胶原支架的临床前评估
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Scaffold-facilitated locomotor improvement post complete spinal cord injury: Motor axon regeneration versus endogenous neuronal relay formation.支架辅助完全性脊髓损伤后的运动功能改善:运动轴突再生与内源性神经元中继形成。
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Significant Improvement of Acute Complete Spinal Cord Injury Patients Diagnosed by a Combined Criteria Implanted with NeuroRegen Scaffolds and Mesenchymal Stem Cells.联合标准诊断的急性完全性脊髓损伤患者植入神经再生支架和间充质干细胞后显著改善。
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Cetuximab and Taxol co-modified collagen scaffolds show combination effects for the repair of acute spinal cord injury.西妥昔单抗和紫杉醇共修饰胶原支架在急性脊髓损伤修复中表现出协同作用。
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