Repeated Cell Therapy: A Paradigm Shift Whose Time Has Come.
Repeated Cell Therapy: A Paradigm Shift Whose Time Has Come.
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DOI：
10.1161/circresaha.117.310710
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发表时间：
2017-03-31
影响因子：
20.1
通讯作者：
Bolli R
中科院分区：
文献类型：
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作者：
Bolli R
尽管干细胞/祖细胞治疗是治疗心脏病的一种有前景的方法，但临床试验中报告的不一致、适度、临界或无法检测到的益处（所有试验都使用一剂细胞）削弱了人们对细胞疗法的热情。结果，临床转化尚未发生（没有一种基于细胞的疗法接近被批准用于治疗心脏病），并且不断高涨的怀疑浪潮困扰着该领域，导致一些批评家甚至质疑临床研究是否应该继续。在这里，我提出，结果一般、临界或令人失望的一个主要原因是仅施用一剂细胞，这导致细胞疗法的益处被低估。我认为，正如大多数药物在一次给药时无效，但在重复给药时可能非常有效一样，细胞产品在作为单一治疗给药时可能无效或适度有效，但如果重复给药则可能非常有效。这个概念构成了一个重大的范式转变，对整个修复医学领域具有潜在的巨大影响。
Although treatment with stem/progenitor cells is a promising approach to heart disease, enthusiasm for cell therapy has been dampened by the inconsistent, modest, borderline, or undetectable benefits reported in clinical trials (all of which have used one dose of cells). As a result, clinical translation has not occurred (no cell-based therapy is close to being approved for heart disease), and a rising tide of skepticism has bedeviled the field, leading some critics even to question whether clinical studies should continue. Here I propose that a major reason for the modest, borderline, or disappointing results is the administration of only one dose of cells, which causes the benefits of cell therapy to be underestimated. Iargue that just as most pharmacologic agents are ineffective when given once but can be highly effective when given repeatedly, so a cell product may be ineffective, or modestly effective, when given as a single treatment, but may turn out to be quite efficacious if given repeatedly. This concept constitutes a major paradigm shift, with potentially vast implications for the entire field of reparative medicine.