嗅鞘细胞移植治疗运动神经元病/肌萎缩侧索硬化的初步报告

Preliminary report of olfactory sheath cells transplantation in the treatment of motor neuron disease or amyotrophic lateral sclerosis

目的:探讨嗅鞘细胞移植治疗运动神经元病/肌萎缩侧索硬化的安全性及有效性。方法:对8例运动神经元病/肌萎缩侧索硬化患者在脊髓病变处分两点共注入50μL嗅鞘细胞悬液,细胞数共约10×105个。结果:术前肌萎缩侧索硬化功能评分(ALSFRS)犤(18.6±7.9)分犦分别与术后2～4周犤(21.8±7.6)分犦比较,差异有显著性意义(t=-2.376,P=0.049),与术后3～6个月犤(21.5±7.6)分犦比较,差异无显著性意义(t=-2.025,P=0.083),8例患者的神经功能均稳定或改善。术后行肌电图检查的患者显示术后自发电位减少或消失,收缩时肌电波幅较术前明显降低,电位密度明显增加。结论:嗅鞘细胞移植安全可行,术后2～4周和3～6个月均能阻止或逆转运动神经元病肌萎缩侧索硬化的病情恶化。

AIM:To explore the safety and effectiveness of transplanting olfactory ensheat hing cells(OECs) for the treatment of motor neuron disease(MND) or amyotrophic l ateral sclerosis(ALS). METHODS:Eight patients with MND or ALS were given injection of 50 μL of OEC s uspension with 10×105 cells into the two sites of pathological spinal cord. RESULTS:Compared with those before operation(18.6±7.9),the functional score s of ALS(ALSFRS) changed significantly 2-4 weeks after the operation(21.8±7.6 ,t=-2.376,P=0.049),but insignificantly 3-6 months after the operation(21.5±7 .6,t=-2.025,P=0.083).Neurological function of all the patients was improved or stabilized after the operation.Electromyogram showed that spontaneous potential diminished or disappeared,the amplitude of the motor unit action potential remar kably dropped,and the density of motor unit action potential greatly increased. CONCLUSION:OEC transplantation for ALS treatment is feasible,safe and can be e ffective in preventing or reversing the aggravation of MND or ALS 2-4 weeks and 3-6 months after operation.