Stem Cell Therapy Ushers nyob rau hauv Ib Txoj Kev Tshiab Tshiab hauv Kev Kho Mob raum
Feb 21, 2023
Raws li kev txheeb cais, qhov tshwm sim ntawm cov kab mob raum hauv Suav teb yog 10 feem pua mus rau 13 feem pua, ntawm cov uas muaj cov kab mob raum mob ntev li 10.8 feem pua, thiab feem ntau cov mob raum yuav ua rau mob ntev lossis mob raum tsis ua haujlwm, uas yog. , uremia. Ntawd yog, 1 ntawm 10 tus neeg raug mob raum. Nws ua rau 5 lab txog 10 lab tus neeg tuag txhua xyoo, uas tau ua rau muaj kev saib xyuas thiab saib xyuas ntawm cov zej zog kho mob.
Nyem rau cistanche tubulosa hmoov rau mob raum
Stem cells tseem tau txais kev saib xyuas ntau dua thiab ntau dua hauv kev kho mob raum. Tam sim no, kev siv cov qia hlwb rau ntshav qab zib nephropathy thiab lupus nephritis tau nkag mus rau theem kho mob ntawm cov qia cell hauv kuv lub tebchaws, thiab ntau lub chaw soj ntsuam kev tshawb fawb tau ua tiav los txhim kho qhov tseeb thiab kev ua tau zoo ntawm kev sim tshuaj. Cov qia hlwb tau maj mam pom cov txiaj ntsig zoo hauv kev tshawb fawb ntawm cov kab mob raum ntev (CKD), mob raum mob (AKI), mob ntshav qab zib nephropathy (DN), lupus nephritis (LN), IgA nephropathy, obstructive nephropathy, thiab lwm yam kab mob raum. lub hauv paus rau kev siv tshuaj kho mob.
Cia kuv tham nrog koj hnub no: Cov kab mob hauv lub raum twg tau tshawb fawb thiab siv los kho cov qia hlwb?
01 Mob raum raug mob
Mob raum raug mob yog ib qho ntawm cov kab mob tseem ceeb tshaj plaws uas muaj kev tuag ntau. Feem ntau etiology ntawm AKI yog mob tubular necrosis tshwm sim los ntawm lub raum ischemia thiab nephrotoxicity. Tsis ntev los no, Qi et al. siv BMSC nruab nrab los tsim cov kab mob rau lub raum proximal tubular hlwb NRK-52E hauv vitro, uas tuaj yeem txhim kho cell viability thiab inhibit cell apoptosis.
Rau tib lub hom phiaj kev tshawb fawb, AMSCs tau hloov mus rau hauv nas nrog ischemia-reperfusion raug mob los ntawm lub raum cov hlab ntsha lossis cov hlab ntsha, thiab nws tau pom tias cov qib ntawm cov ntshav creatinine thiab ntshav urea nitrogen tau txo, thiab lub raum tubular qhab nia tau txhim kho, uas. ua pov thawj tias AMSCs tuaj yeem txo qis apoptosis thiab txhawb lub raum tubular cell regeneration. kev loj hlob.
02 Kab mob raum mob
Hauv Suav teb, mob raum mob yog ib yam kab mob uas muaj ntau tshaj plaws, nrog rau ntau txog 119.5 lab tus neeg mob, siab dua cov neeg mob ntshav qab zib (113.9 lab), thiab thib ob tsuas yog cov neeg mob ntshav siab (254 lab). Lub raum interstitial fibrosis yog ib txoj hauv kev rau lub raum tsis ua haujlwm hauv ntau yam kab mob raum (kab mob raum kawg, ESRD). Rau ESRD, kev hloov lub raum thiab tu lub lim dej yog cov kev kho mob ib txwm muaj.
Qhov tsis muaj lub raum qhov chaw, cov kev mob tshwm sim ntawm cov tshuaj tiv thaiv kab mob, tus nqi siab ntawm cov tshuaj tua kab mob, kev phais mob, thiab cov txiaj ntsig tsis zoo ntawm kev hloov pauv hauv lub raum vim lub sijhawm tos ntev rau kev hloov pauv tag nrho txwv txoj kev loj hlob ntawm lub raum hloov pauv. Dialysis tsis tuaj yeem txhim kho qhov kev puas tsuaj ntawm lub raum parenchyma, thiab tsis tuaj yeem tiv thaiv qhov tshwm sim ntawm ntau yam teeb meem.
Cov kev tshawb fawb tau pom tias nyob rau hauv 5/6 nephrectomy raum tsis ua haujlwm qauv ntawm SD nas, muaj kev hloov pauv hauv glomerular sclerosis thiab lub raum interstitial fibrosis ntawm 30 hnub tom qab nephrectomy, thaum txhaj tshuaj subrenal capsule ntawm pawg MSC tau hloov lub raum ntawm 30 hnub. Glomerular sclerosis tau txo qis, thaum lub raum interstitial fibrosis kuj txo.
03 Obstructive nephropathy
Obstructive nephropathy yog ib qho ua rau lub raum tsis ua haujlwm rau cov neeg laus thiab menyuam yaus. Yog tias qhov mob hnyav ureteral obstruction thiab mob ntev tsis ua tiav tsis tuaj yeem daws tau raws sijhawm, lub raum kev ua haujlwm yuav raug puas tsuaj loj, thiab thaum kawg, ESRD (kab mob raum kawg) yuav raug tsim, yuav tsum tau kho lub raum hloov. Cov kev tshawb fawb pom tau hais tias nyob rau hauv tus qauv nas ntawm unilateral ureteral obstruction, tom qab arterial txhaj ntawm hMSCs, lawv tseem active nyob rau hauv lub raum rau 4 lub lis piam, uas yuav zoo tiv thaiv tubulointerstitial fibrosis los ntawm kev cuam tshuam.
04 IgA nephropathy
IgA nephropathy (IgA nephropathy, IgAN) yog ib qho tseem ceeb ua rau lub raum tsis ua haujlwm ntev, kev kho mob tam sim no tseem tsis yog kev kho mob tshwj xeeb raws li glucocorticoids, thiab cyclophosphamide, thiab qee cov neeg mob thaum kawg yuav tsim ESRD.
Kunter et al. pom tias BMSCs sau nrog ntsuab fluorescent protein GFP tau hloov mus rau hauv nas nrog IgAN, BMSCs qhia GFP cov cim tuaj yeem pom hauv thaj chaw mesangial, thiab kev sib sau ntawm IgA hauv cheeb tsam no tau txo qis, thiab lub raum ua haujlwm tau zoo dua qub. Ntau qhov kev sim tau ua pov thawj tias MSC muaj kev tiv thaiv tseem ceeb ntawm lub raum hauv kev kho IgAN qauv nas. Tom qab daim ntawv thov ntawm MSC, qib ntawm glomerular thiab interstitial fibrosis, hematuria, thiab proteinuria raug txo qis, thiab cov tsos mob ntawm IgAN tau zoo tuaj.
05 Lub raum tsis ua haujlwm kawg
Lub raum tsis ua haujlwm kawg yog ib qho tseem ceeb ntawm kev tuag ntawm cov neeg mob raum mob ntev. Hauv 20 xyoo dhau los, lub raum tsis ua haujlwm tau nyob rau qib 5 txog 9 ntawm qhov ua rau tib neeg tuag. Lesions thiab lwm yam.
Tam sim no, cov kev kho mob muaj xws li hemodialysis, peritoneal dialysis, thiab hloov lub raum. Cov qub ob yog hu ua kev kho tsis tiav. Erythropoietin yuav tsum tau muab ntxiv rau tib lub sijhawm ua rau kev lim ntshav, thiab muaj ntau yam teeb meem thiab lub neej tsis zoo; Kev hloov hauv lub raum yog kev hloov tag nrho. Txawm li cas los xij, kev tsis txaus, kev tiv thaiv kab mob, kev phais mob, thiab kev tos ntev rau lub raum hloov pauv, cov txiaj ntsig tsis zoo, suav nrog cov nqi siab, yuam cov tib neeg mus nrhiav cov kev kho mob zoo dua thiab qib siab.
Intravenous infusion ntawm umbilical qaum mesenchymal qia hlwb yog ib txoj kev kho tshiab rau lub raum tsis ua haujlwm, uas tuaj yeem txhim kho, ncua lossis txawm thim rov qab qhov kev mob ntawm lub raum tsis ua haujlwm.
Mechanism of Action of Stem Cells
(1) Stem cells muaj cov yam ntxwv ntawm kev rov tsim dua tshiab thiab ntau qhov sib txawv, thiab tuaj yeem sib txawv rau hauv cov hlwb ua haujlwm ntawm lub raum xws li glomerular endothelial cells, mesangial cells, thiab lub raum tubular cells, pab kho cov ntaub so ntswg puas thiab kho lub raum;
(2) Paracrine muaj nuj nqi ntawm cov qia hlwb txhawb cov qia hlwb kom zais cov ntsiab lus loj hlob, cytokines, tswj peptides, cell signaling molecules, thiab lwm yam khoom siv roj ntsha, uas tuaj yeem ua lub luag haujlwm tseem ceeb hauv angiogenesis thiab raum tiv thaiv, thiab tswj lub raum microenvironment;
(3) Cov khoom siv hauv tsev ntawm cov qia hlwb tuaj yeem ua rau lub raum puas tsuaj, ua si lub cev tiv thaiv kab mob, txo cov kab mob hauv lub raum, ua kom tiav kev kho mob hauv lub raum, thiab tiv thaiv lub raum ua haujlwm.
Kev tshawb nrhiav kev nce qib ntawm kev kho mob qia cell rau cov kab mob raum ntev
Kev tshawb fawb soj ntsuam hauv tsev: Tam sim no, qee qhov kev sim tshuaj tau ua los ntsuas kev nyab xeeb thiab kev ua haujlwm ntawm kev hloov pauv ntawm tes hauv kev kho mob raum. Vim lub cev tsis muaj zog thiab muaj peev xwm rov ua tau zoo ntawm MSCs, feem ntau cov kev sim siv MSCs ua cov khoom siv ntawm tes.
Tam sim no, ntau thiab ntau cov kev tshawb fawb tau mob siab rau kev siv ntawm tes kho mob los kho lub raum ua haujlwm hauv cov neeg mob AKI thiab CKD. Raws li cov ntaub ntawv soj ntsuam tsis ntev los no, qee tus neeg tshawb xyuas yuav pib qhov kev sim tshuaj ntsuam xyuas theem II siv autologous MSCs thiab lwm hom hlwb hauv kev kho mob raum tsis ua haujlwm.
Hauv Wanfang Cov Ntaub Ntawv, cov ntaub ntawv cuam tshuam tau tshawb fawb los ntawm lo lus tseem ceeb "kev kho mob ntawm lub raum tsis ua haujlwm". Cov txiaj ntsig kawg tau pom tias muaj ntau txog 129 qhov kev tshawb fawb hauv paus thiab kev tshawb fawb soj ntsuam ntawm qia cell kho ntawm lub raum tsis ua haujlwm. Txij xyoo 2016 txog 2019, Tuam Tshoj lub hauv paus nyiaj txiag tau faib nyiaj los pab txhawb kev tshawb fawb stem cell nrog rau mob raum mob hnyav thiab lwm yam kab mob, thiab National Health thiab Medical Commission tau pom zoo "Umbilical Cord Mesenchymal Stem Cell Therapy for Lupus Nephritis: Randomized Blind Parallel Control Multi. -center Research" ua qhov project.
Yog xav paub ntxiv:ali.ma@wecistanche.com
