Inyenyeri mu ngirabuzimafatizo! Ubushakashatsi bwa Clinical no gukoresha umbilical cord mesenchymal stem selile

Mu myaka yashize, ubushakashatsi bwakozwe ku ngirabuzimafatizo ya mesenchymal bwakomeje kwiyongera, kandi kugeza ubu, ingingo zirenga 47000 zijyanye n'ingirabuzimafatizo ya Mesenchymal zagaruwe kuri Pubmed.

Umbilical cord mesenchymal stem selile yamye ifatwa nkubutunzi nabahanga kandi bahora bagaragaza ubushobozi bwabo bwo kuvura indwara no kurwanya gusaza.

Uyu munsi, umwanditsi azagusobanurira icyo ururenda rwitwa mesenchymal stem selile aricyo, kandi werekane igikundiro cyururondogoro rwitwa mesenchymal stem selile murwego rwubuvuzi mugutangiza ubushakashatsi bwubuvuzi bwamavuriro ya selile yumutima mesenchymal stem selile.

Umuhengeri wa mesenchymal stem selile ni iki?

Umbilical cord mesenchymal stem selile (HUC MSCs) ikomoka kumurambararo wimpinja zikivuka kandi zifite umutekano kandi zambere cyane ugereranije ningirabuzimafatizo zikuze za mesenchymal. Bafite ikwirakwizwa ryinshi, gutandukanya, hamwe nubushobozi bwo kugenzura ubudahangarwa; Byongeye kandi, ugereranije nandi masoko ya selile mesenchymal stem selile, umbilical cord mesenchymal stem selile ikurwa mubice byumutwe bitandukanijwe nta nkomyi byangiza umubiri wumuntu. Kubwibyo, umugozi MSCs ikwiranye nubushakashatsi bwamavuriro no kubishyira mu bikorwa, kandi ni byo byatoranijwe kuvura imiti n’ubuvuzi bushya.

Umbilical cord mesenchymal stem selile yerekanye ubushobozi bwo gutandukanya cyane muri vitro, harimo chondrocytes, adipocytes, osteoblasts, selile skeletale, cardiomyocytes, selile yumwijima, ndetse no gukora selile glucagon, somatostatine isohora selile, selile glial (oligodendrocytes), na neuron dopaminergic. Kubwibyo, umbilical cord mesenchymal stem selile ikwiranye cyane nubuvuzi nubushakashatsi bwa siyansi.

Mesenchymal stem selile yahindutse ahantu h'ubushakashatsi

Mu myaka yashize, ubushakashatsi bwakozwe ku ngirabuzimafatizo ya mesenchymal bwagiye bwiyongera, kandi ClinicalTrials yo muri NIH muri Amerika ni imibare nini y’ubushakashatsi ku mavuriro ku isi. Dukurikije ibyavuye mu bushakashatsi bwakozwe muri data base, guhera ku ya 13 Gicurasi 2019, hari ubushakashatsi bw’amavuriro 753 bwanditswe muri data base bwerekeye ingirabuzimafatizo ya Mesenchymal. Muri byo, umubare w’ubushakashatsi bw’amavuriro bwakorewe mu Bushinwa, mu Burayi, no muri Amerika biza mu bihugu bitatu bya mbere ku isi.

Ukurikije ubwoko bwindwara zavuwe, ubushakashatsi bwamavuriro kuri selile stem mesenchymal burimo indwara amagana. Muri byo, indwara zifata ubwonko, iz'umutima, n'iz'amagufwa ni byo bice bitatu by'ubushakashatsi, bingana na 15%, kandi byose birenga kimwe cya kabiri. Byongeye kandi, igipimo cya diyabete, umwijima, ibihaha, inzira ya gastrointestinal, uruhu, indwara ziterwa na autoimmune hamwe na graft hamwe nindwara zakira (GVHD) ni hafi 5%, kikaba ari icyerekezo cyingenzi cyubushakashatsi bwamavuriro ya selile mesenchymal stem selile.

Ubuvuzi bukoreshwa mubushakashatsi bwururenda mesenchymal stem selile

01. Indwara ziterwa na metabolike

1.1 Diyabete

Kugeza ubu, nta muti ukabije wa diyabete uvura, kandi dushobora kwishingikiriza gusa kuri insuline cyangwa ibiyobyabwenge muri vitro kugirango tugabanye isukari mu maraso, kandi icyarimwe tugafatanya nimirire no gukora siporo. Mesenchymal stem selile ifite ubushobozi bwo gukangura ibirwa bya pancreatic β Igikorwa cyo kuvugurura ingirabuzimafatizo.

Mu Bushinwa, hari ibitaro bitatu byo hejuru byakoze ubushakashatsi ku mavuriro ku bijyanye no kwimura ingirabuzimafatizo ya mesenchymal mu kuvura diyabete yo mu bwoko bwa II. Abarwayi benshi bageze ku ngaruka zo kugabanya isukari yo mu maraso na insuline, ndetse bamwe bareka gufata imiti. Muri icyo gihe, umubiri wumurwayi wateye imbere kandi ubuzima bwabo bwarakosowe ku rugero runaka.

Ibitaro Bikuru bya Fuzhou byo mu karere ka Gisirikare ka Nanjing byakoze ubushakashatsi ku mutekano n’akamaro k’ingirabuzimafatizo ya mesenchymal stem selile hamwe na selile autologique bone marrow mesenchymal stem selile mu kuvura diyabete yo mu bwoko bwa I nta immunotherapie. Ibisubizo byagaragaje ko ingaruka zo kuvura abarwayi 42 ari nziza. C-Pep yiyongereyeho 105.7%, insuline 49,3%, HbA1c yagabanutseho 12,6%, glucose yamaraso yagabanutseho 24.4%, naho insuline ikenera 29.2%.

1.2 Ingorane za diyabete

Mesenchymal stem selile ifite uburyo bwagutse bwo gukoresha mubibazo bya diyabete.

1.2.1 Ikirenge cya diyabete

Mu bitaro by’abaturage bo mu Ntara ya Shaanxi, mu bihe bidasanzwe, ururenda rwitwa mesenchymal stem selile rwatewe mu mitsi intera ya 3cm x 3cm ku gikomere cy’abarwayi 5 barwaye diyabete yo mu bwoko bwa II bigoye n'amaguru ya diyabete. Kubafite ibikomere bikabije, inshinge zashyizwe hagati ya 1cm x 1cm hagati yamaguru, hibandwa ku gutera inshinge hafi y ibisebe. Nyuma yo kuvurwa, urugero rwo kubabara ibirenge no kunanirwa byagabanutse cyane, claudication rimwe na rimwe yateye imbere ku buryo bugaragara, kandi ibisebe byakize rwose.

Mu bitaro by’intara bya Anhui byo muri kaminuza y’ubuvuzi ya Anhui, ingirangingo ngengabuzima ya mesenchymal stem yatewe mu gisebe cy’ibisebe by’ingingo zanduye z’abarwayi 53 bafite ikirenge cya diyabete yo mu cyiciro cya II-IV. Nyuma y'amezi atatu yo kwivuza, ugereranije n'itsinda rishinzwe kugenzura, itsinda rivura ryerekanye ko ryateye imbere cyane mu bushyuhe bw'uruhu, igipimo cy'umuvuduko ukabije w'amaguru, impagarara za ogisijeni y'uruhu, n'intera yo kugenda.

1.2.2 Indwara ya diabete

Ishuri Rikuru ry’Ubuvuzi ry’ibitaro bikuru bya Fuzhou, Kaminuza ya kabiri y’ubuvuzi ya Gisirikare, n’ibitaro bishamikiye kuri Changzheng byo muri kaminuza ya kabiri y’ubuvuzi ya Gisirikare byavuzaga abarwayi 15 bafite ururenda rwitwa mesenchymal stem selile binyuze mu kwivanga mu mitsi ya pancreatic dorsal, imiyoboro y’impyiko zombi, no kwinjiza imitsi ya peripheri. . Nyuma yo kuvurwa, abarwayi bagaragaje iterambere ryumuvuduko wamaraso, isukari yamaraso, urugero rwa C-peptide, nibipimo byerekana imikorere yimpyiko. Ku bijyanye n’ubuvuzi bwiza mu kuzamura umuvuduko wamaraso wa diastolique nimikorere yimpyiko, itsinda ryivura ryarushije itsinda rishinzwe kugenzura imiti ivura telmisartan yo mu kanwa hiyongereyeho inshinge zo mu bwoko bwa insuline.

02.Uburwayi bw'imitsi

Indwara ya Parkinson

Ikibazo cya mbere cyo kwimura ingirabuzimafatizo ku ndwara ya Parkinson mu Bushinwa cyarangiye mu bitaro bya Shijiazhuang. Xie Xiyun, umusaza w'imyaka 76 ukomoka muri Indoneziya, yari amaze imyaka isaga icumi arwaye indwara ya Parkinson, agira uburibwe no kwikuramo intoki eshatu z'ukuboko kwe kw'iburyo, gukomera k'umubiri, kumira ingorane, no gutakaza ubushobozi bwo kwiyitaho. Mu masaha make yakiriye insimburangingo ya mesenchymal stem selile, yashoboye kurya neza kandi neza kureba televiziyo nimugoroba, afite iterambere ryinshi mubindi bimenyetso.

Dr. Sun Li wo muri kaminuza y’ubuvuzi y’Ubushinwa yashyizemo ihagarikwa ririmo ingirangingo ngengabuzima ya mesenchymal stem selile mu ijosi ry’abarwayi 10 ba Parkinson. Nyuma yo guhindurwa, abarwayi bagaragaje iterambere ryimyitwarire, kugenda guhinda umushyitsi, kugenda kubushake, nubushobozi bwo kwicara no guhagarara. Ntabwo yagenzuye neza iterambere ryindwara ya Parkinson gusa, ahubwo yanateje imbere imikorere yimitsi yubwonko yangiritse, bityo bizamura imibereho yabarwayi.

2.2 guta umutwe

Iri tsinda riyobowe na Zhou Qiang mu bitaro bya Jinyang mu Mujyi wa Guiyang ryavuye abarwayi bane bageze mu za bukuru bakoresheje ingirabuzimafatizo zikomoka ku magufwa. Umurwayi wa mbere, umugabo w’imyaka 75, ntiyigeze amenya abagize umuryango nyuma yo kwinjira kandi yatakaje uruhago no kugenzura amara. Nyuma yo kuvurwa kwa transplant, ibi bimenyetso byahindutse vuba, kandi amaze gusohoka, ntabwo yamenye abo mu muryango we gusa ahubwo yanagaruye uruhago rusanzwe n amara.

2.3 Kudasinzira

Muganga Wang Yali wo mu bitaro bya polisi bitwaje intwaro bya Zhejiang yavuye abarwayi 19 bafite ikibazo cyo kudasinzira batewe no kwinjiza imitsi y’ingirabuzimafatizo ya mesenchymal stem selile. Aba barwayi bose bagize ikibazo cyo gusinzira, kugabanuka gusinzira, hamwe nigihe cyo gusinzira kitarenze amasaha 6. Nyuma yukwezi kumwe kwivuza, kuzamura ireme ryibitotsi kubarwayi byagereranijwe nubuvuzi bwo mu kanwa. Nyuma y'amezi abiri yo kwivuza, amanota meza yo gusinzira y'abarwayi yari meza cyane ugereranije n'imiti yo mu kanwa. Nyuma y'amezi atatu yo kuvurwa, ubwiza bw'abarwayi nabwo bwari bwiza cyane kuruta ubw'imiti yo mu kanwa, kandi ingaruka z'ubuvuzi bumwe zishobora kumara umwaka umwe, bikazamura cyane ibitotsi ku barwayi.

03. Indwara ya musculoskeletal

3.1 Indwara ifatika

Mu myaka ya za 90, Brittberg n'abandi batangiye kugera ku bisubizo bimwe na bimwe byo gusana ibikomere bya karitsiye bakoresheje chondrocytes autologique. Kubwibyo, ubushakashatsi bwinshi kandi bwinshi bwatangiye kwibanda kuri mesenchymal stem selile. Mesenchymal stem selile irashobora gutandukanya mubice bitandukanye kandi igasana imitsi ya articular artilage hamwe nibikomere byamagufwa.

Mu bushakashatsi bwakozwe na Akgun n'abandi. bo mu ishami rya orthopedie na ihahamuka muri kaminuza ya Istanbul muri Turukiya, bagereranije ingaruka zo kuvura indwara zifata amagufwa ya magenchymal stem selile na chondrocytes ku barwayi 14 barwaye osteoarthritis. Basanze abarwayi bahabwa imiti ya Mesenchymal stem selile bagaragaje iterambere ryinshi mu gukomeretsa kw'ivi hamwe n'amanota yavuye muri osteoarthritis (KOOS) n'amanota agereranya (VAS).

Wakitani n'abandi. wo mu Ishuri Rikuru ry’Ubuvuzi rya Feinberg muri kaminuza y’Amajyaruguru y’Uburengerazuba n’ibitaro bya Clinique bya Cleveland muri kaminuza ya Ohio bakoze igeragezwa ry’amavuriro bakoresheje selile stem mesenchymal. Mu itsinda ry’ubushakashatsi, gel ya kolagen ivanze na selile autologique bone marrow ikomoka kuri mesenchymal stem selile yatewe mumyanya ndangagitsina yabarwayi, mugihe itsinda ryigenzura ryakiriye geli ya kolagen ingana gusa. Amatsinda yombi yerekanye iterambere mu mikorere ihuriweho, ariko itsinda ryubushakashatsi ryerekanye gusa kuvugurura karitsiye ibonerana aho yakomeretse. Bakurikiranye abarwayi 41 bakiriye mesenchymal stem selile ivura imyaka igera kuri 11 basanga nta ngorane zikomeye.

04. Indwara zimyororokere

4.1 Kutabyara

Gusana ibyangiritse bikabije kuri endometrium, ninzozi mbi zabagore benshi batabyara, ubu birashoboka hifashishijwe ikoranabuhanga rya mesenchymal stem selile regenerative tekinoloji, bizana ibyiringiro byo gusohoza inzozi zabagore zububyeyi.

Itsinda rya Porofeseri Hu Yali wo mu ishami ry’ububyaza n’ubuvuzi bw’ibitaro bya Gulou i Nanjing, rifatanya n’itsinda rya Porofeseri Dai Jianwu wo mu Ishuri Rikuru ry’Ubuzima n’Iterambere ry’ibinyabuzima ry’Ishuri Rikuru ry’Ubushinwa, ryateye imbere, ku nshuro ya mbere ku rwego mpuzamahanga, uburyo bwo guhuza collagen scafolds hamwe na mesenchymal stem selile. Mu guhuza tekinike gakondo ya hysteroskopi, bageze ku gusana imikorere ya endometrium yangiritse, ifasha abarwayi batatu gusohoza inzozi zabo zo kuba ababyeyi.

Madamu Hu ukomoka i Yancheng, muri Jiangsu, yakuyemo inda eshatu karemano hagati y’imyaka 31 na 34, bituma afatana cyane mu cyondo cye cya nyababyeyi kubera kubagwa nyuma yo gukuramo inda ya curettage. Ukoresheje ingirabuzimafatizo ya Mesenchymal, Ibitaro bya Gulou i Nanjing byasannye neza endometrium mu mezi umunani. Ibi byamushoboje gusama neza, maze ku ya 17 Nyakanga 2014, yibaruka "umwana w’ubuvuzi bushya" mu Bushinwa.

Ibitaro bya Nanjing Gulou byo mu bwoko bwa mesenchymal stem selile "endometrial regeneration surgery" byafashije abarwayi 13 batabyara bafite uburibwe bukabije bwa nyababyeyi gusama no kubyara, bivamo abana 14 bafite ubuzima bwiza "bushya bwo kuvura."

4.2 Kunanirwa kw'intanga ngore

Kunanirwa kw'intanga imburagihe bivuga ibintu aho usanga abagore bahura nintanga ngore kandi bakareka gutera intanga mbere yimyaka 40. Kugeza ubu, hafi 1% byabagore bafite imyaka yimyororokere kwisi yose bahura nintanga ngore imburagihe, bikaba ari impamvu ikomeye itera ubugumba bwumugore.

Porofeseri Wu Ji n'itsinda rye bo muri kaminuza ya Shanghai Jiao Tong yo mu Bushinwa batandukanije ingirabuzimafatizo z'imyororokere y'abagore kuva ku cyumweru kimwe kugeza ku byumweru bibiri icyatsi kibisi cyitwa fluorescent protein transgenic. Nyuma yo kwezwa, umuco, nibindi bikorwa, utugingo ngengabuzima twatewe mu mbeba hamwe no kunanirwa kw'intanga ngore. Ibisubizo byubushakashatsi byagaragaje ko ingirabuzimafatizo yimyororokere yumugore, kimwe nizindi selile, zifite imiterere yo gutaha. Nyuma yo gutaha, selile zimwe ziratandukana kandi buhoro buhoro zikura muri oocytes ikuze, bityo igarura imikorere yintanga.

4.3 Imikorere idahwitse (ED)

Gukoresha ingirangingo ngengabuzima yo kuvura imikorere mibi irashobora gusimbuza ingirabuzimafatizo zangiritse cyangwa zapfuye ndetse no gusohora ibintu kugirango bisane ingirabuzimafatizo zangiza imikorere.

Abarwayi 15 badakora neza muri Danimarike bakiriye mesenchymal stem selile nta miti cyangwa transplantation. Nyuma y'amezi atandatu, abagabo umunani bashoboye gukora imibonano mpuzabitsina bisanzwe.

05. Indwara za Autoimmune

Mu 2007, Porofeseri Sun Lingyun mu Bushinwa yakemuye neza ibibazo bibiri bya sisitemu yo mu bwoko bwa lupus erythematosus yifashishije ingirabuzimafatizo ya mesenchymal, maze umwaka wakurikiyeho, avura izindi ndwara icyenda. Nyuma yo kuvurwa, ibimenyetso by’abarwayi byagabanutse ku buryo bugaragara, kandi nta byongeye kubaho mu gihe cy’amezi 6 yakurikiranwe.

Mu mwaka wa 2012, Ishami rya Rheumatology na Immunology ry’ibitaro bishamikiye kuri kaminuza ya Jiangsu byinjije mu mitsi ingirabuzimafatizo ya Mesenchymal stem selile ku barwayi 21 barwaye lupus erythematosus, byagabanije cyane urugero rwa poroteyine y’inkari muri aba barwayi, bigabanya ibikorwa by’indwara, kandi bigabanya Sisitemu ya Lupus Erythematosus. Indangantego y'ibikorwa Indwara amanota.

Ingaruka zo kwimura ingirabuzimafatizo ya mesenchymal ku bikorwa byindwara na proteine ​​yinkari ku barwayi bafite lupus erythematosus (SLE)

Mu mwaka wa 2013, Ishami rya Rheumatology na Immunology ry’ibitaro bya mbere bishamikiye kuri kaminuza ya Yangtze hamwe n’ibitaro bya mbere by’abaturage bya Jingzhou byayoboye ingirangingo z'umutima mesenchymal stem selile binyuze mu mitsi y'imbere ku barwayi 18 barwaye lupus erythematosus. Ukwezi kumwe, abarwayi benshi bagaragaje iterambere ryinshi mubimenyetso byubuvuzi nibimenyetso nkumuriro, umunaniro, nintege nke ugereranije na mbere yo guterwa.

06.anti-gusaza

Gusaza k'umubiri w'umuntu bifitanye isano n'umubare w'ingirabuzimafatizo udahagije cyangwa udakora. Uko imyaka igenda yiyongera, hari inzira igabanuka haba mubwinshi nubwiza bwingirabuzimafatizo mu mubiri. Iyi myumvire iganisha ku kugabanuka no gusaza kwingirangingo zangiritse ningingo ningirangingo bigizwe na selile, bikaviramo ubuzima budasanzwe no gusaza. Mesenchymal stem selile ifite ubushobozi bwo gutandukanya ibintu byinshi, ibasha gutandukanya ubwoko butandukanye bwingirabuzimafatizo zikenewe mumubiri. Mu kuzuza ingirabuzimafatizo zidahagije mu mubiri no gusana ingingo n'ingirangingo byangiritse, ingirabuzimafatizo ya Mesenchymal igira uruhare mu kurwanya gusaza.

Hamwe nogushaka kwiyongera no gushyira mubikorwa umbilical cord mesenchymal stem selile, byizerwa ko mugihe cya vuba, bizakoreshwa cyane mubuvuzi, bityo biha agaciro gakomeye ubuzima bwabantu.