Summary of clinical results of 202 1 mesenchymal stem cells
Treatment with (1) mesenchymal stem cells can better improve osteonecrosis.
(2) Mesenchymal stem cells treat osteoarthritis.
(3) Mesenchymal stem cells helped 10 patients with spinal cord injury to improve their symptoms.
(4) Perinatal mesenchymal stem cells can improve the symptoms of children with cerebral palsy.
(5) Mesenchymal stem cells are safe and effective in treating ischemic stroke.
(6) Multi-center clinical study of mesenchymal stem cells in the treatment of severe liver diseases has been started.
(7) Umbilical cord mesenchymal stem cells have made great progress in treating type 2 diabetes.
(8) Japan approved mesenchymal stem cell therapy for the treatment of complicated anal fistula in patients with Crohn's disease.
(9) The 9)FDA approved perinatal mesenchymal stem cells to be used for phase III clinical treatment in COVID-19.
Mesenchymal stem cells (10) have been used to treat cerebral palsy in China, and satisfactory results have been achieved.
(1 1) The clinical trial of mesenchymal stem cells in the treatment of stroke will soon be launched in Japan.
(12) Twenty autistic children were treated with mesenchymal stem cells, and their condition improved.
(13) Mesenchymal stem cells help patients return to work.
(14) Mesenchymal stem cells have a significant effect on chronic knee pain.
(15) Umbilical cord mesenchymal stem cells help AIDS patients rebuild their immunity.
(16) Reverses cirrhosis! Mesenchymal stem cells and hematopoietic stem cells have achieved remarkable results.
(17) Gene Modified Mesenchymal Stem Cells Combined with Three-dimensional Microcarriers in the Treatment of Type 2 Diabetes
(18) Mesenchymal stem cells increased the survival rate of patients with new coronary pneumonia by 4.5 times.
(19) Mesenchymal stem cells are effective in treating liver cirrhosis for a long time, improving liver function and survival rate.
(20) China's first expert's knowledge about mesenchymal stem cells treating novel coronavirus.
Great potential and obvious advantages
Mesenchymal stem cells are important members of the stem cell family, and their early development originated from mesoderm and ectoderm. Mesenchymal stem cells (MSCs) are adult stem cells with self-replicating ability and multi-directional differentiation potential, belonging to non-terminally differentiated cells, which have the characteristics of mesenchymal cells, endothelial cells and epithelial cells.
Mesenchymal stem cells can differentiate into fat, cartilage, bone, muscle, tendon, nerve, liver, myocardium, islet β cells and endothelium under specific induction conditions in vitro, and they still have multi-directional differentiation potential after continuous subculture and cryopreservation. Mesenchymal stem cells, whether autologous or allogeneic, generally do not cause immune response in the host. It has great clinical application potential and can be used to treat various acute and degenerative diseases.
(1) Strong proliferation ability and multidirectional differentiation potential: it can rapidly self-renew and replicate in a suitable in vivo or in vitro environment, and can be induced to differentiate into osteoblasts, chondrocytes, adipocytes, muscle cells, nerve cells, hepatocytes, endothelial cells, stromal cells and other cells.
(2) Immune regulation function: through the interaction between cells and the production of cytokines, it interferes with the function of dendritic cells, inhibits the proliferation of T cells and their immune response, and thus plays the role of immune reconstruction.
(3) It has diverse sources, convenient materials, easy separation, culture, amplification and purification, and still has the characteristics of stem cells after repeated passage and amplification.
Global overview of therapeutic products
At present, the clinical trial of mesenchymal stem cells exceeds 1300, which is used to treat various diseases. Most commonly, mesenchymal stem cells, as a cell therapeutic agent, are undergoing comprehensive clinical trials. Mesenchymal stem cells usually disappear soon after transplantation, which may play a role through paracrine.
At present, mesenchymal stem cells have become the cells with the largest number of clinical research projects in the world, and nearly ten kinds of mesenchymal stem cell drugs have been listed in the world, such as tem cell products for treating acute graft-versus-host disease and Alofisel products for treating Crohn's disease.
Regulators in Canada and New Zealand have approved mesenchymal stem cells derived from allogeneic bone marrow of prethymen for the treatment of acute GVHD in children.
South Korea has approved two MSCs products: one is mesenchymal stem cells derived from umbilical cord blood for the treatment of degenerative arthritis, and the other is mesenchymal stem cells derived from autologous adipose tissue for the treatment of anal fistula in patients with Crohn's disease.
AloFisel (TiGenix and Takeda approved by the European Union), Temcell(JCR drug approved by Japan) and Cellgram-AMI(FCB-pharmicell approved by South Korea) are other approved mesenchymal stem cell products.
India has approved Stempeucel transplantation, an allogeneic cell therapy product for commercial use. It is also the world's first mesenchymal stem cell product approved for the treatment of severe limb ischemia. ?
Mesenchymal stem cells are widely available, easy to obtain and have low ethical risk. They can be cultured in large scale in vitro and can be widely used in commercial clinical treatment in the future. With the help of drug delivery technology or gene editing technology, the application scope of mesenchymal stem cells has been further broadened.
Scientists have transformed it through genetic engineering technology, which greatly broadened the clinical use of mesenchymal stem cells.
In tissue repair, transformed stem cells can promote tissue healing and recovery by expressing neurotrophic factors, anti-inflammatory cytokines or angiogenesis factors.
In the treatment of hereditary diseases, modified stem cells are usually used as long-term enzyme substitutes to correct or eliminate the influence of pathogenic mutations.
Scientists' transformation through cell engineering technology has also greatly expanded another therapeutic use of stem cells-drug delivery, which is an important direction for the future development of mesenchymal stem cell technology.
The most promising method is to treat tumors by loading stem cells with prodrug invertase, apoptosis inducer or oncolytic virus. Mesenchymal stem cells have been used to deliver anti-tumor drugs. One is low immunogenicity, and the other is that mesenchymal stem cells are tumor-oriented. These mesenchymal stem cells will migrate to tumors according to chemical attractants, angiogenic factors or inflammatory signals secreted by tumors.
Examples of clinical application
At present, mesenchymal stem cells have been widely used in a variety of clinical research scenarios, such as the repair of tissues and organs, the carrier of gene therapy and so on. , for example:
For osteochondral repair, mesenchymal stem cells are currently being studied to treat various bone diseases. The osteogenic differentiation ability of mesenchymal stem cells has been used to treat defective fracture healing, and whether it is used alone or combined with scaffold to repair large bone defects, it has certain curative effect. In addition, mesenchymal stem cells are also used for cartilage repair. In one study, autologous mesenchymal stem cells were expanded in vitro and embedded in collagen gel, and then transplanted into articular cartilage defects of patients with osteoarthritis. The results showed that compared with the control group, the formation of hyaline chondroid tissue in the experimental group was improved.
For pancreatic repair, it has been proved that mesenchymal stem cells have the potential to differentiate into β -islet cells, and rat bone marrow mesenchymal stem cells can differentiate into functional islet-like cells in vitro [4]. This discovery represents the potential use of mesenchymal stem cells to treat a series of pancreatic related diseases, including: diabetes; Pancreatic cancer; Pancreatic injury caused by cystic fibrosis; And congenital pancreatic malformation.
Bring more choices to medicine
In recent years, mesenchymal stem cells are increasingly regarded as a new therapeutic method and a powerful candidate for regenerative medicine. Mesenchymal stem cells have been proved to have the ability to induce vascular regeneration, protect tissues from stress-induced apoptosis, and have a positive impact on inflammatory response. In addition, exosomes derived from mesenchymal stem cells are also a promising cell-free method, which can exert the same therapeutic effect as mesenchymal stem cells.