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自体脂肪来源干细胞脑内移植治疗慢性缺血性脑卒中:Ⅰ期研究。

Intracerebral transplantation of autologous adipose-derived stem cells for chronic ischemic stroke: A phase I study.

机构信息

Department of Neurosurgery, Bioinnovation Center, Tzu Chi Foundation, Buddhist Tzu Chi General Hospital, Tzu Chi University, Hualien, Taiwan, ROC.

Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan, ROC.

出版信息

J Tissue Eng Regen Med. 2022 Jan;16(1):3-13. doi: 10.1002/term.3256. Epub 2021 Oct 21.

Abstract

Current therapy does not provide significant benefits for patients with chronic stroke. Pre-clinical studies suggested that autologous adipose-derived stem cells have benefits for the treatment of chronic stroke. This Phase I open-label study was conducted to demonstrate the safety and efficacy of autologous adipose-derived stem cells (GXNPC1) in chronic stroke. Three patients with chronic stroke were treated with stereotactic implantation of autologous adipose-derived stem cells (1 × 10 cells). The primary endpoints of safety evaluation included adverse events, over a 6 months post-implantation period. The secondary endpoints included improvements in neurological functions. Evolutional change of brain parenchyma was also followed with magnetic resonance imaging (MRI). All three participants improved significantly at 6 months follow-up. The extent of improvement from pre-treatment was: National Institutes of Health Stroke Scale improved 5-15 points, Barthel Index: 25-50 points, Berg balance scale 0-21 points and Fugl-Meyer modified sensation 3-28 points. All three patients had signal change along the implantation tract on MRI one month after surgery. There is no related safety issue through 6 months observation. Clinical measures of neurological symptoms of these patients with chronic stroke improved at 6 months without adverse effects after implantation of autologous adipose-derived stem cells (GXNPC1), which might be correlated with post-implantation changes on brain MRI. Clinical Trial Registration-URL: https://clinicaltrials.gov/ct2/show/NCT02813512?term=ADSC&cond=Stroke&cntry=TW&draw=2&rank=1 Unique identifier: NCT02813512.

摘要

目前的治疗方法并不能为慢性中风患者带来显著的益处。临床前研究表明,自体脂肪来源干细胞有益于慢性中风的治疗。这项 I 期开放标签研究旨在证明自体脂肪来源干细胞(GXNPC1)治疗慢性中风的安全性和有效性。3 名慢性中风患者接受了自体脂肪来源干细胞(1×10 个细胞)的立体定向植入治疗。安全性评估的主要终点包括植入后 6 个月内的不良事件。次要终点包括神经功能的改善。还通过磁共振成像(MRI)跟踪脑实质的演变变化。所有 3 名参与者在 6 个月的随访中均有显著改善。从治疗前到治疗后的改善程度为:国立卫生研究院中风量表改善 5-15 分,巴氏指数:25-50 分,伯格平衡量表 0-21 分,Fugl-Meyer 改良感觉 3-28 分。所有 3 名患者在手术后 1 个月 MRI 上均显示沿植入轨迹的信号变化。在 6 个月的观察期内没有发现相关的安全问题。这些慢性中风患者的神经症状的临床测量在 6 个月时得到改善,并且在植入自体脂肪来源干细胞(GXNPC1)后没有不良反应,这可能与 MRI 上的植入后变化有关。临床试验注册网址:https://clinicaltrials.gov/ct2/show/NCT02813512?term=ADSC&cond=Stroke&cntry=TW&draw=2&rank=1 独特标识符:NCT02813512。

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