regenerative therapy

再生疗法
  • 文章类型: Journal Article
    本文旨在总结腰椎间盘退变再生治疗领域的最新进展和挑战。目前症状性腰椎间盘退变的一线治疗方案不能改变疾病进程或恢复正常结构,composition,和退化椎间盘的生物力学功能。已经开发了适于促进椎间盘(IVD)再生的基于细胞的疗法以恢复IVD细胞外基质或减轻炎症状况。间充质干细胞(MSCs)的人类临床试验报告了MSCs在减轻疼痛和改善功能方面表现出的有希望的结果。髓核(NP)细胞具有独特的再生能力。针对IVD再生中NP替代的生物材料,包括合成和生物材料,旨在恢复椎间盘高度和节段稳定性,而不损害纤维环。同样,复合IVD替代品,结合各种生物材料策略来模拟天然椎间盘结构,包括有组织的纤维环和NP组件,显示出了希望。此外,利用细胞的再生医学疗法的临床前研究,生物材料,生长因子,富血小板血浆(PRP),和生物制剂已经证明了它们在修复退化的腰椎间盘方面的前景。然而,这些疗法伴随着显著的局限性和挑战,阻碍了它们的临床应用.因此,必须进行进一步的研究来应对这些挑战。
    This review aimed to summarize the recent advances and challenges in the field of regenerative therapies for lumbar disc degeneration. The current first-line treatment options for symptomatic lumbar disc degeneration cannot modify the disease process or restore the normal structure, composition, and biomechanical function of the degenerated discs. Cell-based therapies tailored to facilitate intervertebral disc (IVD) regeneration have been developed to restore the IVD extracellular matrix or mitigate inflammatory conditions. Human clinical trials on Mesenchymal Stem Cells (MSCs) have reported promising outcomes exhibited by MSCs in reducing pain and improving function. Nucleus pulposus (NP) cells possess unique regenerative capacities. Biomaterials aimed at NP replacement in IVD regeneration, comprising synthetic and biological materials, aim to restore disc height and segmental stability without compromising the annulus fibrosus. Similarly, composite IVD replacements that combine various biomaterial strategies to mimic the native disc structure, including organized annulus fibrosus and NP components, have shown promise. Furthermore, preclinical studies on regenerative medicine therapies that utilize cells, biomaterials, growth factors, platelet-rich plasma (PRP), and biological agents have demonstrated their promise in repairing degenerated lumbar discs. However, these therapies are associated with significant limitations and challenges that hinder their clinical translation. Thus, further studies must be conducted to address these challenges.
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  • 文章类型: Journal Article
    骨髓穿刺液(BMA)关节内注射是骨关节炎(OA)的一种微创生物矫正治疗选择。髋关节OA影响了很大一部分人群,并且缺乏有关正交生物学治疗的数据。这项研究的主要目的是描述骨髓穿刺液关节内注射对减轻髋关节OA患者疼痛和改善功能的临床影响。
    单中心,31例患者的回顾性分析,32至83岁(62.4±16.5),Kellgren-Lawrence(KL)髋关节OA分级为2-4(平均2.9±0.7),患者接受了髋关节内注射骨髓穿刺液,并随访了12个月。评估是在基线,12周,6个月,和12个月使用数字评定量表(NRS)进行疼痛和髋关节残疾和骨关节炎结果评分Jr(HOOS-Jr)进行功能。响应者的比例,根据NRS疼痛评分降低≥50%的定义,在12周时进行评估,6个月和12个月。
    随访6个月和12个月时,NRS评分有统计学显著改善(P<0.05)。按KL等级分层,KL2级和3级受试者在6个月和12个月时NRS评分有统计学意义的改善.KL4级患者在12个月时疼痛有显著改善。42%的患者在6个月和61%的患者在12个月时报告疼痛减轻≥50%。按KL等级分层时,到12个月时,分别有80%和71%的KL2和KL3等级是应答者。患者在6个月和12个月时的HOOS-Jr评分有统计学意义的改善。
    轻度患者,中度,和严重的髋关节OA,BMA可能是一种替代疗法,可以在长达12个月的时间内改善患者的疼痛和功能。此外,BMA也可能是有效的,更低成本的选择更昂贵的BMAC准备。
    UNASSIGNED: Bone marrow aspirate (BMA) intra-articular injection is a minimally invasive orthobiologic treatment option for osteoarthritis (OA). Hip OA affects a significant portion of the population and has a paucity of data surrounding orthobiologic treatments. The primary objective of this study was to delineate the clinical impact of bone marrow aspirate intra-articular injections on decreasing pain and improving function in patients with hip OA.
    UNASSIGNED: A single-center, retrospective analysis of thirty-one patients, aged 32 to 83 (62.4 ​± ​16.5), with Kellgren-Lawrence (KL) Hip OA grading of 2-4 (mean 2.9 ​± ​0.7), who underwent intra-articular bone marrow aspirate injection into the hip and were followed for twelve months. Evaluation was at baseline, 12 weeks, 6 months, and 12 months using the Numerical Rating Scale (NRS) for pain and the Hip Disability and Osteoarthritis Outcome Score Jr (HOOS-Jr) for function. The proportion of responders, as defined by a ≥50% reduction in NRS pain score, was assessed at 12 weeks, 6 months and 12 months.
    UNASSIGNED: At 6 and 12 months follow-up, there was a statistically significant improvement in NRS scores (P ​< ​0.05). Stratifying by KL grade, subjects with KL grades 2 and 3 experienced statistically significant improvement in NRS scores at 6 and 12 months. Patients with KL grade 4 showed significant improvement in pain at 12 months. Forty-two percent of patients at 6 months and 61% at 12 months reported ≥50% reduction in pain. When stratifying by KL grade, 80% and 71% of KL2 and KL3 grades respectively were responders by 12 months. Patients experienced statistically significant improvement in HOOS-Jr scores at 6 and 12 months.
    UNASSIGNED: In patient with mild, moderate, and severe hip OA, BMA may be an alternative treatment that improves pain and function in patients for as long as 12 months. In addition, BMA may also be an effective, lower cost option to more expensive BMAC preparations.
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  • 文章类型: Journal Article
    中枢神经系统(CNS)损伤和神经退行性疾病的预后明显较差,并且由于CNS神经元普遍无法再生而导致永久性功能障碍。移植干细胞的分化已成为在受损区域再生组织结构的治疗途径。电刺激是指导移植干细胞的分化结果和生长模式的一种有前途的方法。然而,传统的无机生物电极会引起不良反应,如炎症。这项研究证明了两种有机薄膜的实现,聚合物/还原氧化石墨烯纳米复合材料(P(rGO))和PEDOT:PSS,具有作为电刺激的导电材料的良好性能,以及无机氧化铟锡(ITO)导电膜。转录组学分析显示,电刺激改善了SH-SY5Y细胞在所有三个膜上的神经元分化,对P(rGO)的影响最大。观察到独特的材料和电刺激介导的效应,与分化相关,细胞-基质粘附,和翻译。这项工作表明,P(rGO)和PEDOT:PSS是非常有前途的有机材料,用于开发生物相容性,导电支架,将增强电辅助干细胞治疗中枢神经系统损伤和神经退行性疾病。
    Central nervous system (CNS) injuries and neurodegenerative diseases have markedly poor prognoses and can result in permanent dysfunction due to the general inability of CNS neurons to regenerate. Differentiation of transplanted stem cells has emerged as a therapeutic avenue to regenerate tissue architecture in damaged areas. Electrical stimulation is a promising approach for directing the differentiation outcomes and pattern of outgrowth of transplanted stem cells, however traditional inorganic bio-electrodes can induce adverse effects such as inflammation. This study demonstrates the implementation of two organic thin films, a polymer/reduced graphene oxide nanocomposite (P(rGO)) and PEDOT:PSS, that have favorable properties for implementation as conductive materials for electrical stimulation, as well as an inorganic indium tin oxide (ITO) conductive film. Transcriptomic analysis reveals that electrical stimulation improves neuronal differentiation of SH-SY5Y cells on all three films, with the greatest effect for P(rGO). Unique material- and electrical stimuli-mediated effects are observed, associated with differentiation, cell-substrate adhesion, and translation. The work demonstrates that P(rGO) and PEDOT:PSS are highly promising organic materials for the development of biocompatible, conductive scaffolds that will enhance electrically-aided stem cell therapeutics for CNS injuries and neurodegenerative diseases.
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  • 文章类型: Journal Article
    细胞外囊泡(EV)对于细胞与细胞的通讯至关重要,转移蛋白质,脂质,以及各种生理和病理过程中的核酸。它们在免疫调节和组织再生中起关键作用,但也参与炎症和退行性疾病等致病疾病。电动汽车有异质的种群和货物,目前正在调查许多亚群。EV疗法在刺激组织修复和作为药物输送工具方面显示出希望,提供优于细胞疗法的优势,例如易于工程和最小的肿瘤发生风险。然而,挑战依然存在,包括不一致的命名法,复杂的表征,和不发达的大规模生产协议。这篇综述强调了电动汽车异质性的最新进展和意义,强调需要更好地了解它们在疾病病理中的作用,以开发针对神经系统疾病的临床应用的量身定制的EV疗法。
    Extracellular vesicles (EVs) are vital for cell-to-cell communication, transferring proteins, lipids, and nucleic acids in various physiological and pathological processes. They play crucial roles in immune modulation and tissue regeneration but are also involved in pathogenic conditions like inflammation and degenerative disorders. EVs have heterogeneous populations and cargo, with numerous subpopulations currently under investigations. EV therapy shows promise in stimulating tissue repair and serving as a drug delivery vehicle, offering advantages over cell therapy, such as ease of engineering and minimal risk of tumorigenesis. However, challenges remain, including inconsistent nomenclature, complex characterization, and underdeveloped large-scale production protocols. This review highlights the recent advances and significance of EVs heterogeneity, emphasizing the need for a better understanding of their roles in disease pathologies to develop tailored EV therapies for clinical applications in neurological disorders.
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  • 文章类型: Case Reports
    由于病变的大小,短期内对大型皮肤缺损的外科手术可能具有挑战性,感染,和组织缺损。已应用皮肤伤口的再生疗法来促进愈合过程。一个8个月大的孩子,韩国国内短毛母猫,体重3公斤,由于咬伤导致右侧腹股沟区的严重缺陷而获救。在这种情况下,羊膜和脂肪间充质干细胞被用作治疗大面积皮肤缺损的再生疗法,而不是单独的手术干预。据我们所知,这是首次报道一例通过对猫应用同种异体羊膜和同种异体间充质干细胞治疗大型皮肤缺损的病例。
    Surgical procedures on large skin defects can be challenging in the short term due to the size of the lesion, infection, and tissue defect. A regenerative therapy for skin wounds has been applied to promote the healing process. An 8-month-old, Korean domestic short-haired female cat, weighing 3 kg, was rescued with extensive defects on the right flank to right inguinal region caused by bite wounds. In this case, amniotic membranes and adipose-derived mesenchymal stem cells were used as the regenerative therapy to treat the large skin defect rather than a surgical intervention alone. To the best of our knowledge, this is the first report of a case with of a large skin defect treated by applying allogeneic amniotic membranes and allogeneic mesenchymal stem cells to a cat.
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  • 文章类型: Journal Article
    干细胞分裂过程中变异表型的空间排列在细胞组织的自组织中起着至关重要的作用。在这些细胞组件中观察到的模式,多种表型争夺空间和资源,在很大程度上受到不同扩散化学信号的混合影响。这个复杂的过程是在细胞内和细胞间事件相互作用的时间顺序框架内进行的。这包括接受外部兴奋剂,无论是由其他人分泌还是由环境提供,解释这些环境信号,并结合信息来指定细胞命运。这里,给定图灵系统产生的两种不同的信号模式,我们研究了使用这些信号作为改变生产率的外部线索的分化细胞的空间分布。通过提出一个计算地图,我们发现多重信号和发育细胞模式之间存在对应关系。换句话说,该模型为多信号中分化细胞的最终结构提供了适当的预测,多小区环境。相反,当给出细胞模式的最终快照时,我们的算法可以部分识别影响细胞结构形成的信号模式,前提是信令模式的管理动态是已知的。
    The spatial arrangement of variant phenotypes during stem cell division plays a crucial role in the self-organization of cell tissues. The patterns observed in these cellular assemblies, where multiple phenotypes vie for space and resources, are largely influenced by a mixture of different diffusible chemical signals. This complex process is carried out within a chronological framework of interplaying intracellular and intercellular events. This includes receiving external stimulants, whether secreted by other individuals or provided by the environment, interpreting these environmental signals, and incorporating the information to designate cell fate. Here, given two distinct signaling patterns generated by Turing systems, we investigated the spatial distribution of differentiating cells that use these signals as external cues for modifying the production rates. By proposing a computational map, we show that there is a correspondence between the multiple signaling and developmental cellular patterns. In other words, the model provides an appropriate prediction for the final structure of the differentiated cells in a multi-signal, multi-cell environment. Conversely, when a final snapshot of cellular patterns is given, our algorithm can partially identify the signaling patterns that influenced the formation of the cellular structure, provided that the governing dynamic of the signaling patterns is already known.
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  • 文章类型: Journal Article
    背景:脊髓损伤(SCI)是一种毁灭性的损伤,由于其棘手的性质,仍然是最大的医疗和社会负担之一。根据干细胞生物学的最新进展,脊髓再生和功能恢复的可能性已被认为通过引入适当的干细胞。多谱系分化应激持久(Muse)细胞是一种非致瘤内源性修复干细胞。先前显示了用于SCI的Muse细胞移植的阳性结果。作为人类SCI临床应用的第一步,我们进行了一项临床试验,旨在确认静脉注射供体Muse细胞的安全性和可行性。
    方法:当前试验的研究设计是前瞻性的,多中心,非随机化,非盲化,单臂研究。临床试验登记号为JRCT1080224764。包括颈性SCI患者,其神经系统损伤程度为C4至C7,严重程度为改良的Frankel分类B1和B2。主要终点设定为安全性和可行性。我们的方案得到了PMDA的批准,这项试验由生命科学研究所资助,东京,日本。本临床试验招募了10名参与者(8名男性和2名女性),平均年龄为49.3±21.2岁。所有10名参与者均接受了单剂量的同种异体CL2020(总共15×106个细胞,2.1-2.7×105个细胞/kg体重),它是由人类间充质干细胞生产的Muse细胞产品,通过静脉滴注。
    结果:报告了两次严重不良事件,两者都被确定与Muse细胞治疗没有因果关系。ISNCSCI运动评分的变化,与CL2020给药时的数据相比,日常生活活动能力和生活质量评分显示出统计学上显著的改善.
    结论:在本试验中,没有发现安全问题,Muse细胞产品移植表现出良好的耐受性。结合对照臂的适当研究设计的未来临床试验将阐明静脉内给药单剂量同种异体Muse细胞治疗SCI的最终疗效。
    背景:jRCT,JRCT1080224764。2019年7月3日注册,https://jrct。尼夫.走吧。jp/最新细节/jRCT1080224764。
    BACKGROUND: Spinal cord injury (SCI) is a devastating injury and remains one of the largest medical and social burdens because of its intractable nature. According to the recent advances in stem cell biology, the possibility of spinal cord regeneration and functional restoration has been suggested by introducing appropriate stem cells. Multilineage-differentiating stress enduring (Muse) cells are a type of nontumorigenic endogenous reparative stem cell. The positive results of Muse cell transplantation for SCI was shown previously. As a first step for clinical application in human SCI, we conducted a clinical trial aiming to confirm the safety and feasibility of intravenously injected donor-Muse cells.
    METHODS: The study design of the current trial was a prospective, multicenter, nonrandomized, nonblinded, single-arm study. The clinical trial registration number was JRCT1080224764. Patients with a cervical SCI with a neurological level of injury C4 to C7 with the severity of modified Frankel classification B1 and B2 were included. A primary endpoint was set for safety and feasibility. Our protocol was approved by the PMDA, and the trial was funded by the Life Science Institute, Tokyo, Japan. The present clinical trial recruited 10 participants (8 males and 2 females) with an average age of 49.3 ± 21.2 years old. All 10 participants received a single dose of allogenic CL2020 (a total of 15 × 106 cells, 2.1-2.7 × 105 cells/kg of body weight), which is a Muse cell-based product produced from human mesenchymal stem cells, by an intravenous drip.
    RESULTS: There were two reported severe adverse events, both of which were determined to have no causal relationship with Muse cell treatment. The change in the ISNCSCI motor score, the activity of daily living and quality of life scores showed statistically significant improvements compared to those data at the time of CL2020 administration.
    CONCLUSIONS: In the present trial, no safety concerns were identified, and Muse cell product transplantation demonstrated good tolerability. Future clinical trials with appropriate study designs incorporating a control arm will clarify the definitive efficacy of single-dose allogenic Muse cell treatment with intravenous administration to treat SCI.
    BACKGROUND: jRCT, JRCT1080224764. Registered 03 July 2019, https://jrct.niph.go.jp/latest-detail/jRCT1080224764 .
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  • 文章类型: Editorial
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    Loxscelism是指由Loxsceles属的蜘蛛叮咬引起的一组临床表现。经典的临床症状的特征是在咬伤部位发生强烈的炎症反应,然后是局部坏死,可以归类为皮肤氧合。这种皮肤形式难以愈合,和建议的治疗是不具体的或有效的。本研究旨在评估间充质基质细胞来源的分泌组对Loxosceles中间蜘蛛毒诱导的兔皮肤坏死的保护作用。
    将16只兔分为4组(n=4)。除第1组(G1)外,只收到PBS,其他三组(G2,G3和G4)最初用10μg中间乳杆菌毒液攻击,在100μL0.9%NaCl中稀释,通过在肩胛骨区域进行皮内注射。攻击后30分钟,所有组都用分泌组治疗,除了第2组。第1组(G1-对照组)接受在0.15MPBS中的60μg分泌体的皮内注射(ID);第2组(G2)通过ID接受0.9%NaCl;第3组(G3)接受60μg分泌体,通过ID和组4(G4),通过静脉途径接受60μg的分泌体。每天对兔子进行评估,15天后实施安乐死,收集坏死病灶周围的尸检和皮肤样本进行组织学分析.
    G1兔没有出现水肿,红斑,出血性光环,或坏死。在来自G2、G3和G4的动物中,在6h后出现水肿。然而,在G2和G3的动物中观察到轻微的水肿。在动物中观察到出血性光环,六小时零三天后,在G2、G3和G4上。宏观上,在G4中,4只动物中只有1只出现了演变为皮肤坏死伤口的病变.通过显微镜评估,在G1的动物的皮肤中没有观察到变化。所有受到中间乳杆菌毒液攻击的动物都表现出相似的改变,如坏死和异源性浸润。然而,来自G4的动物显示成纤维细胞活化,结缔组织的早期发育,新生血管形成,组织再上皮化,表明一个更突出的愈合过程。
    这些结果表明,在无异种和无人类成分的培养基中培养的间充质基质细胞的分泌组有希望治疗Loxsqueles蜘蛛咬伤后引起的皮肤坏死。
    UNASSIGNED: Loxoscelism refers to a set of clinical manifestations caused by the bite of spiders from the Loxosceles genus. The classic clinical symptoms are characterized by an intense inflammatory reaction at the bite site followed by local necrosis and can be classified as cutaneous loxoscelism. This cutaneous form presents difficult healing, and the proposed treatments are not specific or effective. This study aimed to evaluate the protective effect of mesenchymal stromal cells-derived secretome on dermonecrosis induced by Loxosceles intermedia spider venom in rabbits.
    UNASSIGNED: Sixteen rabbits were distributed into four groups (n = 4). Except for group 1 (G1), which received only PBS, the other three groups (G2, G3, and G4) were initially challenged with 10 μg of L. intermedia venom, diluted in 100 μL of NaCl 0.9%, by intradermic injection in the interscapular region. Thirty minutes after the challenge all groups were treated with secretome, except for group 2. Group 1 (G1-control group) received intradermal injection (ID) of 60 μg of secretome in 0.15 M PBS; Group 2 (G2) received 0.9% NaCl via ID; Group 3 (G3) received 60 μg of secretome, via ID and Group 4 (G4), received 60 μg of secretome by intravenous route. Rabbits were evaluated daily and after 15 days were euthanized, necropsied and skin samples around the necrotic lesions were collected for histological analysis.
    UNASSIGNED: Rabbits of G1 did not present edema, erythema, hemorrhagic halo, or necrosis. In animals from G2, G3, and G4, edema appeared after 6h. However, minor edema was observed in the animals of G2 and G3. Hemorrhagic halo was observed in animals, six hours and three days after, on G2, G3, and G4. Macroscopically, in G4, only one animal out of four had a lesion that evolved into a dermonecrotic wound. No changes were observed in the skin of the animals of G1, by microscopic evaluation. All animals challenged with L. intermedia venom showed similar alterations, such as necrosis and heterophilic infiltration. However, animals from G4 showed fibroblast activation, early development of connective tissue, neovascularization, and tissue re-epithelialization, indicating a more prominent healing process.
    UNASSIGNED: These results suggest that secretome from mesenchymal stromal cells cultured in a xeno-free and human component-free culture media can be promising to treat dermonecrosis caused after Loxosceles spiders bite envenoming.
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