背景:创伤性脑损伤(TBI)的特征是由于创伤后的损伤而导致大脑的正常功能中断,这可能会导致严重的身体,认知,和情绪障碍。干细胞移植已经发展成为治疗TBI的一种新的治疗方式。因为它有可能阻止退化并促进大脑中新细胞的再生。沃顿的果冻来源的间充质干细胞(WJ-MSCs)最近在神经功能缺损的功能恢复中显示出有益的作用。
目的:评价MSC治疗TBI的安全性和有效性。
方法:我们介绍了6例患者,4名男性和2名女性,年龄在21至27岁之间,患有TBI。这6名患者接受了6剂鞘内注射,对于每种施用途径,以1×106/kg的目标剂量肌内(i.m.)和静脉内移植WJ-MSC。使用改良的Ashworth量表(MAS)评估痉挛,根据医学研究理事会肌肉力量量表的运动功能,通过功能独立性量表(FIM)和Karnofsky绩效状态量表评估生活质量。
结果:我们的患者仅显示早期,短暂性并发症,比如低热热,轻度头痛,以及由于静脉注射引起的肌肉疼痛,在24小时内解决。在一年的随访中,未报告其他安全性问题或不良事件.这6名患者的认知能力有所改善,肌肉痉挛,肌肉力量,干预前后比较的表现得分和精细运动技能。MAS值,我们用来评估痉挛状态,左侧和右侧均有统计学上的显着下降(P<0.001)。FIM量表包括运动评分(P<0.05)和认知评分(P<0.001),并显示测试前测试后分析的显着增加。参与者在干预前后的Karnofsky绩效量表中观察到的差异具有统计学意义(P<0.001)。
结论:这项研究表明,细胞移植具有安全、在TBI管理中有效和有希望的未来。
BACKGROUND: Traumatic brain injury (TBI) is characterized by a disruption in the normal function of the brain due to an injury following a trauma, which can potentially cause severe physical, cognitive, and emotional impairment. Stem cell transplantation has evolved as a novel treatment modality in the management of TBI, as it has the potential to arrest the degeneration and promote regeneration of new cells in the brain. Wharton\'s Jelly-derived mesenchymal stem cells (WJ-MSCs) have recently shown beneficial effects in the functional recovery of neurological deficits.
OBJECTIVE: To evaluate the safety and efficiency of MSC therapy in TBI.
METHODS: We present 6 patients, 4 male and 2 female aged between 21 and 27 years who suffered a TBI. These 6 patients underwent 6 doses of intrathecal, intramuscular (i.m.) and intravenous transplantation of WJ-MSCs at a target dose of 1 × 106/kg for each application route. Spasticity was assessed using the Modified Ashworth scale (MAS), motor function according to the Medical Research Council Muscle Strength Scale, quality of life was assessed by the Functional Independence Measure (FIM) scale and Karnofsky Performance Status scale.
RESULTS: Our patients showed only early, transient complications, such as subfebrile fever, mild headache, and muscle pain due to i.m. injection, which resolved within 24 h. During the one year follow-up, no other safety issues or adverse events were reported. These 6 patients showed improvements in their cognitive abilities, muscle spasticity, muscle strength, performance scores and fine motor skills when compared before and after the intervention. MAS values, which we used to assess spasticity, were observed to statistically significantly decrease for both left and right sides (P < 0.001). The FIM scale includes both motor scores (P < 0.05) and cognitive scores (P < 0.001) and showed a significant increase in pretest posttest analyses. The difference observed in the participants\' Karnofsky Performance Scale values pre and post the intervention was statistically significant (P < 0.001).
CONCLUSIONS: This study showed that cell transplantation has a safe, effective and promising future in the management of TBI.