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自体移植 P63 肺祖细胞治疗慢性阻塞性肺疾病。

Autologous transplantation of P63 lung progenitor cells for chronic obstructive pulmonary disease therapy.

机构信息

Department of Organ Regeneration, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.

Department of Respiratory and Critical Care Medicine, Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an 223300, China.

出版信息

Sci Transl Med. 2024 Feb 14;16(734):eadi3360. doi: 10.1126/scitranslmed.adi3360.

Abstract

Adult lung resident stem/progenitor cells, including P63 progenitor cells, have demonstrated the capacity for regeneration of lung epithelium in preclinical models. Here, we report a clinical trial of intrapulmonary P63 progenitor cell transplantation in 28 participants with stage II to IV chronic obstructive pulmonary disease (COPD). Autologous P63 progenitor cells were isolated from the airway basal layer of participants in the intervention group via bronchoscopic brushing, cultured for 3 to 5 weeks, and then transplanted back into the lungs via bronchoscopy at 0.7 × 10 to 5.2 × 10 cells per kilogram of body weight. Twenty patients were evaluable at the end of the study (intervention group, = 17; control group, = 3). No grade 3 to 5 adverse events (AEs) or serious AEs occurred. Although bronchoscopy-associated AEs were recorded in participants in the intervention group, other AEs were not substantial different between groups. Twenty-four weeks after transplantation, participants in the intervention group displayed improvement in gas transfer capacity [diffusing capacity of the lung for carbon monoxide (DLCO) change from baseline: +18.2%], whereas the control group experienced a decrease (DLCO change from baseline: -17.4%; = 0.008). Furthermore, participants in the intervention group showed >30-meter increase in walking distance within 6 minutes. Transcriptomic analysis of progenitor cells isolated from responding and nonresponding individuals in the intervention group showed that higher expression of was associated with treatment efficacy. In conclusion, transplantation of cultured P63 lung progenitor cells was safe and might represent a potential therapeutic strategy for COPD.

摘要

成人肺常驻干细胞/祖细胞,包括 P63 祖细胞,在临床前模型中已显示出再生肺上皮的能力。在这里,我们报告了一项在 28 名 II 期至 IV 期慢性阻塞性肺疾病(COPD)患者中进行肺内 P63 祖细胞移植的临床试验。干预组的参与者通过支气管镜刷从气道基底层分离自体 P63 祖细胞,在体外培养 3 至 5 周,然后通过支气管镜以每千克体重 0.7×10 至 5.2×10 个细胞的剂量回输到肺部。研究结束时,有 20 名患者可进行评估(干预组,n=17;对照组,n=3)。没有发生 3 级至 5 级不良事件(AE)或严重 AE。尽管干预组的参与者记录了与支气管镜相关的 AE,但两组之间其他 AE 没有显著差异。移植后 24 周,干预组参与者的气体转移能力得到改善[一氧化碳弥散量(DLCO)从基线的变化:+18.2%],而对照组则下降(DLCO 从基线的变化:-17.4%;=0.008)。此外,干预组的参与者在 6 分钟内的步行距离增加了 30 米以上。对干预组中反应者和无反应者分离的祖细胞进行转录组分析表明,更高的 表达与治疗效果相关。总之,培养的 P63 肺祖细胞移植是安全的,可能代表 COPD 的一种潜在治疗策略。

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