脐带间充质干细胞移植治疗难治性系统性红斑狼疮3年随访

发布时间：2018-05-24 00:07

本文选题：脐带间充质干细胞 + 移植　；参考：《中国免疫学杂志》2017年06期

【摘要】：目的:观察脐带间充质干细胞(UC-MSC)治疗系统性红斑狼疮(SLE)前后患者免疫学指标、细胞因子表达量的变化和临床疗效。方法:选择10例SLE患者,在激素、免疫抑制剂治疗基础上,静脉输注培养增殖6代以内的UC-MSC,检测UC-MSC移植治疗SLE前后与其免疫病理相关细胞因子CTLA-4、IL-15、IL-2、CD86、IL-17c、Foxp3、TGFβ2的相对表达量。治疗前后进行SLEDAI评分测定并检测血尿常规、24 h尿蛋白定量、肝肾功能、免疫球蛋白、补体水平。结果:UC-MSC移植治疗后IL-15、IL-2表达量均下降,CTLA-4表达量上升,CD86、IL-17c、Foxp3、TGFβ2表达量的差异无显著性意义;UC-MSC移植治疗后补体C3、C4水平、血清白蛋白量较治疗前升高,24 h尿蛋白定量、SLEDAI评分较治疗前降低;UC-MSC移植治疗SLE过程中10例移植患者均未出现严重不良反应,无与移植相关并发症。结论:UC-MSC能够调节SLE患者体内参与免疫应答调控的细胞因子的表达量;UC-MSC移植治疗SLE可升高血清白蛋白及补体C3、C4水平,降低24 h尿蛋白量,减轻肾脏损伤,改善患者的临床症状;UC-MSC移植治疗SLE具有良好的安全性;UC-MSC移植可能是一种可行的治疗SLE的方法。
[Abstract]:Objective: to observe the changes of immunological indexes, cytokine expression and clinical efficacy of UC-MSCT in patients with systemic lupus erythematosus (SLE) before and after treatment. Methods: ten patients with SLE were selected and intravenously infused with UC-MSCs for less than 6 generations of proliferation on the basis of hormone and immunosuppressive therapy. The relative expression of TGF- 尾 2 and CTLA-4 IL-15 IL-21, IL-86, IL-17cTGF- 尾 _ 2 were detected before and after UC-MSC transplantation. SLEDAI scores were measured before and after treatment, and 24 h urine protein, liver and kidney function, immunoglobulin and complement levels were measured. Results the expression of IL-15 and IL-2 decreased after the transplantation of UC-MSC and the expression of CTLA-4 increased. There was no significant difference in the expression of TGF- 尾 _ 2 between IL-17ctrol and Foxp3TGF- 尾 _ 2 after transplantation of UC-MSC, and there was no significant difference in the level of complement C _ 3N _ 4 after transplantation of UC-MSC. The serum albumin level was higher than that before treatment and 24 h urinary protein quantification and SLEDAI scores were lower than those before treatment. During the course of UC-MSC transplantation for SLE, there were no serious adverse reactions and no transplantation-related complications in 10 patients. Conclusion the expression of cytokines involved in immune response regulation in patients with SLE can be regulated by WUC-MSC. UC-MSC transplantation can increase the levels of serum albumin and complement C _ 3N _ 4, decrease 24 h urinary protein content, and alleviate renal injury after UC-MSC transplantation. To improve the clinical symptoms of patients, UC-MSC transplantation has good safety in the treatment of SLE. UC-MSC transplantation may be a feasible method for the treatment of SLE.
【作者单位】：昆明医科大学第一附属医院风湿免疫科;四川省人民医院城东病区内一科;昆明市延安医院中心实验室;昆明市延安医院肾脏内科;
【基金】：云南省科技厅社会发展科技(社会事业发展专项)2010CA004,云南省科技厅对外科技合作项目(国际合作)2013IA013
【分类号】：R593.241

【相似文献】