在首次人類研究中，研究人員發(fā)現(xiàn)相比于傳統(tǒng)的骨再生治療方法,，利用干細胞再生顱面組織---主要是骨---更快速,、更加有效而且侵入性更小。來自美國密歇根大學牙科學院和密歇根口腔健康研究中心的研究人員與Aastrom生物科學公司在一項臨床試驗中開展合作：這項臨床試驗涉及24名牙齒拔出之后接受顎骨重建( jawbone reconstruction)的病人,。
病人們要么接受實驗性組織修復細胞或者傳統(tǒng)引導骨再生療法治療,。這種組織修復細胞被稱作ixmyelocel-T，是由密歇根大學校辦企業(yè)Aastrom生物科學公司開發(fā)的,。
論文第一作者Darnell Kaigler助理教授說,，干細胞療法最適合于顎骨巨大缺損，比如由于創(chuàng)傷,、疾病或出生缺陷而導致的巨大缺損。相對于導入人造的外源物質(zhì)，干細胞療法的主要優(yōu)勢在于它利用病人自己的細胞再生組織,。
實驗結(jié)果是非常有前景的,。在接受實驗性細胞療法治療后6周和12周之后，參與這項研究的病人接受牙移植(dental implant),。接受組織修復細胞治療的病人要比接受傳統(tǒng)引導骨再生療法的病人擁有更高的骨密度和能夠更快地發(fā)生骨修復,。此外，當接受牙移植時,，參與試驗的病人更少需要接受二次骨移植,。
用于組織修復細胞治療的細胞最初是從病人臀部獲取的骨髓中抽提出來的。骨髓經(jīng)過處理之后而允許包括干細胞在內(nèi)的很多不同細胞生長,。這些干細胞然后被植入口腔和顎骨不同區(qū)域之中,。
Kaigler說，干細胞療法仍然可能需要5到10年的時間才能被用于治療口腔和面部損傷和缺陷,。研究人員接下來想在更多的病人身上進行更多的涉及更大顱面缺陷的臨床試驗,。(生物谷：Bioon.com)
本文編譯自Stem Cell Therapy Could Offer New Hope for Defects and Injuries to Head, Mouth
doi: 10.3727/096368912X652968
PMC:
PMID:
Stem Cell Therapy for Craniofacial Bone Regeneration: A Randomized, Controlled, Feasibility Trial
Darnell Kaigler, Giorgio Pagni, Chan Ho Park, Thomas Braun, Lindsay A. Holman, Erica Yi, Susan A. Tarle, Ronnda L. Bartel, William V. Giannobile
Background: Stem cell therapy offers potential in the regeneration of craniofacial bone defects however, has it not been studied clinically. Tissue repair cells (TRCs) isolated from bone marrow represent a mixed stem and progenitor population enriched in CD90 and CD14 positive cells. In this Phase I/II, randomized, controlled, feasibility trial, we investigated TRC cell therapy to reconstruct localized craniofacial bone defects. Methods: 24 patients requiring localized reconstruction of jawbone defects participated in this longitudinal trial. For regenerative therapy, patients were randomized to receive either guided bone regeneration (GBR) or TRC transplantation. 6 or 12 weeks following treatment, clinical and radiographic assessments of bone repair were performed. Bone biopsies were harvested and underwent quantitative micro-computed tomographic (μCT) and bone histomorphometric analyses. Oral implants were installed, subsequently restored and functionally loaded with tooth restorations. Reconstructed sites were assessed for one year following therapy. Results: No study-related, serious adverse events were reported. Following therapy, clinical, radiographic, tomographic, and histological measures demonstrated that TRC therapy accelerated alveolar bone regeneration compared to GBR therapy. Additionally, TRC treatment significantly reduced the need for secondary bone grafting at the time of oral implant placement with a 5-fold decrease in implant bony dehiscence exposure (residual bone defects) as compared to GBR-treated sites (p < 0.01). Conclusions: Transplantation of TRCs for treatment of alveolar bone defects appears safe and accelerates bone regeneration, enabling jawbone reconstruction with oral implants. The results from this trial support expanded studies of TRC therapy in the treatment of craniofacial deformities (ClinicalTrials.gov number CT00755911).
