Isuzuma ryumutekano ningirakamaro bya Neurotrophique factor therapy in Ischemic Stroke

Ubwonko bwubwonko, buzwi kandi nka "stroke" cyangwa "impanuka yubwonko" (CVA), nindwara ikaze yubwonko bwamaraso irangwa no guturika gutunguranye kwimitsi yamaraso mubwonko cyangwa kubuza amaraso gutembera mubwonko, bikaviramo kwangirika kwinyama zubwonko. Harimo ischemic na hemorhagie stroke. Indwara ya stroke ni yo mpamvu ya kabiri itera impfu ku isi, hamwe n’imfu nyinshi n’ubumuga ku bantu bakuru.

Ischemic Stroke (IS) bivuga isekemike ya ischemic necrosis yaho cyangwa koroshya ingirangingo zubwonko ziterwa nubwonko bwubwonko bwamaraso, ischemia, na hypoxia. Bitewe n’ubwiyongere bukabije, ubwiyongere, impfu, n’ubumuga, byabaye imwe mu mpamvu zitera umutwaro w’indwara ku isi. Nk’uko imibare ibigaragaza, abantu bagera kuri miliyoni 15 ku isi barwara indwara y’indwara ziterwa n’indwara ziterwa n’indwara ziterwa n’indwara ziterwa na ischemic buri mwaka, aho abantu miliyoni 5 bapfa naho miliyoni 5 n’abantu bafite ubumuga bwigihe kirekire.

Uburyo bwo kuvura ingirabuzimafatizo zo mu bwoko bwa Ischemic Stroke

Mesenchymal Stem Cells (MSCs) ni ubwoko bwingirabuzimafatizo nyinshi zishobora gutandukanywa nuduce dutandukanye, harimo igufwa ryamagufa, ingirangingo ya adipose, namaraso yumutima. Bitewe nubwinshi bwa pluripotent, barashobora gutandukanya osteoblasts, chondrocytes, adipocytes, ndetse na neuron. Kugeza ubu, transplantation ya MSC yagaragaye nk'uburyo bushya bwo kuvura indwara ziterwa na ischemic, harimo ubwonko, indwara zifata imitsi, n'indwara ya arteriire. Ubushakashatsi bwinshi bwerekanye ko ingaruka nziza za neuroprotective ya MSCs ari ikintu cyingenzi mu kuvura indwara yimitsi.

Raporo y'ubushakashatsi iriho yerekana ko MSC iteza imbere cyane cyane gusana ibyangiritse ku mitsi, kugarura imikorere y’imitsi, kugabanya ingano y’ubwonko bw’ubwonko, no guteza imbere neurogenezi na angiogenezi binyuze mu ngaruka za parasrine, ingaruka z’ubudahangarwa, n’ingaruka zo kurwanya apoptotique, bityo bikagira uruhare mu kuvura mu bwonko.

Ingaruka ya parasrine

Ibintu bya parasrine ya MSC, harimo exosomes na viticles zidasanzwe, nizo zigira uruhare runini mu ngaruka zo kuvura. Mu rwego rwo gukomeretsa ubwonko bwubwonko, MSCs irashobora gutuma hagaragazwa ibintu bitandukanye bikura, harimo nubwonko bukomoka mu bwonko bukomoka mu bwonko (BDNF), imikurire yimitsi iva mu mitsi (VEGF), ingirabuzimafatizo ikomoka kuri selile 1 (SDF-1), fibroblast y'ibanze ibintu byo gukura (bFGF), glial selile ikomoka kuri neurotrophique, hamwe na hepatocyte yo gukura, nibindi. Izi ngingo zifasha kugabanya ubuso bwubwonko bwubwonko no kugarura imikorere yimitsi, bityo bikomeretsa ubwonko bwubwonko.

Ingaruka zo gukingira indwara

Ubushakashatsi bwerekanye ko MSCs ifite kandi imikorere ibiri yo kugenzura ibibazo by’ubudahangarwa hagati y’ubwonko: Ku ruhande rumwe, zishobora kongera cyane umubare w’uturemangingo B, selile NK, na T selile zo mu bwonko, bikagira ingaruka zo gukingira indwara. Ku rundi ruhande, ibintu byinshi byo gutwika bishobora gukora imikorere y’ubudahangarwa bwa MSCs, bityo bikagira ingaruka zibiri zibuza ikwirakwizwa rya lymphocyte no kubyara ibintu, bigatuma habaho fenotipike yo kurwanya inflammatory.

Amabwiriza ya apoptose

Apoptose selile ni uburyo bwingenzi bwo gukomeretsa ubwonko mu bwonko bwa ischemic, kandi MSCs irashobora kubuza apoptose ya neuronal, bikagira ingaruka kuri neuroprotective. Ubuvuzi bwa MSC burashobora kandi kugabanya ischemic stroke iterwa na astrocyte necrosis, kandi byongeye kandi, MSCs hypoxia-yabanje kwerekana ingaruka nziza zo kuvura mukugabanya necrosis selile iterwa no kuva amaraso mu bwonko.

Isuzuma rya clinique yo kuvura ingirabuzimafatizo ya ischemic stroke.

Guhindura ingirabuzimafatizo ya Mesenchymal stem selile (MSCs) yo kuvura indwara yubwonko bwerekanye ibisubizo bitanga umusaruro mubushakashatsi bwibanze. Abashakashatsi bakoze meta-isesengura ry’ibizamini 20 by’amavuriro birimo abarwayi 1127 bose hamwe, 573 bo mu itsinda ry’ubushakashatsi (bavuwe na MSCs) na 554 mu itsinda rishinzwe kugenzura (ubuvuzi busanzwe). Ugereranije no kuvura bisanzwe, transplantation ya MSC yagabanije cyane Ikigo cyigihugu cyita ku buzima bw’indwara zanduye (NIHSS) amanota 1, 3, 6, n’umwaka 1 nyuma yo kuvurwa. Yatezimbere kandi cyane ibikorwa byubuzima bwa buri munsi mumezi 1 na 6, hamwe nimikorere ya moteri n amanota yubwigenge bukora mumezi 1, 3, na 6.

Ibipimo by'ingenzi by'isuzuma birimo: (1) amanota y'ibigo by'igihugu byita ku buzima bw’indwara (NIHSS); (2) Ironderero rya Barthel (BI); (3) Isuzuma rya Fugl-Meyer (FMA); (4) Igipimo cyubwigenge bukora (FIM) amanota; na (5) Byahinduwe amanota ya Rankin (mRS).

Ugereranije no kuvura bisanzwe, mesenchymal stem selile (MSC) ivura indwara yubwonko igabanya cyane amanota ya NIH Stroke Scale (NIHSS) mumezi 3.

Ugereranije no kuvura bisanzwe, nta tandukaniro rikomeye ryagaragaye mu manota ya Barthel (BI) mu mezi 3 hamwe na mesenchymal stem selile (MSC) ivura indwara yubwonko.

Ugereranije no kuvura bisanzwe, mesenchymal stem selile (MSC) ivura indwara yubwonko yazamuye cyane amanota yimikorere (FMA) mumezi 3.

Ugereranije no kuvura bisanzwe, mesenchymal stem selile (MSC) ivura indwara yubwonko yazamuye cyane amanota yimikorere yubwigenge (FIM) mumezi 3.

Ugereranije no kuvura bisanzwe, mesenchymal stem selile (MSC) ivura indwara yubwonko ntiyerekanye itandukaniro rinini mumanota yahinduwe Rankin Scale (mRS) mumezi 3.

Ufatiye hamwe, umubiri munini wubushakashatsi bwibanze bwerekana uburyo bushoboka ningirakamaro byubuvuzi bwa Mesenchymal stem selile (MSC) bwo kuvura insimburangingo mu kuvura indwara ziterwa na ischemic, ibyo bikaba bimwe na bimwe biteza imbere imitekerereze ya neurologiya, imikorere ya moteri, nibikorwa byubuzima bwa buri munsi kubarwayi bafite ischemic. inkorora.

Ejo hazaza

Mu myaka yashize, uhereye kubitandukanya byoroheje no guhindura ubumenyi bwubushakashatsi bwingirangingo kugeza ubu bwimbitse no kwagura uburyo butandukanye bwubushakashatsi bwa MSC, iterambere ryurwego rwubushakashatsi bwingirabuzimafatizo rumaze gukura no guhanga udushya. Kugeza ubu, ntabwo ubushakashatsi bw’inyamaswa bwemeje gusa ingaruka zo kuvura ingirangingo fatizo, ariko hanasabwe uburyo bwo kuvura MSC bwo kuvura indwara ziterwa na ischemic. Mu bigeragezo byinshi byamavuriro, MSC ivura indwara ya ischemic stroke iratera imbere.

Kuva vuba aha, habaye ibizamini 101 by’amavuriro byanditswe mu bubiko bw’ubuvuzi bw’Amerika muri Amerika kugira ngo bivure ingirabuzimafatizo, hamwe n’ubushakashatsi 25 bujyanye no kuvura MSC kuvura indwara y’indwara ya ischemic. Igeragezwa ry’amavuriro ryerekanye ko MSCs ifite iterambere ryinshi mu mikorere y’imitsi y’abarwayi ba stroke ischemic, yemeza ko ikora neza n’umutekano muremure.

Mu bihe biri imbere, hazabaho iterambere ryinshi mu buvuzi ririmo MSCs izahindurwa mu mavuriro, igire uruhare mu nganda zita ku buzima no kurengera ubuzima n’imibereho myiza y’abantu ku isi.