Qiimaynta Badbaadada iyo Waxtarka Daawaynta Cunsurka Neurotrophic ee Istaroogga Ischemic

Istaroogga maskaxda, oo sidoo kale loo yaqaan "stroke" ama "shilka maskaxda ee maskaxda" (CVA), waa cudur ba'an oo ku dhaca maskaxda oo lagu garto dillaac degdeg ah ee xididdada dhiigga ee maskaxda ama xannibaadda socodka dhiigga ee maskaxda, taasoo keentay dhaawac soo gaadhay unugyada maskaxda. Waxaa ka mid ah ischemic iyo dhiigbax labadaba. Faaliggu waa sababta labaad ee keenta dhimashada adduunka oo dhan, iyadoo heerka dhimashada iyo naafanimada uu sareeyo dadka waaweyn.

Ischemic Stroke (IS) waxaa loola jeedaa ischaemic necrosis maxalli ah ama jilicsanaanta unugyada maskaxda ee ay keento khalkhalka wareegga dhiigga ee maskaxda, ischemia, iyo hypoxia. Sababo la xiriira xad-dhaafkeeda, baahsanaanta, dhimashada, iyo heerka naafanimada, waxay noqotay mid ka mid ah sababaha ugu waaweyn ee culeyska cudurrada adduunka. Marka loo eego tirakoobyada, qiyaastii 15 milyan oo qof oo adduunka ah ayaa la ildaran istaroogga ischaemic sanad walba, iyadoo 5 milyan ay u dhintaan 5 milyan oo qofna ay la kulmaan naafo muddo dheer ah.

Farsamaynta Daaweynta Unugyada Jirka ee Istaroogga Ischemic

Unugyada stem Mesenchymal (MSCs) waa nooc ka mid ah unugyo tarma oo awood badan oo laga sooci karo unugyo kala duwan, oo ay ku jiraan dhuuxa lafta, unugyada adipose, iyo dhiigga xudunta. Sababo la xiriira hantidooda pluripotent, waxay u kala saari karaan osteoblasts, chondrocytes, adipocytes, iyo xitaa neurons. Waqtigan xaadirka ah, ku-tallaalidda MSC waxay u soo baxday sidii hab cusub oo daaweyneed oo loogu talagalay cudurrada ischaemic, oo ay ku jiraan istaroogga, cudurka halbowlaha halbowlaha, iyo cudurrada halbowlaha durugsan. Daraasado dhowr ah ayaa muujiyay in saameynta neuroprotective ee ugu fiican ee MSCs ay tahay arrin muhiim ah oo lagu daaweynayo istaroogga ischaemic.

Warbixinnada cilmi-baarista hadda waxay muujinayaan in MSC ay inta badan kor u qaaddo hagaajinta dhaawaca nudaha neerfaha, dib u soo celinta shaqada neerfaha, yareynta xajmiga faleebo maskaxda, iyo kor u qaadista neurogenesis iyo angiogenesis iyada oo loo marayo saameynta paracrine, saameynta immunomodulatory, iyo saameynta anti-apoptotic, sidaas darteed door daaweyn ah. ischemic stroke.

Saamaynta paracrine

Qodobbada paracrine ee MSC, oo ay ku jiraan exosomes iyo vesicles unug ka baxsan, ayaa ah ka qaybqaatayaasha ugu muhiimsan ee saameyntooda daawaynta. Aagga dhaawaca istaroogga maskaxda, MSCs waxay keeni kartaa muujinta arrimo kala duwan oo koritaan ah, oo ay ku jiraan maskaxda-derived neurotrophic factor (BDNF), vascular endothelial factor factor (VEGF), stromal cell-derived factor 1 (SDF-1), fibroblast aasaasiga ah. factor koritaanka (bFGF), glial unug ka soo jeeda neurotrophic factor, iyo factor koritaanka hepatocyte, iyo kuwo kale. Qodobbadani waxay gacan ka geystaan ​​dhimista aagga faleebada maskaxda waxayna soo celiyaan shaqada neerfaha, taas oo hagaajinaysa dhaawacyada istaroogga maskaxda.

Saamaynta immunomodulatory

Cilmi-baaristu waxay ogaatay in MSC-yadu ay sidoo kale leeyihiin laba nidaam oo nidaamsan oo ku saabsan jawaabaha difaaca dhexe ee istaroogga ka dib: Dhinaca kale, waxay si weyn u kordhin karaan tirada unugyada B, unugyada NK, iyo unugyada T ee unugyada maskaxda, iyagoo samaynaya saameyn difaac-dhis ah. Dhanka kale, heerarka sare ee arrimaha caabuqa ayaa kicin kara shaqada difaaca jirka ee MSCs, taas oo ku samaynaysa saameyn laba geesood ah oo ku saabsan faafinta lymphocyte iyo wax soo saarka cuncunka bararka, taasoo keenta phenotype anti-bararka.

Nidaaminta apoptosis unugga

Apoptosis-ka unuggu waa hab muhiim ah oo ah dhaawaca neerfaha ee istaroogga ischaemic, iyo MSC-yadu waxay joojin karaan apoptosis neuronal, oo sameeya saameyn neuroprotective ah. Daawaynta MSC waxay sidoo kale yareyn kartaa ischaemic ischaemic-induced astrocyte necrosis, iyo sidoo kale, hypoxia-pre-conditioned MSC-yada waxay muujinayaan saameyno daweyn oo wanaagsan oo lagu dhimayo necrosis unug ee uu keeno dhiigbaxa maskaxda.

Qiimaynta kiliinikada ee daaweynta unugyada stem ee istaroogga ischaemic.

Ku-tallaalidda unugyada stem mesenchymal (MSCs) ee daaweynta istaroogga ischaemic waxay muujisay natiijooyin rajo leh oo daraasado hore ah. Cilmi-baadhayaashu waxay sameeyeen falanqayn-xaalad ah oo ah 20 tijaabo caafimaad oo ku lug leh wadar ahaan 1127 bukaan, oo ay ku jiraan 573 ee kooxda tijaabada ah (oo lagu daaweeyay MSCs) iyo 554 ee kooxda kantaroolka (daaweynta caadiga ah). Marka la barbar dhigo daawaynta caadiga ah, ku-tallaalidda MSC waxay si weyn hoos ugu dhigtay buundooyinka machadyada Qaranka ee Miisaanka Stroke Stroke (NIHSS) ee 1, 3, 6 bilood, iyo 1 sano daaweynta ka dib. Waxa kale oo ay si weyn u wanaajisay dhaqdhaqaaqyada tusmada nolol maalmeedka ee 1 iyo 6 bilood, iyo sidoo kale dhaqdhaqaaqa dhaqdhaqaaqa iyo buundooyinka madaxbannaanida shaqeynta ee 1, 3, iyo 6 bilood.

Tilmaamaha qiimaynta ugu muhiimsan waxa ka mid ah: (1) Dhibcaha machadyada Qaranka ee Miisaanka Stroke Health (NIHSS); (2) Tusmada Barthel (BI); (3) Dhibcaha Qiimaynta Fugl-Meyer (FMA); (4) Dhibcaha Cabbirka Madaxbanaanida Shaqada (FIM); iyo (5) Dhibcaha Qiyaasta Rankin ee la beddelay (mRS).

Marka la barbardhigo daawaynta caadiga ah, daawaynta istaroogga ee unugyada istaroogga ee mesenchymal (MSC) waxay si weyn u dhimaysaa dhibcaha NIH Stroke Scale (NIHSS) 3 bilood.

Marka la barbar dhigo daawaynta caadiga ah, ma jirin farqi weyn oo u dhexeeya dhibcaha Barthel Index (BI) ee bilaha 3 ee daawaynta unugyada asliga ee mesenchymal (MSC) ee istaroogga.

Marka la barbar dhigo daawaynta caadiga ah, daawaynta istaroogga ee unugyada mesenchymal (MSC) ayaa si weyn u wanaajisay dhibcaha Qiimaynta Dhaqdhaqaaqa Waxqabadka (FMA) ee 3 bilood.

Marka la barbar dhigo daawaynta caadiga ah, daawaynta istaroogga ee unugyada mesenchymal (MSC) waxay si weyn u wanaajisay buundada Cabbiraadda Madaxbanaanida Shaqada (FIM) 3 bilood.

Marka la barbar dhigo daawaynta caadiga ah, daawaynta istaroogga ee unugyada istaroogga (MSC) ma muujin wax farqi ah oo la taaban karo oo ku yimid dhibcaha Miisaanka Rankin ee la beddelay (mRS) ee 3 bilood.

Isku soo wada duuboo, tiro badan oo daraasado hore ah ayaa muujinaya suurtogalnimada iyo waxtarka daaweynta unugyada unugyada jirka ee ischaemic (MSC) ee daaweynta istaroogga ischaemic, taas oo ilaa xad wanaajisa cilladaha neerfaha, shaqada dhaqdhaqaaqa, iyo hawlaha nolol maalmeedka bukaanka qaba ischaemic. istaroog.

Mustaqbalka iyo Rajada

Sanadihii la soo dhaafay, laga soo bilaabo kala duwanaansho fudud iyo garaadka isbeddelka ee cilmi-baarista unugyada asliga ah ilaa qoto-dheeraynta joogtada ah iyo ballaarinta hababka kala duwan ee cilmi-baarista MSC, horumarinta goobta cilmi-baarista unugyada asliga ah ayaa noqday qaan-gaar ah oo cusub. Waqtigan xaadirka ah, kaliya maahan tijaabooyinka xayawaanku waxay xaqiijiyeen saamaynta daaweynta unugyada asliga ah, laakiin sidoo kale suurtagalnimada daaweynta MSC ee istaroogga ischaemic ayaa la soo jeediyay. Tijaabooyin caafimaad oo badan, daawaynta MSC ee istaroogga ischaemic ayaa si joogto ah u horumaraysa.

Dhawaanahan, waxa jiray 101 tijaabo caafimaad oo ka diiwaan gashan kaydka xogta tijaabada ee Maraykanka ee daawaynta unugyada stem ee istaroogga, iyada oo 25 daraasadood oo la xidhiidha daawaynta MSC ee istaroogga ischaemic. Tijaabooyin caafimaad ayaa muujiyay in MSCs ay horumar weyn ku sameeyeen shaqada neerfaha ee bukaannada istaroogga ischaemic, iyagoo xaqiijinaya waxtarkooda iyo badbaadada muddada dheer.

Mustaqbalka, waxaa jiri doona horumaro caafimaad oo badan oo ku lug leh MSCs kuwaas oo loo tarjumi doono codsiyada caafimaadka, wax ku biirinta warshadaha daryeelka caafimaadka iyo ilaalinta caafimaadka iyo ladnaanta dadka adduunka oo dhan.