脐血单个核细胞移植对帕金森病的临床疗效研究

目的观察经寰枕间隙侧方穿刺术移植人脐血单个核细胞（hUCB-MNCs）治疗帕金森病（PD）的临床疗效。 方法选取聊城市人民医院神经内科经寰枕间隙侧方穿刺术移植hUCB-MNCs治疗的31例PD患者，于治疗前及治疗后1、3、6、12个月，采用统一帕金森评估量表（UPDRS）第Ⅱ部分、第Ⅲ部分和帕金森非运动症状评价量表（NMSS）、匹兹堡睡眠质量指数量表（PSOI）对患者进行评分，并记录左旋多巴等效剂量（LED）。采用重复测量资料方差分析对治疗前后多个时间点的评分及左旋多巴等效剂量进行比较，两两比较采用Bonferroni检验。 结果（1）与治疗前比较，治疗后3、6、12个月UPDRS Ⅱ评分[（17.75±6.81）分比（13.67±5.62）分、（12.54±4.39）分、（10.41±4.31）分]均降低；治疗后3、6、12个月UPDRS Ⅲ评分[（28.53±14.75）分比（21.65±10.11）分、（19.37±9.26）分、（16.12±7.44）分]亦均降低，差异有统计学意义（P < 0.05）。（2）与治疗前比较，治疗后1、3、6、12个月NMSS评分[（58.94±35.74）分比（50.27±31.06）分、（41.38±28.25）分、（38.42±25.73）分、（36.15±24.56）分]均降低，差异有统计学意义（P < 0.05）。PSOI评分亦有相同变化趋势。（3）与治疗前比较，治疗后6、12个月LED[（629.57±205.33）mg/d比（435.54±160.62）mg/d、（300.71±135.83） mg/ d]下降，差异有统计学意义（P < 0.05）。 结论经寰枕间隙侧方穿刺术移植hUCB-MNCs治疗能改善PD患者的运动及非运动症状，延缓病情的进展。     

脐血单个核细胞对缺血性脑卒中的临床干预

目的观察多份人脐血单个核细胞(MNC)静脉输注对缺血性脑卒中患者神经功能的改善作用。方法选择2008年4月至2015年5月在郑州市第二人民医院、郑州大桥医院住院和门诊收治的缺血性脑卒中患者76例(参照第四届全国脑血管病学术会议修订的脑卒中诊断标准,并经CT、MRI确诊),按照治疗方案的不同分为脐血MNC组和对照组,急性期对照组采用常规治疗,慢性期对照组采用康复治疗,脐血MNC组在常规治疗或康复治疗的基础上加用脐血MNC手背浅静脉输入,每例输入6次,每次细胞数大于或等于1×10~8个,每次间隔1~7 d。治疗前后神经功能缺损程度(NFD)、患侧肢体运动功能评价Fugl-Meyer(FMA)及日常生活评价(ADL)的比较采用配对t检验,组间比较采用独立t检验。结果脐血MNC组急性期治疗后NFD评分(11.50±2.58)明显低于急性期脐血MNC组治疗前(26.83±5.55,t=6.186,P<0.01)和对照组治疗后(24.33±5.16,t=5.442,P<0.01),脐血MNC组慢性期治疗后NFD评分(12.41±3.83)明显低于慢性期脐血MNC组治疗前(23.10±4.54,t=10.184,P=0.000)和对照组治疗后(23.09±3.94,t=11.012,P<0.01);脐血MNC组急性期治疗后Fuel-Meyer(上肢22.16±2.63,下肢32.00±5.32)明显低于急性期脐血MNC组治疗前(上肢11.66±2.94,t=-6.505,P<0.01;下肢12.66±3.01,t=-7.5386,P<0.01)和对照组治疗后(上肢15.00±3.63,t=-3.871,P=0.003;下肢16.83±4.91,t=-5.048,P<0.01),脐血MNC组慢性期治疗后Fuel-Meyer(上肢15.10±2.08,下肢15.03±1.86)明显低于慢性期脐血MNC组治疗前(上肢8.81±2.19,t=-11.748,P<0.01;下肢8.84±2.30,t=-12.619,P<0.01)和对照组治疗后(上肢9.16±2.60,t=-10.069,P<0.01;下肢9.69±2.98,t=-11.441,P<0.01);脐血MNC组急性期治疗后Barthel指数评分(65.83±7.35)明显低于急性期脐血MNC组治疗前(21.66±5.57,t=-11.916,P<0.01)和对照组治疗后(42.50±5.20,t=-6.387,P<0.01),脐血MNC组慢性期治疗后Barthel指数评分(63.40±9.19)明显低于慢性期脐血MNC组治疗前(25.20±3.81,t=-21.733,P<0.01)和对照组治疗后(29.90±5.36,t=20.361,P<0.01)。结论多份人脐血MNC手背浅静脉移植,方法简便、安全有效,有望成为治疗缺血性脑卒中的有效手段。     

生长因子诱导下人脐血单个核细胞向肝细胞的分化

目的：探讨在体外培养条件下人脐血单个核细胞向肝细胞的分化。方法：用FGF4、HGF诱导新鲜分离的脐血单个核细胞,并于培养16d通过RT—PCR、免疫细胞化学染色方法等方法检测肝细胞标志物的表达情况。结果：培养16d后。生长因子组贴壁的脐血MNCs中出现细胞体积增大、胞质丰富的双核细胞,RT—PCR和免疫细胞化学染色显示有肝细胞标志物的阳性表达（P〈0．05）。结论：在生长因子诱导下。脐血单个核细胞能够分化为类肝细胞。     

利用人脐血单个核细胞重建急性肝损伤小鼠肝组织的实验研究

利用人脐血单个核细胞重建急性肝损伤小鼠肝组织,探索建立人-小鼠嵌合肝模型方法。15只SCID小鼠,以四氯化碳(CCL4)制备急性肝损伤模型,24h后行2/3肝切除,然后分为三个实验组细胞移植组(7只)、阴性对照组(3只)及空白对照组(5只);将人脐血单个核细胞悬液注入细胞移植组小鼠脾脏内,阴性对照组小鼠脾脏内注入等量磷酸盐缓冲液(PBS),空白对照组不注射细胞悬液和PBS。术后7d、14d及21d取小鼠肝组织观察病理变化、检测人白蛋白(ALB)及细胞角蛋白19(CK19),同时检测小鼠血清及肝组织匀浆中人ALB含量。全部小鼠表现出急性肝损伤组织学特征;细胞移植组小鼠术后7d、14d、21d肝组织内均见大量人ALB及CK19阳性表达细胞,血清及肝组织匀浆可检测出人ALB;阴性对照组小鼠肝组织未见人ALB及CK19阳性表达,血清及肝组织匀浆中未检测出人ALB。人脐血单个核细胞在部分肝切除的急性肝损伤小鼠肝组织内可大量分化为人肝细胞及胆管细胞,在建立模型方面已取得关键突破。     

五种益生菌菌株对脐血单个核细胞免疫作用的实验研究

目的比较不同剂量的5种不同益生菌菌株的免疫调节作用,为选择适当的菌株进行治疗提供依据。方法取7例健康孕妇的脐血分离出的脐血单个核细胞(cord blood monocular cells,CBMC),分别与长双歧杆菌6-1株、婴儿双歧杆菌CGMCC313-1株、嗜酸乳杆菌YIT2004株、粪链球菌YIT0072株和酪酸梭状芽胞杆菌CGMCC313-2株,以菌和CBMC比例2∶1(低)、20∶1(中)和200∶1(高)共培养24~36 h,同时设阴性对照(PBS)和阳性对照(脂多糖,LPS)。然后采用流式细胞仪检测各组CBMC表面CD4、CD25分子表达情况,用ELISA方法检测培养上清中IL-10、IL-12、IL-4、TGF-β1和IFN-γ的水平。结果 (1)与阴性对照(PBS)组相比,除200∶1比例的酪酸梭状芽胞杆菌CGMCC313-2株能够显著提高CBMC表达CD4CD25(10.45±3.16 vs 5.84±2.32,P=0.009)以外,其余益生菌菌株对表达CD4CD25差异均无统计学意义(P0.05)。(2)长双歧杆菌6-1株在中高剂量下,能够刺激CBMC产生IL-10和IFN-γ,对产生IL-12无明显影响。(3)婴儿型双歧杆菌CGMCC313-1株在各个剂量下均能够刺激CBMC产生IL-10,对IL-12和IFN-γ产生无明显影响。(4)酪酸梭状芽胞杆菌CGMCC313-2株在中高剂量下,能够刺激CBMC产生IL-10,对IL-12和IFN-γ产生无明显影响。(5)粪链球菌YIT0072株在低中剂量下,能够刺激CBMC产生IL-10、IL-12和IFN-γ,而高剂量则无影响。(6)嗜酸乳杆菌YIT2004株在中高剂量下,能够刺激CBMC产生IL-10,在中剂量下,能够刺激CBMC产生IFN-γ,对IL-12无影响。(7)在本研究中均未能检测出IL-4和TGF-β1。结论在目前国内使用的益生菌菌株中,仅酪酸梭状芽胞杆菌CGMCC313-2株能够显著提高CBMC表达CD4CD25。5种菌株均能够刺激CBMC产生抗炎症因子IL-10;长双歧杆菌6-1株、粪链球菌YIT0072株和嗜酸乳杆菌YIT2004株能够刺激CBMC产生Th1型细胞因子INF-γ,仅粪链球菌YIT0072株能够刺激CBMC产生IL-12。各个菌株在不同的剂量下,具有不同作用。提示在应用益生菌治疗免疫等相关性疾病时,应该考虑不同菌株对免疫细胞的不同作用机制。     

两种培养液对人外周血单个核细胞活力影响的比较观察

本文比较了自制细胞培养基和日本1640产细胞培养基对人外周血单个核细胞活力的影响,结果表明两种细胞培养基用于PBMC培养24h、48h、72h后、自制细胞培养基培养的细胞存活率均明显高于日本产1640培养基(P<0.01).说明自制细胞培养基可取代日本产1640培养基而用于人PBMC的实验培养.     

自体骨髓单个核细胞移植治疗缺血性下肢血管病变患者254例

目的探讨自体骨髓单个核细胞移植在下肢缺血性疾病治疗中的应用并评价其疗效。方法回顾性总结分析解放军第四六三医院细胞治疗中心2003年11月至2008年8月住院的具有完整随访资料的下肢缺血性疾病患者254例,经动员后采集及分离自体骨髓,行下肢自体骨髓单个核细胞移植术。随访时间为1年。术后随访指标：3、6、12个月后复查皮温、深感觉、经皮氧分压和踝肱比,随访疼痛、冷感和跛行距离,观察溃疡和坏疽情况。采用F检验分析差异的统计学意义。结果完成随访254例患者。（1）患者的疼痛缓解率为61．8％（157例／254例）,冷感缓解率缓解率74．0％（188例／254例）,跛行好转率40．2％（102例／254例）,溃疡好转率59．0％（36例／61例）,坏疽截肢6例,脱落愈合5例,无变化8例,扩大7例;（2）患者下肢皮温由32．89℃±2．19℃上升至35．52℃±2．26℃（t=13．32,P=0．000）,深感觉缓解由（26．20±15．78）mV下降至（20．34±10．86）mV（t=4．901,P=0．000）,经皮氧分压由（26．46±18．49）mmHg上升至（34．14±14．99）mmHg（t=5．157,P=0．000）,踝肱比由0．62±0．36上升至0．84±0．24（t=8．104,P=0．000）。结论骨髓单个核细胞移植治疗下肢缺血性血管病有效,是一种简单的、有效的治疗下肢动脉缺血性疾病的方法。     

寰枕间隙侧方穿刺移植脐血单个核细胞治疗多系统萎缩的临床观察

目的观察寰枕间隙侧方穿刺移植脐血单个核细胞治疗多系统萎缩(MSA)的安全性及临床疗效。方法选取聊城市人民医院神经内科10例MSA患者进行寰枕间隙侧方穿刺移植脐血单个核细胞治疗,分别观察治疗后3个月、6个月及1年的UMSARS评分,并随访观察有无不良反应。治疗前后评分比较采用t检验。结果治疗后3个月的UMSARS partⅠ评分(18.0±6.02)、治疗后6个月的UMSARS partⅠ评分(12.6±4.43)和治疗后1年的UMSARS partⅠ评分(12.3±3.20)均明显低于治疗前(25.8±4.80),治疗后3个月的UMSARS partⅡ评分(27.3±8.46)、治疗后6个月的UMSARS partⅡ评分(23.2±7.70)和治疗后1年的UMSARS partⅡ评分(22.4±5.93)均明显低于治疗前(34.5±6.79),治疗后3个月、6个月、1年的UMSARS partⅠ、UMSARS partⅡ评分较治疗前比差异具有统计学意义(P0.01)。除1例患者术后第1天低热,余患者均无不良反应。结论寰枕间隙侧方穿刺注射脐血单个核细胞治疗MSA是相对安全并且有效的治疗方法。     

骨髓单个核细胞移植对大鼠溃疡性结肠炎的作用

目的:探讨同种异体骨髓单个核细胞(BM-MNCs)移植大鼠溃疡性结肠炎模型的作用。方法:将DAPI标记的同种异体大鼠骨髓单个核细胞(BM-MNCs)经尾静脉注射移植到大鼠溃疡性结肠炎(UC)模型体内(模型组),以尾静脉注射等量PBS的UC大鼠作为对照组。光镜观察大鼠结肠组织病变改变,荧光显微镜观察标记DAPI的BM-MNCs在结肠组织中的定植及分布情况,免疫荧光检测BM-MNCs中CK19、CD34的表达情况。结果:移植组大鼠结肠组织可见新生黏膜上皮及腺体,黏膜下有新鲜至成熟肉芽组织生成,明显优于对照组;移植14天,大鼠结肠组织中可观察到DAPI标记的BM-MNCs细胞;DAPI标记的细胞可表达血管内皮细胞特异性表达蛋白CD34或黏膜上皮细胞特异性表达蛋白CK19。结论:BM-MNCs可向受损病变部位结肠组织迁移和定植,且分化为血管内皮细胞和黏膜上皮细胞。     

Expanded umbilical cord blood T cells used as donor lymphocyte infusions after umbilical cord blood transplantation

BackgroundUmbilical cord blood (UCB) is an alternative graft source for hematopoietic stem cell transplantation and has been shown to give results comparable to transplantation with other stem cell sources. Donor lymphocyte infusion (DLI) is an effective treatment for relapsed malignancies after hematopoietic stem cell transplantation. However, DLI is not available after UCB transplantation.MethodsIn this study, in vitro–cultured T cells from the UCB graft were explored as an alternative to conventional DLI. The main aim was to study the safety of the cultured UCB T cells used as DLI because such cell preparations have not been used in this context previously. We also assessed potential benefits of the treatment.ResultsThe cultured UCB T cells (UCB DLI) were given to 4 patients with mixed chimerism (n = 2), minimal residual disease (n = 1) and graft failure (n = 1). No adverse reactions were seen at transfusion. Three of the patients did not show any signs of graft-versus-host disease (GVHD) after UCB DLI, but GVHD could not be excluded in the last patient. In the patient with minimal residual disease treated with UCB DLI, the malignant cell clone was detectable shortly before infusion but undetectable at treatment and for 3 months after infusion. In 1 patient with mixed chimerism, the percentage of recipient cells decreased in temporal association with UCB DLI treatment.ConclusionsWe saw no certain adverse effects of treatment with UCB DLI. Events that could indicate possible benefits were seen but with no certain causal association with the treatment.     

Transplantation of human umbilical cord blood cells improves glycemia and glomerular hypertrophy in type 2 diabetic mice

Recent in vitro and in vivo studies have shown that either animal- or human-derived embryonic stem cells can differentiate into insulin-secreting cells and lower blood glucose levels. However, studies utilizing human umbilical cord blood (HUCB) mononuclear cells to improve blood glucose levels in diabetic animals have received little attention. In this study, we examined the effect of transplanted HUCB mononuclear cells on blood glucose levels, survival, and renal pathology in obese mice with spontaneous development of type 2 diabetes. The results show that injection of HUCB mononuclear cells into orbital plexus of mice caused improvement not only in blood glucose levels and survival rate but also normalization of glomerular hypertrophy and tubular dilatation. Thus, transplantation of HUCB mononuclear cells appears to be another modality of stem cell therapy in diabetes mellitus.     

脐带血干细胞移植治疗非恶性血液病进展

异基因造血干细胞移植（allo-HSCT）是治愈多种非恶性病的有效方法。脐带血干细胞（UCB）具有免疫原性低、人类白细胞抗原不合耐受性好、移植物抗宿主反应发生率低以及获取相对快捷等特点,可作为非恶性血液疾病患者allo-HSCT的来源。本文简要综述脐血干细胞移植在原发性免疫缺陷病、遗传性骨髓衰竭、遗传代谢病以及自身免疫性疾病等非恶性血液疾病的治疗效果。     

Direct intracardiac injection of umbilical cord-derived stromal cells and umbilical cord blood-derived endothelial cells for the treatment of ischemic cardiomyopathy

The development of new therapeutic strategies is necessary to reduce the worldwide social and economic impact of cardiovascular disease, which produces high rates of morbidity and mortality. A therapeutic option that has emerged in the last decade is cell therapy. The aim of this study was to compare the effect of transplanting human umbilical cord-derived stromal cells (UCSCs), human umbilical cord blood-derived endothelial cells (UCBECs) or a combination of these two cell types for the treatment of ischemic cardiomyopathy (IC) in a Wistar rat model. IC was induced by left coronary artery ligation, and baseline echocardiography was performed seven days later. Animals with a left ventricular ejection fraction (LVEF) of ≤40% were selected for the study. On the ninth day after IC was induced, the animals were randomized into the following experimental groups: UCSCs, UCBECs, UCSCs plus UCBECs, or vehicle (control). Thirty days after treatment, an echocardiographic analysis was performed, followed by euthanasia. The animals in all of the cell therapy groups, regardless of the cell type transplanted, had less collagen deposition in their heart tissue and demonstrated a significant improvement in myocardial function after IC. Furthermore, there was a trend of increasing numbers of blood vessels in the infarcted area. The median value of LVEF increased by 7.19% to 11.77%, whereas the control group decreased by 0.24%. These results suggest that UCSCs and UCBECs are promising cells for cellular cardiomyoplasty and can be an effective therapy for improving cardiac function following IC.     

In vitro differentiation of human umbilical cord blood-derived mesenchymal stem cells into hepatocyte-like cells

In addition to long-term self-renewal capability, human mesenchymal stem cells (MSCs) possess versatile differentiation potential ranging from mesenchyme-related multipotency to neuroectodermal and endodermal competency. Of particular concern is hepatogenic potential that can be used for liver-directed stem cell therapy and transplantation. In this study, we have investigated whether human umbilical cord blood (UCB)-derived MSCs are also able to differentiate into hepatocyte-like cells. MSCs isolated from UCB were cultured under the pro-hepatogenic condition similar to that for bone marrow (BM)-derived MSCs. Expression of a variety of hepatic lineage markers was analyzed by flow cytometry, RT-PCR, Western blot, and immunofluorescence. The functionality of differentiated cells was assessed by their ability to incorporate DiI-acetylated low-density lipoprotein (DiI-Ac-LDL). As the cells were morphologically transformed into hepatocyte-like cells, they expressed Thy-1, c-Kit, and Flt-3 at the cell surface, as well as albumin, alpha-fetoprotein, and cytokeratin-18 and 19 in the interior. Moreover, about a half of the cells were found to acquire the capability to transport DiI-Ac-LDL. Based on these observations, and taking into account immense advantages of UCB over other stem cell sources, we conclude that UCB-derived MSCs retain hepatogenic potential suitable for cell therapy and transplantation against intractable liver diseases.     

人脐带间充质干细胞移植治疗脊髓损伤的研究进展

脊髓损伤（SCI）由于复杂病理生理和神经修复再生困难,至今仍旧是难以攻克的医学难题,而干细胞因其神经再生和神经保护特性被认为是治疗SCI最有希望的方法。其中人脐带间充质干细胞（HUC-MSCs）近年培养分化方法不断改进、神经修复机制初步阐明,联合移植等综合治疗方案也不断实践,使HUC-MSCs移植治疗效果提高。另外关于HUC-MSCs治疗SCI的临床试验逐渐开展,术后患者神经功能恢复改善且无严重并发症出现,表明干细胞移植应用于人体是安全有效的。本文就HUC-MSCs治疗SCI的研究状况及进展进行综述。     

The umbilical cord matrix is a better source of mesenchymal stem cells (MSC) than the umbilical cord blood

Many studies have drawn attention to the emerging role of MSC (mesenchymal stem cells) as a promising population supporting new clinical concepts in cellular therapy. However, the sources from which these cells can be isolated are still under discussion. Whereas BM (bone marrow) is presented as the main source of MSC, despite the invasive procedure related to this source, the possibility of isolating sufficient numbers of these cells from UCB (umbilical cord blood) remains controversial. Here, we present the results of experiments aimed at isolating MSC from UCB, BM and UCM (umbilical cord matrix) using different methods of isolation and various culture media that summarize the main procedures and criteria reported in the literature. Whereas isolation of MSC were successful from BM (10:10) and (UCM) (8:8), only one cord blood sample (1:15) gave rise to MSC using various culture media [DMEM (Dulbecco's modified Eagle's medium) +5% platelet lysate, DMEM+10% FBS (fetal bovine serum), DMEM+10% human UCB serum, MSCGM®] and different isolation methods [plastic adherence of total MNC (mononuclear cells), CD3⁺/CD19⁺/CD14⁺/CD38⁺‐depleted MNC and CD133⁺‐ or LNGFR⁺‐enriched MNC]. MSC from UCM and BM were able to differentiate into adipocytes, osteocytes and hepatocytes. The expansion potential was highest for MSC from UCM. The two cell populations had CD90⁺/CD73⁺/CD105⁺ phenotype with the additional expression of SSEA4 and LNGFR for BM MSC. These results clearly exclude UCB from the list of MSC sources for clinical use and propose instead UCM as a rich, non‐invasive and abundant source of MSC.