Linaleli ka liseleng tsa stem! Patlisiso ea bongaka le ts'ebeliso ea lisele tsa stem tsa umbilical cord mesenchymal stem

Lilemong tsa morao tjena, lipatlisiso tse mabapi le lisele tsa mesenchymal stem li ntse li eketseha, 'me ho fihlela joale, lihlooho tse fetang 47000 tse amanang le lisele tsa mesenchymal stem li fumanoe ho Pubmed.

Lisele tsa stem tsa umbilical cord mesenchymal li 'nile tsa nkoa e le matlotlo ke bo-rasaense 'me li lula li bontša bokhoni ba bona ba ho phekola maloetse le ho thibela botsofali.

Kajeno, mohlophisi o tla u hlalosetsa hore na lisele tsa 'mele oa mokhubu mesenchymal stem ke eng,' me a bonts'a khahleho ea lisele tsa stem tsa mokhubu lefapheng la bongaka ka ho hlahisa linyeoe tsa ts'ebeliso ea lipatlisiso tsa bongaka tsa lisele tsa stem tsa mokhubu tsa mesenchymal stem.

Lisele tsa stem tsa umbilical cord mesenchymal ke eng?

Lisele tsa stem tsa umbilical cord mesenchymal stem cell (hUC MSCs) li tsoa mothapong oa masea a sa tsoa tsoaloa 'me li bolokehile ebile ke tsa khale ho feta ha li bapisoa le lisele tse kholo tsa mesenchymal stem. Ba na le ho ata ho matla, ho khetholla, le matla a ho laola 'mele oa ho itšireletsa mafung; Ho phaella moo, ha ho bapisoa le mehloli e meng ea lisele tsa mesenchymal stem, lisele tsa stem tsa umbilical cord mesenchymal stem li fumanoa ho tloha lisele tse koetsoeng tsa mokhubu ntle le kotsi leha e le efe 'meleng oa motho. Ka hona, li-MSC tsa mokhubu li loketse lipatlisiso tsa bongaka le ts'ebeliso, 'me ke khetho e ratoang bakeng sa kalafo ea lisele le meriana e nchafatsang.

Lisele tsa stem tsa umbilical cord mesenchymal stem li bonts'itse bokhoni bo phahameng ba phapang in vitro, ho kenyelletsa chondrocyte, adipocytes, osteoblasts, skeletal cell, cardiomyocytes, lisele tsa sebete, hammoho le ho hlahisa lisele tsa glucagon, lisele tsa secretion ea somatostatin, lisele tsa glial (oligodendrocytes) le dopaminergic neurons. Ka hona, lisele tsa stem tsa umbilical cord mesenchymal li loketse haholo lits'ebetsong tsa bongaka le lipatlisiso tsa mahlale.

Lisele tsa stem tsa mesenchymal li fetohile sebaka sa lipatlisiso

Lilemong tsa morao tjena, lipatlisiso tse mabapi le lisele tsa mesenchymal stem li ntse li eketseha, 'me ClinicalTrials e tsoang NIH e United States ke polokelo ea boitsebiso e kholo ka ho fetisisa lefatšeng ea lipatlisiso tsa bongaka. Ho latela liphetho tsa lipatlisiso tsa database, ho tloha ka la 13 Motšeanong 2019, ho bile le lithuto tsa bongaka tse 753 tse ngolisitsoeng polokelong ea litaba mabapi le lisele tsa mesenchymal stem. Har'a tsona, palo ea lithuto tsa bongaka tse entsoeng Chaena, Europe le United States e har'a tse tharo tse holimo lefatšeng.

Ho latela pono ea mefuta ea mafu a phekoloang, lipatlisiso tsa bongaka ka lisele tsa mesenchymal stem li kenyelletsa mafu a makholo. Har'a tsona, mafu a methapo ea pelo, pelo le masapo ke libaka tse tharo tse kholo tsa lipatlisiso, tse ikarabellang ho feta 15%, 'me kakaretso e feta halofo. Ho feta moo, karolo ea lefu la tsoekere, sebete, matšoafo, mala a mala, letlalo, mafu a autoimmune le lefu la graft vs host (GVHD) ke hoo e ka bang 5%, e leng tataiso ea bohlokoa ea lipatlisiso tsa kliniki ea lisele tsa mesenchymal stem.

Nyeoe ea lipatlisiso tsa kliniki ea lisele tsa stem tsa umbilical cord mesenchymal stem

01.Mafu a metabolism

1.1 Lefu la tsoekere

Hajoale, ha ho na pheko e matla ea lefu la tsoekere, 'me re ka itšetleha feela ka insulin kapa lithethefatsi tsa in vitro ho fokotsa tsoekere e maling, 'me ka nako e ts'oanang re sebelisane le lijo le boikoetliso. Lisele tsa mesenchymal stem li na le bokhoni ba ho susumetsa lihlekehleke tsa pancreatic β Mosebetsi oa ho nchafatsa lisele.

Chaena, ho na le lipetlele tse tharo tse holimo tse entseng lipatlisiso tsa bongaka mabapi le phetisetso ea mesenchymal stem cell kalafong ea lefu la tsoekere la mofuta oa II. Bakuli ba bangata ba fihletse phello ea ho fokotsa tsoekere e maling le insulin, ’me ba bang ba bile ba khaotsa ho noa meriana. Ka nako e ts'oanang, boemo ba 'mele ba mokuli bo ntlafetse mme boemo ba bona ba bophelo bo botle bo lokisitsoe ho isa bohōleng bo itseng.

Sepetlele se Akaretsang sa Fuzhou se Seterekeng sa Sesole sa Nanjing se ile sa hlahloba polokeho le katleho ea lisele tsa stem tsa mokhubu tsa mesenchymal tse kopantsoeng le lisele tsa 'mele tsa mesenchymal stem tsa autologous kalafong ea lefu la tsoekere la mofuta oa pele ntle le immunotherapy. Liphello li bontšitse hore phello ea phekolo ea bakuli ba 42 e ne e le ntle. C-Pep e eketsehile ka 105.7%, insulin 49.3%, HbA1c e fokotsehile ka 12,6%, tsoekere e potlakileng ea mali e fokotsehile ka 24,4%, 'me tlhokahalo ea insulin e fokotsehile ka 29,2%.

1.2 Mathata a lefu la tsoekere

Lisele tsa mesenchymal stem li na le tebello e pharaletseng ea ts'ebeliso mathateng a lefu la tsoekere.

1.2.1 Leoto la lefu la tsoekere

Sepetleleng sa Batho ba Setereke sa Shaanxi, tlas'a maemo a nyopa, ho emisoa ha lisele tsa mokhubu mesenchymal stem ho ile ha kenngoa ka har'a mesifa ka nako ea 3cm x 3cm maqeba a bakuli ba 5 ba nang le lefu la tsoekere la mofuta oa II le rarahaneng leoto la lefu la tsoekere. Bakeng sa ba nang le liso tse matla, liente li ne li arohane ka 1cm x 1cm ka thōko ho leoto, ho tsepamisitsoe ente e potolohileng seso. Ka mor'a ho phekoloa, tekanyo ea bohloko ba maoto le ho tsieleha li ile tsa fokotseha haholo, claudication ea nakoana e ile ea ntlafala haholo, 'me liso li ile tsa fola ka ho feletseng.

Sepetleleng sa Anhui Provincial Sepetlele sa Univesithi ea Bongaka ea Anhui, lisele tsa umbilical cord mesenchymal stem li ile tsa kenngoa libakeng tsa maqeba a litho tse amehileng tsa bakuli ba 53 ba nang le leoto la lefu la tsoekere la II-IV. Ka mor'a likhoeli tse tharo tsa phekolo, ha li bapisoa le sehlopha sa taolo, sehlopha sa phekolo se bontšitse ntlafatso e kholo ea mocheso oa letlalo, khatello ea khatello ea maqaqailana-brachial, khatello ea oksijene ea letlalo, le sebaka sa ho tsamaea.

1.2.2 Diabetes nephropathy

Clinical Medical College ea Fuzhou General Hospital, Second Military Medical University, le Affiliated Changzheng Hospital of the Second Military Medical University li ile tsa alafa bakuli ba 15 ba nang le li-umbilical cord mesenchymal stem cell ka ho kenella ka har'a mothapo oa pancreatic, methapo ea mahlakoreng a mabeli le ho tšeloa ha methapo ea peripheral. . Kamora kalafo, bakuli ba ile ba bonts'a lintlafatso tsa khatello ea mali, tsoekere ea mali, maemo a C-peptide, le matšoao a ts'ebetso ea renal. Mabapi le katleho ea bongaka ho ntlafatseng khatello ea mali ea diastolic le ts'ebetso ea renal, sehlopha sa kalafo se ile sa feta sehlopha sa taolo se tšoaroang ka telmisartan ea molomo hammoho le ente ea insulin ea subcutaneous.

02.Mathata a methapo ea kutlo

2.1 Lefu la Parkinson

Nyeoe ea pele ea ho fetisetsa lisele tsa stem bakeng sa lefu la Parkinson naheng ea Chaena e ile ea phethoa sepetleleng sa Shijiazhuang. Xie Xiyun, ea lilemo li 76 oa Indonesia, o ne a qetile lilemo tse fetang leshome a tšoeroe ke lefu la Parkinson, a satalla le ho honyela ka menoana e meraro ea letsoho la hae le letona, ho thatafala ha ’mele, mathata a ho metsa le ho lahleheloa ke matla a ho itlhokomela. Ka mor'a lihora tse seng kae ka mor'a hore a fumane mesenchymal stem cell transplantation, o ile a khona ho ja hamonate le ho shebella thelevishene ka boiketlo mantsiboeeng ao, ka ntlafatso e kholo matšoao a mang.

Dr. Sun Li oa Univesithi ea Bongaka ea Chaena o kentse ho fanyeha ho nang le lisele tsa stem mesenchymal stem ka har'a methapo ea molala ea bakuli ba 10 ba lefu la Parkinson. Ka mor'a ho fetisoa, bakuli ba ile ba bontša ntlafatso ea boemo ba ho tsamaea, ho sisinyeha ho matla, ho tsamaea ka boithaopo, le bokhoni ba ho lula le ho ema. Ha ea ka ea laola feela tsoelo-pele ea lefu la Parkinson ka katleho, empa hape e ile ea ntlafatsa haholo tšebetso ea lisele tse senyehileng tsa boko, kahoo ea ntlafatsa bophelo ba bakuli.

2.2 'dementia'

Sehlopha se etelletsoeng pele ke Zhou Qiang Sepetleleng sa Jinyang se Guiyang City se ile sa phekola bakuli ba bane ba 'dementia' ba seng ba hōlile ba sebelisa lisele tsa 'mele oa masapo a autologous. Mokuli oa pele, monna ea lilemo li 75, ha a ka a lemoha litho tsa lelapa ha a amoheloa mme o ne a lahlehetsoe ke senya le mala. Ka mor’a phekolo ea ho fetisoa, matšoao ana a ile a ntlafala ka potlako, ’me ha a tsoa, ​​ha aa ka a hlokomela litho tsa lelapa la hae feela empa hape o ile a boela a sebetsa senyeng le mala a tloaelehileng.

2.3 Ho hlobaela

Dr. Wang Yali oa Sepetlele sa Sepolesa se Hlometseng sa Zhejiang o ile a phekola bakuli ba 19 ba nang le lefu la ho hlobaela ka ho tšeloa ka methapo ea lisele tsa stem tsa umbilical cord mesenchymal stem. Bakuli bana kaofela ba ile ba ba le bothata ba ho robala, boleng ba boroko bo fokotsehileng, le nako eohle ea ho robala e ka tlase ho lihora tse 6. Ka mor'a khoeli ea phekolo, ntlafatso ea boleng ba boroko ho bakuli e ne e tšoana le ea meriana e nooang. Ka mor'a likhoeli tse peli tsa phekolo, lintlha tsa boleng ba boroko ba bakuli li ne li le betere ho feta tsa meriana e nooang. Ka mor’a likhoeli tse tharo tsa phekolo, boleng ba boroko ba bakuli le bona bo ne bo le molemo haholo ho feta ba meriana e nooang, ’me liphello tsa phekolo e le ’ngoe li ne li ka tšoarella ho fihlela selemo se le seng, tsa ntlafatsa haholo boleng ba boroko ba bakuli.

03.Mathata a mesifa

3.1 Boloetse ba manonyeletso bo fokolisang

Lilemong tsa bo-1990, Brittberg le ba bang ba ile ba qala ho finyella liphello tse itseng tsa ho lokisa likotsi tsa lefufuru ba sebelisa li-chondrocyte tsa autologous. Ka hona, liphuputso tse ngata li ile tsa qala ho lebisa tlhokomelo ho lisele tsa mesenchymal stem. Lisele tsa mesenchymal stem li ka ikarola ka har'a lisele tse fapaneng 'me tsa lokisa lefufuru le lesapo la mokokotlo le likotsi tsa masapo a subchondral.

Phuputsong e entsoeng ke Akgun et al. ho tsoa Lefapheng la Orthopedics le Traumatology Univesithing ea Istanbul naheng ea Turkey, ba ile ba bapisa litlamorao tsa kalafo ea autologous bone marrow mesenchymal stem cell le chondrocyte ho bakuli ba 14 ba nang le osteoarthritis. Ba fumane hore bakuli ba fumanang kalafo ea mesenchymal stem cell ba bontšitse ntlafatso e kholo ho lemala ha lengole le lintlha tsa sephetho sa osteoarthritis (KOOS) le lintlha tsa analog scale (VAS).

Wakitani et al. ho tsoa Sekolong sa Bongaka sa Feinberg Univesithing ea Northwestern le Sepetlele sa Cleveland Clinic Univesithing ea Ohio se ile sa etsa tlhahlobo ea bongaka ka ho sebelisa lisele tsa mesenchymal stem. Sehlopheng sa liteko, gel ea collagen e kopantsoeng le lisele tsa 'mele tsa mesenchymal stem tse entsoeng ka masapo a autologous li ile tsa kenngoa ka har'a liso tsa lefufuru tsa bakuli, ha sehlopha sa taolo se fumana feela tekanyo e lekanang ea gel ea collagen. Lihlopha tsena ka bobeli li bontšitse ntlafatso ea ts'ebetso e kopanetsoeng, empa ke sehlopha sa liteko feela se bontšitseng ho tsosolosoa ha lefufuru le pepeneneng sebakeng sa kotsi. Ba ile ba latela bakuli ba 41 ba ileng ba fumana kalafo ea mesenchymal stem cell ho fihlela lilemo tse 11 mme ba fumana ho se na mathata a tebileng.

04.Mafu a tsamaiso ea ho ikatisa

4.1 Ho hloka thari

Ho lokisa tšenyo e khōlō ea endometrium, e leng boemo bo tšosang ba basali ba bangata ba hlokang thari, hona joale ho ka khoneha ka theknoloji ea mesenchymal stem cell regenerative, e tlisang tšepo ea ho phethahatsa litoro tsa basali tsa ho ba 'mè.

Sehlopha sa Moprofesa Hu Yali ho tsoa Lefapheng la Obstetrics le Gynecology la Sepetlele sa Gulou se Nanjing, se sebelisanang le sehlopha sa Moprofesa Dai Jianwu se tsoang Setsing sa Genetics le Developmental Biology ea Chinese Academy of Sciences, se atlehile ho ntshetsa pele, ka lekhetlo la pele machaba, mokhoa oa ho kopanya. li-scaffolds tsa collagen tse nang le lisele tsa mesenchymal stem. Ka ho kopanya mekhoa ea setso ea hysteroscopic, ba fihletse tokiso e sebetsang ea endometrium e senyehileng, ba thusa bakuli ba bararo ho phethahatsa litoro tsa bona tsa ho ba bo-mme.

Mofumahali Hu oa Yancheng, Jiangsu, o ile a ba le likotsi tse tharo tsa tlhaho tse pakeng tsa 31 le 34, e leng se ileng sa etsa hore a khomarele haholo ka har'a sekoti sa uterine ka lebaka la ho buuoa ka mor'a ho senyeheloa ha uterine curettage. Se sebelisa lisele tsa mesenchymal stem, Sepetlele sa Gulou se Nanjing se atlehile ho lokisa endometrium ea hae nakong ea likhoeli tse robeli. Sena se ile sa mo nolofalletsa ho emola ka katleho, 'me ka la 17 July, 2014, o ile a tsoala "lesea la pele la moriana o tsosolosang" Chaena.

Sepetlele sa Nanjing Gulou "mesenchymal stem cell" se atlehile ho thusa bakuli ba 13 ba se nang thari ba nang le maqhama a matla a uterine ho emola le ho beleha, e leng se ileng sa fella ka "bana ba 14 ba phetseng hantle ba nang le meriana e nchafatsang."

4.2 Ho hloleha ha mae a bomme pele ho nako

Ho hloleha ha mae a pele ho nako ho bolela ketsahalo eo ho eona basali ba nang le bothata ba ho ba le mae a bomme le ho khaotsa ho hlahisa mahe pele ho lilemo tse 40. Hona joale, hoo e ka bang 1% ea basali ba lilemo tsa ho ba le bana lefatšeng ka bophara ba na le bothata ba pele ho nako, e leng se etsang hore e be sesosa se seholo sa ho hloka thari ha basali.

Moprofesa Wu Ji le sehlopha sa hae sa Univesithi ea Shanghai Jiao Tong e Chaena ba ile ba arola lisele tsa 'mele tsa basali ho tloha ho libeke tse peli ho isa ho tse peli tsa litoeba tse tala tsa protheine ea fluorescent. Kamora ho hloekisoa, moetlo le lits'ebetso tse ling, lisele tsena li ile tsa fetisetsoa ho litoeba tse nang le bothata ba pele ho nako ea mahe a bomme. Liphetho tsa lipatlisiso li bonts'itse hore lisele tsa stem tsa basali, joalo ka lisele tse ling tsa stem, li na le thepa ea homing. Ka mor'a ho khutlela hae, lisele tse ling li ile tsa ikarola 'me butle-butle tsa fetoha li-oocyte tse hōlileng, kahoo li tsosolosa tšebetso ea mahe a bomme.

4.3 Ho se sebetse ha Erectile dysfunction (ED)

Ho sebelisa stem cell therapy bakeng sa ho se sebetse ha erectile ho ka nka sebaka sa lisele tse senyehileng kapa tse shoeleng tsa lisele tsa penile le ho boloka lintlha tsa ho lokisa lisele tsa lisele tsa penile tse sa sebetseng hantle.

Bakuli ba leshome le metso e mehlano ba nang le bothata ba ho se sebetse ha erectile Denmark ba ile ba fumana mesenchymal stem cell infusions ntle le meriana kapa penile transplantation. Ka mor’a likhoeli tse tšeletseng, banna ba robeli ba ile ba khona ho kopanela liphate ka tsela e tloaelehileng.

05.Mafu a ikemetseng

Ka 2007, Moprofesa Sun Lingyun oa Chaena o atlehile ho phekola linyeoe tse peli tsa refractory systemic lupus erythematosus a sebelisa mesenchymal stem cell, 'me selemong se latelang, a phekola linyeoe tse ling tse robong. Ka mor'a phekolo, matšoao a bakuli a ne a fokotsehile haholo, 'me ha hoa ka ha e-ba le ho pheta-pheta nakong ea ho latela likhoeli tsa 6.

Ka 2012, Lefapha la Rheumatology le Immunology la Sepetlele se Affiliated sa Univesithi ea Jiangsu le ile la kenya lisele tsa mokhubu tsa mesenchymal stem bakeng sa bakuli ba 21 ba nang le systemic lupus erythematosus, e leng se ileng sa fokotsa haholo boemo ba protheine ea moroto ho bakuli bana, sa fokotsa ts'ebetso ea mafu, le ho theola Systemic Lupus Erythematosus. Lintlha tsa Index ea Ketsahalo ea Mafu.

Tšusumetso ea mesenchymal stem cell transplantation mosebetsing oa mafu le protheine ea urinary ho bakuli ba nang le systemic lupus erythematosus (SLE)

Ka 2013, Lefapha la Rheumatology le Immunology la Sepetlele se Kopanetsoeng sa Pele sa Univesithi ea Yangtze le Sepetlele sa Batho ba Pele sa Jingzhou li ile tsa fana ka lisele tsa stem tsa umbilical cord mesenchymal stem ho bakuli ba 18 ba nang le systemic lupus erythematosus. Khoeli hamorao, bakuli ba bangata ba ile ba bontša ntlafatso e kholo matšoao a kliniki le matšoao a kang feberu, mokhathala le bofokoli ha li bapisoa le pele ho transplantation.

06.thibela botsofali

Botsofali ba 'mele oa motho bo amana le palo e sa lekaneng kapa e sa sebetseng ea lisele tsa stem. Ha lilemo li ntse li eketseha, ho na le mokhoa o theohang ka bongata le boleng ba lisele tsa stem 'meleng. Mokhoa ona o lebisa ho theoheng le botsofaling ba lisele tse senyehileng le litho le lisele tse entsoeng ka lisele, e leng se bakang bophelo bo botle le botsofali. Lisele tsa stem tsa mesenchymal li na le monyetla oa ho arola ka bongata, tse khonang ho ikarola ka mefuta e fapaneng ea lisele tsa stem tse hlokahalang 'meleng. Ka ho tlatselletsa lisele tsa stem tse sa lekaneng 'meleng le ho lokisa litho le lisele tse senyehileng, lisele tsa mesenchymal stem li phetha karolo ea ho thibela botsofali.

Ka thahasello e ntseng e eketseha le ts'ebeliso ea lipatlisiso tsa lisele tsa stem tsa umbilical cord mesenchymal stem, ho lumeloa hore haufinyane li tla sebelisoa haholo maemong a kliniki, kahoo li fana ka bohlokoa bo boholo bophelong ba batho.