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阿尔茨海默病干细胞治疗的进展:全面的临床试验综述

Advances in stem cell therapy in Alzheimer's disease: a comprehensive clinical trial review.

作者信息

Karvelas Nikolaos, Bennett Samuel, Politis Georgios, Kouris Nikolaos-Iasonas, Kole Christo

机构信息

Faculty of Medicine, National and Kapodistrian University of Athens, Athina, Greece.

Emory University School of Medicine, Atlanta, GA, USA.

出版信息

Stem Cell Investig. 2022 Feb 21;9:2. doi: 10.21037/sci-2021-063. eCollection 2022.

Abstract

Alzheimer's disease (AD) is the most common type of dementia responsible for more than 121,499 deaths from AD in 2019 making AD the sixth-leading cause in the United States. AD is a progressive neurodegenerative disorder characterized by decline of memory, behavioral impairments that affects a person's ability to function independently ultimately leading to death. The current pressing need for a treatment for (AD) and advances in the field of cell therapy, has rendered stem cell therapeutics a promising field of research. Despite advancements in stem cell technology, confirmed by encouraging pre-clinical utilization of stem cells in AD animal models, the number of clinical trials evaluating the efficacy of stem cell therapy is limited, with the results of many ongoing clinical trials on cell therapy for AD still pending. Mesenchymal stem cells (MSCs) have been the main focus in these studies, reporting encouraging results concerning safety profile, however their efficacy remains unproven. In the current article we review the latest advances regarding different sources of stem cell therapy and present a comprehensive list of every available clinical trial in national and international registries. Finally, we discuss drawbacks arising from AD pathology and technical limitations that hinder the transition of stem cell technology from bench to bedside. Our findings emphasize the need to increase clinical trials towards uncovering the mode of action and the underlying therapeutic mechanisms of transplanted cells as well as the molecular mechanisms controlling regeneration and neuronal microenvironment.

摘要

阿尔茨海默病(AD)是最常见的痴呆类型,2019年有超过121,499人死于AD,使其成为美国第六大死因。AD是一种进行性神经退行性疾病,其特征是记忆力下降、行为障碍,影响一个人独立生活的能力,最终导致死亡。目前对AD治疗的迫切需求以及细胞治疗领域的进展,使干细胞治疗成为一个有前景的研究领域。尽管干细胞技术取得了进展,这在AD动物模型中干细胞的临床前应用得到了证实,但评估干细胞治疗疗效的临床试验数量有限,许多正在进行的AD细胞治疗临床试验的结果仍未可知。间充质干细胞(MSCs)一直是这些研究的主要焦点,报告显示其安全性方面的结果令人鼓舞,但其疗效仍未得到证实。在本文中,我们回顾了关于不同干细胞治疗来源的最新进展,并列出了国家和国际注册机构中所有可用的临床试验的完整清单。最后,我们讨论了AD病理学和技术限制所带来的阻碍干细胞技术从实验室转化到临床应用的缺点。我们的研究结果强调需要增加临床试验,以揭示移植细胞的作用方式和潜在治疗机制,以及控制再生和神经元微环境的分子机制。

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