Ƙididdiga na Tsaro da Ƙwarewar Neurotrophic Factor Far a cikin Ischemic Stroke

Shanyewar kwakwalwa, wanda kuma aka sani da "stroke" ko "hatsarori na cerebrovascular" (CVA), cuta ce mai tsanani ta cerebrovascular cuta mai saurin fashewar tasoshin jini a cikin kwakwalwa ko toshewar jini zuwa kwakwalwa, wanda ke haifar da lalacewa ga nama na kwakwalwa. Ya ƙunshi duka ischemic da bugun jini. Shanyewar jiki shi ne na biyu kan gaba wajen mutuwa a duniya, tare da yawan mace-mace da nakasa a cikin manya.

Ischemic Stroke (IS) yana nufin ischemic necrosis na gida ko tausasa nama na kwakwalwa wanda ya haifar da rikice-rikice na wurare dabam dabam na cerebrovascular, ischemia, da hypoxia. Sakamakon yawaitar yawaitar ta, da yawaitar mace-mace, da nakasassu, ya zama daya daga cikin manyan abubuwan da ke haifar da nauyin cututtuka a duniya. Bisa kididdigar da aka yi, kimanin mutane miliyan 15 a duk duniya suna fama da ciwon ischemic a kowace shekara, tare da mutuwar mutane miliyan 5 da kuma mutane miliyan 5 suna fuskantar nakasa na dogon lokaci.

Hanyar Kula da Kwayoyin Kwayoyin Jiki don Ciwon Jiki

Mesenchymal Stem Cells (MSCs) nau'in sel masu ƙarfi ne masu yawa waɗanda za'a iya keɓance su daga kyallen takarda daban-daban, gami da bargo, nama mai adipose, da jinin cibi. Saboda abubuwan da suke da ƙarfi, za su iya bambanta zuwa osteoblasts, chondrocytes, adipocytes, har ma da ƙananan ƙwayoyin cuta. A halin yanzu, dashen MSC ya fito a matsayin sabuwar hanyar warkewa don cututtukan ischemic, gami da bugun jini, cututtukan jijiyoyin jini, da cututtukan jijiyoyin jijiya. Yawancin karatu sun nuna cewa kyakkyawan sakamako na neuroprotective na MSC shine mabuɗin mahimmanci wajen magance bugun jini na ischemic.

Rahoton bincike na yanzu ya nuna cewa MSC ya fi inganta gyaran gyare-gyaren nama na jijiyoyi, maido da aikin jijiyoyi, rage girman infarction na cerebral, da inganta neurogenesis da angiogenesis ta hanyar paracrine effects, immunomodulatory effects, da anti-apoptotic effects, don haka wasa da warkewa rawa. a cikin ischemic bugun jini.

Paracrine sakamako

Abubuwan paracrine na MSC, gami da exosomes da vesicles na waje, sune manyan masu ba da gudummawa ga tasirin warkewar su. A cikin yanki na raunin bugun jini na kwakwalwa, MSCs na iya haifar da bayyanar cututtuka daban-daban na girma, ciki har da ƙwayar neurotrophic da aka samu ta kwakwalwa (BDNF), ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta (VEGF), 1 (SDF-1) 1 (SDF-1), fibroblast na asali. factor factor (bFGF), glial cell-samu neurotrophic factor, da hepatocytes girma factor, da sauransu. Wadannan abubuwan suna taimakawa wajen rage yanki na ƙwayar cuta da kuma mayar da aikin jijiyoyi, don haka inganta raunin bugun jini.

Tasirin immunomodulatory

Bincike ya gano cewa MSCs kuma suna da aiki na tsari guda biyu akan martanin rigakafi na tsakiya bayan bugun jini: A gefe guda, suna iya ƙara yawan adadin ƙwayoyin B, ƙwayoyin NK, da ƙwayoyin T a cikin nama na kwakwalwa, suna yin tasiri mai haɓaka rigakafi. A gefe guda, manyan abubuwan da ke haifar da kumburi na iya kunna aikin rigakafi na MSCs, ta haka ne ke haifar da tasirin hanawa na dual akan yaduwar lymphocyte da kuma samar da ƙwayar cuta, yana haifar da phenotype na anti-inflammatory.

Ka'idar apoptosis cell

Apoptosis na salula shine muhimmin mahimmanci na raunin neuronal a cikin bugun jini na ischemic, kuma MSCs na iya hana apoptosis neuronal, suna yin tasiri mai mahimmanci. Magungunan MSC kuma na iya rage ischemic bugun jini-induced astrocyte necrosis, haka kuma, MSCs-preconditioned hypoxia yana nuna mafi kyawun tasirin warkewa a cikin rage necrosis na sel wanda ke haifar da zubar jini na cerebral.

Ƙimar asibiti na maganin ƙwayar cuta don bugun jini na ischemic.

Dasawa da ƙwayoyin ƙwayoyin cuta na mesenchymal (MSCs) don maganin bugun jini na ischemic ya nuna sakamako mai ban sha'awa a cikin binciken bincike na asali. Masu bincike sun gudanar da bincike-bincike na gwaje-gwaje na asibiti na 20 da suka shafi jimillar marasa lafiya 1127, ciki har da 573 a cikin ƙungiyar gwaji (wanda aka yi wa MSCs) da 554 a cikin ƙungiyar kulawa (jiyya ta al'ada). Idan aka kwatanta da jiyya na al'ada, dashen MSC ya rage mahimmancin ƙimar Cibiyar Kiwon Lafiya ta Ƙasa (NIHSS) a 1, 3, 6 months, da 1 shekara bayan jiyya. Hakanan ya inganta ayyukan fiididdigar rayuwa ta yau da kullun a cikin watanni 1 da 6, da kuma aikin mota da ƙimar 'yancin kai na aiki a watanni 1, 3, da 6.

Babban alamomin kimantawa sun haɗa da: (1) Cibiyoyin Cibiyoyin Kiwon Lafiya na Ƙasa (NIHSS); (2) Barthel Index (BI); (3) Fugl-Meyer Assessment (FMA) ci; (4) Maki na Independence Aiki (FIM); da (5) Maki Madaidaicin Rankin (mRS).

Idan aka kwatanta da jiyya na al'ada, maganin ƙwayar cuta na mesenchymal (MSC) don bugun jini yana rage ƙimar NIH Stroke Scale (NIHSS) a cikin watanni 3.

Idan aka kwatanta da jiyya na al'ada, babu wani gagarumin bambanci a cikin ma'aunin Barthel (BI) a cikin watanni 3 tare da maganin ƙwayar cuta na mesenchymal (MSC) don bugun jini.

Idan aka kwatanta da jiyya na al'ada, maganin ƙwayar cuta na mesenchymal stem cell (MSC) don bugun jini ya inganta ƙimar Aiki na Motsawa (FMA) a cikin watanni 3.

Idan aka kwatanta da jiyya na al'ada, maganin ƙwayar cuta na mesenchymal stem cell (MSC) don bugun jini ya inganta ma'aunin Independence Measure (FIM) sosai a cikin watanni 3.

Idan aka kwatanta da jiyya na al'ada, maganin ƙwayar cuta na mesenchymal stem cell (MSC) don bugun jini ya nuna babu wani muhimmin bambanci a cikin Modified Rankin Scale (mRS) a cikin watanni 3.

A hade tare, babban nau'i na bincike na musamman yana nuna yiwuwar da tasiri na maganin daskarewa na mesenchymal stem cell (MSC) a cikin maganin bugun jini na ischemic, wanda har zuwa wani lokaci yana inganta rashin lafiyar jiki, aikin motsa jiki, da ayyukan rayuwa na yau da kullum a marasa lafiya tare da ischemic. bugun jini.

Gaba da Halaye

A cikin 'yan shekarun nan, daga bambance-bambance mai sauƙi da sauye-sauye na binciken bincike na kwayar halitta zuwa ci gaba da zurfafawa da fadada hanyoyin bincike daban-daban na MSC, ci gaban fannin binciken kwayoyin halitta ya zama balagagge da sababbin abubuwa. A halin yanzu, ba wai kawai gwaje-gwajen dabba sun tabbatar da tasirin warkewar ƙwayoyin ƙwayoyin cuta ba, har ma an ba da shawarar yiwuwar maganin MSC don bugun jini na ischemic. A cikin gwaje-gwajen asibiti da yawa, maganin MSC don bugun jini na ischemic yana ci gaba a hankali.

Ya zuwa kwanan nan, an yi rajistar gwaje-gwaje na asibiti 101 a cikin bayanan gwaji na asibiti na Amurka don maganin ƙwayoyin cuta don bugun jini, tare da nazarin 25 da ke da alaƙa da jiyya na MSC don bugun jini. Gwaje-gwaje na asibiti sun nuna cewa MSCs suna da gagarumin ci gaba a cikin aikin jijiya ga marasa lafiya na ischemic bugun jini, yana tabbatar da tasiri da aminci na dogon lokaci.

A nan gaba, za a sami ƙarin ci gaban kiwon lafiya da suka haɗa da MSCs waɗanda za a fassara su zuwa aikace-aikacen asibiti, suna ba da gudummawa ga masana'antar kiwon lafiya da kiyaye lafiya da jin daɗin mutane a duk duniya.