使用细胞疗法治疗脊髓疾病/脊髓损伤的特定疾病干预措施
Carl Moritz Zipser1, Armin Curt1
1Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland.
Handbook of clinical neurology
|September 28, 2024
概括
细胞和干细胞疗法对脊髓损伤 (SCI) 恢复有希望,最近的试验表明神经干细胞和施万细胞的安全性和可行性. 临床采用需要进一步证明疗效.
科学领域:
- 神经科学是一个神经科学.
- 再生医学是一种再生医学.
- 临床试验 临床试验
背景情况:
- 创伤性脊髓损伤 (SCI) 导致严重残疾,包括和慢性疼痛,自然再生能力有限.
- 目前的管理重点是急性稳定和神经康复,但对持续性损伤缺乏有效的治疗方法.
- 在SCI之后,急需促进轴突再生和复髓化疗法.
研究的目的:
- 在过去二十年中,审查和批判性地评估基于细胞和干细胞治疗SCI的I/II期临床试验.
- 评估急性SCI治疗和神经康复的现状.
- 评估各种基于细胞的干预措施的安全性,可行性和潜在有效性.
主要方法:
- 对I/II期临床试验的系统审查,研究基于细胞的疗法 (施万细胞,巨细胞,嗅觉增生细胞) 和基于干细胞的疗法 (神经干细胞,介质干细胞,造血干细胞).
- 对最近大型多中心和单中心试验的分析.
- 评估有关安全性,可行性和初步疗效的数据.
主要成果:
- 最近的试验表明神经干细胞移植到受伤的脊髓中的安全性和可行性.
- 单中心试验表明施万细胞移植到创伤后带腔的安全性和可行性.
- 有限的令人鼓舞的数据,通常来自单个患者,但没有经过验证的试验证据支持监管批准.
结论:
- 细胞和干细胞疗法是SCI治疗的有希望的途径,最近的试验建立了安全性和可行性基准.
- 里程碑研究为进一步的干预试验铺平了道路.
- 由于缺乏可靠的疗效数据和监管部门的批准,临床采用仍未得到证实.
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