间充质干细胞(MSC)移植治疗肌萎缩性侧索硬化症(ALS):是否存在应答人群 ?

Tomasz Siwek, M. Barczewska, Åukasz Grabarczyk, M. Sowa, Katarzyna Jezierska-Woźniak, Aleks, ra Habich, J. Wojtkiewicz, A. Badowska, W. Maksymowicz
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引用次数: 5

摘要

目的:分析干细胞治疗渐冻症的安全性和临床效果。方法:在I期试验中,ALS患者通过外科手术在鞘内移植自体骨髓间充质干细胞(MSCs)。结果:我们对正在进行的研究进行了为期6个月的中期分析。肌萎缩侧索硬化症患者鞘内给药MSCs是可行和安全的。我们在整个患者组(n=25)中显示了明显的临床益处。移植前ALSFRS-R评分平均变(减)率为1.76±1.36分/周期,移植后平均变(减)率为1.06±0.9分/周期(p=0.014)。我们研究的关键发现是,似乎有一组患者,我们称之为“反应者”,他们对治疗的反应与其他我们称之为“无反应者”的患者的反应不同。结论:在我们的研究中,“应答者”比“无应答者”在治疗前进展更快。因此,我们假设治疗前的进展率可能作为一种预测因素和选择ALS患者进行细胞治疗的标准。
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Mesenchymal Stem Cell (MSC) Transplantation in Patients with Amyotrophic Lateral Sclerosis (ALS): Is there a âResponder Populationâ?
Objective: To analyze the safety and clinical effect of stem cell therapy in ALS. Methods: In phase I of the trial, ALS subjects have been intrathecally transplanted with autologous bone marrowderived mesenchymal stem cells (MSCs) using a surgical procedure. Results: We present the results of a 6-month interim analysis of the ongoing study. Intrathecal administration of MSCs into ALS patients was feasible and safe. We showed a clinical benefit evident for the entire group of patients (n=25). The mean rate of ALSFRS-R score change (decrease) pre-transplant was 1.76 ± 1.36 points/period whereas the mean post-transplant rate was 1.06 ± 0.9 points/period (p=0.014). The key finding of our study is that there appears to be a group of patients, whom we call “responders” whose reaction to the treatment was different from the reaction of other patients we call “nonresponders”. Conclusion: In our study the “responders” progressed faster prior to the treatment than “non-responders”. Hence, we hypothesize that the pre-treatment progression rate may play a role as a predictive factor and a criterion for selecting ALS patients for cell-based therapies.
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