局部性硬皮病(LoS)如何治疗?自体脂肪衍生的干细胞具有改善脂肪保留的功效

2021-05-09 Allan MedSci原创

这项初步研究表明,ADSCs辅助AFG在纠正LoS患者面部萎缩方面是安全、可行和有吸引力的替代方案。

局部性硬皮病(LoS)是一种罕见的自身免疫性结缔组织病,其特征是受影响区域皮肤和皮下脂肪的炎症和纤维化,主要表现为皮下组织萎缩,每100000人/年约有0.3-3例。自体脂肪移植(AFG)取代了微血管游离皮瓣移植,具有创伤小、恢复快和外观自然的优点。由于局部炎症微环境以及脂肪来源的干细胞(ADSCs)的减少,大多数脂肪移植物难以移植,LoS患者不得不经历多轮移植程序以维持外观。一些研究表明,在健康人群中,基质血管分数(SVF)辅助的脂肪移植可以使脂肪移植物的保留提高约35%。

近年来,临床上已报道了ADSCs具有免疫调节作用的多种优势,促进血管生成的能力以及向成熟脂肪细胞分化的能力,显示出在治疗许多自身免疫性疾病方面的潜在作用和改善脂肪保留的能力。先前的临床研究表明,ADSCs对改善LoS小鼠脂肪移植物的保留具有显著益处。

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研究者旨在比较ADSCs辅助AFG和传统AFG在LoS患者中改善脂肪保留的可行性和有效性。在18名LoS患者中进行了为期6个月的随访研究。参与者被随机分为三个AFG组:常规组、SVF辅助组和ADSC辅助组。ADSCs辅助组接受混合了5×105 ADSCs / mL ADSCs的脂肪移植物混合物。通过磁共振成像测量体积保留,并拍摄临床照片以评估结局。在6个月的随访中,ADSCs辅助组的脂肪保留率为49.83±3.61%,显著高于SVF辅助组的31.75±1.73%(P=0.0004)和常规组的21.86±1.68%(P<0.0001)。SVF辅助组和常规组之间的脂肪滞留率也存显著差异(P=0.0346)。在手术和随访过程中没有发生严重的不良事件。

这项初步研究表明,ADSCs辅助AFG在纠正LoS患者面部萎缩方面是安全、可行和有吸引力的替代方案。需要对大量患者样本进行进一步的研究以进行确认(中国临床试验注册号:ChiCTR1900025717)。

 

原始出处:

https://stemcellsjournals.onlinelibrary.wiley.com/doi/full/10.1002/sctm.20-0419

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1025557, encodeId=c96a102555ee4, content=干细胞是热点,但是进入临床仍然需要时间和临床疗效验证哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=独孤立克, createdTime=Wed May 12 21:40:07 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377139, encodeId=579d13e71399a, content=<a href='/topic/show?id=dccfe3605ff' target=_blank style='color:#2F92EE;'>#硬皮病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73605, encryptionId=dccfe3605ff, topicName=硬皮病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Tue May 11 12:40:07 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406043, encodeId=9024140604310, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Tue May 11 12:40:07 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1544098, encodeId=2aba1544098ed, content=<a href='/topic/show?id=610d266582b' target=_blank style='color:#2F92EE;'>#体脂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26658, encryptionId=610d266582b, topicName=体脂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e74a13632472, createdName=ms4964546379600229, createdTime=Tue May 11 12:40:07 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964225, encodeId=47559642259d, content=为自身免疫性疾病的治疗提供了新的思路, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210510/90a79dc86831421f9728133d0816052b/505330afdb674052ad1e5d4884b271e8.jpg, createdBy=19a51375424, createdName=dt.ybqc, createdTime=Mon May 10 10:07:35 CST 2021, time=2021-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964101, encodeId=f398964101a0, content=学习了,涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=ms2000001051330459, createdTime=Sun May 09 21:58:59 CST 2021, time=2021-05-09, status=1, ipAttribution=)]
    2021-05-12 独孤立克

    干细胞是热点,但是进入临床仍然需要时间和临床疗效验证哦

    0

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    2021-05-11 rgjl
  3. [GetPortalCommentsPageByObjectIdResponse(id=1025557, encodeId=c96a102555ee4, content=干细胞是热点,但是进入临床仍然需要时间和临床疗效验证哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=独孤立克, createdTime=Wed May 12 21:40:07 CST 2021, time=2021-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377139, encodeId=579d13e71399a, content=<a href='/topic/show?id=dccfe3605ff' target=_blank style='color:#2F92EE;'>#硬皮病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73605, encryptionId=dccfe3605ff, topicName=硬皮病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Tue May 11 12:40:07 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1406043, encodeId=9024140604310, content=<a href='/topic/show?id=a5404e589d7' target=_blank style='color:#2F92EE;'>#局部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47589, encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Tue May 11 12:40:07 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1544098, encodeId=2aba1544098ed, content=<a href='/topic/show?id=610d266582b' target=_blank style='color:#2F92EE;'>#体脂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26658, encryptionId=610d266582b, topicName=体脂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e74a13632472, createdName=ms4964546379600229, createdTime=Tue May 11 12:40:07 CST 2021, time=2021-05-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964225, encodeId=47559642259d, content=为自身免疫性疾病的治疗提供了新的思路, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210510/90a79dc86831421f9728133d0816052b/505330afdb674052ad1e5d4884b271e8.jpg, createdBy=19a51375424, createdName=dt.ybqc, createdTime=Mon May 10 10:07:35 CST 2021, time=2021-05-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=964101, encodeId=f398964101a0, content=学习了,涨知识了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=ms2000001051330459, createdTime=Sun May 09 21:58:59 CST 2021, time=2021-05-09, status=1, ipAttribution=)]
    2021-05-11 chg122
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    2021-05-10 dt.ybqc

    为自身免疫性疾病的治疗提供了新的思路

    0

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    2021-05-09 ms2000001051330459

    学习了,涨知识了!

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拓展阅读

Arthritis Rheumatol:硬皮病不同自身抗体谱在疾病发病和病程中对患者癌症风险的分层作用

硬皮病患者中的五种不同免疫反应的单独或组合使用,可能是评估癌症风险的有用工具。

JAMA Dermatol:使用三维立体摄影测量法检测颅面硬斑病的疾病进展

对颅面硬斑病患者连续3D立体摄影测量图像的评估不仅可证实疾病进展,而且还发现了仅通过临床检查无法察觉的面部不对称的隐匿性进展。

一文详解|系统性硬化症:从诊断到治疗

系统性硬化症是一种以雷诺现象和皮肤肿胀硬化为主要表现的自身免疫性疾病,部分患者可出现全身各系统受累,包括心肺、肝肾、消化道、骨骼关节、甲状腺、神经系统等。

关于系统性硬化症病例分析

系统性硬化症(SSc)是风湿免疫科常见的罕见病,也称为硬皮病,是一种以局限性或弥漫性皮肤增厚和纤维化为特征的慢性结缔组织病,在中医属“皮痹”。

超过三分之一Th/To抗体阳性的硬皮病患者会出现肺动脉高压

一项单中心研究表明,某些自身抗体的检测表明患有硬皮病(也称为系统性硬化症)的患者在长期随访中特别容易发生肺动脉高压。

Lancet Rheumatology: 硬皮病患者为中心的干预网络 (SPIN) 队列中的疼痛水平和相关因素:一项多中心横断面研究

疼痛在系统性硬化症患者中很常见。控制社会人口学变量后,更大的疼痛与多种系统性硬化症相关的症状有关,包括关节挛缩、手指溃疡、胃肠道受累、皮肤受累和重叠综合征的存在。