Treatment of acute respiratory distress syndrome with allogeneic adipose-derived mesenchymal stem cells: a randomized, placebo-controlled pilot study.
Treatment of acute respiratory distress syndrome with allogeneic adipose-derived mesenchymal stem cells: a randomized, placebo-controlled pilot study.
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用同种异体脂肪间充质干细胞治疗急性呼吸窘迫综合征：一项随机、安慰剂对照的试点研究
DOI：
10.1186/1465-9921-15-39
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发表时间：
2014-04-04
影响因子：
5.8
通讯作者：
Xu J
中科院分区：
文献类型：
--
作者：
Zheng G;Huang L;Tong H;Shu Q;Hu Y;Ge M;Deng K;Zhang L;Zou B;Cheng B;Xu J
最近的研究表明，间充质干细胞（MSCs）在动物模型中调节免疫反应并减轻肺损伤。目前还没有关于间充质干细胞在急性呼吸窘迫综合征（ARDS）中的作用的临床研究。本研究的目的首先是检查ARDS患者全身给予同种异体脂肪来源的MSCs后可能发生的不良事件，其次是确定MSCs对ARDS的潜在疗效。12例PaO2/FiO2比值< 200符合柏林急性呼吸窘迫综合征定义的成年患者按1:1的比例随机接受同种异体脂肪来源的间充质干细胞或安慰剂治疗。患者静脉注射1 × 106个细胞/kg体重或生理盐水。治疗后监测可能出现的副作用。检测急性肺损伤生物标志物，包括IL-6、IL-8和表面活性剂蛋白D (SP-D)，以确定MSCs对肺损伤和炎症的影响。没有输注毒性或与MSCs给药相关的严重不良事件，两组之间不良事件总数无显著差异。治疗后第28天的住院时间、无呼吸机天数和无icu天数相似。安慰剂组检测的生物标志物没有变化。MSCs组第5天血清SP-D水平显著低于第0天（p = 0.027）， IL-8水平变化不显著。与第0天相比，第5天IL-6水平有降低的趋势，但这种趋势无统计学意义（p = 0.06）。同种异体脂肪来源的间充质干细胞治疗ARDS似乎是安全可行的。然而，MSCs使用剂量的临床效果较弱，可能需要进一步优化该策略，以达到减少ARDS肺泡上皮损伤的目标。临床试验网站，NCT01902082
Recent studies have demonstrated that mesenchymal stem cells (MSCs) modulate the immune response and reduce lung injury in animal models. Currently, no clinical studies of the effects of MSCs in acute respiratory distress syndrome (ARDS) exist. The objectives of this study were first to examine the possible adverse events after systemic administration of allogeneic adipose-derived MSCs in ARDS patients and second to determine potential efficacy of MSCs on ARDS. Twelve adult patients meeting the Berlin definition of acute respiratory distress syndrome with a PaO2/FiO2 ratio of < 200 were randomized to receive allogeneic adipose-derived MSCs or placebo in a 1:1 fashion. Patients received one intravenous dose of 1 × 106 cells/kg of body weight or saline. Possible side effects were monitored after treatment. Acute lung injury biomarkers, including IL-6, IL-8 and surfactant protein D (SP-D), were examined to determine the effects of MSCs on lung injury and inflammation. There were no infusion toxicities or serious adverse events related to MSCs administration and there were no significant differences in the overall number of adverse events between the two groups. Length of hospital stay, ventilator-free days and ICU-free days at day 28 after treatment were similar. There were no changes in biomarkers examined in the placebo group. In the MSCs group, serum SP-D levels at day 5 were significantly lower than those at day 0 (p = 0.027) while the changes in IL-8 levels were not significant. The IL-6 levels at day 5 showed a trend towards lower levels as compared with day 0, but this trend was not statistically significant (p = 0.06). Administration of allogeneic adipose-derived MSCs appears to be safe and feasible in the treatment of ARDS. However, the clinical effect with the doses of MSCs used is weak, and further optimization of this strategy will probably be required to reach the goal of reduced alveolar epithelial injury in ARDS. Clinical trials.gov, NCT01902082
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影响因子：
24
作者：
Hare, Joshua M.;Traverse, Jay H.;Henry, Timothy D.;Dib, Nabil;Strumpf, Robert K.;Schulman, Steven P.;Gerstenblith, Gary;DeMaria, Anthony N.;Denktas, Ali E.;Gammon, Roger S.;Hermiller, James B., Jr.;Reisman, Mark A.;Schaer, Gary L.;Sherman, Warren
通讯作者：
Sherman, Warren
DOI：
10.1165/rcmb.2012-0406oc
发表时间：
2013-10-01
影响因子：
6.4
作者：
Martinez-Gonzalez, Itziar;Roca, Oriol;Aran, Josep M.
通讯作者：
Aran, Josep M.
DOI：
10.1152/ajplung.00195.2012
发表时间：
2012-10-01
影响因子：
4.9
作者：
Agrawal, Ashish;Zhuo, Hanjing;Liu, Kathleen D.
通讯作者：
Liu, Kathleen D.
影响因子：
4.4
作者：
Gupta, Naveen;Su, Xiao;Matthay, Michael A.
通讯作者：
Matthay, Michael A.
DOI：
10.1186/cc10249
发表时间：
2011
期刊：
Critical care (London, England)
影响因子：
--
作者：
Hodgson CL;Tuxen DV;Davies AR;Bailey MJ;Higgins AM;Holland AE;Keating JL;Pilcher DV;Westbrook AJ;Cooper DJ;Nichol AD
通讯作者：
Nichol AD