中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (9): 1507-1515.doi: 10.4103/1673-5374.165525

• 原著:神经损伤修复保护与再生 • 上一篇    下一篇

干细胞治疗复发自身免疫视神经病:干细胞眼科治疗研究临床试验

  

  • 收稿日期:2015-08-02 出版日期:2015-09-28 发布日期:2015-09-28

Stem Cell Ophthalmology Treatment Study (SCOTS) for retinal and optic nerve diseases: a case report of improvement in relapsing auto-immune optic neuropathy

Jeffrey N. Weiss1, Steven Levy2, Susan C. Benes3   

  1. 1 Retina Associates of South Florida, Margate, FL, USA
    2 MD Stem Cells, Ridgefield, CT, USA
    3 Wilmer Eye Institute, The Johns Hopkins Hospital, Baltimore, MD, USA
  • Received:2015-08-02 Online:2015-09-28 Published:2015-09-28
  • Contact: Steven Levy, M.D., stevenlevy@mdstemcells.com.

摘要:

干细胞眼科治疗研究(SCOTS)是一项经人体研究伦理委员会批准的、利用自体骨髓干细胞治疗视神经和视网膜疾病的临床试验;是目前为止,美国国立卫生研究院在临床试验注册数据库(www.clinicaltrials.gov Identifier NCT 01920867)注册的最大型眼科干细胞研究。我们应用SCOTS治疗1例复发自身免疫性视神经病。治疗前后的复杂眼科检查在美国Florida研究中心和Columbus眼中心完成。患者复发视神经炎时,右眼和左眼视力从正常降至20/350-20/400和20/70,双眼视野缺损。右眼行骨髓干细胞视神经内注射,左眼行骨髓干细胞眼球后、结膜下和玻璃体内注射。SCOTS治疗后15个月,患者右眼和左眼视力提高至20/150和20/20,双眼视野缺损明显改善。治疗后3和6个月,视网膜黄斑区和视网膜神经纤维层厚度也明显改善。治疗所用的免疫抑制剂麦考酚酸酯在治疗后的15月的随访期所用剂量从每日1500mg降至500mg,且逐渐不再并用类固醇类制剂。

关键词: 干细胞, 视神经, 自身免疫, 视神经病变, 眼科, 骨髓干细胞, 失明, 干细胞眼科治疗研究, SCOTS

Abstract:

We present the results from a patient with relapsing optic neuropathy treated within the Stem Cell Ophthalmology Treatment Study (SCOTS). SCOTS is an Institutional Review Board approved clinical trial and has become the largest ophthalmology stem cell study registered at the National Institutes of Health to date (www.clinicaltrials.gov Identifier NCT 01920867). SCOTS utilizes autologous bone marrow-derived stem cells (BMSCs) for treatment of retinal and optic nerve diseases. Pre-treatment and post-treatment comprehensive eye exams of a 54 year old female patient were performed both at the Florida Study Center, USA and at The Eye Center of Columbus, USA. As a consequence of a relapsing optic neuritis, the patient’s previously normal visual acuity decreased to between 20/350 and 20/400 in the right eye and to 20/70 in the left eye. Significant visual field loss developed bilaterally. The patient underwent a right eye vitrectomy with injection of BMSCs into the optic nerve of the right eyeand retrobulbar, subtenon and intravitreal injection of BMSCs in the left eye. At 15 months after SCOTS treatment, the patient’s visual acuity had improved to 20/150 in the right eye and 20/20 in the left eye. Bilateral visual fields improved markedly. Both macular thickness and fast retinal nerve fiber layer thickness were maximally improved at 3 and 6 months after SCOTS treatment. The patient also reduced her mycophenylate dose from 1,500 mg per day to 500 mg per day and required no steroid pulse therapy during the 15-month follow up.

Key words: nerve regeneration, stem cells, optic nerve, autoimmune, optic neuropathy, ophthalmology, bone marrow-derived stem cells, blindness, visual loss, Stem Cell Ophthalmology Treatment Study, neural regeneration