嗅鞘细胞移植损伤脊髓组织的超微结构变化

背景：脊髓损伤后神经功能难以自行恢复,嗅鞘细胞具有外周性和中枢性两种胶质细胞的成鞘功能,是修复受损神经最有前途的种子细胞。嗅鞘细胞移植到受损脊髓后的组织学和超微结构的变化可能帮助解释嗅鞘细胞发挥修复作用的机制。 目的: 验证嗅球源性嗅鞘细胞移植对脊髓损伤功能恢复的促进作用,并观察移植的嗅鞘细胞对神经元和轴突组织和超微结构的影响。 方法：将已制备脊髓模型的Wistar大鼠随机分为3组,对照组不做任何注射操作,DMEM/F12组注射DMEM/F12培养基,嗅鞘细胞组注射嗅鞘细胞悬液。每周进行肢体活动BBB评分,8周后取脊髓标本进行组织学和免疫组织化学观察,评价脊髓损伤的修复情况,并观察嗅鞘细胞移植对脊髓组织和超微结构的影响。 结果与结论：3组动物均出现后肢运动功能的恢复,嗅鞘细胞组优于对照组和DMEM/F12组,在4周后更为明显。组织学观察可见,在嗅鞘细胞组可见有神经纤维通过损伤处。损伤处附近,嗅鞘细胞组脊髓腹侧的神经纤维和神经元形态较好,损伤较轻。而对照组和DMEM/F12组神经纤维和神经元损害严重。嗅鞘细胞组的caspsase-3阳性细胞数少于对照组和DMEM/F12组。超微结构观察可见,嗅鞘细胞组的神经纤维和细胞形态均优于对照组和DMEM/F12组。结果表明嗅鞘细胞移植对大鼠脊髓损伤修复有明显的促进作用,并可恢复损伤神经的部分功能,对受损神经纤维和神经元有保护作用。     

嗅鞘细胞移植治疗脊髓损伤的研究进展

脊髓损伤的研究一直是神经科学界探讨的热点,而脊髓损伤后的神经修复和功能重建也一直困扰着临床医学界。既往认为中枢神经细胞的轴突损伤在自然条件下几乎不能再生,其原因是中枢神经环境不利于轴突再生、中枢神经细胞本身的再生能力低下、以及神经轴突不能穿越损伤瘢痕区到达靶细胞。脊髓损伤包括原发性损伤和继发性损伤,二者均可引起部分神经元的丢失和神经纤维的断裂;而继发性损伤可导致原发性损伤范围的扩大,使更多的神经元凋亡和神经纤维的变性、脱髓鞘改变等,从而导致相应部位的感觉、运动和神经反射功能的丧失。近年来,随着神经科学…     

嗅鞘细胞移植修复大鼠脊髓损伤的组织病理学变化☆

背景：对于脊髓损伤,目前临床尚无有效的治疗对策,近年来嗅鞘细胞移植对脊髓损伤修复取得了一定的进展。 目的：观察嗅鞘细胞移植在缓解损伤脊髓的病理反应和超微结构变化,及其在发生发展中的作用。 方法：60只大鼠随机分为空白组,模型组,嗅鞘胞移植组和DF12组,每组15只。空白组：仅切开T10全椎板及T9,T11部分椎板,对脊髓未作其他处理,明胶海绵轻柔压迫止血;模型组：仅切断脊髓,未作特殊处理;嗅鞘细胞移植组和DF12组：切断脊髓后用微量注射器分别注射嗅鞘细胞和DF12培养液,随后缝合切口。脊髓损伤后1,3,7,14,28,42,56 d每组麻醉2只受检大鼠,取材做光镜观察和电镜观察。 结果与结论：单纯脊髓横切损伤后,发生了出血、水肿、变性、坏死以及囊腔形成,胶质细胞增生和神经纤维再生。嗅鞘细胞移植后,明显减轻了神经元和神经纤维的坏死变性程度,减轻病理反应,并能对损伤神经元实施保护;防止了胶质细胞过度增生形成瘢痕屏障,明显增加了再生神经纤维的数量。提示嗅鞘细胞移植对损伤脊髓具有减轻病理反应和促进修复的作用。     

嗅鞘细胞移植治疗晚期脊髓损伤临床试验初步报告

目的　开展嗅鞘细胞移植治疗晚期脊髓损伤的临床试验研究 ,探讨其移植是否安全可行 ,对晚期脊髓损伤患者是否有帮助脊髓神经功能恢复的作用。方法　取胚胎嗅球 ,消化成单个嗅鞘细胞后 ,培养 2～ 3周 ,然后将其移植到脊髓损伤部位的上下处。共治疗 171例伤后时间为 6个月至 18年 ,脊髓损伤部位没有压迫性病变的脊髓损伤患者 ,其中男 139例 ,女 32例 ,年龄为 2 .5～ 6 4岁。结果　嗅鞘细胞移植后两周～两个月时随访 ,按ASIA脊髓损伤神经功能分类国际标准评价 ,171例患者的脊髓功能均有部分恢复 ,其中运动功能由术前 34.5± 2 0 .3提高到 4 2 .0± 2 0 .0 ,轻触觉由术前 4 7.2± 2 4 .0提高到 6 1.8± 2 2 .9,痛觉由术前 4 8.6± 2 3.5提高到 6 4 .0± 2 2 .8。自身术前术后对照t检验 ,P <0 .0 0 1。患者无术后长期发热、脊髓感染和功能恶化等并发症 ,无与手术有关的死亡。结论　嗅鞘细胞移植安全可行 ,能帮助晚期脊髓损伤患者恢复部分脊髓神经功能。     

嗅鞘细胞移植治疗脊髓损伤的临床研究现状

目的：对嗅鞘细胞生物学特性、培养纯化、嗅鞘细胞移植的可能机制及嗅鞘细胞移植在临床的应用等方面进行分析,介绍嗅鞘细胞移植治疗脊髓损伤的研究现状。 资料来源：以olfactory ensheathing cells,spinal cord injury,嗅鞘细胞,脊髓损伤为检索词检索PubMed数据库(2000/2009),中国期刊全文数据库(2000/2009)。 资料选择：纳入标准：①文章所述内容应与嗅鞘细胞及脊髓损伤密切相关。②同一领域选择近期发表或在权威杂志上发表的文章。排除标准：①重复性研究。②Meta分析。 结局评价指标：嗅鞘细胞移植治疗脊髓损伤的研究进展。 结果：嗅鞘细胞具有与许旺细胞和星形胶质细胞相似的特征。目前嗅鞘细胞移植的动物实验主要致力于提高轴突再生能力、替代细胞成分、阻止脱髓鞘病变和促进髓鞘再生等方面,移植的嗅鞘细胞具有促进感觉及运动功能恢复的客观结果,有些移植研究甚至已经进入了临床试验阶段。不过嗅鞘细胞移植由动物实验转化到临床应用还受到很多因素的影响,诸如移植剂量、细胞生长因子的活力,细胞移植的风险等,尤其是嗅鞘细胞移植后的近期及远期效果还需要进一步深入研究、评价,并且需要长时间的随访。有研究已经把用基因转染的嗅鞘细胞用于移植,在动物试验身上已经取得了满意的效果。 结论：随着基因工程技术发展以及嗅鞘细胞移植修复神经机制的深入研究,嗅鞘细胞移植必将为临床治疗脊髓损伤的患者带来康复的希望。     

嗅鞘细胞移植后大鼠损伤脊髓神经生长因子的表达

目的 研究嗅鞘细胞移植对大鼠损伤脊髓内的神经生长因子(NGF)表达的影响,以从NGF角度探讨嗅鞘细胞移植修复大鼠脊髓损伤的机制.方法 48只SD大鼠用NYU -Ⅱ撞击机(10g-25 mm)损伤T10脊髓制作脊髓损伤(SCI)模型,随机分为嗅鞘细胞组、DMEM组各24只;另设立正常对照组6只.将GFP-嗅鞘细胞细胞悬液移植入嗅鞘细胞组大鼠损伤处,DMEM组用单纯的DMEM/F12液代替,正常对照组不做任何处理.移植术后1d、7d、14 d、21 d,用BBB评分法测定脊髓运动功能,RT - PCR方法比较各时间点NGF表达差异.移植术后第21天应用免疫组化比较嗅鞘细胞组、DMEM组、正常对照组大鼠脊髓损伤区NGF的表达差异.结果 移植后1d、7d、14 d、21 d,嗅鞘细胞移植组运动功能评分均高于同期DMEM组.NGF表达量在术后第1天最高,第7天达峰值,之后缓慢降低.移植后第21天,嗅鞘细胞移植组脊髓NGF表达量高于同期DMEM组和正常对照组.结论 嗅鞘细胞移植可上调损伤脊髓NGF的表达,从而促进了损伤脊髓的修复.     

嗅鞘细胞移植脊髓损伤大鼠NG2的表达

背景：对于脊髓损伤,目前临床尚无有效的治疗对策,近年来嗅鞘细胞移植治疗脊髓损伤修复取得了一定的进展。NG2是主要的硫酸软骨素蛋白多糖分子,对轴突有抑制作用。 目的：观察嗅鞘细胞移植对脊髓损伤大鼠NG2表达的影响,进一步分析嗅鞘细胞移植在修复脊髓损伤中的作用途径。 方法：将112只大鼠随机分为4组,空白组、模型组、嗅鞘细胞移植组及DF12组各28只。空白组仅切开T10全椎板及T9,T11部分椎板,对脊髓未作其他处理;其他3组应用脊髓横切法制作脊髓损伤动物模型。嗅鞘细胞移植组进行嗅鞘细胞移植,每侧断端植入20 000 cells;DF12组于相同部位注射DF12培养液。在大鼠脊髓损伤后1,3,7,14,28,42和56 d时,取材按照SP试剂盒的操作步骤检测NG2的表达。 结果与结论：空白组NG2呈低表达,在模型组、DF12组脊髓损伤24 h后损伤部位的NG2的表达开始升高,7 d时达到顶点,4周时NG2表达明显降低,6,8周时仅在局部有所表达。嗅鞘细胞移植组脊髓损伤1 d时NG2表达开始增加,主要在损伤部位,在各时间点与模型组、DF12组相比NG2表达水平明显降低,但高于空白组NG2各时间点的表达。提示嗅鞘细胞移植后NG2的表达水平降低,嗅鞘细胞具有抑制NG2表达的作用,可消除或减轻细胞外基质中对轴突有抑制作用的化学屏障,这可能是其治疗脊髓损伤促进轴突再生的机制之一。     

嗅鞘细胞移植治疗脊髓损伤的临床验证

背景: 一系列基础研究证实在动物脊髓损伤的模型中,嗅鞘细胞移植能够促进脊髓损伤的再生和恢复脊髓的部分神经功能。部分临床实验证明嗅鞘细胞的移植的确能改善脊髓损伤患者的神经功能,从而改善其生活质量。 目的：验证嗅鞘细胞移植对脊髓损伤患者神经功能修复的作用及安全性。 方法：取流产胚胎嗅球并消化成为单个嗅鞘细胞,培养纯化2周左右,制成嗅鞘细胞悬液。选择脊髓损伤患者213例,全麻下将制备好的嗅鞘细胞悬液采用区域性多靶点注射方法移植于损伤脊髓的周围。采用ASIA量表对患者移植前1d及移植后3周~2个月进行评分,评价患者脊髓恢复状况。 结果与结论：所有患者的脊髓神经功能于术后3周均有不同程度的改变,脊髓功能评分及感觉与运动功能均较移植前明显提高(P < 0.001),且随时间延长呈不断改善趋势;最长患者随访5年,未见已恢复的神经功能 减退及移植不良反应。证实嗅鞘细胞移植对脊髓损伤患者的神经功能恢复有促进作用,可以部分恢复及改善其部分脊髓神经功能,且治疗方法安全。     

嗅鞘细胞静脉移植治疗脊髓损伤

背景：嗅鞘细胞移植治疗脊髓损伤在众多疗法中效果较佳,成为最有前景的治疗方法之一。目前移植方法为局部移植,存在操作复杂、创伤大、重复移植治疗困难等缺点。寻找一种简单易行且疗效好的移植方法成为各国学者研究的热点。 目的：分析嗅鞘细胞静脉移植治疗脊髓损伤的可行性和疗效。 方法：制备Wistar大鼠脊髓半切模型,随机分4组：嗅鞘细胞髓内局部移植组、嗅鞘细胞静脉移植组、D/F12静脉移植组和空白对照组。定期行CBS功能评分及组织学检查,评价脊髓修复情况。 结果与结论：嗅鞘细胞髓内局部移植组、嗅鞘细胞静脉移植组的功能恢复和组织学改变优于D/F12静脉移植组和空白对照组,嗅鞘细胞髓内局部移植组、嗅鞘细胞静脉移植组间无显著差别。说明嗅鞘细胞静脉移植可向脊髓损伤部位迁移并修复脊髓损伤,其疗效与嗅鞘细胞髓内局部移植相当。     

嗅鞘细胞与脊髓损伤的治疗

摘要：嗅鞘细胞是一种特殊类型的神经胶质细胞,起源于嗅基底膜,分布在嗅球、嗅神经,并可伴随嗅神经轴突迁徙入脑。尽管目前嗅鞘细胞移植技术治疗脊髓损伤的疗效已经被大量基础实验证实,并且已经开始了初步的临床试验,但其在移植后作用的主要机制仍然需要继续探讨。脊髓的再生与修复是一个非常复杂的过程, 目前还有许多问题有待解决, 如嗅鞘细胞移植治疗的主要机制、嗅鞘细胞移植时机的选择、嗅鞘细胞纯度对移植效果的影响、嗅鞘细胞植入的方法等。     

甲基强的松龙联合嗅鞘细胞移植对急性脊髓损伤大鼠运动功能和诱发电位的影响

背景：嗅鞘细胞移植和甲基强的松龙是两种非常有前途的治疗脊髓损伤方法,关于二者联合治疗脊髓损伤的报道较少,结果也不尽相同。 目的：通过对大鼠行为学评分和诱发电位学检测了解嗅球嗅鞘细胞移植和甲基强的松龙对大鼠急性脊髓损伤的修复作用以及二者之间有无协同作用。 方法：以NYU脊髓打击法建立大鼠急性T10脊髓损伤模型,术后分别注射嗅鞘细胞、甲基强的松龙、嗅鞘细胞+甲基强的松龙、无血清的DF12培养液、生理盐水。于术后8周进行后肢体感诱发电位、运动诱发电位检测,并通过BBB评分了解各组大鼠手术前、后运动功能的变化。 结果与结论：术后8周,嗅鞘细胞组、甲基强的松龙组、嗅鞘细胞+甲基强的松龙组与损伤组、DF12组比较,大鼠后肢BBB评分明显升高,体感诱发电位、运动诱发电位 N1波潜伏期缩短,波幅升高,差异有显著性意义(P < 0.05)。嗅鞘细胞+甲基强的松龙组与嗅鞘细胞组、甲基强的松龙组比较,大鼠后肢BBB评分明显升高,体感诱发电位、运动诱发电位N1波潜伏期缩短,波幅升高,差异有显著性意义(P < 0.05)。说明嗅鞘细胞移植和甲基强的松龙单独应用均可以显著促进急性脊髓损伤大鼠运动功能恢复。二者联合促进急性脊髓损伤大鼠运动功能恢复的效果更加显著。     

Influence of olfactory ensheathing cell transplantation on body temperature of patients with old spinal cord injury★

BACKGROUND： Olfactory ensheathing cell transplantation may transiently raise body temperature in some patients with old spinal cord injury.
OBJECTIVE： To analyze the influence of olfactory ensheathing cell transplantation on body temperature changes and neurological functional recovery in patients with old spinal cord injury.
DESIGN, TIME AND SETTING： A non-randomized self-controlled study, which was performed in the wards of the Department of Surgery, Taian Disabled Soldier＇s Hospital of Shandong Province, between June 2004 and July 2007.
PARTICIPANTS： 119 inpatients with old spinal cord injury were selected for this study, including 110 males and 9 females, aged 5-58 years.
METHODS： The olfactory bulb of an aborted fetus was digested into a single-cell suspension of olfactory ensheathing cells, which were then cultured and purified for 7-10 days, and once again made into a single-cell suspension. The olfactory ensheathing cell suspension was then transplanted in the juncture of the normal spinal cord and the abnormal spinal cord under surgical microscopy, with 1 × 10^6 cells per target point, with 2-5 target points in total. According to changes in postoperative temperature, 119 patients were divided into three groups： body temperature （T） ≤ 38.0 ℃ （n = 40）, 38.0 ℃ 〈 T ≤ 39.0 ℃ （n = 67）, T 〉 39.0℃ （n = 12）. In particular, T 〉 38℃ （n = 79） patients were divided into two subgroups according to duration of fever： ≤3 days （n = 61） and ≥ 4 days （n = 18）.
MAIN OUTCOME MEASURES： Neurological function was evaluated by the American Spinal Cord Injury （ASIA） scale set by American Spinal Cord Injury Academy in 2000 one day prior to transplantation and one or two months after transplantation.
RESULTS： 119 patients were included in the final analysis, without any loss. Following olfactory ensheathing cell transplantation, body temperatures changed as follows： T ≤ 38.0 ℃ （n = 40, 33.6%）, 38.0 ℃ 〈 T ≤ 39.0 ℃ （n = 67, 5     

Influence of olfactory ensheathing cell transplantation on body temperature of patients with old spinal cord injury

BACKGROUND:Olfactory ensheathing cell transplantation may transiendy raise body temperature in some patients with old spinal cord injury.OBJECTIVE:To analyze the influence of olfactory ensheathing cell transplantation on body temperature changes and neurological functional recovery in patients with old spinal cord injury.DESIGN,TIME AND SETTING:A non-randomized self-controlled study,which was performed in the wards of the Department of Surgery,Taian Disabled Soldier's Hospital of Shandong Province.between June 2004 and July 2007.PARTICIPANTS:119 inpatients with old spinal cord injury were selectcd for this study,including 110 males and 9 females,aged 5-58 years.METHODS:The olfactory bulb of an aborted fetus was digested into a single-cell suspension of olfactory ensheathing cells.which were then cultured and purified for 7-10 days,and once again made into a single-cell suspension.The elfactory ensheathing cell suspension was then transplanted in the iuncture of the normal spinal cord and the abnormal spinal cord under surgical microscopy,with 1 ×10°cells per target point,with 2-5 target points in total.According to changes in postoperative temperature,119 patients were divided into three groups:body temperature(T)≤38.0℃(n=40),38.0℃39.0℃(n=12).In particular,T>38℃(n=79)patients were divided into two subgroups according to duration of fever:≤3 days(n=61)and≥4days(n=18).MAIN OUTCOME MEASURES:Neurological function was evaluated by the American Spinal Cord Injury(ASIA)scale set by American Spinal Cord Injury Academy in 2000 one day prior to transplantation and one or two months after transplantation.RESUITS:119 patients were included in the final analysis,without any loss.Following olfactory ensheathing cell transplantation,body temperatures changed as follows:T≤38.0℃(n=40,33.6%),38.0℃39.0℃(n=12,10.1%).Moreover,among 79 patients(T>38℃),the febrile time of 61 cases(77%)was≤3 days,and that of 18 cases(23%)≥4 days.ASIA scores increased after olfactory ensheathing cell transplantation (P<0.05 0.01).CONCLUSION:Moderate febricity frequently occurred jn patients tbat received olfactory ensheathing cell transplantation,and febrile time lasted for more than 3 days.Additionally,olfactory ensheathing cell transplantation can remarkably improve neurological functional recovery.     

Transplantation of olfactory ensheathing cells promotes axonal regeneration in a rat model of spinal cord injury

BACKGROUND:Transplantation of olfactory ensheathing cells (OECs) into the injured spinal cord has been shown to promote axonal regeneration and functional recovery.However,the mechanisms underlying the effects of OEC transplantation remain controversial.OBJECTIVE:To observe fibrotic scar formation and axonal regeneration in the damaged spinal cord following OEC transplantation,and to determine whether OEC transplantation promotes neural regeneration by attenuating fibrotic scar formation.DESIGN,TIME AND SETTING:A randomized,controlled animal experiment was performed at the Department of Developmental Morphology,Tokyo Metropolitan Institute for Neuroscience,Fuchu,Japan and at the Department of Human Anatomy,College of Basic Medical Sciences,China Medical University,China between April 2007 and May 2009.MATERIALS:OECs were obtained from olfactory nerves and olfactory bulbs of male,4-week-old,Sprague Dawley rats.Rabbit anti-serotonin polyclonal antibody,rabbit anti-calcitonin gene-related peptide polyclonal antibody,rabbit anti-glial fibrillary acidic protein polyclonal antibody,rabbit anti-type IV collagen polyclonal antibody,and mouse anti-rat endothelial cell antigen-1 monoclonal antibody were used.METHODS:Male,Sprague Dawley rats aged 8 weeks were randomly divided into three groups:sham-surgery (n = 3),surgery (n = 9),and OEC transplantation (n = 11).Spinal cord transection at the T9-10 level was performed and the rats were transplanted with a 2-μL (1 × 105 cells) cell suspension.MAIN OUTCOME MEASURES:Formation of glial and fibrotic scars was examined using immunohistochemistry for glial fibrillary acidic protein and type IV collagen.Serotonin-positive and calcitonin gene-related peptide-positive axons were visualized by immunohistochemistry,respectively.Double immunofluorescence for type IV collagen and rat endothelial cell antigen-1 was also performed to determine co-localization of type IV collagen deposition and blood vessels.RESULTS:At 1 week after spinal cord injury,numerous glial cells were observed around the lesion site.Formation of fibrotic scar was determined by a large amount of type IV collagen deposition in the lesion center,and descending serotonin- or ascending calcitonin gene-related peptideconiaining axons stopped at the fibrotic scar that was formed in the lesion site.At week after transplantation,the formation of fibrotic scar was significantly inhibited.In addition,the fibrotic structure was partly formed and centralized in the blood vessel,and serotonergic and calcitonin gene-related peptide-containing axons were regenerated across the lesion site.CONCLUSION:OEC transplantation into the injured spinal cord attenuated fibrotic scar formation and promoted axon regeneration.