根據(jù)德州大學(xué)健康科學(xué)中心的第一期臨床實(shí)驗(yàn)結(jié)果表明。采用患者自身的骨髓干細(xì)胞,，可有效地治療創(chuàng)傷性腦損傷(TBI)的患者,。該研究已發(fā)表在本月的神經(jīng)外科期刊上。
該研究的主要作者,，小兒神經(jīng)外科教授Charles S. Cox, Jr說,，我們的數(shù)據(jù)表明將骨髓單個(gè)核細(xì)胞注入TBI小兒患者是安全的。臨床試驗(yàn)的對象是十名5到14歲的患有重度TBI的兒童,，該試驗(yàn)與赫爾曼紀(jì)念醫(yī)院共同完成,。Cox是該項(xiàng)目的負(fù)責(zé)人。
所有的兒童將在受傷48小時(shí)內(nèi)注入來自其自身骨髓的干細(xì)胞,，并使其由靜脈內(nèi)還原,。目前研究人員正在對急性腦卒中的成年患者進(jìn)行相同的骨髓干細(xì)胞植入程序的測試。在另一項(xiàng)測試中,，Cox正在嘗試使用兒童自身的臍帶血干細(xì)胞治療TBI,。
第一階段的測試旨在研究治療的安全性和可行性，還沒有評估其療效,。然而,，在之后的六個(gè)月內(nèi)，所有的兒童的病癥都有顯著改善,，十個(gè)兒童中的七名兒童擁有"良好的療效",，這意味著沒有或只有輕微的殘疾。
在TBI中幸存的兒童,，常常伴有嚴(yán)重的并發(fā)癥和殘疾,。目前，對這些腦部受傷兒童還沒有有效的治療以保護(hù)和促進(jìn)大腦損傷的修復(fù),。
中文鏈接：http://www.chinastemcell.org/page/zixun_xwdtlist.aspx?infoid=1014
生物谷推薦英文摘要：
Neurosurgery. 2011 Mar;68(3):588-600.
Autologous bone marrow mononuclear cell therapy for severe traumatic brain injury in children.
Cox CS Jr, Baumgartner JE, Harting MT, Worth LL, Walker PA, Shah SK, Ewing-Cobbs L, Hasan KM, Day MC, Lee D, Jimenez F, Gee A.
Department of Pediatric Surgery, University of Texas Medical School at Houston, and Children's Memorial Hermann Hospital, University of Texas, Houston, Texas 77030, USA. [email protected]
BACKGROUND: Severe traumatic brain injury (TBI) in children is associated with substantial long-term morbidity and mortality. Currently, there are no successful neuroprotective/neuroreparative treatments for TBI. Numerous preclinical studies suggest that bone marrow-derived mononuclear cells (BMMNCs), their derivative cells (marrow stromal cells), or similar cells (umbilical cord blood cells) offer neuroprotection.
OBJECTIVE: To determine whether autologous BMMNCs are a safe treatment for severe TBI in children.
METHODS: Ten children aged 5 to 14 years with a postresuscitation Glasgow Coma Scale of 5 to 8 were treated with 6×10 autologous BMMNCs/kg body weight delivered intravenously within 48 hours after TBI. To determine the safety of the procedure, systemic and cerebral hemodynamics were monitored during bone marrow harvest; infusion-related toxicity was determined by pediatric logistic organ dysfunction (PELOD) scores, hepatic enzymes, Murray lung injury scores, and renal function. Conventional magnetic resonance imaging (cMRI) data were obtained at 1 and 6 months postinjury, as were neuropsychological and functional outcome measures.
RESULTS: All patients survived. There were no episodes of harvest-related depression of systemic or cerebral hemodynamics. There was no detectable infusion-related toxicity as determined by PELOD score, hepatic enzymes, Murray lung injury scores, or renal function. cMRI imaging comparing gray matter, white matter, and CSF volumes showed no reduction from 1 to 6 months postinjury. Dichotomized Glasgow Outcome Score at 6 months showed 70% with good outcomes and 30% with moderate to severe disability.
CONCLUSION: Bone marrow harvest and intravenous mononuclear cell infusion as treatment for severe TBI in children is logistically feasible and safe.
