人脐带间充质干细胞应用于肝移植患者的观察

发布时间：2018-03-04 22:29

本文选题：肝移植　切入点：脐带　出处：《中国组织工程研究》2017年17期 　论文类型：期刊论文

【摘要】：背景:近年来间充质干细胞的免疫调节作用可被应用于诱导机体免疫耐受研究。目的:评估脐带间充质干细胞应用于肝移植患者的安全性和可行性。方法:培养人脐带间充质干细胞并进行鉴定。经医学伦理委员会同意后,将总计50例患者经1∶1的比例按入组时间随机分入试验组和对照组,每组25例。试验组分别在术中门静脉灌注及术后第3天给予颈内静脉输注脐带间充质干细胞,剂量为1×10~6/kg(制备成50 m L的细胞悬液)。两组患者均采用标准免疫抑制方案。术前,术后第3,7天,术后第1,2,3,6,12个月检测血生化、免疫功能指标,统计急、慢性排斥反应发生率,感染发生率,移植相关并发症发生率。结果与结论:(1)与对照组相比,术后第3,7天试验组外周血的CD4~+CD25~+(调节性T细胞)细胞比例高于对照组,差异有显著性意义(P0.05),CD4~+(辅助性/诱导性T细胞)细胞比例及CD4~+/CD8~+T淋巴细胞的比值低于对照组,差异有显著性意义(P0.05);(2)与对照组相比,试验组谷丙转氨酶、总胆红素水平差异无显著性意义(P0.05);(3)试验组术后肝功能异常事件的发生率明显低于对照组,差异有显著性意义(P0.05);(4)两组移植后相关并发症的发生率、感染发生率差异无显著性意义(P0.05);(5)以上结果提示,肝移植术后静脉输注脐带间充质干细胞安全可行,早期可促进CD4~+CD25~+(调节性T细胞)的增殖和活化,降低CD4~+(辅助性/诱导性T细胞)比例及CD4+/CD8+T淋巴细胞的比值,进而改善肝移植受者免疫状态。
[Abstract]:Background: in recent years, the immunomodulatory effect of mesenchymal stem cells can be used to induce immune tolerance. Objective: to evaluate the safety and feasibility of umbilical cord mesenchymal stem cells in liver transplantation patients. Human umbilical cord mesenchymal stem cells were identified. A total of 50 patients were randomly divided into the experimental group (n = 25) and the control group (n = 25) according to the proportion of 1: 1. The experimental group received intraoperative portal vein infusion and intrajugular vein infusion of umbilical cord mesenchymal stem cells respectively on the third day after operation. The dosage was 1 脳 10 ~ (-6) / kg (50 mL cell suspension). The two groups were treated with standard immunosuppressive regimen. The blood biochemistry, immune function index, acute and chronic rejection rate were detected at 12 months. Results compared with the control group, the percentage of CD4 ~ CD25 ~ (regulatory T cells) cells in peripheral blood of the experimental group was higher than that of the control group on the 3rd day after operation. The percentage of CD4 ~ (helper / induced T cells) and the ratio of CD4 ~ / / CD8 ~ T lymphocytes in the control group were significantly lower than those in the control group, and there was a significant difference between the two groups. There was no significant difference in total bilirubin level between the two groups. The incidence of abnormal liver function events in the trial group was significantly lower than that in the control group, and there was a significant difference in the incidence of postoperative complications between the two groups. There was no significant difference in the incidence of infection (P 0.05). The results suggested that intravenous infusion of umbilical cord mesenchymal stem cells after liver transplantation was safe and feasible, and could promote the proliferation and activation of CD4 ~ CD25 ~ (regulatory T cells) in the early stage. The ratio of CD4 ~ (helper / inducible T cells) and the ratio of CD4 / CD8 T lymphocytes were decreased in order to improve the immune status of the recipients of liver transplantation.
【作者单位】：安徽医科大学解放军八一临床学院全军肿瘤中心肿瘤外科;南京中医药大学附属八一医院全军肿瘤中心肿瘤外科;南京中医药大学附属八一医院中心实验科;
【基金】：南京军区医学科技创新重点资助项目(14ZX07)~~
【分类号】：R657.3

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