Mazzini Letizia, De Marchi Fabiola, Buzanska Leonora, Follenzi Antonia, Glover Joel Clinton, Gelati Maurizio, Lombardi Ivan, Maioli Margherita, Mesa-Herrera Fatima, Mitrečić Dinko, Olgasi Cristina, Pivoriūnas Augustas, Sanchez-Pernaute Rosario, Sgromo Chiara, Zychowicz Marzena, Vescovi Angelo, Ferrari Daniela
ALS Center, Neurology Unit, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
Department of Stem Cell Bioengineering, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland.
Expert Opin Biol Ther. 2024 Sep;24(9):933-954. doi: 10.1080/14712598.2024.2392307. Epub 2024 Aug 23.
Cell therapy development represents a critical challenge in amyotrophic lateral sclerosis (ALS) research. Despite more than 20 years of basic and clinical research, no definitive safety and efficacy results of cell-based therapies for ALS have been published.
This review summarizes advances using stem cells (SCs) in pre-clinical studies to promote clinical translation and in clinical trials to treat ALS. New technologies have been developed and new experimental and animal models are now available to facilitate pre-clinical research in this field and to determine the most promising approaches to pursue in patients. New clinical trial designs aimed at developing personalized SC-based treatment with biological endpoints are being defined.
Knowledge of the basic biology of ALS and on the use of SCs to study and potentially treat ALS continues to grow. However, a consensus has yet to emerge on how best to translate these results into therapeutic applications. The selection and follow-up of patients should be based on clinical, biological, and molecular criteria. Planning of SC-based clinical trials should be coordinated with patient profiling genetically and molecularly to achieve personalized treatment. Much work within basic and clinical research is still needed to successfully transition SC therapy in ALS.
细胞疗法的发展是肌萎缩侧索硬化症(ALS)研究中的一个关键挑战。尽管进行了 20 多年的基础和临床研究,但尚未公布基于细胞的疗法治疗 ALS 的明确安全性和有效性结果。
本综述总结了使用干细胞(SCs)在临床前研究中的进展,以促进临床转化,以及在临床试验中治疗 ALS。已经开发了新技术,并且现在有新的实验和动物模型可用于促进该领域的临床前研究,并确定在患者中最有前途的方法。目前正在定义旨在开发基于 SC 的个性化治疗并具有生物学终点的新临床试验设计。
对 ALS 的基础生物学和使用 SC 来研究和潜在治疗 ALS 的认识不断提高。然而,对于如何最好地将这些结果转化为治疗应用,尚未达成共识。患者的选择和随访应基于临床、生物学和分子标准。基于 SC 的临床试验的规划应与患者的基因和分子特征相协调,以实现个性化治疗。在 ALS 中成功过渡 SC 治疗仍需要在基础和临床研究中开展大量工作。