Kev ntsuam xyuas ntawm Kev Nyab Xeeb thiab Kev Ua Haujlwm ntawm Neurotrophic factor therapy hauv Ischemic Stroke

Cerebral stroke, tseem hu ua "stroke" los yog "cerebrovascular kev huam yuaj" (CVA), yog ib tug mob cerebrovascular kab mob tshwm sim los ntawm tam sim ntawd rupture ntawm cov hlab ntsha nyob rau hauv lub hlwb los yog muaj kev cuam tshuam ntawm cov ntshav ntws mus rau lub hlwb, uas ua rau muaj kev puas tsuaj rau lub paj hlwb. Nws suav nrog ob qho tib si ischemic thiab hemorrhagic strokes. Stroke yog qhov thib ob ua rau tuag thoob ntiaj teb, nrog kev tuag siab thiab kev tsis taus ntawm cov neeg laus.

Ischemic Stroke (IS) yog hais txog lub zos ischemic necrosis lossis softening ntawm lub hlwb cov ntaub so ntswg tshwm sim los ntawm cerebrovascular circulation disorders, ischemia, thiab hypoxia. Vim nws qhov xwm txheej siab, qhov muaj ntau, kev tuag, thiab kev xiam oob qhab, nws tau dhau los ua ib qho ntawm cov laj thawj tseem ceeb ntawm tus kab mob thoob ntiaj teb. Raws li kev txheeb cais, kwv yees li 15 lab tus tib neeg thoob ntiaj teb raug kev txom nyem los ntawm ischemic stroke txhua xyoo, nrog 5 lab tus neeg tuag thiab 5 lab tus tib neeg muaj kev tsis taus mus ntev.

Lub Mechanism ntawm Stem Cell Therapy rau Ischemic Stroke

Mesenchymal Stem Cells (MSCs) yog ib hom kab mob uas muaj zog ntau yam uas tuaj yeem cais tawm ntawm ntau cov ntaub so ntswg, suav nrog cov pob txha pob txha, cov ntaub so ntswg adipose, thiab cov ntshav qaum. Vim lawv cov khoom pluripotent, lawv tuaj yeem sib txawv rau hauv osteoblasts, chondrocytes, adipocytes, thiab txawm tias neurons. Tam sim no, MSC kev hloov pauv tau tshwm sim los ua ib txoj hauv kev kho tshiab rau cov kab mob ischemic, suav nrog mob stroke, kab mob plawv, thiab kab mob peripheral artery. Ntau qhov kev tshawb fawb tau pom tias cov txiaj ntsig zoo neuroprotective ntawm MSCs yog qhov tseem ceeb hauv kev kho mob stroke ischemic.

Cov ntaub ntawv tshawb fawb tam sim no qhia tau hais tias MSC feem ntau txhawb kev kho cov ntaub so ntswg puas hlwb, rov ua haujlwm ntawm neural, txo qis ntawm cerebral infarction loj, thiab txhawb nqa neurogenesis thiab angiogenesis los ntawm cov teebmeem paracrine, cov teebmeem immunomodulatory, thiab cov teebmeem tiv thaiv apoptotic, yog li ua lub luag haujlwm kho mob. hauv ischemic stroke.

Paracrine nyhuv

MSC's paracrine yam, suav nrog exosomes thiab extracellular vesicles, yog cov tseem ceeb pab rau lawv cov kev kho mob. Hauv thaj tsam ntawm kev raug mob ntawm lub paj hlwb, MSCs tuaj yeem ua rau muaj ntau yam kev loj hlob, suav nrog lub paj hlwb-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), stromal cell-derived factor 1 (SDF-1), theem pib fibroblast. Kev loj hlob zoo (bFGF), glial cell-derived neurotrophic factor, thiab hepatocyte loj hlob yam, thiab lwm yam. Cov yam ntxwv no pab txo qhov chaw ntawm cerebral infarction thiab rov qab ua haujlwm neural, yog li txhim kho kev raug mob hauv hlwb.

Cov nyhuv immunomodulatory

Kev tshawb fawb tau pom tias MSCs kuj tseem muaj kev tswj hwm kev ua haujlwm ntawm lub cev tiv thaiv kab mob hauv nruab nrab tom qab mob stroke: Ntawm ib sab, lawv tuaj yeem ua kom cov B hlwb, NK hlwb, thiab T hlwb hauv hlwb, ua rau muaj kev tiv thaiv kab mob. Ntawm qhov tod tes, cov theem siab ntawm cov kab mob inflammatory tuaj yeem ua rau lub cev tiv thaiv kab mob ntawm MSCs, yog li ua rau muaj kev cuam tshuam ob qho kev cuam tshuam ntawm lymphocyte proliferation thiab inflammatory factor production, inducing anti-inflammatory phenotype.

Kev tswj ntawm cell apoptosis

Cell apoptosis yog ib qho tseem ceeb ntawm kev raug mob neuronal hauv ischemic stroke, thiab MSCs tuaj yeem cuam tshuam neuronal apoptosis, ua rau muaj kev tiv thaiv neuroprotective. MSC txoj kev kho kuj tuaj yeem txo cov ischemic stroke-induced astrocyte necrosis, thiab ntxiv mus, hypoxia-preconditioned MSCs qhia tau zoo dua kev kho mob hauv kev txo cov cell necrosis vim los ntawm cerebral hemorrhage.

Kev soj ntsuam kev soj ntsuam ntawm qia cell kho rau ischemic stroke.

Kev hloov pauv ntawm mesenchymal qia hlwb (MSCs) rau kev kho mob ntawm ischemic stroke tau pom tias muaj txiaj ntsig zoo hauv cov kev tshawb fawb ua ntej. Cov kws tshawb fawb tau ua qhov kev tshuaj ntsuam meta-kev soj ntsuam ntawm 20 qhov kev sim tshuaj uas muaj tag nrho ntawm 1127 tus neeg mob, suav nrog 573 hauv pawg sim (kho nrog MSCs) thiab 554 hauv pawg tswj hwm (kev kho mob ib txwm muaj). Piv nrog rau kev kho mob ib txwm, MSC hloov pauv tau txo qis hauv National Institutes of Health Stroke Scale (NIHSS) cov qhab nia ntawm 1, 3, 6 lub hlis, thiab 1 xyoo tom qab kev kho mob. Nws kuj tseem txhim kho cov dej num ntawm kev ua neej nyob txhua hnub ntawm 1 thiab 6 lub hlis, nrog rau kev ua haujlwm ntawm lub cev muaj zog thiab kev ua haujlwm ywj pheej ntawm 1, 3, thiab 6 lub hlis.

Cov kev ntsuas tseem ceeb suav nrog: (1) National Institutes of Health Stroke Scale (NIHSS) cov qhab nia; (2) Barthel Index (BI); (3) Fugl-Meyer Assessment (FMA) qhab nia; (4) Kev ntsuas kev ywj pheej (FIM) tau qhab nia; thiab (5) Modified Rankin Scale (mRS) tau qhab nia.

Piv nrog rau cov kev kho mob ib txwm muaj, kev kho mesenchymal qia cell (MSC) rau kev mob stroke txo qis NIH Stroke Scale (NIHSS) tau qhab nia ntawm 3 lub hlis.

Piv nrog rau kev kho mob, tsis muaj qhov sib txawv tseem ceeb hauv Barthel Index (BI) qhab nia ntawm 3 lub hlis nrog mesenchymal qia cell (MSC) kho mob stroke.

Piv nrog rau cov kev kho mob ib txwm muaj, kev kho mesenchymal qia cell (MSC) rau kev mob stroke tau txhim kho qhov Kev Ntsuas Kev Ua Haujlwm (FMA) tau qhab nia ntawm 3 lub hlis.

Piv nrog rau cov kev kho mob ib txwm muaj, kev kho mesenchymal qia cell (MSC) rau kev mob stroke tau txhim kho qhov txiaj ntsig ntawm Kev Ntsuas Kev ywj pheej (FIM) ntawm 3 lub hlis.

Piv nrog rau cov kev kho mob ib txwm muaj, kev kho mesenchymal qia cell (MSC) rau kev mob stroke tsis muaj qhov sib txawv tseem ceeb hauv Modified Rankin Scale (mRS) tau qhab nia ntawm 3 lub hlis.

Ua ke, lub cev loj ntawm cov kev tshawb fawb preclinical qhia qhov ua tau thiab kev ua tau zoo ntawm kev hloov pauv ntawm mesenchymal qia cell (MSC) hauv kev kho mob ntawm ischemic stroke, uas rau qee qhov kev txhim kho neurological tsis txaus, lub cev muaj zog, thiab kev ua ub no ntawm kev ua neej nyob txhua hnub hauv cov neeg mob ischemic. mob stroke.

Yav tom ntej thiab kev cia siab

Nyob rau hauv xyoo tas los no, los ntawm kev sib txawv yooj yim thiab kev hloov pauv kev paub txog kev tshawb fawb qia cell mus rau qhov txuas ntxiv thiab nthuav dav ntawm ntau hom kev tshawb fawb ntawm MSC, txoj kev loj hlob ntawm kev tshawb fawb qia hlwb tau ua kom paub tab thiab muaj tswv yim tshiab. Tam sim no, tsis yog tsuas yog muaj kev sim tsiaj tau lees paub txog kev kho mob ntawm cov qia hlwb, tab sis kuj tau hais txog qhov ua tau ntawm MSC kev kho mob rau ischemic stroke. Hauv ntau qhov kev sim tshuaj, MSC kev kho mob rau ischemic stroke yog nce mus ntxiv.

Raws li tsis ntev los no, muaj 101 qhov kev sim tshuaj uas tau sau npe hauv Asmeskas kev sim tshuaj ntsuam xyuas cov ntaub ntawv rau cov kab mob hauv lub cev rau kev mob stroke, nrog 25 cov kev tshawb fawb ntsig txog MSC kev kho mob rau ischemic stroke. Kev sim tshuaj ntsuam xyuas tau pom tias MSCs muaj kev txhim kho tseem ceeb hauv kev ua haujlwm ntawm lub paj hlwb rau cov neeg mob ischemic stroke, lees paub lawv cov txiaj ntsig thiab kev nyab xeeb mus ntev.

Nyob rau hauv lub neej yav tom ntej, yuav muaj kev kho mob ntau ntxiv nrog rau MSCs uas yuav raug muab txhais ua cov ntaub ntawv kho mob, pab txhawb kev lag luam kho mob thiab tiv thaiv kev noj qab haus huv thiab kev noj qab haus huv ntawm tib neeg thoob ntiaj teb.