Injection of autologous muscle stem cells (myoblasts) for the treatment of vocal fold paralysis: A pilot study
Injection of autologous muscle stem cells (myoblasts) for the treatment of vocal fold paralysis: A pilot study
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DOI：
10.1097/mlg.0b013e31803e8c8d
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发表时间：
2007-05-01
期刊：
影响因子：
2.6
通讯作者：
Hingtgen, Cynthia M.
中科院分区：
文献类型：
--
作者：
Halum, Stacey L.;Naidu, Moumita;Hingtgen, Cynthia M.
objective.自体肌肉干细胞（成肌细胞）治疗可能是声带麻痹的理想治疗方法，因为其技术简便（注射给药），具有恢复肌肉缺陷和动态功能的潜力，以及其自体来源。本项目的目的是确定在喉返神经（RLN）损伤后将自体成肌细胞注射到甲杓肌（TA）中是否可以减轻TA肌萎缩并增强自发性神经再支配。研究设计：这是一项动物实验。方法：切断单侧喉返神经。和胸锁乳突肌（约1g）活组织检查。使用活组织检查为每只动物建立成肌细胞培养物。1个月后，将106个荧光细胞膜标记物（PKH 26）标记的自体成肌细胞注射到每只研究动物的失神经支配的TA中，对照组注射生理盐水。在成肌细胞注射后2周和2个月对动物实施安乐死。结果包括成肌细胞存活率、TA纤维直径和体积以及神经再支配状态（运动终板与神经接触染色）。结果所有失神经支配的TA研究标本在荧光显微镜下显示出存活的成肌细胞，成肌细胞在2个月时与TA肌纤维融合。在2个月时，成肌细胞治疗组的平均TA纤维直径大于去神经TA对照组（25.1 μ m vs. 21.1 μ m; P = 0.04），但在2周时并非如此（25.7 μ m vs. 23.5 μ m; P = 0.06）。在两个时间点，成肌细胞治疗组的平均TA体积更大。成肌细胞治疗组中的两只动物在2个月时表现出内收肌运动，而2周研究动物或对照动物均未恢复内收。成肌细胞治疗组和去神经对照组之间的神经再支配没有显著差异。结论.自体成肌细胞疗法可能是声带麻痹的未来治疗方法，目前的研究结果表明成肌细胞存活与TA肌肉萎缩的衰减。
Objective. Autologous muscle stem cell (myoblast) therapy may be an ideal treatment for vocal fold paralysis because of its technical ease (administered by injection), its potential to restore muscular defects and dynamic function, and its autologous origin. The goal of this project was to determine whether autologous myoblast injection into the thyroarytenoid (TA) muscle after recurrent laryngeal nerve (RLN) injury could attenuate TA muscle atrophy and enhance spontaneous reinnervation. Study Design: This was an animal experiment. Methods: Unilateral RLN transection. and sternocleidomastoid muscle (approximately 1 g) biopsies were performed in 16 male Wistar rats. Biopsies were used to create myoblast cultures for each animal. One month later, 106 autologous myoblasts labeled with fluorescent cell membrane marker (PKH26) were injected into the denervated TA of each study animal, with saline injected into controls. Animals were euthanized at 2 weeks and 2 months after myoblast injection. Outcomes included myoblast survival, TA fiber diameter and volume, and reinnervation status (motor end-plate to nerve contact staining). Results. All denervated TA study specimens demonstrated viable myoblasts under fluorescent microscopy, with the myoblasts demonstrating fusion with the TA myofibers at 2 months. The myoblast-treated group had greater mean TA fiber diameter than denervated TA controls at 2 months (25.1 vs. 21.1 mu m; P =.04) but not at 2 weeks (25.7 mu m vs. 23.5 mu m; P =.06). Mean TA volumes were greater in the myoblast-treated groups at both time points. Two of the animals in the myoblast-treated group demonstrated adductor motion at 2 months, whereas none of the 2 week study animals or controls recovered adduction. Reinnervation was not significantly different between the myoblast-treated groups and the denervated controls. Conclusions. Autologous myoblast therapy may be a future treatment for vocal fold paralysis, with current findings demonstrating myoblast survival with attenuation of TA muscle atrophy.