Karpati G, Ajdukovic D, Arnold D, Gledhill R B, Guttmann R, Holland P, Koch P A, Shoubridge E, Spence D, Vanasse M
Montreal Neurological Institute, Quebec, Canada.
Ann Neurol. 1993 Jul;34(1):8-17. doi: 10.1002/ana.410340105.
One biceps muscle of 8 patients with Duchenne muscular dystrophy was injected at 55 sites with a total of 55 million viable, purified, and contamination-free normal myoblasts (myoblast transfer). The other biceps of each patient was injected with a placebo to serve as a control. The procedure was blinded to the patients, parents, and investigators. Myoblasts derived from a biopsy specimen of the fathers were cultured and purified under strict conditions and carefully screened for microbial contamination. All patients received cyclophosphamide for immunosuppression for 6 or 12 months. No serious complications were observed after myoblast transfer, indicating that the procedure is safe. The overall therapeutic efficiency of myoblast transfer was poor as judged by the results in maximal voluntary force generation, dystrophin content of the muscle, magnetic resonance imaging of the muscle, and the lack of donor-derived DNA and dystrophin messenger RNA in the injected muscle. An improved efficiency of the take of myoblasts might be achieved by using younger cells and injecting the myoblasts with a myonecrotic agent (to increase the prevalence of regeneration) and a basal laminal fenestrating agent.
对8例杜氏肌营养不良症患者的一侧肱二头肌在55个部位注射了总共5500万个存活、纯化且无污染的正常成肌细胞(成肌细胞移植)。每位患者的另一侧肱二头肌注射了安慰剂作为对照。该操作对患者、家长和研究人员均设盲。取自父亲活检标本的成肌细胞在严格条件下培养和纯化,并仔细筛查微生物污染。所有患者接受环磷酰胺免疫抑制治疗6或12个月。成肌细胞移植后未观察到严重并发症,表明该操作是安全的。根据最大随意肌力产生、肌肉中抗肌萎缩蛋白含量、肌肉磁共振成像结果以及注射肌肉中缺乏供体来源的DNA和抗肌萎缩蛋白信使核糖核酸判断,成肌细胞移植的总体治疗效果较差。使用更年轻的细胞,并将成肌细胞与一种肌坏死剂(以增加再生发生率)和一种基底膜开窗剂一起注射,可能会提高成肌细胞的植入效率。