脉络细胞自体移植治疗老年性黄斑变性的再生疗法: 初步体内报告
1Low Vision Research Centre of Milan, 2Department of Ophthalmology, A. Fiorini Hospital,Sapienza University of Rome, 3Glaucoma and Low Vision Study Center, Department of General Surgery and Organ Transplants,University of Bologna, 4Department of Sense Organs, Faculty of Medicine and Odontology,Sapienza University of Rome
Summary
本研究的目的是评估脉络移植的脂肪干细胞是否包含在基质血管和血小板丰富的血浆 Limoli 视网膜恢复技术, 可以提高视力和老年黄斑变性患者眼内视网膜敏感反应的影响。
Abstract
本研究的目的是检查自体细胞脉络移植是否能提高最佳矫正视力 (BCVA) 和对 microperimetry (我) 的眼睛的反应, 在受干旱年龄相关的黄斑变性 (AMD) 期间通过生长因子 (GFs) 在周围组织的生产和分泌。患者随机分配给每个研究组。所有患者均确诊为干性 AMD, BCVA 等于或大于1对数的最小分辨率 (logMAR)。采用 Limoli 视网膜修复技术 (LRRT) 在 a 组脉络自体移植, 其中包括11例11眼。该技术是通过植入脂肪细胞, 从基质血管分数获得的脂肪干细胞, 以及富含血小板的血浆在脉络空间中的血小板进行的。相反, B 组, 包括14眼14例患者, 被用作对照组。对于每位患者, 通过共焦扫描激光检眼镜和光谱域光学相干层析成像 (SD OCT) 验证诊断。在 A 组, 术后 BCVA 改善0.581 至 0.504 90 天, 0.376 logMAR 180 天 (升 32.20%)。此外, 我的测试在180天内增加了11.44 分贝到12.59 分贝。脉络膜后接枝的不同细胞类型能够保证其在脉络流中的恒定分泌。结果表明, 在六月后, 嫁接组的视力 (VA) 可比对照组增加多。
Introduction
细胞治疗, 包括全身或局部注射在受伤地区的茎/祖细胞治疗多种慢性疾病, 已引起密切注意在过去十年1。自二十世纪九十年代以来, 研究了生长因子 (GFs) 在视网膜萎缩症的潜在治疗作用2。事实上, 许多人类细胞可以生产 GFs, 这是特定的蛋白质, 能够阻止或减缓细胞凋亡,即, 程序性死亡的细胞3。
众所周知, 干燥年龄相关的黄斑变性 (AMD) 是一种萎缩性视网膜疾病, 其中渐进和不可逆转的细胞死亡涉及感光层损伤, 因此, 中央视觉功能丧失4。AMD 是发达国家55岁以上人群失明的主要原因, 占所有黄斑退化的 80%, 至今尚无有效治疗。
有数项研究显示, 有多种来源可供自体飞行情报队获得。这些构成不同的细胞类型, 包括来自眼眶脂肪的脂肪基质细胞, 富含血小板的血浆 (PRP) 的血小板, 以及脂肪来源的干细胞 (干细胞) 包括在脂肪组织的基质血管分数 (SVF) 中5 ,6,7。目前的 GF 集确保视网膜 neuroenhancement, 和菲拉托夫, Meduri, 佩洛斯和 Limoli 进行的研究表明, 自体脂肪移植 (尾部) 是有效的8,9,10。
此外, 一项先前的研究显示, 在干燥的 AMD 受影响的眼睛中, 视网膜电图 (脉络) 的数据有显著的改善, 记录后的自体移植,11。脉络空间的手术移植组织调节视网膜细胞的分泌分泌, 延缓其凋亡6,7,12。考虑外核层厚度, 豚鼠视网膜组织学检查显示, GFs 对视网膜有营养作用。因此, 直接或间接使用 GFs 可以通过分子诱导剂和抑制剂之间的平衡关系带来治疗好处6,7,12。
该方法的目的是评估脂肪细胞, 干细胞在 SVF 和 PRP 的脉络移植是否能提高最佳矫正视力 (BCVA) 和 microperimetry (我) 反应在干燥的 AMD 受影响的眼睛。本研究的目的是在其 GF 生产的基础上, 展示自体移植的治疗效果, 根据引用文献6,7,12,13。
Protocol
该研究协议经低视力学院道德委员会批准, 所有受试者均按照《赫尔辛基宣言》签署书面同意书。本研究已获得拉夫博勒和谢菲尔德大学的伦理认同。 注: 在表 1中描述了与干燥年龄相关的黄斑变性患者接受脉络自体移植的 Limoli 视网膜修复技术 (LRRT) 的纳入和排除标准。 1. 干燥年龄相关黄斑变性患者的诊断 确定用共焦扫描激光检眼镜?…
Representative Results
使用这里提出的程序, 两组的干燥 AMD 受影响的病人, 与 BCVA 等于或大于1对数的最低分辨率 (logMAR), 被登记在该研究。a 组, 包括11眼11例, 接受脉络自体移植 Limoli 视网膜修复技术 (LRRT), 而 B 组, 包括14眼14例患者, 被用作对照组。 学生的 t 检验和卡方测试分别用于比较两个研究组之间的平均年龄和性别分布 (表 2)。LRRT …
Discussion
本研究的主要目的是评估脂肪细胞、干细胞在 SVF 和 PRP 中的脉络移植是否能改善长期干性 AMD 影响眼中的 VA 和视网膜敏感度。另一项主要目的是根据最近的文献证明这些细胞可能的治疗效果, 因为一些临床前研究表明, 基于 GF 的治疗方法对于几种疾病的病人护理是有益的。
事实上, 一些研究表明, 自体人类诱导多潜能干细胞 (iPSC) 可以代表一个细胞源的移植, 目的是视网膜色素…
Disclosures
The authors have nothing to disclose.
Acknowledgements
作者没有确认。
Materials
| Blunt cannula, 3 mm. | Mentor, Santa Barbara, CA. | ||
| Luer-LokTM syringe. | BD Biosciences, Franklin Lakes, NJ. | ||
| Regen-BCT tube. | RegenKit; RegenLab, Le Mont-sur-Lausanne, CH. | ||
| Centrifuge | RegenPRP Centri. RegenLab, Le Mont-sur-Lausanne, CH. | ||
| BD Venflon Pro Safety 22G x 1.00 inch (0.9 mm x 25 mm). | BD Biosciences, Franklin Lakes, NJ. | ||
| SPSS Statistics Version 19.0 | IBM Corp., Armonk, NY, USA. | ||
| Confocal scanning laser ophthalmoscope | Nidek Inc, Fremont, CA | Nidek F10 | |
| Cirrus 5000 Spectral Domain-Optical Coherence Tomography | Carl Zeiss Meditec AG, Jena, Germany | SD-OCT | |
| Maia 100809 Microperimetry | CenterVue S.p.A., Padua, Italy | ||
| Ocular electrophysiology electromedical system, | C.S.O., S.r.l., Scandicci, Italy | Retimax for ERG |
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Tags
Regenerative TherapySuprachoroidal Cell AutograftDry Age-related Macular DegenerationRetinal Neuro EnhancementRetinal Cell ApoptosisLow VisionDry AMDNeural Optic AtrophyVascular Pedicle FatVascularizationGrowth FactorsRetinal RestorationPlatelet-rich PlasmaAdipose-derived Stem CellsStromal Vascular FractionHyaluronic Acid
Cite This Article
Limoli, P. G., Vingolo, E. M., Limoli, C., Scalinci, S. Z., Nebbioso, M. Regenerative Therapy by Suprachoroidal Cell Autograft in Dry Age-related Macular Degeneration: Preliminary In Vivo Report. J. Vis. Exp. (132), e56469, doi:10.3791/56469 (2018).