Department of Urology, Ewha Womans University, Mokdong Hospital, Seoul, Korea.
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Stem Cells Transl Med. 2022 Oct 21;11(10):1010-1020. doi: 10.1093/stcltm/szac065.
There are still no definite treatment modalities for interstitial cystitis (IC). Meanwhile, stem cell therapy is rising as potential alternative for various chronic diseases. This study aimed to investigate the safety of the clinical-grade mesenchymal stem cells (MSCs) derived from human embryonic stem cells (hESCs), code name MR-MC-01 (SNU42-MMSCs), in IC patients. Three female IC patients with (1) symptom duration >6 months, (2) visual pain analog scale (VAS) ≥4, and (3) one or two Hunner lesions <2 cm in-office cystoscopy within 1 month were included. Under general anesthesia, participants received cystoscopic submucosal injection of SNU42-MMSCs (2.0 × 107/5 mL) at the center or margin of Hunner lesions and other parts of the bladder wall except trigone with each injection volume of 1 mL. Follow-up was 1, 3, 6, 9, and 12 months postoperatively. Patients underwent scheduled follow-ups, and symptoms were evaluated with validated questionnaires at each visit. No SNU42-MMSCs-related adverse events including immune reaction and abnormalities on laboratory tests and image examinations were reported up to 12-month follow-up. VAS pain was temporarily improved in all subjects. No de novo Hunner lesions were observed and one lesion of the first subject was not identifiable on 12-month cystoscopy. This study reports the first clinical application of transurethral hESC-derived MSC injection in three patients with IC. hESC-based therapeutics was safe and proved to have potential therapeutic efficacy in IC patients. Stem cell therapy could be a potential therapeutic option for treating IC.
目前对于间质性膀胱炎(IC)尚无明确的治疗方法。与此同时,干细胞疗法作为各种慢性疾病的潜在替代疗法正在兴起。本研究旨在探讨临床级人胚胎干细胞(hESC)来源间充质干细胞(MSC),编号为 MR-MC-01(SNU42-MMSCs)在 IC 患者中的安全性。纳入 3 名女性 IC 患者,(1)症状持续时间>6 个月,(2)视觉疼痛模拟量表(VAS)≥4,(3)1 个月内膀胱镜检查发现 1 个或 2 个 Hunner 病变,病变<2cm。全身麻醉下,患者接受 SNU42-MMSCs(2.0×107/5mL)经膀胱镜黏膜下注射,注射部位为 Hunner 病变的中心或边缘以及膀胱壁的其他部位(三角区除外),每次注射量为 1mL。术后 1、3、6、9 和 12 个月进行随访。患者定期随访,每次就诊时均使用经过验证的问卷评估症状。截至 12 个月随访时,未报告与 SNU42-MMSCs 相关的不良反应,包括免疫反应,以及实验室检查和影像学检查的异常。所有患者的 VAS 疼痛均暂时得到改善。所有患者均未出现新的 Hunner 病变,且第 1 例患者的 1 个病变在 12 个月膀胱镜检查时无法识别。本研究报道了首例经尿道 hESC 来源 MSC 注射治疗 3 例 IC 患者的临床应用。基于 hESC 的治疗方法是安全的,并且在 IC 患者中显示出潜在的治疗效果。干细胞治疗可能是治疗 IC 的一种潜在治疗选择。