Gastroenterology:自体间充质干细胞借助生物可吸收材料治疗克罗恩病引起的肛瘘

2017-06-07 xuyihan MedSci原创

克罗恩病患者有很大的几率会并发肛瘘,累计发生率高达26%,目前对于此类并发症,无论是药物还是手术治疗都很难取得令人满意的疗效。最近来自美国梅奥医疗中心的相关研究表明,运用自体间充质干细胞来治疗克罗恩病引发的肛瘘具有不错的疗效与前景。

克罗恩病患者有很大的几率会并发肛瘘,累计发生率高达26%,目前对于此类并发症,无论是药物还是手术治疗都很难取得令人满意的疗效。最近来自美国梅奥医疗中心的相关研究表明,运用自体间充质干细胞来治疗克罗恩病引发的肛瘘具有不错的疗效与前景。


研究人员首先进行了长达6个月的Ⅰ期临床试验证明间充质干细胞治疗的安全性,然后筛选了12名患有克罗恩病引发肛瘘的患者,将患者自身的间充质干细胞在体外培养扩增后,再以生物可吸收材料为载体,定期填塞至患者肛瘘瘘管处进行治疗,并定期随访观察。6个月后,有10名患者的肛瘘完全闭合(临床表现与影像学检查同时符合瘘管闭合定义),2名患者的肛瘘情况出现好转,并且没有1例出现间充干细胞治疗相关的严重并发症。

此研究证明了间充质干细胞在治愈顽固性克罗恩病引发的肛瘘中是安全并且有效的,也给将来治疗克罗恩相关的肠瘘、直肠阴道瘘等相关并发症提供了新思路与新方法。


原始出处:

Dietz AB, Dozois EJ, et al. Autologous Mesenchymal Stem Cells, Applied in a Bioabsorbable Matrix, for Treatment of Perianal Fistulas in Patients With Crohn's
Disease
.
Gastroenterology.2017 April 5.doi: 10.1053/j.gastro.2017.04.001

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createdBy=4b632500090, createdName=h.y200607_23674418, createdTime=Tue Jan 16 06:20:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2076862, encodeId=8cd620e686277, content=<a href='/topic/show?id=0b93692e416' target=_blank style='color:#2F92EE;'>#生物可吸收#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69274, encryptionId=0b93692e416, topicName=生物可吸收)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/C2EFD5CFB07FE291138AD4FD0C98E3DE/100, createdBy=e3d52500031, createdName=膀胱癌, createdTime=Wed Mar 07 15:20:00 CST 2018, time=2018-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071787, encodeId=fa7720e1787a6, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu Sep 21 10:20:00 CST 2017, time=2017-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2030865, encodeId=3c202030865b5, content=<a href='/topic/show?id=bdf038440bb' target=_blank style='color:#2F92EE;'>#可吸收#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38440, encryptionId=bdf038440bb, topicName=可吸收)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e03212, createdName=liao1619, createdTime=Sun May 06 01:20:00 CST 2018, time=2018-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064113, encodeId=c9a92064113d3, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri Nov 17 14:20:00 CST 2017, time=2017-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239090, encodeId=9dae239090cd, content=学习了.很好的想法, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoSRqSjAnIdtDpgvE8JB6Zib02XtRMLicDuzHBO8bhMe3bIzR4icdSwWnbjlicyZ4o6OPM5hhT0VZlzow/132, createdBy=9f442101507, createdName=泓儒鹤, createdTime=Thu Aug 31 20:58:07 CST 2017, time=2017-08-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=215256, encodeId=71942152560f, content=肝也是运用方向之一, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLbkwiamQRUZ02EtNQ6eQflk4CHafHibKTV9ju5ia6AkEvQuZagYnTGsFTuibpHDwZUicuFmVBsIZ0qbJg/0, createdBy=bc812071404, createdName=xuyihan, createdTime=Sun Jun 25 15:29:12 CST 2017, time=2017-06-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289919, encodeId=904112899195b, content=<a href='/topic/show?id=d13a8113143' target=_blank style='color:#2F92EE;'>#肛瘘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81131, encryptionId=d13a8113143, topicName=肛瘘)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504291, encodeId=9efa150429118, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=)]
    2017-09-21 许安
  5. 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style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri Nov 17 14:20:00 CST 2017, time=2017-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239090, encodeId=9dae239090cd, content=学习了.很好的想法, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoSRqSjAnIdtDpgvE8JB6Zib02XtRMLicDuzHBO8bhMe3bIzR4icdSwWnbjlicyZ4o6OPM5hhT0VZlzow/132, createdBy=9f442101507, createdName=泓儒鹤, createdTime=Thu Aug 31 20:58:07 CST 2017, time=2017-08-31, status=1, ipAttribution=), 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createdName=mgqwxj, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504291, encodeId=9efa150429118, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1711063, encodeId=2a071e11063a1, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Sat Mar 17 03:20:00 CST 2018, time=2018-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1815260, encodeId=4458181526003, content=<a href='/topic/show?id=ae359e231d4' target=_blank style='color:#2F92EE;'>#间充质干细#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97231, encryptionId=ae359e231d4, topicName=间充质干细)], attachment=null, authenticateStatus=null, createdAvatar=, 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style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri Nov 17 14:20:00 CST 2017, time=2017-11-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=239090, encodeId=9dae239090cd, content=学习了.很好的想法, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoSRqSjAnIdtDpgvE8JB6Zib02XtRMLicDuzHBO8bhMe3bIzR4icdSwWnbjlicyZ4o6OPM5hhT0VZlzow/132, createdBy=9f442101507, createdName=泓儒鹤, createdTime=Thu Aug 31 20:58:07 CST 2017, time=2017-08-31, status=1, ipAttribution=), 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createdName=mgqwxj, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504291, encodeId=9efa150429118, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=)]
  7. 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createdName=mgqwxj, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504291, encodeId=9efa150429118, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=)]
    2017-08-31 泓儒鹤

    学习了.很好的想法

    0

  8. 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createdName=mgqwxj, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504291, encodeId=9efa150429118, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=)]
    2017-06-25 xuyihan

    肝也是运用方向之一

    0

  9. 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createdName=mgqwxj, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504291, encodeId=9efa150429118, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Fri Jun 09 13:20:00 CST 2017, time=2017-06-09, status=1, ipAttribution=)]
    2017-06-09 mgqwxj
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Sci Trans Med:一种真菌通过调节宿主嘌呤代谢加剧小鼠肠炎。

炎症性肠病(IBD)是一种自身免疫性疾病,包括溃疡性结肠炎和克罗恩病,其特征在于胃肠道的慢性炎症,临床上常表现为严重的腹泻、疼痛、疲劳和体重减轻。过去几十年,医生已经开始利用特异性的抗酿酒酵母细胞壁抗体来区分克罗恩病和溃疡性结肠炎,但是酵母对IBD的作用仍然还不清楚。

大咖解读,精彩云集——2017 ECCO大咖解读上线啦

2017年2月15-18日,欧洲克罗恩和结肠炎组织(ECCO)2017年会议在西班牙巴塞罗那召开。为了方便大家第一时间掌握会议新动态,我们邀请了五位国内知名专家,进行了视频解读。那专家们都有什么样的精彩言论呢?让小编带你先睹为快吧!钱家鸣教授  北京协和医院消化内科主任医师,教授、医学博士、博士生导师尽管进入生物治疗时代,但IBD治疗领域仍存在种种挑战:如何进一步改善IBD的结局?如何维

AIBD 2016:存在IBS症状的IBD女性患者更易发生慢性疲劳

据AIBD 2016上展示的一项新娥研究表明,炎症性肠病同时伴有肠易激综合征的患者,尤其是女性,或可增加慢性疲劳的风险。为了探究IBD患者中IBS症状与慢性疲劳之间的关联,并确定影响慢性疲劳患者的预后因素,研究人员评估了参与20年IBSEN研究的470例IBD患者,该研究已在2014年完成。记录患者的症状,并完成了临床检查、实验室检查、IBS症状评分和慢性疲劳问卷调查。在344名钙卫蛋白数据可获得

Gastroenterology:英夫利昔单抗暴露与IBD小儿患者发生恶性肿瘤或HLH的风险增加无关!

来自于大型临床试验和SEER数据库的数据得到的对年龄、性别和种族进行调整后的SIRs,研究人员发现英夫利昔单抗暴露与IBD小儿患者发生恶性肿瘤或HLH的风险增加无关。巯基嘌呤暴露是IBD小儿患者发生恶性肿瘤或HLH的一个重要前提事件。

Gut:CD177+中性粒细胞负性调节IBD!

由此可见,CD177+中性粒细胞是具有功能活性的亚群,在IBD中通过增加杀菌活性和IL-22的生产来发挥保护作用。针对CD177+中性粒细胞的治疗策略可能有益于IBD的治疗。

PLos One:炎症性肠病患者的生活保健费用和住院费用

寿命终止(EOL)的护理需要很大的成本,特别是急性护理服务。在炎症性肠病(IBD)患者中,由于依赖医院服务和昂贵的诊断测试和治疗,EOL的成本可能会更多。近期,一项发表在杂志PLos One上的研究旨在比较IBD与非IBD患者之间的EOL医疗保健用途和成本。研究者们使用相关的健康管理数据,对2010年至2013年期间加拿大安大略省所有死亡人员进行了回顾性队列研究。对IBD(N = 2,214)和非