嗅鞘细胞移植治疗慢性脊髓损伤的临床研究进展*★

摘要

背景：虽然迄今为止大量的体外和动物实验都证实了嗅鞘细胞对脊髓损伤的修复作用，但是利用嗅鞘细胞移植治疗脊髓损伤的临床试验尚处于起步阶段。目的：观察嗅鞘细胞移植治疗慢性脊髓损伤的临床安全性、有效性及实用性。方法：由第一作者检索至2012年5月为止 PubMed数据及CNKI中国期刊全文数据库有关嗅鞘细胞移植治疗慢性脊髓损伤的临床试验研究及安全性、疗效方面相关的报道，以“olfactory ensheathing cel s, spinal cord injury, clinical research”为英文检索词，“嗅鞘细胞移植，脊髓损伤”为中文检索词。结果与结论：计算机初检得到133篇文献，阅读标题和进行初筛，排除重复性研究，共34篇文献符合纳入标准。结果显示，利用嗅鞘细胞移植治疗脊髓损伤，在体外试验和动物模型中获得了良好的效果。在临床试验方面，到目前为止，嗅鞘细胞病灶直接移植治疗慢性脊髓损伤按嗅鞘细胞来源分主要集中在以下几个方面：①胚胎嗅鞘细胞移植。②嗅黏膜移植。③嗅黏膜源性嗅鞘细胞移植。3种嗅鞘细胞移植方法的总体安全性(96.4%)和有效性(23.4%)较高，但是其移植方法均存在明显的不足。提示嗅鞘细胞移植治疗慢性脊髓损伤的安全性和有效性还需要进一步验证，转化为临床应用还有很长的路要走。%BACKGROUND:A large number of in vitro and animal experiments have demonstrated the effects of olfactory ensheathing cel s in the repair of spinal cord injury, but the clinical studies regarding olfactory ensheathing cel transplantation for the treatment of spinal cord injury are in infancy. OBJECTIVE:To investigate the clinical safety, efficacy and practicality of the olfactory ensheathing cel transplantation for treatment of chronic spinal cord injury. METHODS:Using“olfactory ensheathing cel s, spinal cord injury, clinical research”as keywords, the first author retrieved PubMed databases and CNKI database for papers regarding clinical studies on olfactory ensheathing cel transplantation for treatment of chronic spinal cord injury as wel as clinical safety and effectiveness published before May 2012. RESULTS AND CONCLUSION:A total of 133 papers were initial y retrieved. After reading titles and abstracts, repetitive studies were excluded and 34 papers were included in the final analysis. Olfactory ensheathing cel transplantation for spinal cord injury has acquired good efficacy in in vitro and animal experiments. In the clinical trials, there are several sources of olfactory ensheathing cel s used in treatment of chronic spinal cord injury:(1) embryonic olfactory ensheathing cel transplantation;(2) olfactory mucosa transplantation;(3) olfactory mucosa-derived olfactory ensheathing cel transplantation. The oval safety and efficacy of three kinds of olfactory ensheathing cel transplantation methods are 96.4%and 23.4%, respectively, but there are obvious limitations. These findings suggest that the safety and efficacy of olfactory ensheathing cel transplantation in the treatment of chronic spinal cord injury need further investigation and there is a long road ahead for clinical application.