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骨髓间充质干细胞治疗镰状细胞病继发儿童骨坏死的骨再生

Therapy with bone marrow mesenchymal stem cells in bone regeneration in children with osteonecrosis secondary to sickle cell disease.

作者信息

Teixeira Thiago Rhangel Gomes, Daltro Gildásio de Cerqueira, Sberge Fernando Luis, Barreto Eduardo Silva Reis, da Silva Antônio Ferreira

机构信息

Postgraduate Program in Biotechnology, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.

Department of Experimental Surgery and Surgical Specialties, Federal University of Bahia (UFBA), Salvador, Bahia, Brazil.

出版信息

Front Cell Dev Biol. 2024 May 6;12:1410861. doi: 10.3389/fcell.2024.1410861. eCollection 2024.

Abstract

INTRODUCTION

This study aimed to describe the evolution of bone regeneration in children with hip osteonecrosis associated with sickle cell disease, treated with bone marrow-derived mesenchymal stem cell implants at the Professor Edgar Santos University Hospital Complex.

MATERIALS AND METHODS

A non-randomized clinical trial was conducted with 48 patients of both sexes, aged between 11 and 18 years, diagnosed with femoral head osteonecrosis secondary to sickle cell disease. Patient selection was based on strict criteria, including confirmed diagnosis of sickle cell anemia and a stage of osteonecrosis compatible with the proposed treatment. Bone regeneration assessment was performed through radiographic examinations and magnetic resonance imaging, following the Ficat & Arlet criteria and the Salter-Thompson classification.

RESULTS

Statistical analysis revealed a significant association between the patients' age and positive treatment outcomes, suggesting that autologous bone marrow cell implantation is a safe and effective approach in the early stages of osteonecrosis. The majority of patients (87.5%) reported complete pain relief, while 10.42% experienced significant symptom improvement. Only one patient (2.08%) did not observe improvement. The results indicate that cell therapy can regenerate or slow the progression of bone necrosis, reducing the need for more invasive surgical procedures.

CONCLUSION

The study demonstrates the potential of bone marrow-derived mesenchymal stem cell implantation in treating hip osteonecrosis in children with sickle cell disease, emphasizing the importance of long-term monitoring of bone structure stability.

摘要

引言

本研究旨在描述在埃德加·桑托斯教授大学医院综合体接受骨髓源性间充质干细胞植入治疗的镰状细胞病相关儿童髋部骨坏死的骨再生演变情况。

材料与方法

对48名年龄在11至18岁之间、被诊断为镰状细胞病继发股骨头坏死的男女患者进行了一项非随机临床试验。患者选择基于严格标准,包括镰状细胞贫血的确诊诊断以及与拟议治疗相匹配的骨坏死阶段。根据菲卡特和阿莱特标准以及索尔特 - 汤普森分类法,通过放射学检查和磁共振成像进行骨再生评估。

结果

统计分析显示患者年龄与积极治疗结果之间存在显著关联,表明自体骨髓细胞植入在骨坏死早期是一种安全有效的方法。大多数患者(87.5%)报告疼痛完全缓解,而10.42%的患者症状有显著改善。只有一名患者(2.08%)未观察到改善。结果表明细胞疗法可以再生或减缓骨坏死的进展,减少对更具侵入性手术的需求。

结论

该研究证明了骨髓源性间充质干细胞植入在治疗镰状细胞病儿童髋部骨坏死方面的潜力,强调了长期监测骨结构稳定性的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5442/11102969/5dcb12bdce95/fcell-12-1410861-g001.jpg

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