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SCTM:新型干细胞可治疗心力衰竭

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2015年8月5日讯/生物谷BIOON/-(每日健康)——近日,一种新的研究方法可传递干细胞到受损心肌细胞从而治疗严重的心脏衰竭,本文于7月27日发表在《干细胞转化医学》杂志上。

Amit Patel医学博士,他是盐湖城犹他大学心血管再生医学主任,他和他的同事们招募了60名严重的心力衰竭患者。他们随机分配48名患者到常规护理干细胞疗法组,另外12名患者只用标准疗法治疗。

研究人员指出,干细胞疗法非常安全,治疗本身没有副作用。一年之后,病人的射血分数有了适度改善。目前还不清楚这些改善是否可能有意义,Patel补充说,更大的临床试验正在进行中用来观察这种方法是否可以作为重度心衰的适用方法。

Patel的团队使用了一种新颖的技术可将干细胞传递到心脏。他们从患者的骨髓中抽取干细胞并通过冠状窦注入到心脏中。“其他技术是通过动脉注入干细胞,”Patel解释道,心力衰竭患者普遍都有的一个障碍是硬化现象,它缩小了冠状动脉,注入的干细胞“不应该经常去这个地方。”(生物谷Bioon.com)

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原文链接:REVIVETrial: Retrograde Delivery of Autologous Bone Marrow in Patients With HeartFailure

doi:10.5966/sctm.2015-0070

Cell therapy is anevolving option for patients with end-stage heart failure and ongoing symptoms,despite optimal medical therapy. Our goal was to evaluate retrograde bonemarrow cell delivery in patients with either ischemic heart failure (IHF) ornonischemic heart failure (NIHF). This was a prospective randomized,multicenter, open-label study of the safety and feasibility of bone marrowaspirate concentrate (BMAC) infused retrograde into the coronary sinus. Sixtypatients were stratified by IHF and NIHF and randomized to receive either BMACinfusion or control (standard heart failure care) in a 4:1 ratio. Accordingly,24 subjects were randomized to the ischemic BMAC group and 6 to the ischemiccontrol group. Similarly, 24 subjects were randomized to the nonischemic BMACgroup and 6 to the nonischemic control group. All 60 patients were successfullyenrolled in the study. The treatment groups received BMAC infusion withoutcomplications. The left ventricular ejection fraction in the patients receivingBMAC demonstrated significant improvement compared with baseline, from 25.1% atscreening to 31.1% at 12 months (p = .007) in the NIHF group and from26.3% to 31.1% in the IHF group (p = .035). The end-systolic diameterdecreased significantly in the nonischemic BMAC group from 55.6 to 50.9 mm (p = .020). Retrograde BMAC delivery issafe. All patients receiving BMAC experienced improvements in left ventricularejection fraction, but only those with NIHF showed improvements in leftventricular end-systolic diameter and B-type natriuretic peptide. These resultsprovide the basis for a larger clinical trial in HF patients.

Significance

This work is the firstprospective randomized clinical trial using high-dose cell therapy deliveredvia a retrograde coronary sinus infusion in patients with heart failure. Thiswas a multinational, multicenter study, and it is novel, translatable, andscalable. On the basis of this trial and the safety of retrograde coronarysinus infusion, there are three other trials under way using this route ofdelivery.