There is a small amount of clinical data regarding the safety and feasibility of autologous peripheral blood mononuclear cell transplantation into the subarachnoid space for the treatment of amyotrophic lateral sclero...There is a small amount of clinical data regarding the safety and feasibility of autologous peripheral blood mononuclear cell transplantation into the subarachnoid space for the treatment of amyotrophic lateral sclerosis.The objectives of this retrospective study were to assess the safety and efficacy of peripheral blood mononuclear cell transplantation in 14 amyotrophic lateral sclerosis patients to provide more objective data for future clinical trials.After stem cell mobilization and collection,autologous peripheral blood mononuclear cells（1 × 109） were isolated and directly transplanted into the subarachnoid space of amyotrophic lateral sclerosis patients.The primary outcome measure was incidence of adverse events.Secondary outcome measures were electromyography 1 week before operation and 4 weeks after operation,Functional Independence Measurement,Berg Balance Scale,and Dysarthria Assessment Scale 1 week preoperatively and 1,2,4 and 12 weeks postoperatively.There was no immediate or delayed transplant-related cytotoxicity.The number of leukocytes,serum alanine aminotransferase and creatinine levels,and body temperature were within the normal ranges.Radiographic evaluation showed no serious transplant-related adverse events.Muscle strength grade,results of Functional Independence Measurement,Berg Balance Scale,and Dysarthria Assessment Scale were not significantly different before and after treatment.These findings suggest that peripheral blood mononuclear cell transplantation into the subarachnoid space for the treatment of amyotrophic lateral sclerosis is safe,but its therapeutic effect is not remarkable.Thus,a large-sample investigation is needed to assess its efficacy further.展开更多
Neglected for years, astrocytes are now recognized to fulfill and support many, if not all, homeostatic functionsof the healthy central nervous system(CNS). During neurodegenerative diseases such as amyotrophic latera...Neglected for years, astrocytes are now recognized to fulfill and support many, if not all, homeostatic functionsof the healthy central nervous system(CNS). During neurodegenerative diseases such as amyotrophic lateral sclerosis(ALS) and spinal cord injury(SCI), astrocytes in the vicinity of degenerating areas undergo both morphological and functional changes that might compromise their intrinsic properties. Evidence from human and animal studies show that deficient astrocyte functions or loss-of-astrocytes largely contribute to increased susceptibility to cell death for neurons, oligodendrocytes and axons during ALS and SCI disease progression. Despite exciting advances in experimental CNS repair, most of current approaches that are translated into clinical trials focus on the replacement or support of spinal neurons through stem cell transplantation, while none focus on the specific replacement of astroglial populations. Knowing the important functions carried out by astrocytes in the CNS, astrocyte replacement-based therapies might be a promising approach to alleviate overall astrocyte dysfunction, deliver neurotrophic support to degenerating spinal tissue and stimulate endogenous CNS repair abilities. Enclosed in this review, we gathered experimental evidence that argue in favor of astrocyte transplantation during ALS and SCI. Based on their intrinsic properties and according to the cell type transplanted, astrocyte precursors or stem cell-derived astrocytes promote axonal growth, support mechanisms and cells involved in myelination, are able to modulate the host immune response, deliver neurotrophic factors and provide protective molecules against oxidative or excitotoxic insults, amongst many possible benefits. Embryonic or adult stem cells can even be genetically engineered in order to deliver missing gene products and therefore maximize the chance of neuroprotection and functional recovery. However, before broad clinical translation, further preclinical data on safety, reliability and therapeutic efficiency should be collected. Although several technical challenges need to be overcome, we discuss the major hurdles that have already been met or solved by targeting the astrocyte populationin experimental ALS and SCI models and we discuss avenues for future directions based on latest molecular findings regarding astrocyte biology.展开更多
Amyotrophic lateral sclerosis(ALS)is a fatal neurodegenerative disorder characterized by the loss of motor neurons.Currently,no effective therapy is available to treat ALS,except for Riluzole,which has only limited cl...Amyotrophic lateral sclerosis(ALS)is a fatal neurodegenerative disorder characterized by the loss of motor neurons.Currently,no effective therapy is available to treat ALS,except for Riluzole,which has only limited clinical benefits.Stem-cell-based therapy has been intensively and extensively studied as a potential novel treatment strategy for ALS and has been shown to be effective,at least to some extent.In this article,we will review the current state of research on the use of stem cell therapy in the treatment of ALS and discuss the most promising stem cells for the treatment of ALS.展开更多
目的:探索嗅鞘细胞移植实验性自身免疫性脑脊髓炎(EAE)大鼠的移植途径、可行的移植时间窗,移植后的迁移特性以及发挥保护作用的可能机制。方法:分别采用豚鼠脊髓匀浆(GPSCH)与MOGIgd融合蛋白免疫Lewis大鼠,制作EAE模型;每组发病大鼠分...目的:探索嗅鞘细胞移植实验性自身免疫性脑脊髓炎(EAE)大鼠的移植途径、可行的移植时间窗,移植后的迁移特性以及发挥保护作用的可能机制。方法:分别采用豚鼠脊髓匀浆(GPSCH)与MOGIgd融合蛋白免疫Lewis大鼠,制作EAE模型;每组发病大鼠分别归入:MOG组和GPSCH组。MOG组分为:OECs空白对照组(MOG0组)4只、OECs尾静脉移植组(MOG1组)7只、OECs侧脑室移植组(MOG2组)4只;GPSCH组分为:OECs空白对照组(GPSCH0组)4只、OECs尾静脉移植组(GPSCH1组)4只。发病高峰期,按照实验分组,分别采用立体定向侧脑室细胞移植和尾静脉细胞移植,观察移植后大鼠的临床症状;移植后2周观察OECs在大鼠体内的分布情况及组织病理学方面的缓解情况。结果:OECs分别经尾静脉、侧脑室移植后,EAE大鼠症状改善,与空白对照组神经功能评分峰差值比较有显著差异(F=18.470,P<0.01;t=-7.147,P<0.01),MOG1组和MOG2组评分峰差值间无显著差异(P>0.05);Hoechst33342示踪证实了OECs能在大鼠体内存活及强大的迁移能力;OECs经尾静脉移植后,可以透过破坏的血脑屏障进入脑内,分布于软脑膜和病灶周围;经侧脑室移植的嗅鞘细胞,向病灶局部广泛迁移;组织病理学评分(HE染色和Luxol fast blue髓鞘染色),移植组与未移植组间无显著差异(P>0.05),2种途径移植组间亦无显著差异(P>0.05)。结论:纯化培养的成年大鼠嗅球嗅鞘细胞分别经尾静脉和侧脑室移植EAE大鼠,均可缓解发病大鼠的症状。展开更多
基金supported by the National Natural Science Foundation of China,No.81471308a grant from the Science and Technology Plan Project of Dalian City in China,No.2015F11GH094
文摘There is a small amount of clinical data regarding the safety and feasibility of autologous peripheral blood mononuclear cell transplantation into the subarachnoid space for the treatment of amyotrophic lateral sclerosis.The objectives of this retrospective study were to assess the safety and efficacy of peripheral blood mononuclear cell transplantation in 14 amyotrophic lateral sclerosis patients to provide more objective data for future clinical trials.After stem cell mobilization and collection,autologous peripheral blood mononuclear cells（1 × 109） were isolated and directly transplanted into the subarachnoid space of amyotrophic lateral sclerosis patients.The primary outcome measure was incidence of adverse events.Secondary outcome measures were electromyography 1 week before operation and 4 weeks after operation,Functional Independence Measurement,Berg Balance Scale,and Dysarthria Assessment Scale 1 week preoperatively and 1,2,4 and 12 weeks postoperatively.There was no immediate or delayed transplant-related cytotoxicity.The number of leukocytes,serum alanine aminotransferase and creatinine levels,and body temperature were within the normal ranges.Radiographic evaluation showed no serious transplant-related adverse events.Muscle strength grade,results of Functional Independence Measurement,Berg Balance Scale,and Dysarthria Assessment Scale were not significantly different before and after treatment.These findings suggest that peripheral blood mononuclear cell transplantation into the subarachnoid space for the treatment of amyotrophic lateral sclerosis is safe,but its therapeutic effect is not remarkable.Thus,a large-sample investigation is needed to assess its efficacy further.
基金Supported by The NINDS,No.#1R01NS079702(to Angelo C Lepore)
文摘Neglected for years, astrocytes are now recognized to fulfill and support many, if not all, homeostatic functionsof the healthy central nervous system(CNS). During neurodegenerative diseases such as amyotrophic lateral sclerosis(ALS) and spinal cord injury(SCI), astrocytes in the vicinity of degenerating areas undergo both morphological and functional changes that might compromise their intrinsic properties. Evidence from human and animal studies show that deficient astrocyte functions or loss-of-astrocytes largely contribute to increased susceptibility to cell death for neurons, oligodendrocytes and axons during ALS and SCI disease progression. Despite exciting advances in experimental CNS repair, most of current approaches that are translated into clinical trials focus on the replacement or support of spinal neurons through stem cell transplantation, while none focus on the specific replacement of astroglial populations. Knowing the important functions carried out by astrocytes in the CNS, astrocyte replacement-based therapies might be a promising approach to alleviate overall astrocyte dysfunction, deliver neurotrophic support to degenerating spinal tissue and stimulate endogenous CNS repair abilities. Enclosed in this review, we gathered experimental evidence that argue in favor of astrocyte transplantation during ALS and SCI. Based on their intrinsic properties and according to the cell type transplanted, astrocyte precursors or stem cell-derived astrocytes promote axonal growth, support mechanisms and cells involved in myelination, are able to modulate the host immune response, deliver neurotrophic factors and provide protective molecules against oxidative or excitotoxic insults, amongst many possible benefits. Embryonic or adult stem cells can even be genetically engineered in order to deliver missing gene products and therefore maximize the chance of neuroprotection and functional recovery. However, before broad clinical translation, further preclinical data on safety, reliability and therapeutic efficiency should be collected. Although several technical challenges need to be overcome, we discuss the major hurdles that have already been met or solved by targeting the astrocyte populationin experimental ALS and SCI models and we discuss avenues for future directions based on latest molecular findings regarding astrocyte biology.
基金This research was supported by the National Natural Science Foundation of China(NSFC 81471302)。
文摘Amyotrophic lateral sclerosis(ALS)is a fatal neurodegenerative disorder characterized by the loss of motor neurons.Currently,no effective therapy is available to treat ALS,except for Riluzole,which has only limited clinical benefits.Stem-cell-based therapy has been intensively and extensively studied as a potential novel treatment strategy for ALS and has been shown to be effective,at least to some extent.In this article,we will review the current state of research on the use of stem cell therapy in the treatment of ALS and discuss the most promising stem cells for the treatment of ALS.
文摘目的:探索嗅鞘细胞移植实验性自身免疫性脑脊髓炎(EAE)大鼠的移植途径、可行的移植时间窗,移植后的迁移特性以及发挥保护作用的可能机制。方法:分别采用豚鼠脊髓匀浆(GPSCH)与MOGIgd融合蛋白免疫Lewis大鼠,制作EAE模型;每组发病大鼠分别归入:MOG组和GPSCH组。MOG组分为:OECs空白对照组(MOG0组)4只、OECs尾静脉移植组(MOG1组)7只、OECs侧脑室移植组(MOG2组)4只;GPSCH组分为:OECs空白对照组(GPSCH0组)4只、OECs尾静脉移植组(GPSCH1组)4只。发病高峰期,按照实验分组,分别采用立体定向侧脑室细胞移植和尾静脉细胞移植,观察移植后大鼠的临床症状;移植后2周观察OECs在大鼠体内的分布情况及组织病理学方面的缓解情况。结果:OECs分别经尾静脉、侧脑室移植后,EAE大鼠症状改善,与空白对照组神经功能评分峰差值比较有显著差异(F=18.470,P<0.01;t=-7.147,P<0.01),MOG1组和MOG2组评分峰差值间无显著差异(P>0.05);Hoechst33342示踪证实了OECs能在大鼠体内存活及强大的迁移能力;OECs经尾静脉移植后,可以透过破坏的血脑屏障进入脑内,分布于软脑膜和病灶周围;经侧脑室移植的嗅鞘细胞,向病灶局部广泛迁移;组织病理学评分(HE染色和Luxol fast blue髓鞘染色),移植组与未移植组间无显著差异(P>0.05),2种途径移植组间亦无显著差异(P>0.05)。结论:纯化培养的成年大鼠嗅球嗅鞘细胞分别经尾静脉和侧脑室移植EAE大鼠,均可缓解发病大鼠的症状。
