我们旨在确定自体脂肪组织来源的间充质干细胞(AD-MSCs)的全身治疗对腹膜透析(PD)患者腹膜功能和炎症的不同参数的影响。
我们招募了9名超滤衰竭(UFF)的PD患者。患者经肘静脉接受1.2±0.1×106细胞/kg的AD-MSCs,然后在基线时间点随访6个月。输注后3、6、12、16和24周。在基线以及第12周和第24周进行UNI-PET以评估腹膜特征。肿瘤坏死因子α(TNF-α)的全身和腹膜水平,白细胞介素-6(IL-6),IL-2和CA125(通过ELISA)和转化生长因子β(TGF-β)的基因表达水平,在基线和第3、6、12、16和24周测量PD流出物衍生细胞中的平滑肌肌动蛋白(α-SMA)和成纤维细胞特异性蛋白1(FSP-1)(通过定量实时PCR)。
在以下UF容量指数中观察到轻微改善:自由水运输(FWT,32%),超滤-小孔(UFSP,18%),超滤总量(UFT,25%),对葡萄糖的渗透电导(OCG,25%),D/P肌酐(0.75至0.70),和Dt/D0葡萄糖(0.23至0.26)。全身和腹膜的CA125水平略有升高,TGF-β的基因表达水平略有下降,α-SMA和FSP-1在第12周更为突出,并在研究结束时消失。
我们的结果首次显示了MSCs在临床试验中治疗腹膜损伤的潜力。我们的结果可以被视为假设建议,需要在未来的研究中得到证实。
We aimed to determine the effects of systemic therapy with autologous adipose tissue derived mesenchymal stem cells (AD-MSCs) on different parameters of peritoneal function and inflammation in peritoneal dialysis (PD) patients.
We enrolled nine PD patients with ultrafiltration failure (UFF). Patients received 1.2±0.1×106 cell/kg of AD-MSCs via cubital vein and were then followed for six months at time points of baseline, 3, 6, 12, 16 and 24 weeks after infusion. UNI-PET was performed for assessment of peritoneal characteristics at baseline and weeks 12 and 24. Systemic and peritoneal levels of tumor necrosis factor α (TNF-α), interleukin-6(IL-6), IL-2 and CA125 (by ELISA) and gene expression levels of transforming growth factor beta (TGF-β), smooth muscle actin (𝛼-SMA) and fibroblast-specific protein-1 (FSP-1) in PD effluent derived cells (by quantitative real-time PCR) were measured at baseline and weeks 3, 6, 12, 16 and 24.
Slight improvement was observed in the following UF capacity indices: free water transport (FWT, 32%), ultrafiltration - small pore (UFSP, 18%), ultrafiltration total (UFT, 25%), osmotic conductance to glucose (OCG, 25%), D/P creatinine (0.75 to 0.70), and Dt/D0 glucose (0.23 to 0.26). There was a slight increase in systemic and peritoneal levels of CA125 and a slight decrease in gene expression levels of TGF-β, α-SMA and FSP-1 that was more prominent at week 12 and vanished by the end of the study.
Our results for the first time showed the potential of MSCs for treatment of peritoneal damage in a clinical trial. Our results could be regarded as hypothesis suggestion and will need confirmation in future studies.