regenerative therapy

再生疗法
  • 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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  • 文章类型: Journal Article
    再生疗法被认为是治疗各种疾病的新选择。而发育中的胚胎是帮助修复患病组织和器官的主要分子来源。类器官培养研究还证实了几种胚胎因子的固有生物学功能。然而,胚胎蛋白组分(EPF)的体内安全性和有效性未得到验证.在这项研究中,我们研究了EPF对健康成年大鼠的有效性。我们从E14,E16和E19胚胎天的SD雌性大鼠中获得了胚胎,并收集了蛋白质裂解液。在连续几天将该裂解物静脉内给予成年Sprague-Dawley大鼠。我们收集血液并对接受EPF的大鼠进行血液学和生化指标。C反应蛋白水平,白细胞介素-6,血糖水平,血清肌酐,血尿素,白细胞总数,在接受EPF和生理盐水的大鼠之间,中性粒细胞和淋巴细胞的百分比相当。给予EPF的大鼠组织的组织学检查没有异常。我们的研究表明,向健康成年大鼠静脉注射EPF表明EPF是非免疫原性的,非炎性,非致瘤和安全的体内应用。我们的分析表明,EPF或其组件可以推荐用于验证其在器官再生治疗中的治疗能力。
    Regenerative therapy is considered a novel option for treating various diseases, whereas a developing embryo is a prime source of molecules that help repair diseased tissue and organs. Organoid culture studies also confirmed the inherent biological functions of several embryonic factors. However, the in vivo safety and efficacy of embryonic protein fraction (EPF) were not validated. In this study, we investigated the effectiveness of EPF on healthy adult rats. We obtained embryos from SD female rats of E14, E16, and E19 embryonic days and collected protein lysate. This lysate was administered intravenously into adult Sprague-Dawley rats on sequential days. We collected blood and performed hematological and biochemical parameters of rats that received EPF. C-reactive protein levels, interleukin-6, blood glucose levels, serum creatinine, blood urea, total leucocyte counts, and % of neutrophils and lymphocytes were comparable between rats receiving EPF and saline. Histological examination of rats\' tissues administered with EPF is devoid of abnormalities. Our study revealed that intravenous administration of EPF to healthy adult rats showed that EPF is non-immunogenic, non-inflammatory, non-tumorigenic and safe for in vivo applications. Our analysis suggests that EPF or its components could be recommended for validating its therapeutic abilities in organ regenerative therapy.
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  • 文章类型: Case Reports
    背景:经常在末磨牙远端观察到非角化粘膜下的骨内缺损。因此,对于这些特定的牙齿状况,使用改良的楔形皮瓣技术进行再生治疗被认为是不切实际的。
    方法:本文提出了一种改良的外科手术方法,旨在通过在角化颊牙龈上做垂直切口来暴露远端骨内缺损。主要目的是保持牙龈瓣的稳定性,从而促进牙周再生。所描述的技术已成功用于涉及左下颌第二磨牙的病例,在远端部位表现为无角化牙龈的骨内缺损。在这种情况下,在离颊牙龈组织上做了一个切口,创建远端非角化软组织的隧道状分离,以暴露骨内缺损。随后,进行骨移植和引导组织再生手术,术后9个月骨填充满意。
    结论:该技术为非角化粘膜下的骨内缺损提供了再生机会,建议进行进一步研究。
    BACKGROUND: Intrabony defects beneath non-keratinized mucosa are frequently observed at the distal site of terminal molars. Consequently, the application of regenerative treatment using the modified wedge-flap technique is considered impractical for these specific dental conditions.
    METHODS: This article proposes a modified surgical procedure aimed at exposing the distal intrabony defect by making a vertical incision in the keratinized buccal gingiva. The primary objective is to maintain gingival flap stability, thereby facilitating periodontal regeneration. The described technique was successfully employed in a case involving the left mandibular second molar, which presented with an intrabony defect without keratinized gingiva at the distal site. In this case, an incision was made on the disto-buccal gingival tissue, creating a tunnel-like separation of the distal non-keratinized soft tissue to expose the intrabony defect. Subsequently, bone grafting and guided tissue regeneration surgeries were performed, resulting in satisfactory bone fill at 9 mo postoperatively.
    CONCLUSIONS: This technique offers a regenerative opportunity for the intrabony defects beneath non-keratinized mucosa and is recommended for further research.
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  • 文章类型: Journal Article
    尽管基于干细胞的再生医学已被广泛研究,在体外结合血管系统重建三维组织和器官仍然很困难。一种临床上成功的疗法是将间充质干细胞(MSC)移植到患有移植物抗宿主病的患者中。然而,由于血栓形成性炎症引起的先天免疫反应,移植细胞立即受损和破坏,患者需要服用免疫抑制药物对同种异体细胞进行免疫调节。这降低了干细胞移植的益处。因此,替代疗法是更现实的临床选择.在这项研究中,我们的目的是利用MSC的治疗效果,并使用从MSC释放的多种细胞因子,也就是说,来自人类脱落乳牙(SHED)的干细胞。这里,我们从永生化SHED(IM-SHED-CM)的条件培养基中纯化成分,并评估了细胞内脱氢酶的活性,细胞迁移,和通过研究细胞的抗氧化应激。SHED的永生化可以使CM的稳定供应成为可能。我们发现来自IM-SHED-CM的50-100kD的分级成分在细胞内脱氢酶和细胞迁移方面具有比原始IM-SHED-CM更高的功效,其中细胞内信号转导通过受体酪氨酸激酶激活,谷胱甘肽过氧化物酶和还原酶系统具有很高的活性。尽管50-100kD的分馏成分中的抗氧化应激活性略低于原始IM-SHE-CM,这部分仍然有活动。因此,使用来自IM-SHED-CM的50-100kD的分级成分可能是MSC移植的替代选择,因为来自CM的纯化成分可以维持来自SHED的细胞因子的作用。
    Although stem cell-based regenerative medicine has been extensively studied, it remains difficult to reconstruct three dimensional tissues and organs in combination with vascular systems in vitro. One clinically successful therapy is transplantation of mesenchymal stem cells (MSC) into patients with graft versus host disease. However, transplanted cells are immediately damaged and destroyed because of innate immune reactions provoked by thrombogenic inflammation, and patients need to take immunosuppressive drugs for the immunological regulation of allogeneic cells. This reduces the benefits of stem cell transplantation. Therefore, alternative therapies are more realistic options for clinical use. In this study, we aimed to take advantage of the therapeutic efficacy of MSC and use multiple cytokines released from MSC, that is, stem cells from human exfoliated deciduous teeth (SHEDs). Here, we purified components from conditioned media of immortalized SHED (IM-SHED-CM) and evaluated the activities of intracellular dehydrogenase, cell migration, and antioxidative stress by studying the cells. The immortalization of SHED could make the stable supply of CM possible. We found that the fractionated component of 50-100 kD from IM-SHED-CM had higher efficacy than the original IM-SHED-CM in terms of intracellular dehydrogenase and cell migration in which intracellular signal transduction was activated via receptor tyrosine kinases, and the glutathione peroxidase and reductase system was highly active. Although antioxidative stress activities in the fractionated component of 50-100 kD had slightly lower than that of original IM-SHE-CM, the fraction still had the activity. Thus, the use of fractionated components of 50-100 kD from IM-SHED-CM could be an alternative choice for MSC transplantation because the purified components from CM could maintain the effect of cytokines from SHED.
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  • 文章类型: Case Reports
    髌骨软骨软化症(CMP)是髌股疼痛综合征(PFPS)的广泛原因,表现为前膝疼痛和功能限制。目前的治疗方法往往不能长期缓解,需要探索新的治疗技术。最近的研究已经证明了骨髓吸入浓缩物(BMAC)治疗的疗效,利用间充质干细胞(MSCs)和生长因子的再生特性。我们介绍了一名36岁的III级CMP男性患者,该患者对保守治疗有抵抗力,但成功接受了BMAC治疗。BMAC准备的详细方法,如双离心和生长因子分析,被呈现。治疗后6周和12周,患者在疼痛和功能方面表现出显着改善,以及BMAC中生长因子和CD34+细胞的水平提高。这项研究提供了对BMAC疗法的再生潜力的见解,并强调了其在治疗软骨异常中的有希望的作用。更大规模的临床试验和BMAC制备程序的标准化对于确立其作为CMP标准治疗方法的有效性和一致性是必要的。
    Chondromalacia patellae (CMP) is a widespread cause of patellofemoral pain syndrome (PFPS), which manifests as anterior knee pain and functional limitations. Current treatments frequently fail to give long-term relief, necessitating the exploration of new therapeutic techniques. Recent research has demonstrated the efficacy of Bone Marrow Aspirate Concentrate (BMAC) therapy, which utilizes the regeneration characteristics of mesenchymal stem cells (MSCs) and growth factors. We present the case of a 36-year-old male patient with Grade III CMP who was resistant to conservative treatment but was successfully treated with BMAC therapy. Detailed methods for BMAC preparation, such as double centrifugation and growth factor analysis, are presented. At six and 12 weeks after therapy, the patient showed significant improvements in pain and functional results, as well as enhanced levels of growth factors and CD34+ cells in the BMAC. This study provides insights into the regeneration potential of BMAC therapy and highlights its promising role in managing chondral abnormalities. Larger clinical trials and standardization of BMAC preparation procedures are necessary for establishing its effectiveness and consistency as a standard treatment approach for CMP.
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  • 文章类型: Journal Article
    矫形术被定义为骨科疾病的解决方案,利用生物学的好处来改善愈合,减轻疼痛,改善功能,和最佳的,为组织再生提供环境。选择包括药物,手术干预,脚手架,生物制品作为细胞的产物,物理和电磁刺激。再生医学的目标是增强肌肉骨骼损伤后组织的愈合,作为隔离治疗和手术治疗的辅助手段。使用新疗法来改善恢复和结果。已经研究了各种骨科生物制剂(直视生物学),用于治疗涉及肘部和上肢的病理,包括肌腱(外上髁炎,内上髁炎,二头肌肌腱炎,肱三头肌肌腱炎),关节软骨(骨关节炎,骨软骨损伤),和骨头(骨折,非工会,缺血性坏死,骨坏死)。有希望和已建立的治疗方式包括透明质酸(HA);肉毒杆菌毒素;皮质类固醇;富含白细胞和缺乏白细胞的富含血小板的血浆(PRP);自体血;包含间充质基质细胞(也称为药物信号细胞,通常称为间充质干细胞)的骨髓抽吸物(BMA)和BMA浓缩物(BMAC);从皮肤和皮肤(真皮)来源收获的MSC;来自三聚钙血管内的脂肪凝胶(PCP-人类MSC,和基质金属蛋白酶(MMPs);和胶原海绵。自体血液制剂,如自体血液注射和富含血小板的血浆显示出无反应性肌腱病的阳性结果。此外,细胞疗法如组织来源的肌腱细胞样细胞和MSC显示出通过调节组织对炎症的反应和防止持续降解和支持组织恢复来调节变性过程的有希望的能力。
    Orthoregeneration is defined as a solution for orthopaedic conditions that harnesses the benefits of biology to improve healing, reduce pain, improve function, and, optimally, provide an environment for tissue regeneration. Options include drugs, surgical intervention, scaffolds, biologics as a product of cells, and physical and electromagnetic stimuli. The goal of regenerative medicine is to enhance the healing of tissue after musculoskeletal injuries as both isolated treatment and adjunct to surgical management, using novel therapies to improve recovery and outcomes. Various orthopaedic biologics (orthobiologics) have been investigated for the treatment of pathology involving the elbow and upper extremity, including the tendons (lateral epicondylitis, medial epicondylitis, biceps tendonitis, triceps tendonitis), articular cartilage (osteoarthritis, osteochondral lesions), and bone (fractures, nonunions, avascular necrosis, osteonecrosis). Promising and established treatment modalities include hyaluronic acid; botulinum toxin; corticosteroids; leukocyte-rich and leukocyte-poor platelet-rich plasma; autologous blood; bone marrow aspirate comprising mesenchymal stromal cells (alternatively termed medicinal signaling cells and frequently mesenchymal stem cells [MSCs]) and bone marrow aspirate concentrate; MSCs harvested from adipose and skin (dermis) sources; vascularized bone grafts; bone morphogenic protein scaffold made from osteoinductive and conductive β-tricalcium phosphate and poly-ε-caprolactone with hydrogels, human MSCs, and matrix metalloproteinases; and collagen sponge. Autologous blood preparations such as autologous blood injections and platelet-rich plasma show positive outcomes for nonresponsive tendinopathy. In addition, cellular therapies such as tissue-derived tenocyte-like cells and MSCs show a promising ability to regulate degenerative processes by modulating tissue response to inflammation and preventing continuous degradation and support tissue restoration.
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