摘要
目的观察临床级脐带间充质干细胞(clinical grade umbilical cord mesenchymal stem cell,UC-MSC)治疗放射性肺纤维化(radiation-induced pulmonary fibrosis,RPF)的安全性和有效性。方法从2014年1月至2016年6月共入组8例RPF患者,其中2例乳腺癌,6例肺癌。通过支气管镜对RPF病灶部位灌洗后单次注入脐带间充质干细胞(1×10~6/kg),观察治疗前及治疗后第3天、3个月、6个月的临床症状、血液指标和圣乔治呼吸问卷(St George’s respiratory questionnaire,SGRQ)、6 min步行距离(six-minute walk distance,6MWD)、肺功能指标、相关炎症因子、CT肺密度的变化情况。结果 8例患者均能耐受UC-MSC治疗,6例患者自觉气促、咳嗽等症状有所好转,圣乔治呼吸问卷评分有差异(P<0.05),血常规、C反应蛋白、肝肾功指标治疗前后无明显变化,转化生长因子-β1(transforming growth factor-β1,TGF-β1)在治疗后有下降趋势,但差异无统计学意义(P>0.05),CT肺密度自身治疗前后比较有下降。结论 UC-MSC治疗RPF对患者的肝肾等主要脏器无损害,且能够减轻患者的临床症状和降低肺纤维化密度,但其确切的治疗效果及机制需更加严谨的研究进一步证实。
Objective To assess the safety and efficacy of clinical-grade umbilical mesenchymal stem cell （UC-MSC） therapy in the treatment of radiation-induced pulmonary fibrosis （RPF）. Methods From January 2014 to June 2016, 8 patients with RPF received UC-MSC treatment, including 2 female patients with breast cancer, 1 female patient with lung cancer and 5 male patients with lung cancer. After cleansing the pulmonary lesions by bronchoscopy lavage, clinical-grade UC-MSCs （1 × 10^6/kg） were administered in the lesions via a single injection. At 3 d before, and 3 d, and 3 and 6 months after the cell transplantation, the patients were examined for clinical symptoms, blood biochemical parameters, St George＇s questionnaires （SGRQ） scores, 6-minute walk distance （6MWD）, lung function, inflammatory factors, and lung density on CT images. Results All the 8 patients showed a good tolerance to UC-MSC treatment. Six patients reported improvement of shortness of breath, cough and other symptoms after the treatment. In all the 8 patients, the St George＇ s questionnaires scores were decreased significantly after the treatment （ P 〈 0.05 ）, while routine blood test results, C-reactive protein, liver and kidney function indexes showed no obvious changes. The level of transforming growth factor-1β （ TGF-1β） tended to decrease over time after the cell transplantation, but the changes were not statistically significant （ P 〉 0.05 ）. The pulmonary density on the CT images decreased significantly in these patients after the treatment. Conclusion In the 8 patients with PRF, UC-MSC therapy alleviates the clinical symptoms and lowers the density of pulmonary lesions without affecting the functions of the liver, kidneys or other major organs, but the therapeutic effect of UC-MSC treatment still awaits further confirmation by studies with a larger sample size.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2017年第10期1013-1018,共6页
Journal of Third Military Medical University
基金
中国科学院战略性先导专项项目(XDA 01030000)~~
关键词
脐带间充质干细胞
放射性肺纤维化
细胞治疗
umbilical cord mesenchymal stem cells
radiation-induced pulmonary fibrosis
cell therapy
