来稿:陈琳  北京康复中心神经外科

Cell Transplant. 2013 Apr 2.

 

Transplantation of autologous olfactory ensheathing cells  in complete human spinal cord injury

 

Tabakow P, Jarmundowicz W, Czapiga B, Fortuna W,  Miedzybrodzki R, Czyz M, Huber J, Szarek D, Okurowski S, Szewczyk P, Gorski A,  Raisman G.

 

OBJECTIVE: Numerous studies in animals have shown the  unique property of olfactory ensheathing cells to stimulate regeneration of  lesioned axons in the spinal cord. In a Phase I clinical trial, we assessed the  safety and feasibility of transplantation of autologous mucosal olfactory  ensheathing cells and olfactory nerve fibroblasts in patients with complete  spinal cord injury. METHODS: Six patients with chronic thoracic paraplegia  (American Spinal Injury Association class AASIA A) were enrolled for the study.  Three patients were operated and three served as a control group. The trial  protocol consisted of pre- and postoperative neuro-rehabilitation, olfactory  mucosal biopsy, culture of olfactory ensheathing cells, and intraspinal cell  grafting. Patient's clinical state was evaluated by clinical, neurophysiological  and radiological tests. RESULTS: There were no adverse findings related to  olfactory mucosa biopsy or transplantation of olfactory ensheathing cells at one  year after surgery. There was no evidence of neurological deterioration,  neuropathic pain, neuroinfection or tumorigenesis. In one cell-grafted patient  an asymptomatic syringomyelia was observed. Neurological improvement was  observed only intransplant recipients. The first 2 operated patients improved  from ASIA A to ASIA C and ASIA B. Diffusion tensor imaging  showed restitution of continuity of some white matter tracts throughout the  focus of spinal cord injury in these patients. The third operated patient  although remained ASIA A, showed improved motor  and sensory function of the first spinal cords segments below the level of  injury. Neurophysiological examinations showed improvement in spinal cord  transmission and activity of lower extremity muscles in surgically treated  patients but not in patients receiving only neuro-rehabilitation. CONCLUSIONS:  Observations at 1 year indicate that the obtaining, culture and intraspinal  transplantation of autologous olfactory ensheathing cells was safe and feasible.  The significance of the neurological improvement in the transplant recipients  and the extent to which the cell transplants contributed to it will require  larger numbers of patients.


脊髓损伤患者自体骨髓间充质干细胞移植临床研究报告
人类关节内培养干细胞疗法的安全性:一个系统性文献回顾

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完全性脊髓损伤患者自体嗅鞘细胞移植