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Stem Cells Therapy for Spinal Cord Injury: An Overview of Clinical Trials

干细胞治疗脊髓损伤: 临床试验综述

  • 影响因子:4.32
  • DOI:10.3390/ijms21020659
  • 作者列表:"Serena Silvestro","Placido Bramanti","Oriana Trubiani","Emanuela Mazzon
  • 发表时间:2020-01-24
Abstract

Spinal cord injury (SCI) is a traumatic lesion that causes disability with temporary or permanent sensory and/or motor deficits. The pharmacological approach still in use for the treatment of SCI involves the employment of corticosteroid drugs. However, SCI remains a very complex disorder that needs future studies to find effective pharmacological treatments. SCI actives a strong inflammatory response that induces a loss of neurons followed by a cascade of events that lead to further spinal cord damage. Many experimental studies demonstrate the therapeutic effect of stem cells in SCI due to their capacity to differentiate into neuronal cells and by releasing neurotrophic factors. Therefore, they appear to be a valid strategy to use in the field of regenerative medicine. The purpose of this paper is to provide an overview of clinical trials, recorded in clinical trial.gov during 2005−2019, aimed to evaluate the use of stem cell-based therapy in SCI. The results available thus far show the safety and efficacy of stem cell therapy in patients with SCI. However, future trials are needed to investigate the safety and efficacy of stem cell transplantation.

摘要

脊髓损伤 (SCI) 是一种创伤性病变,导致暂时性或永久性感觉和/或运动缺陷的残疾。目前仍在使用的治疗 SCI 的药理学方法涉及皮质类固醇药物的使用。然而,SCI 仍然是一种非常复杂的疾病,需要未来的研究来寻找有效的药物治疗。SCI 激活了一种强烈的炎症反应,诱导神经元丢失,随后发生级联事件,导致脊髓进一步损伤。许多实验研究证明了干细胞在 SCI 中的治疗作用,因为它们能够分化成神经元细胞并通过释放神经营养因子。因此,它们似乎是再生医学领域使用的有效策略。本文的目的是提供临床试验的概述,记录在 clinical trial.gov 2005年 & #8722; 2019 中,旨在评估基于干细胞的治疗在 SCI 中的使用。迄今为止可用的结果显示了干细胞治疗 SCI 患者的安全性和有效性。然而,需要未来的试验来研究干细胞移植的安全性和有效性。

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影响因子:3.21
发表时间:2020-01-13
来源期刊:Journal of Neurology
DOI:10.1007/s00415-019-09685-3
作者列表:["Zhang, Weihe","Cui, Lei","Zhang, Yeqiong","Wang, Wei","Wang, Renbin","Liu, Zunjing","Peng, Dantao","Jiao, Yujuan","Jiao, Jinsong"]

METHODS:Objective To clarify the existence of monophasic neuromyelitis optica spectrum disorders (NMOSD) and to identify predictive factors of long-term relapse-free form. Methods We retrospectively analyzed 289 Chinese patients with NMOSD. Selected subjects were divided into three groups based on the time interval between disease onset and the first relapse, if any. Clinical and imaging data were acquired from each patient’s medical record and evaluated as predictive factors for NMOSD. Results In total, none of the participating patients exhibited a monophasic form of NMOSD. Rather, 241 patients were selected for relapse tendency analysis; 143 (59.3%) patients relapsed within the first year, 66 (27.4%) during 1–5 years, and 32 (13.3%) beyond 5 years. Such onset symptoms as optic neuritis (ON) and non-longitudinally extensive transverse myelitis (LETM) were independent prognostic factors for a prolonged remission interval.

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影响因子:3.21
发表时间:2020-01-31
来源期刊:Journal of neurology
DOI:10.1007/s00415-020-09716-4
作者列表:["Bukhari W","Clarke L","O'Gorman C","Khalilidehkordi E","Arnett S","Prain KM","Woodhall M","Silvestrini R","Bundell CS","Ramanathan S","Abernethy D","Bhuta S","Blum S","Boggild M","Boundy K","Brew BJ","Brownlee W","Butzkueven H","Carroll WM","Chen C","Coulthard A","Dale RC","Das C","Dear K","Fabis-Pedrini MJ","Fulcher D","Gillis D","Hawke S","Heard R","Henderson APD","Heshmat S","Hodgkinson S","Jimenez-Sanchez S","Kilpatrick TJ","King J","Kneebone C","Kornberg AJ","Lechner-Scott J","Lin MW","Lynch C","Macdonnell RAL","Mason DF","McCombe PA","Pereira J","Pollard JD","Reddel SW","Shaw C","Spies J","Stankovich J","Sutton I","Vucic S","Walsh M","Wong RC","Yiu EM","Barnett MH","Kermode AG","Marriott MP","Parratt J","Slee M","Taylor BV","Willoughby E","Wilson RJ","Brilot F","Vincent A","Waters P","Broadley SA"]

METHODS::Neuromyelitis optica spectrum disorders (NMOSD) are an inflammation of the central nervous system associated with autoantibodies to aquaporin-4. We have undertaken a clinic-based survey of NMOSD in the Australia and New Zealand populations with the aim of characterising the clinical features and establishing the value of recently revised diagnostic criteria. Cases of possible NMOSD and age and sex-matched controls with multiple sclerosis (MS) were referred from centres across Australia and New Zealand. Cases were classified as NMOSD if they met the 2015 IPND criteria and remained as suspected NMOSD if they did not. Clinical and paraclinical data were compared across the three groups. NMOSD was confirmed in 75 cases and 89 had suspected NMOSD. There were 101 controls with MS. Age at onset, relapse rates and EDSS scores were significantly higher in NMOSD than in MS. Lesions and symptoms referable to the optic nerve were more common in NMOSD whereas brainstem, cerebellar and cerebral lesions were more common in MS. Longitudinally extensive spinal cord lesions were seen in 48/71 (68%) of cases with NMOSD. Elevations of CSF, white cell count and protein were more common in NMOSD. We have confirmed a clinical pattern of NMOSD that has been seen in several geographical regions. We have demonstrated the clinical utility of the current diagnostic criteria. Distinct patterns of disease are evident in NMOSD and MS, but there remains a large number of patients with NMOSD-like features who do not meet the current diagnostic criteria for NMOSD and remain a diagnostic challenge.

影响因子:4.32
发表时间:2020-01-24
DOI:10.3390/ijms21020659
作者列表:["Serena Silvestro","Placido Bramanti","Oriana Trubiani","Emanuela Mazzon"]

METHODS:Spinal cord injury (SCI) is a traumatic lesion that causes disability with temporary or permanent sensory and/or motor deficits. The pharmacological approach still in use for the treatment of SCI involves the employment of corticosteroid drugs. However, SCI remains a very complex disorder that needs future studies to find effective pharmacological treatments. SCI actives a strong inflammatory response that induces a loss of neurons followed by a cascade of events that lead to further spinal cord damage. Many experimental studies demonstrate the therapeutic effect of stem cells in SCI due to their capacity to differentiate into neuronal cells and by releasing neurotrophic factors. Therefore, they appear to be a valid strategy to use in the field of regenerative medicine. The purpose of this paper is to provide an overview of clinical trials, recorded in clinical trial.gov during 2005−2019, aimed to evaluate the use of stem cell-based therapy in SCI. The results available thus far show the safety and efficacy of stem cell therapy in patients with SCI. However, future trials are needed to investigate the safety and efficacy of stem cell transplantation.

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