嗅鞘细胞移植修复脊髓损伤

Olfactory ensheathing cell transplantation repairs spinal cord injury

背景:脊髓损伤后导致损伤平面以下的运动、感觉及自主神经功能障碍,其修复一直是神经科学研究领域的一大难题。目的:对嗅鞘细胞移植治疗脊髓损伤的可能机制及在实验研究、临床应用等方面进行分析,探讨其对脊髓神经功能恢复的作用。方法:回顾性分析以往嗅鞘细胞移植治疗脊髓损伤的实验基础研究和临床研究的状况,分析嗅鞘细胞移植后的存活数量和时间与损伤脊髓结构和功能的恢复关系,明确限定临床研究入选病例及排除病例的标准,明确移植细胞的来源、类型及植入方法,建立客观有效的评估标准。结果与结论:嗅鞘细胞移植治疗脊髓损伤动物实验已经取得了满意的效果,脊髓功能评分及感觉与运动功能均较移植前明显提高(P<0.001),动物实验中成功的经验为临床试验和应用提供了依据,部分临床试验最长患者随访5年,但因临床研究病例数较少,随访期短,到目前还不能判断其大宗病例的最终恢复程度,还需要进一步观察和研究。但这一研究结果的重要意义有助于找到合理的策略,使嗅鞘细胞发挥最大的修复效果。

BACKGROUND： Spinal cord injury can cause the motor, sensory and autonomic dysfunction below the damaged surface, so the repair of spinal cord injury has been the problem of neuroscience research. OBJECTIVE： To analyze the mechanism, experimental research and clinical application of olfactory ensheathing cell transplantation for the repair of spinal cord injury, and to investigate the effect of olfactory ensheathing cell transplantation on neurological function recovery. METHODS： The basic experimental and clinical researches on olfactory ensheathing cell transplantation for the repair of spinal cord injury were retrospectively analyzed, in order to analyze the relationship between the number and time of the survival cells and the structure and function of the damages spinal cord after olfactory ensheathing cell transplantation. The inclusion and exclusion criteria of the included clinical researches, and the sources, types and transplantation method of the cells used for transplantation were clearly defined, then the effective and objective evaluation criteria was established. RESUTLS AND CONCLUSION： The animal experiments of olfactory ensheathing cell transplantation for the repair of spinal cord injury have achieved satisfactory effects. The spinal cord function score and the sensory and motor function were significantly improved compared with those before transplantation （P 0.001）. The successful animal experiment could provide basis for the clinical experiment and application. Parts of the clinical experiments were followed-up for 5 years. Because of a small amount of the cases in the clinical research and the short follow-up period, the final recovery of large number of cases cannot judged yet, further observation and research were required. The great significance of the research result is to help to find a reasonable strategy that can make the olfactory ensheathing cells displayed repairing effect sufficiently.