中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (11): 1841-1845.doi: 10.4103/1673-5374.165325

• 原著:脊髓损伤修复保护与再生 • 上一篇    下一篇

自体骨髓间充质干细胞治疗视神经脊髓炎患者压疮

  

  • 收稿日期:2015-08-26 出版日期:2015-12-07 发布日期:2015-12-07
  • 基金资助:

    该项目由罗马尼亚教育与研究部(研究项目:替代疗法在主要组织缺损中的应用42136/01.10.2008)支持

Autologous mesenchymal stem cells applied on the pressure ulcers had produced a surprising outcome in a severe case of neuromyelitis optica

Adriana Octaviana Dulamea1, 2, #, *, Mirela-Patricia Sirbu-Boeti1, 2, #, Coralia Bleotu3, Denisa Dragu3, Lucia Moldovan4, Ioana Lupescu1, 2,
Giancarlo Comi5   

  1. 1 U.M.F. Carol Davila, 8 Bulevardul Eroii Sanitari, Bucharest, Sector 2, Romania
    2 Department of Neurology, Fundeni Clinical Institute, 258 Soseaua Fundeni, Bucharest, Sector 5, Romania
    3 National Virology Institute Stefan S. Nicolau, 285 Mihai Bravu Avenue, Bucharest, Sector 3, PO 77, PO Box 201, Romania
    4 National Institute of Research and Development for Biological Sciences, 296 Splaiul Independen?ei, Bucharest, Sector 6, PO Box 17-16, Romania
    5 Universita Vita-Salute San Raffaele, 58 Via Olgettina, Milan, Italy
  • Received:2015-08-26 Online:2015-12-07 Published:2015-12-07
  • Contact: Adriana Octaviana Dulamea, M.D., Ph.D., adrianadulamea@gmail.com.
  • Supported by:

    This work was supported by the Romanian Ministry of Education and Research (Research project: Alternative therapies for major tissue defects 42136/01.10.2008).

摘要:

骨髓干细胞促进严重视神经脊髓炎压力性溃疡愈合:令人惊讶的结果
最近一些研究提供的证据表明,间充质干细胞在皮肤修复方面具有再生潜能,同时它们的深度免疫调节特性使其成为治疗神经免疫性疾病的候选方法之一。视神经脊髓炎是一种自身免疫性及中枢神经系统脱髓鞘疾病,病变特点是纵向广泛的脊髓损伤。文章报道了一名被诊断为视神经脊髓炎46岁男性患者,虽已经过治疗但复发后截瘫,并且腿部形成两个阶段的压力性溃疡。Adriana Dulamea教授等采用患者自体骨髓间充质干细胞对溃疡部位局部进行治疗。结果显示干细胞治疗后第8天,患者压力性溃疡部位逐步愈合,残疾状况开始改善;两个月后,患者能走20米远;1年后,患者可以在没有帮助下行走;76个月时,患者无复发且无不良事件报告。这个病例报告提示使用原始方法进行自体骨髓间充质干局部应用能够促成压力性溃疡愈合。6年时间内,患者无复发,并且残疾情况得到极大改进。

Abstract:

Recent studies provided evidence that mesenchymal stem cells (MSCs) have regenerative potential in cutaneous repair and profound immunomodulatory properties making them a candidate for therapy of neuroimmunologic diseases. Neuromyelitis optica (NMO) is an autoimmune, demyelinating
central nervous system disorder characterized by a longitudinally extensive spinal cord lesion. A 46-year-old male diagnosed with NMO had relapses with paraplegia despite treatment and developed two stage IV pressure ulcers (PUs) on his legs. The patient consented for local application of autologous MSCs on PUs. MSCs isolated from the patient’s bone marrow aspirate were multiplied in vitro during three passages and embedded in a tridimensional collagen-rich matrix which was applied on the PUs. Eight days after MSCs application the patient showed a progressive healing of PUs and improvement of disability. Two months later the patient was able to walk 20 m with bilateral assistance and one year later he started to walk without assistance. For 76 months the patient had no relapse and no adverse event was reported. The original method of local application of autologous BM-MSCs contributed to healing of PUs. For 6 years the patient was free of relapses and showed an improvement of disability. The association of cutaneous repair, sustained remission of NMO and improvement of disability might be explained by a promotion/optimization of recovery mechanisms
in the central nervous system even if alternative hypothesis should be considered. Further studies are needed to assess the safety and efficacy of mesenchymal stem cells in NMO treatment.

Key words: neuromyelitis optica, Devic’s syndrome, mesenchymal stem cells, multiple sclerosis, pressure ulcers