来稿:陈琳   北京康复中心神经外科

Cell Transplant. 2014 Jan 29.

Intracerebral Implantation of Autologous  Peripheral Blood Stem Cells in Stroke Patients: a Randomized Phase II  Study

 

 Chen, DerCherng ; Lin, ShinnZong ; Fan, JiaRong; Lin, ChenHuan ; Lee, Wei; Lin,  ChaoChun ; Liu, YiJui; Tsai, ChonHaw ; Chen, JuiCheng ; Cho, DerYan ; Lee, ChauChin ; Shyu, WoeiCherng

 

In our previous study, intracerebral implantation of  peripheral blood stem cells (PBSC) improved functional outcome in rats with  chronic cerebral infarction. Based on this findings, a randomized, single blind  controlled study was conducted in 30 patients [PBSC group (n=15) and control  group (n=15)] with middle cerebral artery infarction confirmed on  T2weighted MRI 6 months to 5 years after a stroke. Only  subjects with neurological deficits of intermediate severity based on the  National Institute of Health Stroke Scale (NIHSS) (range: 9–20) that had been  stable for at least 3 months were enrolled. Those in the PBSC group received  subcutaneous GCSF injections (15 μg/kg/d) for 5 consecutive days and  then stereotaxic implantation of 38 x 106CD34+immunosorted PBSCs. All  30 patients completed the 12month followup. No serious adverse events were noted during study  peroid. Improvements in stroke scales (NIHSS, ESS and EMS) and functional outcome (mRS) from baseline to the end  of the 12month followup period were significantly greater in the PBSC than the  control group. The fiber numbers asymmetry (FNA) scores based on diffusion  tensor image tractography (DTI) were reduced in every PBSCtreated subject, but not in the control group. Reduction  in FNA score was correlated well with improvement in NIHSS. Furthermore, a  positive motor evoked potentials (MEP) response by transcranial magnetic  stimulation (TMS) appeared in 9 of the 15 subjects in the PBSC group. This phase  II study demonstrated that implantation of autologous CD34+PBSC was  safe, feasible, and effective in improving functional outcome.


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首届国际神经修复学会年会会议纪要

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卒中患者脑内注入自体外周血干细胞:一项随机II期研究