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脂肪来源的基质血管成分细胞治疗帕金森病的安全性。

Safety of adipose-derived stromal vascular fraction cells to treat Parkinson's disease.

作者信息

Carstens Michael, Martínez-Cerrato Jorge, Garcia Luis, Rivera Bayron, Bertram Kenneth

机构信息

Department of Surgery, Hospital Esucela Oscar Danilo Rosales Argüello, León, Nicaragua; Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC, USA.

Department of Medicine, Division of Neurology, Hospital Vivian Pellas - Managua, Nicaragua.

出版信息

Parkinsonism Relat Disord. 2025 Mar;132:107214. doi: 10.1016/j.parkreldis.2024.107214. Epub 2024 Nov 28.

Abstract

Neuroinflammation is a significant correlate of Parkinson's Disease (PD), with positron emission tomography showing microglial activation early in the PD process and post-mortem tissue containing reactive microglia. Adipose-derived (AD) stromal vascular fraction (SVF) cells have been shown to respond to pro-inflammatory conditions with secretion of anti-inflammatory paracrine factors. This pilot clinical trial was to examine the safety and clinical response using autologous ADSVF to treat PD. Nine PD subjects had baseline neurological exams and Parkinson's Disease Questionnaire 39 (PDQ-39) and "off-medication" Movement Disorder Society (MDS) - Unified Parkinson's Disease Rating Scale (UPDRS) Part III assessments. Each subject had a liposuction procedure; the lipoaspirate was then processed via enzymatic digestion to yield SVF. All subjects were treated with a total dose of 30 million autologous SVF cells injected in the forehead and maxillary regions. Subjects were followed at 1-, 3-, 6-, 12-, and 24-months for safety and potential clinical improvement. There were no SVF intervention-related serious adverse events. PDQ-39 scores at 12-months and 24-months were improved in 6 of 9 subjects evaluable and 4 of 7 subjects evaluable, respectfully. Scores were stable in 1 subject and worse in 2 subjects. MDS-UPDRS Part III scores were improved at 24, months in 3 evaluable subjects and were stable in 2 subjects. One subject required increased dopaminergic medication for increased tremor (disease progression). Autologous ADSVF via facial injections to treat PD was safe, showed evidence of clinical improvement at 12 and 24 months and should be further evaluated in a Phase II placebo-controlled clinical trial.

摘要

神经炎症是帕金森病(PD)的一个重要相关因素,正电子发射断层扫描显示在PD病程早期存在小胶质细胞激活,且尸检组织中含有反应性小胶质细胞。脂肪来源的(AD)基质血管成分(SVF)细胞已被证明可通过分泌抗炎旁分泌因子来应对促炎状态。这项初步临床试验旨在研究使用自体ADSVF治疗PD的安全性和临床反应。9名PD受试者进行了基线神经学检查、帕金森病问卷39项(PDQ-39)以及“未服药”状态下运动障碍协会(MDS)-统一帕金森病评定量表(UPDRS)第三部分评估。每位受试者均接受了抽脂手术;然后通过酶消化处理抽脂物以获得SVF。所有受试者均接受了总量为3000万个自体SVF细胞的治疗,这些细胞被注射到前额和上颌区域。在1个月、3个月、6个月、12个月和24个月时对受试者进行随访,以评估安全性和潜在的临床改善情况。未发生与SVF干预相关的严重不良事件。在可评估的9名受试者中,有6名在12个月时PDQ-39评分得到改善,在可评估的7名受试者中,有4名在24个月时PDQ-39评分得到改善。1名受试者的评分保持稳定,2名受试者的评分变差。在可评估的3名受试者中,MDS-UPDRS第三部分评分在24个月时得到改善,2名受试者的评分保持稳定。1名受试者因震颤加剧(疾病进展)需要增加多巴胺能药物剂量。通过面部注射自体ADSVF治疗PD是安全的,在12个月和24个月时显示出临床改善的证据,应在II期安慰剂对照临床试验中进一步评估。

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