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临床经验:五例中风患者间充质干细胞移植的结果。

Clinical experience: Outcomes of mesenchymal stem cell transplantation in five stroke patients.

作者信息

Ercelen Nesrin, Karasu Nilgun, Kahyaoglu Bulent, Cerezci Onder, Akduman Rana Cagla, Ercelen Defne, Erturk Gizem, Gulay Gokay, Alpaydin Nagihan, Boyraz Gizem, Monteleone Berrin, Kural Zekiye, Silek Hakan, Temur Sibel, Bingol Canan Aykut

机构信息

Department of Medical Genetics, Faculty of Medicine, Üsküdar University, Istanbul, Türkiye.

Department of Neurology, American Hospital, Istanbul, Türkiye.

出版信息

Front Med (Lausanne). 2023 Jan 19;10:1051831. doi: 10.3389/fmed.2023.1051831. eCollection 2023.

Abstract

Stem cell therapy, which has promising results in acute disorders such as stroke, supports treatment by providing rehabilitation in the chronic stage patients. In acute stroke, thrombolytic medical treatment protocols are clearly defined in neurologic emergencies, but in neurologic patients who miss the "thrombolytic treatment intervention window," or in cases of hypoxic-ischemic encephalopathy, our hands are tied, and we are still unfortunately faced with hopeless clinical implementations. We consider mesenchymal stem cell therapy a viable option in these cases. In recent years, novel research has focused on neuro-stimulants and supportive and combined therapies for stroke. Currently, available treatment options are limited, and only certain patients are eligible for acute treatment. In the scope of our experience, five stroke patients were evaluated in this study, who was treated with a single dose of 1-2 × 10 cells/kg allogenic umbilical cord-mesenchymal stem cells (UC-MSCs) with the official confirmation of the Turkish Ministry of Health Stem Cell Commission. The patients were followed up for 12 months, and clinical outcomes are recorded. NIH Stroke Scale/Scores (NIHSS) decreased significantly ( = 0.0310), and the Rivermead Assessment Scale (RMA) increased significantly ( = 0.0234) for all patients at the end of the follow-up. All the patients were followed up for 1 year within a rehabilitation program. Major clinical outcome improvements were observed in the overall clinical conditions of the UC-MSC treatment patients. We observed improvement in the patients' upper extremity and muscle strength, spasticity, and fine motor functions. Considering recent studies in the literature together with our results, allogenic stem cell therapies are introduced as promising novel therapies in terms of their encouraging effects on physiological motor outcomes.

摘要

干细胞疗法在中风等急性疾病中取得了有前景的成果,可为慢性期患者提供康复支持治疗。在急性中风中,溶栓药物治疗方案在神经科急症中已有明确规定,但对于错过“溶栓治疗干预窗口”的神经科患者,或在缺氧缺血性脑病的情况下,我们束手无策,不幸的是,我们仍然面临着无望的临床实施情况。我们认为间充质干细胞疗法在这些情况下是一种可行的选择。近年来,新的研究集中在中风的神经兴奋剂以及支持性和联合治疗上。目前,可用的治疗选择有限,只有某些患者有资格接受急性治疗。根据我们的经验,本研究评估了5名中风患者,他们接受了单剂量1 - 2×10个细胞/千克的同种异体脐带间充质干细胞(UC - MSCs)治疗,该治疗得到了土耳其卫生部干细胞委员会的官方批准。对患者进行了12个月的随访,并记录了临床结果。随访结束时,所有患者的美国国立卫生研究院卒中量表/评分(NIHSS)显著降低( = 0.0310),Rivermead评估量表(RMA)显著升高( = 0.0234)。所有患者在康复计划中随访了1年。观察到UC - MSC治疗患者的整体临床状况有重大临床结果改善。我们观察到患者的上肢、肌肉力量、痉挛和精细运动功能有所改善。结合文献中的最新研究和我们的结果,同种异体干细胞疗法因其对生理运动结果的鼓舞人心的作用而被引入作为有前景的新疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/394c/9892908/85bc37469521/fmed-10-1051831-g001.jpg

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