脐带间充质干细胞在南京“5．7”^192Ir源放射事故患者局部伤口修复中的应用

Application of human umbilical cord mesenchymal stem cells in promoting the recovery of skin injury of a case exposed to ＂5.7＂ ^192 Ir source radiological accident in Nanjing

目的 应用脐带间充质干细胞（hUC-MSCs）治疗1例外照射轻度骨髓型急性放射病合并Ⅳ度急性放射性皮肤损伤患者,初步探讨其在创面修复中的有效性及机制。方法 采用上海脐血库提供的hUC-MSCs,输注前进行病原学检测,于第2次肌皮瓣移植术后的第8、15天对患者进行了hUC-MSCs静脉输注,每次剂量10.1×10^6 U,并3次通过外周血DNA短串联重复序列复合扩增方法（STR-PCR）检测在不同时期创面愈合过程中hUC-MSCs的植入情况,用酶联免疫吸附法（ELISA）分别检测第1次输注hUC-MSCs 1 d前、1 d后以及第2次输注hUC-MSCs 1 d前、1 d后、7 d后患者的外周血及创面组织中血管内皮生长因子（VEGF）的表达。结果 输注脐带间充质干细胞后,患者手术创面愈合良好;STR-PCR结果显示, 3次均未检测到hUC-MSCs植入;ELISA分析显示,在输注hUC-MSCs 1 d后,两次输注的患者血清中VEGF浓度分别由输注前的100.9、128.1 ng/ml上升至895.9、931.4 ng/ml,而在创面组织中则分别由122.2、138.6 ng/ml上升至850.8、978.6 ng/ml,升高明显,但是在输注hUC-MSCs 1周后,患者血清中及创面组织中的VEGF浓度与输注前相比变化不大。结论 hUC-MSCs可增强血液及局部创面中VEGF的表达,在一定程度上促进急性放射性皮肤损伤创面的修复。

Objective To explore the efficiency and mechanism of human umbilical cord mesenchymal stem cells （hUC-MSCs） in wound healing, which is used for therapying a case with mild bone marrow form of acute radiation sickness combined with degree Ⅳ acute radiation-induced skin injury.Methods The hUC-MSCs available from Shanghai Cord Blood Bank was administrated intravenously, following etiology tests, to the patient at a dosage of 10.1×10^6 U each time on days 8, 15 after the second skin flap transplantation; the chimera starus of hUC-MSCs transplantation were observed by using short tandem repeats-PCR（STR-PCR） method; and the expressions of VEGF in serum and wound tissues were detected on first day before and after the first injection and on first day before and after, and 7th day after the second injection with immunohistochemistry. Results After hUC-MSCs intravenous injection, the radiation-induced skin injury had been healing gradually. The results of STR-PC showed that hUC-MSCs implants couldn＇t be detected. As was shown from the ELISA analysis, 1 day after hUC-MSCs intravenous injection, the expressions of VEGF in serum had risen significantly, respectively, from 100.9 to 895.9 ng/ml for the first infusion and from 128.1 to 931.4 ng/ml for the second, and in wounded from 122.2 to 850.8 ng/ml for the first infusion and from 138.6 to 978.6 ng/ml for the second, whereas there had been no significant changes in the results one week after and before hUC-MSCs injection. Conclusions hUC-MSCs can raise the expression of VEGF in serum and wound tissue and facilitate the healing of acute radiation-induced injury to a certain extent.