Role of Vascular Endothelial Growth Factor-C during Stem Cell Therapy Using Autologous Bone Marrow Mononuclear Cells in Patients with Lower Limb Lymphedema

Introduction: Vascular endothelial growth factor-C (VEGF-C) is the primary lymphangiogenic factor that stimulates lymphangiogenesis by signaling via specific receptor, vascular endothelial growth factor receptor 3 (VEGFR3). This study was conducted to evaluate the change in the level of VEGF-C before and after autologous bone marrow mononuclear cell transplantation for treatment of Lower limb lymphedema. Patient and methods: Forty patients with lower limb lymphedema were divided into two groups. Group I included 20 patients with chronic lower limb lymphedema who underwent autologous bone marrow mononuclear cell transplantation. Group II included 20 patients with chronic lower limb lymphedema who were exposed only to compression therapy as a control group. VEGF-C level in the diseased limbs was measured in both groups at the beginning of the study then 3 and 6 months respectively. Results: Group I included 20 patients, 8 patients were male (40%) and 12 patients were females (60%) with mean age 29.5 ± 12.15 while group II included 20, 10 patients were male (50%) and 10 patients were females (50%) with mean age 39.5 ± 11.5. In group I, the specimens were taken at 3 and 6 months after transplantation showed a marked decrease in the VEGF-C level with statistically significant p value, 0.02 and 0.001 respectively. In group II the level of VEGF-C after compression therapy alone at 3 and 6 months interval showed fluctuation with statistically non-significant p value, 0.64 and 0.55 respectively. Conclusion: VEGF-C is essential for regulation of lymphangiogenesis. The level of VEGF-C was found elevated in patients with lymphedema and decrease after autologous mononuclear bone marrow cells, however these results were statically non-significant.

Outcomes of autologous bone marrow mononuclear cell transplantation in decompensated liver cirrhosis

AIM: To determine the long-term efficacy of autologous bone marrow mononuclear cells (BM-MNCs) transplantation in terms of improving liver function and reducing complications in patients with decompensated cirrhosis.

Preventive effects of autologous bone marrow mononuclear cell implantation on intrahepatic ischemic-type biliary lesion in rabbits

BACKGROUND: The ischemic-type biliary lesion (ITBL) is one of the most serious biliary complications of liver transplantation. This study aimed to investigate the effects of autologous bone marrow mononuclear cell (BM-MNC) implantation on neovascularization and the prevention of intrahepatic ITBL in a rabbit model. METHODS: The rabbits were divided into control, experimental model, and cell implantation groups, with 10 in each group. The model of intrahepatic ITBL was established by clamping the hepatic artery and common bile duct. Autologous BM-MNCs were isolated from the tibial plateau by density gradient centrifugation and were implanted through the common hepatic artery. Changes in such biochemical markers as aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyltranspeptidase, total bilirubin and direct bilirubin were measured. Four weeks after operation, cholangiography, histopathological manifestations, differentiation of BM-MNCs, microvessel density and the expression of vascular endothelial growth factor were assessed. RESULTS: Compared with the experimental model group, the BM-MNC implantation group showed superiority in the time to recover normal biochemistry. The microvessel density and vascular endothelial growth factor expression of the implantation group were significantly higher than those of the control and experimental model groups. The ITBL in the experimental model group was more severe than that in the implantation group and fewer new capillary blood vessels occurred around it. CONCLUSIONS: Implanted autologous BM-MNCs can differentiate into vascular endothelial cells, promote neovascularization and improve the blood supply to the ischemic bile duct, and this provides a new way to diminish or prevent intrahepatic ITBL after liver transplantation. (Hepatobiliary Pancreat Dis Int 2010; 9:593-599)

Influence of Transplantation of Allogenic Bone Marrow Mononuclear Cells on the Left Ventricular Remodeling of Rat after Acute Myocardial Infarction

To probe into the influence of transplantation of allogenic bone marrow mononuclear cells （BM-MNCs） on the left ventricular remodeling of rat after acute myocardial infarction （AMI）, 60 male Wistar rats were evenly divided into three groups at random： control group 1, control group 2 and transplantation group. In control group 1, chest was opened without ligation of coronary artery; in control group 2 and transplantation group, the left anterior descending branch of coronary artery was ligated to establish AMI model. Prepared culture medium and allogenic BM-MNCs suspension were respectively implanted the surrounding area of infracted cardiac muscle via epicardium of control group 2 and transplantation group. Four weeks after the operation, the osteopontin gene （OPN mRNA, P〈0.01）, type Ⅰ collagen （P〈0.01） and angiotensin Ⅱ （AngⅡ, P〈0.01） content in the left ventricular non-infracted myocardium, and the Ang Ⅱ density in blood plasma （P〈0.05） of transplantation group and control group 2 were all significantly higher than that of control group Ⅰ. In the transplantation group, the myocardial OPN InRNA, type Ⅰ collagen and Ang Ⅱ content of non-infracted zone in left ventricle, and the Ang Ⅱ concentration in blood plasma were all significantly lower than those of control group 2 （P〈0.05 for all）. It is concluded that allogenic BM-MNCs transplantation may ease left ventricular remodeling after AMI by inhibiting the synthesis of type Ⅰ collagen in the cardiac muscle and down-regulating the expression of Ang Ⅱ and OPN gene.

IMPLANTATION OF AUTOLOGOUS BONE MARROW MONONUCLEAR CELLS INTO ISCHEMIC MYOCARDIUM ENHANCES CORONARY CAPILLARIES AND SYSTOLIC FUNCTION IN MINISWINE

Objective To investigate the therapeutic effectiveness of intracoronary implantation of autologous bone marrow mononuclear cells (BM-MNC) in miniswine model of reperfused myocardial infarction. Methods Sixteen miniswine myocardial ischemic reperfusion injury models made by ligation of the distal one third segment of left anterior descending artery for 90 minutes were randomized into 2 groups. In BM-MNC group (n = 9), (3.54±0.90)×108 BM-MNC were intracoronary injected, and in the control group (n = 7), phosphate buffered saline was injected by the same way. Echocardiographic and hemodynamic results, vessel density, and myocardial infarction size were evaluated and compared before and 4 weeks after cell transplantation. Results In BM-MNC group, there were no differences between before and 4 weeks after transplantation in aspects of left ventricular ejection fraction (LVEF), interventricular septal thickness, left ventricular lateral and anterior septal wall thickness, cardiac output, or +dp/dtmax. In control group, LVEF, interventricular septal thickness, left ventricular lateral and anterior septal wall thickness, cardiac output, and +dp/dtmax decreased significantly 4 weeks after transplantation (P < 0.05). Left ventricular end-diastolic pressure and –dp/dtmax did not change significantly before and after cell transplantation in both groups. Capillary density in BM-MNC group was greater than that in control group [(13.39 ± 6.96)/high power field vs. (3.50 ± 1.90)/high power field, P < 0.05]. Infarction area assessed by tetrazolium red staining and the infarction percentage decreased in BM-MNC group compared with those in control group (P < 0.05). Conclusions Transplantation of BM-MNC into myocardium with ischemic reperfusion injury increases capillary density and decreases infarction area. It has significantly beneficial effect on cardiac systolic function rather than on diastolic function.

Effect of Intracoronary Infusion of Bone Marrow Mononuclear Cells or Peripheral Endothelial Progenitor Cells on Myocardial Ischemia-reperfusion Injury in Mini-swine

Objective To simulate and assess the clinical effect of intracoronary infusion of bone marrow mononuclear cells or peripheral endothelial progenitor cells on myocardial reperfusion injury in mini-swine model. Methods Twenty-three mini-swine with myocardial reperfusion injury were used as designed in the study protocol. About （3.54±0.90）×10^7 bone marrow mononuclear cells （MNC group, n=9） or （1.16± 1.07）× 10^7 endothelial progenitor cells （EPC group, n=7） was infused into the affected coronary segment of the swine. The other mini-swine were infused with phosphate buffered saline as control （n=7）. Echocardio- graphy and hemodynamic studies were performed before and 4 weeks after cell infusion. Myocardium infarc- tion size was calculated. Stem cell differentiation was analyzed under a transmission electromicroscope. Results Left ventricular ejection fraction dropped by 0% in EPC group, 2% in MNC group, and 10% in the control group 4 weeks after cell infusion, respectively （P〈0.05）. The systolic parameters increased in MNC and EPC groups but decreased in the control group. However, the diastolic parameters demonstrated no significant change in the three groups （P〉0.05）. EPC decreased total infarction size more than MNC did （1.60±0.26 cm2 vs. 3.71±1.38 cm2, P〈0.05）. Undermature endothelial cells and myocytes were found under transmission electromlcroscope. Conclusions Transplantation of either MNC or EPC may be beneficial to cardiac systolic function, but might not has obvious effect on diastolic function. Intracoronary infusion of EPC might be better than MNC in controlling infarction size. Both MNC and EPC may stimulate angiogenesis, inhibit flbrogenesis, and differentiate into myocardial cells.

The effectiveness of the mononuclear fraction of autologous bone marrow in the treatment of experimental chronic limb ischemia

Objective To study of the effectiveness of using autologous mononuclear fraction of bone marrow for the treatment of chronic limb ischemia. Methods Results of autologous mononuclear fraction of bone marrow in 90 laboratory Wistar rats on a background of creating chronic limb ischemia was presented. Sampling was carried out from the bone marrow of the femur of the animal. The mononuclear fraction of bone marrow autologous 4 × 106 cells in a volume of 200 microliter were injected into the ischemic limb of the two points,in each of which 100 microliter:(1)Paravessel directly below the inguinal ligament at the level of the sacroiliac joint in the area of the anatomical location of collaterals in the projection of the internal iliac artery and its branches;(2)Intramuscularly in gastrocnemius muscle anterior-lateral surface of the middle third of the leg. Results In the experimental group of rats treated with autologous mononuclear fraction of bone marrow,the level of microcirculation compared with the intact group of animals on day 21 was higher than 6. 1% by day 28% ~ 31. 2%; compared with the control group-day 10 increased by 111% at day 21,85. 7% on day 28% ~ 97%. Conclusion Proposed method of treating pathogenically justified and can be recommended for use in clinical practice in the treatment of patients with chronic obliterating diseases of lower limb arteries.

Bone Marrow Mononuclear Cell Extraction. Does the Operator Performance Affect Processing Efficacy？

Different cell populations from bone marrow are used in various clinical trials for cardiac diseases during last decade. Four clinical studies are on going in our institution and enrol patients with cardiac diseases, coronary disease and type 2 diabetes, patients with osteoarthritis. Density gradient is used to separate bone marrow mononuclear cells. Cell processing looses are significant. To find out critical control points we analysed processing process and differences in cell yields between operators performing cell extraction. Bone marrow mononuclear cells were isolated using Ficoll density gradient centrifugation. Cells were counted using flow cytometry for mononuclear cell total counts, CD34＋ population count and viability analysis. The patients who underwent bone marrow aspiration followed by cell isolation received cell suspension for transplantation. Two cells processing for separate patients were performed at once. Same standard operation procedures were applied. Processing looses between operators performing cell extraction were analysed. Bone marrow samples from eight patients were processed. Mononuclear cells were extracted. Operator performances were compared. Operator A average bone marrow mononuclear cell yield in starting material was 9,97 ± 9,98 %, CD34＋ population yield 75,46±79,67%. Operator B average bone marrow mononuclear cell yield in starting material was 24,68 ± 14,8 %, CD34＋ population yield 70,42 ±44.84%. Operator A average cell viability in starting material was 45,24 ± 9,55%, after cell processing 42,96 ± 23,66 %. Operator B average cell viability in starting material was 49,85 ± 5,48%, after cell processing 69,52 ± 6,65 %.

TISSUE-ENGINEERED GRAFT CONSTRUCTED BY SELF-DERIVED BONE MARROW MONONUCLEAR CELLS AND HETEROGENEOUS ACELLULARIZED TISSUE MATRIX

Objective To create a method for constructing a tissue-engineered graft with self-derived bone marrow cells and heterogeneous acellular matrix.Methods The mononuclear cells were isolated from bone marrows drawn from piglets and cultured in different mediums including either vascular endothelial growth factor(VEGF)or platelet derived growth factor BB(PDGF-BB)to observe their expansion and differentiation.The aortas harvested from canines were processed by a multi-step decellularizing technique to erase.The bone marrow mononuclear cells cultured in the mediums without any growth factors were seeded to the acellular matrix.The cells-seeded grafts were incubated in vitro for 6 d and then implanted to the cells-donated piglets to substitute parts of their native pulmonary arteries.Results After 4 d culturing,the cells incubated in the medium including VEGF showed morphological feature of endothelial cells(ECs)and were positive to ECs-specific monoclonal antibodies of CD31,FLK-1,VE-Cadherin and vWF.The cells incubated in the medium including PDGF-BB showed morphological feature of smooth muscle cells(SMCs)and were positive to SMCs-specific monoclonal antibodies of α-SMA and Calponin.One hundred days after implantation of seeded grafts,the inner surfaces of explants were smooth without thrombosis,calcification and aneurysm.Under the microscopy,plenty of growing cells could be seen and elastic and collagen fibers were abundant.Conclusion Mesenchymal stem cells might exist in mononuclear cells isolated from bone marrow.They would differentiate into endothelial cells or smooth muscle cells in proper in vitro or in vivo environments.The bone marrow mononuclear cells might be a choice of seeding cells in constructing tissue-engineered graft.

Bone marrow-derived monocyte infusion improves hepatic fibrosis by decreasing osteopontin,TGF-β1,IL-13 and oxidative stress

To evaluate the therapeutic effects of bone marrow-derived CD11b+CD14+ monocytes in a murine model of chronic liver damage.METHODSChronic liver damage was induced in C57BL/6 mice by administration of carbon tetrachloride and ethanol for 6 mo. Bone marrow-derived monocytes isolated by immunomagnetic separation were used for therapy. The cell transplantation effects were evaluated by morphometry, biochemical assessment, immunohistochemistry and enzyme-linked immunosorbent assay.RESULTSCD11b+CD14+ monocyte therapy significantly reduced liver fibrosis and increased hepatic glutathione levels. Levels of pro-inflammatory cytokines, including tumor necrosis factor-α, interleukin (IL)-6 and IL-1β, in addition to pro-fibrotic factors, such as IL-13, transforming growth factor-β1 and tissue inhibitor of metalloproteinase-1 also decreased, while IL-10 and matrix metalloproteinase-9 increased in the monocyte-treated group. CD11b+CD14+ monocyte transplantation caused significant changes in the hepatic expression of α-smooth muscle actin and osteopontin.CONCLUSIONMonocyte therapy is capable of bringing about improvement of liver fibrosis by reducing oxidative stress and inflammation, as well as increasing anti-fibrogenic factors.

Pre-degenerated peripheral nerves co-cultured with bone marrow-derived cells: a new technique for harvesting high-purity Schwann cells

Schwann cells play an important role in the peripheral nervous system, especially in nerve repair following injury, so artificial nerve regen- eration requires an effective technique for obtaining purified Schwann cells. In vivo and in vitro pre-degeneration of peripheral nerves have been shown to obtain high-purity Schwann cells. We believed that in vitro pre-degeneration was simple and controllable, and available for the clinic. Thus, we co-cultured the crushed sciatic nerves with bone marrow-derived cells in vitro. Results demonstrated that, 3 hours after injury, a large number of mononuclear cells moved to the crushed nerves and a large number of bone marrow-derived cells infiltrated the nerve segments. These changes promoted the degradation of the nerve segments, and the dedifferentiation and proliferation of Schwann cells. Neural cell adhesion molecule and glial fibrillary acidic protein expression were detected in the crushed nerves. Schwann cell yield was 9.08 ± 2.01 ×104/mg. The purity of primary cultured Schwann cells was 88.4 ± 5.79%. These indicate a successful new method for ob- taining Schwann cells of high purity and yield from adult crushed sciatic nerve using bone marrow-derived cells.

大鼠骨髓单个核细胞诱导扩增为内皮祖细胞的细胞分离方法、接种数目、培养瓶包被条件

目的筛选大鼠骨髓单个核细胞(BMMNCs)诱导扩增为内皮祖细胞(BM-EPCs)的细胞分离方法、接种数目、培养瓶包被条件,构建一个高效、高产量、高纯度的骨髓来源BM-EPCs分离培养诱导扩增方法。方法取2周龄雄性SD大鼠,脱颈处死后分离大鼠双侧胫骨和股骨,收集骨髓细胞悬液。配制30%、50%、60%和70%浓度的Percoll细胞分离液,通过Percoll密度梯度离心法分离出大鼠BMMNCs种子细胞,并计算活细胞比例。将获得的BMMNCs分为1×10^(5)、5×10^(5)、1×10^(6)、2.5×10^(6)、5×10^(6)、1×10^(7)六个组别,分别接种于25 cm^(2)无菌培养瓶中,培养7 d后镜下观察各组细胞集落形成数目,并计算每10^(6)细胞的集落形成数。运用Graphpad prism9.5软件进行Logistic拟合曲线,根据相关系数R^(2)确定相关性,根据其P值将有统计学差异的接种数目纳入范围,随后使用R语言编程定义计算函数,根据已知种子细胞总数及相关性函数限制下,通过迭代寻找最佳的BMMNCs细胞接种数目。分别配制20、50、100 nmol/L浓度的人纤连蛋白(FN)溶液,以不添加FN的空白溶液为对照,分别包被空白培养瓶2、6、12、24 h,将收集的48 h未贴壁BMMNCs接种于FN包被的各培养瓶中,静置培养3 d后计算各组集落形成数目,确定FN包被的最佳浓度与时间。接种48 h未贴壁BMMNCs于25 cm^(2)培养瓶底,使用EGM-2完全培养基定向诱导,于显微镜下观察集落形成及诱导扩增进程。取培养14 d的BM-EPCs,分别采用双阳性染色法和流式细胞术鉴定BM-EPCs的纯度。结果使用Percoll分离法可把BMMNCs细胞清晰的分为5层,其中30%与50%Percoll细胞分离层之间为BMMNCs活细胞比率最高。BMMNCs的最优接种数目为2.5×10^(6)个。以50 nmol/L的FN溶液包被24 h或以100 nmol/L的FN溶液包被6 h皆可有效促进细胞集落形成。细胞接种7 d后获得形态良好的铺路石样细胞并建立生长优势,表明BMMNCs已经诱导成为形态良好的BM-EPCs。Dil-Ac-LDL/FITC-UEA-1双阳性细胞占比为91.89%±5.77%,CD31+KDR阳性率为90.73%±0.61%、CD14阳性率为0.53%±0.17%、CD45阳性率0.77%±0.34%,说明获得的BM-EPCs纯度良好。结论大鼠BMMNCs诱导扩增为BM-EPCs过程中,可使用Percoll密度梯度离心法分离BMMNCs,BMMNCs的最优细胞接种数目为2.5×10^(6)个,细胞培养瓶包被条件为以50 nmol/L的FN溶液包被24 h或以100 nmol/L的FN溶液包被6 h,分离培养诱导获得的BM-EPCs形态和纯度均良好。

仙茅苷下调ROS/NLRP3途径对大鼠骨髓单核细胞增殖及向破骨细胞分化的影响

目的研究仙茅苷(curculigoside,CCG)对骨髓单核细胞体外增殖及分化的抑制作用。方法体外无菌分离大鼠骨髓单核细胞,通过细胞染色、周期分析评估CCG对巨噬细胞集落刺激因子(macrophage colony-stimulating factor,M-CSF)刺激的细胞增殖及核因子κB受体活化因子配体(receptor-activating factor ligand,RANKL)诱导分化的抑制效果。检测并分析活性氧(reactive oxygen species,ROS)/核苷酸结合寡聚化结构域样受体蛋白3(nucleotide-binding oligomerization domain-like receptor protein 3,NLRP3)途径相关成分的变化明确其作用途径和效果。结果CCG对骨髓单核细胞体外增殖有显著抑制作用,对细胞周期的作用在S期,并能诱导细胞凋亡(P<0.01)。当CCG干预浓度达到10-6 mol/L时,对骨髓单核细胞的体外破骨诱导有显著抑制作用。NLRP3、Cleaved casp-1、ROS、白介素18(interleukin-18,IL-18)、白介素1β(interleukin-1β,IL-1β)水平随着CCG干预浓度增大而降低(P<0.05)。构建NLRP3过表达质粒,转染骨髓单核细胞可逆转CCG在破骨诱导过程中对Cleaved casp-1的表达和IL-1β和IL-18水平的作用,使其上调(P<0.01)。结论CCG通过下调ROS/NLRP3途径抑制骨髓单核细胞增殖及向破骨细胞分化。

N-乙酰基转移酶10基因与急性髓系白血病病人预后的关系分析

目的:探究N-乙酰基转移酶10(N-acetyltransferase 10,NAT10)与急性髓系白血病(acute myeloid leukemia,AML)预后的关系。方法:选取2015年9月至2018年1月收治的84例初治AML病人(初治组)、20例复发AML病人(复发组)、20例AML完全缓解病人(缓解组)和20名健康人(对照组)为研究对象。用RT-PCR检测受试者骨髓单个核细胞中NAT10 mRNA的表达。ROC曲线分析NAT10 mRNA早期诊断AML的价值,计算曲线下面积(AUC)、灵敏度和特异度。以NAT10 mRNA中位表达水平将84例AML病人分为高表达组和低表达组,比较2组病人的生存预后。结果:初治组和复发组骨髓单个核细胞中NAT10 mRNA相对表达量均高于缓解组和对照组(P<0.05~P<0.01)。NAT10 mRNA早期诊断AML的AUC为0.827(95%CI:0.723~0.930,P<0.01),灵敏度和特异度分别为83.6%和82.6%。COX多因素分析显示,FLT3-ITD/TKD突变和NAT10 mRNA高表达是AML病人总生存时间的独立影响因素(P<0.05),FLT3-ITD/TKD突变和NAT10 mRNA高表达也是AML病人无事件生存时间的独立影响因素(P<0.05)。NAT10 mRNA高表达组中位总生存时间为4个月,低于低表达组的10个月(P<0.01)。NAT10 mRNA高表达组中位无进展生存时间为3个月,低于低表达组的8个月(P<0.01)。结论:NAT10对AML的早期诊断及病情评估可能有一定价值,NAT10 mRNA高表达与AML病人的不良生存预后有关。

Expression and function of c-kit receptor in bone marrow mononuclear cells of patients with myelodysplastic syndromes

Objective To determine the expression and function of the c-kit receptor in bone marrow mononuclear cells (BMMNC) of patients with myelodysplastic syndromes (MDS). Methods Direct immunofluorescence assay and reverse transcriptase-polymerase chain reaction (RTPCR) were used to detect c-kit protein and c-kit mRNA expressions in the BMMNC of 29 MDS patients and 10 normal controls. Cell culture was used to detect the function of the c-kit receptor. Results c-kit protein expression in the MDS group was significantly higher than that in the control group (8.58％ +5.28％ vs 3.04％ + 1.49％, P＜0.05). c-kit protien expression in the refractory anemia (RA)group was significantly lower than that in the RA with an excess of blasts (RAEB)/RAEB in transformation (RAEB-t) group (5.12％ +2.13％ vs 10.01％ +5.07％, P＜0.05). The rate of c-kit protein expression was 32.43％ in aoute myeloblastic leukemia (AML) cases transformed from MDS (t-AML). c-kit mRNA expression in the MDS group was correlated with c-kit protein expression. Interieukin-3 (IL-3) and erythropoietin (Epo), with or without stem cell factor (SCF), upregulated c-kit protein and its mRNA expression. In the presence of IL-3 and Epo, SCF showed significant stimulating effects on the formation of CFU-GM and BFU-E in semi-solid cultures of normal BMMNC, but had no effects on those of the MDS patients.Conclusion The protein and mRNA expression of the c-kit receptor in the BMMNC of MDS patients were higher than those of normal controls, and the function of this receptor in MDS BMMNC was abnormal. Chin Med J 2001; 114(5) :481-485

红景天苷对高原红细胞增多症模型大鼠骨髓CD71+有核红细胞凋亡的影响

目的:探讨红景天苷对高原红细胞增多症(HAPC)模型大鼠骨髓CD71+有核红细胞(RBC)凋亡的影响,并阐明其作用机制。方法:45只SD雄性大鼠随机分为对照组(海拔1500 m条件+NaCl溶液)、模型组(海拔5000m条件+NaCl溶液)和药物组(海拔5000 m条件+0.15 g·kg^(-1)·d^(-1)红景天苷),每组15只。检测各组大鼠血常规中RBC数、血红蛋白(Hb)水平和红细胞比容(HCT)水平,流式细胞术检测各组大鼠骨髓CD71+有核RBC百分率、骨髓CD71+有核RBC凋亡率、骨髓CD71+有核RBC中线粒体膜电位(MMP)和含半胱氨酸的天冬氨酸蛋白水解酶3(Caspase-3)蛋白表达水平,Western blotting法检测各组大鼠骨髓CD71+有核RBC中B细胞淋巴瘤2(Bcl-2)、Bcl-2相关X蛋白(Bax)和含半胱氨酸的天冬氨酸蛋白水解酶9(Caspase-9)蛋白表达水平。结果:与对照组比较,模型组大鼠外周血中RBC数、Hb水平和HCT水平均升高(P<0.01),骨髓CD71+有核RBC百分率和骨髓CD71+有核RBC凋亡率升高(P<0.01),骨髓CD71+有核RBC中Bax、Caspase-9和Caspase-3蛋白表达水平升高(P<0.05)。与模型组比较,药物组大鼠外周血中骨髓CD71+有核RBC百分率均明显降低(P<0.01),骨髓CD71+有核RBC百分率和骨髓CD71+有核RBC凋亡率降低(P<0.01),骨髓CD71+有核RBC中MMP水平升高(P<0.05),Caspase-3、Bax和Caspase-9蛋白表达水平降低(P<0.01)。结论:红景天苷可有效抑制HAPC大鼠骨髓有核RBC凋亡增加,并改善低氧引起的RBC过度积累,可能在大鼠HAPC发病过程起预防和保护作用。

骨髓、脾脏FDG摄取水平与非小细胞肺癌临床病理特征

目的观察^(18)F-FDG PET/CT所示骨髓及脾脏FDG摄取水平与非小细胞肺癌(NSCLC)患者临床病理特征的关系。方法纳入82例术前接受^(18)F-FDG PET/CT检查的NSCLC患者(NSCLC组)及41例非肿瘤患者(对照组),比较2组骨髓、脾脏FDG摄取水平差异,观察其与临床病理特征之间的关系。结果NSCLC组骨髓平均标准摄取值(SUV_(mean))、骨髓SUV_(mean)与肝脏SUV_(mean)比值(BLR),以及脾脏SUV_(mean)与肝脏SUV_(mean)比值(SLR)均高于对照组(P均<0.05)。男性患者、鳞癌、高TNM分期、肿瘤>3 cm及伴局部淋巴结转移者NSCLC原发灶的最大标准摄取值(SUV max)更高(P均<0.05);高TNM分期、肿瘤>3 cm及伴局部淋巴结转移患者骨髓SUV_(mean)及BLR更高(P均<0.05);高TNM分期及肿瘤>3 cm者SLR更高(P均<0.05);TNMⅢ期肿瘤患者脾脏SUV_(mean)高于TNMⅡ期(P<0.05)。结论NSCLC患者骨髓及脾脏高FDG摄取水平与反映不良预后的肿瘤临床病理特征相关。

Transplantation of autologous bone marrow mononuclear cells for patients with lower limb ischemia

Background Many treatment options for lower limb ischemia are difficult to apply for the patients with poor arterial outflow or with poor general conditions. The effect of medical treatment alone is far from ideal, especially in patients with diabetic foot. A high level amputation is inevitable in these patients. This study aimed to explore the effect of transplantation of autologous bone marrow mononuclear cells on the treatment of lower limb ischemia and to compare the effect of intra-arterial transplantation with that of intra-muscular transplantation. Methods In this clinical trial, 32 patients with lower limb ischemia were divided into two groups. Group 1 （16 patients with 18 affected limbs） received transplantation of autologous bone marrow mononuclear cells by intra-muscular injection into the affected limbs; and group 2 （16 patients with 17 affected limbs） received transplantation of autologous bone marrow mononuclear cells by intra-arterial injection into the affected limbs. Rest pain, coldness, ankle/brachial index （ABI）, claudication, transcutaneous oxygen pressure （tcPO2） and angiography （15 limbs of 14 patients） were evaluated before and after the mononuclear cell transplantation to determine the effect of the treatment. Results Two patients died from heart failure. The improvement of rest pain was seen in 76.5% （13/17） of group 1 and 93.3% （14/15） of group 2. The improvement of coldness was 100% in both groups. The increase of ABI was 44.4% （8/18） in group 1 and 41.2% （7/17） in group 2. The value of tcPO2 increased to 20 mmHg or more in 20 limbs. Nine of 15 limbs which underwent angiography showed rich collaterals. Limb salvage rate was 83.3% （15/18） in group 1 and 94.1% （16/17） in group 2. There was no statistically significant difference in the effectiveness of the treatment between the two groups. Conclusions Transplantation of autologous bone marrow mononuclear cells is a simple, safe and effective method for the treatment of lower limb ischemia, and the two approaches for the implantation, intra-muscular injection and intra-arterial injection, show similar results.

Efficacy of autologous bone marrow mononuclear cell transplantation therapy in patients with refractory diabetic peripheral neuropathy

Background:Owing to the multifactorial nature of the pathogenesis of diabetic peripheral neuropathy (DPN),conventional drug therapies have not been effective.The application of stem cells transplantation may be useful for the treatment of DPN.This study was designed to assess the safety and therapeutic effects of autologous bone marrow mononuclear cells (BMMNCs) transplantation on the treatment of refractory DPN.Methods:One hundred and sixty-eight patients with refractory DPN were recruited and enrolled in the study.They received intramuscular injection of BMMNCs and followed at 1,3,6,12,18,24,and 36 months after the transplantation.Clinical data,Toronto Clinical Scoring System (TCSS),and nerve conduction studies (NCSs) were compared before and after the transplantation.Results:The signs and symptoms of neuropathy were significantly improved after BMMNCs transplantation.The values of the TCSS scores at 1 month (9.68 ± 2.49 vs.12.55 ± 2.19,P<0.001) and 3 months (8.47 ± 2.39 vs.12.55 ± 2.19,P<0.001) after the treatment reduced significantly compared with the baseline value.This decrement remained persistent until the end of the study.The conduction velocity and action potential and sensory nerves were significantly improved after transplantation (3 and 12 months after the treatment vs.the baseline:motor nerve conduction velocity,40.24 ± 2.80 and 41.00 ± 2.22 m/s vs.38.21 ± 2.28 m/s,P<0.001;sensory nerve conduction velocity,36.96 ± 2.26 and 39.15 ± 2.61 m/s vs.40.41 ± 2.22 m/s,P<0.001;compound muscle action potential,4.67 ± 1.05 and 5.50 ± 1.20 μV vs.5.68 ± 1.08 μV,P<0.001;sensory nerve action potential,4.29 ± 0.99 and 5.14 ± 1.26 μV vs.5.41 ± 1.14 μV,P<0.001).No adverse event associated with the treatment was observed during the follow-up period.Conclusions:Autologous transplantation of BMMNCs may be an effective and promising therapeutic strategy for the treatment of refractory DPN.

干细胞治疗神经病理性疼痛的研究进展

神经病理性疼痛(Neuropathic pain,NP)是疼痛科的常见病和多发病,其发病机制仍不完全清楚,目前无根治疗法,许多患者遗留顽固性NP,严重影响生活质量。干细胞是一种具有高度分化、增殖和自我更新潜能的未分化细胞,可以分化为特定类型的细胞和组织,近年来越来越多的研究证明了干细胞在NP治疗中的潜力,干细胞移植有望成为更安全高效的疗法。本文对多种干细胞在NP治疗方面的作用及其研究进展进行综述。