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有效且持久的复色治疗稳定期白癜风:一项自体皮肤细胞悬液移植治疗的随机自身对照试验。

Effective and durable repigmentation for stable vitiligo: A randomized within-subject controlled trial assessing treatment with autologous skin cell suspension transplantation.

机构信息

Department of Dermatology, Henry Ford Health System, Dermatology Research, Detroit, Michigan.

Department of Dermatology, University of California Irvine, Irvine, California.

出版信息

J Am Acad Dermatol. 2024 Dec;91(6):1104-1112. doi: 10.1016/j.jaad.2024.08.027. Epub 2024 Sep 7.

Abstract

BACKGROUND

Vitiligo lesions are often challenging to repigment with conventional medical therapies. Surgical autologous melanocyte transfer methods can be utilized for stable vitiligo but demand specialized skills and equipment. A point-of-care autologous cell harvesting device was designed enabling simple preparation of autologous skin cell suspension (ASCS) containing melanocytes, keratinocytes, and fibroblasts providing a straightforward approach for cellular transplantation.

OBJECTIVE

To evaluate the safety and effectiveness of ASCS for repigmentation of stable vitiligo lesions among adults.

METHODS

A US multicenter, randomized, within-subject controlled trial compared ASCS to narrow band ultraviolet B only (Control) in similar vitiligo lesions. ASCS was applied after laser skin resurfacing and followed by narrow band ultraviolet B treatment. The primary effectiveness endpoint was the proportion of lesions achieving ≥80% repigmentation at week-24. Repigmentation durability was assessed at week-52.

RESULTS

Among 25 subjects, 36% of ASCS-treated lesions achieved ≥80% repigmentation at week-24 compared to 0% for Control (P < .025), with durability through week-52. The safety profile of ASCS was acceptable, with favorable patient- and investigator-reported outcomes.

LIMITATIONS

Study sample size limited robust subgroup analyses.

CONCLUSION

Application of ASCS has potential as a treatment for repigmentation of stable vitiligo lesions with the potential to improve health-related quality of life and reduce burden of disease.

摘要

背景

常规医学疗法往往难以使白癜风病变部位复色。对于稳定型白癜风,可以采用手术自体黑素细胞移植方法,但需要专业技能和设备。我们设计了一种即时自体细胞采集装置,能够简单地制备含有黑素细胞、角质形成细胞和成纤维细胞的自体皮肤细胞悬浮液(ASCS),为细胞移植提供了一种简单的方法。

目的

评估 ASCS 对成人稳定型白癜风病变复色的安全性和有效性。

方法

一项美国多中心、随机、自身对照试验比较了 ASCS 与仅窄带紫外线 B(对照)在类似白癜风病变中的疗效。ASCS 在激光皮肤磨削术后应用,并随后进行窄带紫外线 B 治疗。主要有效性终点是第 24 周时达到≥80%复色的病变比例。在第 52 周时评估复色的耐久性。

结果

在 25 名受试者中,ASCS 治疗的病变中有 36%在第 24 周时达到≥80%复色,而对照组为 0%(P<.025),并且在第 52 周时仍具有耐久性。ASCS 的安全性特征是可以接受的,患者和研究者报告的结果良好。

局限性

研究样本量限制了稳健的亚组分析。

结论

ASCS 的应用具有治疗稳定型白癜风病变复色的潜力,有可能改善与健康相关的生活质量并减轻疾病负担。

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