人神经干细胞移植治疗小脑萎缩

Clinical transplantation of human neural stem cells in treatment of cerebellar atrophy

目的 :探索人神经干细胞 (neural stem cell,NSC)移植治疗小脑萎缩 (cerebellar atrophy,CA)的有效性。 方法 :8～10周龄人胚胎的小脑细胞在体外稳定扩增后 ,借助立体定向技术将其植入经 MRI证实的 2 1例 CA患者的小脑齿状核内 ,将NSC(3× 10 7/ 0 .3ml)缓慢注入小脑齿状核 (此前注入地塞米松 0 .5 m g/ 0 .1m l)。本组男 8例 ,女 13例 ,年龄 19～ 71岁 (平均4 6岁 )。结果 :人胚胎小脑神经细胞可以在体外扩增 ,扩增的细胞可达 1× 10 7倍。移植病例未见明显的移植排斥反应。CA患者移植术后 3个月临床症状改善的有效率为 6 1.9% ,术后 6个月有效率为 85 .7% ;随访 12～ 2 8个月 (平均 18个月 ) ,有效率达 90 .4 %。 结论 :应用体外扩增的人 NSC可以治疗 CA,而且临床安全、有效。

Objective:To study the clinical feasibility of transplanting human neural stem cells in treatment of cerebellar atrophy (CA).Methods:The cells from human fetal cerebellum(8-10 weeks gestation) were expanded in vitro and were allowed to differentiate into neurospheres,the latter were then implanted into CA dentate nuclei with stereotactic operation in 21 CA patients(8 male and 13 female with age ranging 19-71,mean 46) from Feb. 2000 to Aug. 2003. Results:The cells of fetal cerebellum were expanded by 10 7 folds in undifferentiated state. The effective rates were 61.9% 3 months after transplantation,85.7% 6 months after transplantation, and 90.4% during a follow-up of 12-28 months (mean 18 months).Conclusion:It is feasible and effective to implant the neural stem cells expanded in vitro for treatment of CA,but the long-term effectiveness should be futher observed.