Department of Neurology, Liaocheng People's Hospital, Liaocheng, China.
Dis Markers. 2021 Dec 1;2021:5290766. doi: 10.1155/2021/5290766. eCollection 2021.
This study is aimed at examining the efficacy of human umbilical cord blood-mononuclear cell (hUCB-MNCs) transplantation through lateral atlanto-occipital space puncture in multiple system atrophy (MSA) treatment and investigating changes in T-cell subsets in peripheral blood and inflammatory factors in patients before and after treatment.
A total of 20 patients with MSA who underwent hUCB-MNC transplantation through lateral atlanto-occipital space puncture in the Liaocheng People's Hospital were enrolled. Patients were followed up at 0, 1, 3, and 6 months after treatment, and the Unified Multiple System Atrophy Rating Scale (UMSARS) scores, TNF- in the peripheral blood, IL-6, percentage of CD4, and CD4/CD8 ratio were evaluated and compared for each follow-up point; any adverse effects were recorded.
UMSARS Part I scores were 20.55 ± 3.80, 19.20 ± 3.78, and 19.40 ± 4.11, 1, 3, and 6 months, respectively, after treatment and were significantly lower as compared to that before treatment (23.50 ± 4.72; < 0.05). Similarly, UMSARS Part II scores 1, 3, and 6 months after treatment were 25.50 ± 5.01, 24.05 ± 5.01, and 24.25 ± 5.05, respectively, significantly lower as compared to that before treatment (30.15 ± 5.63; < 0.05). The IL-6 values in the peripheral blood 1, 3, and 6 months after treatment were 5.25 ± 2.70 pg/m, 2.96 ± 1.75 pg/m, and 3.31 ± 1.62 pg/m, respectively, which were significantly lower ( < 0.05) than that before treatment (8.22 ± 4.69) pg/m. The TNF- levels at 3 and 6 months after treatment were 13.08 ± 6.13 pg/m and 12.24 ± 4.76 pg/m, respectively, which were significantly lower than that before treatment (22.99 ± 13.30; < 0.01). The CD4/CD8 ratios in the peripheral blood 1, 3, and 6 months after treatment were 1.09 ± 0.25, 1.30 ± 0.24, and 1.43 ± 0.22, respectively, which were significantly different than that before treatment (0.81 ± 0.24, < 0.01). Similarly, the CD4 percentages 1, 3, and 6 months after treatment were 34.09 ± 1.79, 36.05 ± 1.50, and 36.47 ± 1.47, respectively, which were significantly different than that before treatment (0.81 ± 0.24; < 0.01).
hUCB-MNC transplantation through lateral atlanto-occipital space puncture could significantly improve the symptoms and signs in patients with MSA and delay the disease progression. Thus, hUCB-MNCs may modulate immune activity and reduce the inflammatory response.
本研究旨在通过寰枕外侧空间穿刺探讨人脐血单个核细胞(hUCB-MNC)移植治疗多系统萎缩(MSA)的疗效,并观察治疗前后患者外周血 T 细胞亚群及炎症因子的变化。
选取聊城市人民医院 20 例接受寰枕外侧空间穿刺 hUCB-MNC 移植的 MSA 患者。患者治疗后 0、1、3、6 个月进行随访,评估并比较每个随访点的统一多系统萎缩评分量表(UMSARS)评分、外周血 TNF-、IL-6、CD4 百分比及 CD4/CD8 比值;记录任何不良反应。
治疗后 1、3、6 个月 UMSARS 第Ⅰ部分评分分别为 20.55 ± 3.80、19.20 ± 3.78、19.40 ± 4.11,均显著低于治疗前(23.50 ± 4.72; < 0.05)。同样,治疗后 1、3、6 个月 UMSARS 第Ⅱ部分评分分别为 25.50 ± 5.01、24.05 ± 5.01、24.25 ± 5.05,均显著低于治疗前(30.15 ± 5.63; < 0.05)。治疗后 1、3、6 个月外周血 IL-6 分别为 5.25 ± 2.70 pg/ml、2.96 ± 1.75 pg/ml、3.31 ± 1.62 pg/ml,均显著低于治疗前(8.22 ± 4.69)pg/ml。治疗后 3、6 个月 TNF-水平分别为 13.08 ± 6.13 pg/ml、12.24 ± 4.76 pg/ml,均显著低于治疗前(22.99 ± 13.30; < 0.01)。治疗后 1、3、6 个月外周血 CD4/CD8 比值分别为 1.09 ± 0.25、1.30 ± 0.24、1.43 ± 0.22,均显著高于治疗前(0.81 ± 0.24; < 0.01)。同样,治疗后 1、3、6 个月外周血 CD4 百分比分别为 34.09 ± 1.79、36.05 ± 1.50、36.47 ± 1.47,均显著高于治疗前(0.81 ± 0.24; < 0.01)。
通过寰枕外侧空间穿刺进行 hUCB-MNC 移植可显著改善 MSA 患者的症状和体征,延缓疾病进展。因此,hUCB-MNC 可能调节免疫活性,减轻炎症反应。