自体骨髓间充质干细胞治疗矽肺的观察

目的 探讨自体骨髓间充质干细胞(BMSCs)移植治疗矽肺的安全性和治疗作用.方法 选取我院确诊的10例矽肺患者,经医学伦理委员会批准,患者签署知情同意书后,无菌抽取患者骨髓液100 ml,体外分离、纯化培养BMSCs,收获第3代BMSCs 5×107个,细胞质量检测合格后,用生理盐水50ml稀释,静脉滴注同输,每周1次,连续3次,其中3例患者采用肝细胞生长因子(HGF)基因修饰的自体BMSCs输注.移植后6个月、9个月,观察患者的临床症状、胸部CT、X线胸片、肺功能、T细胞亚群、血清中IgG、铜蓝蛋白(CP)等指标.结果 治疗9个月后,所有患者咳嗽、咳痰、胸闷症状基本消失;肺功能:最大肺活量(FVC)从治疗前平均(71.2％±17.0％)提高到(84.0％±10.9％),第1秒最大呼气量(FEV1.0)从治疗前平均(67.5％±17.7％)提高到(80.6％±14.9％),与治疗前比较,差异有统计学意义(P＜0.01);血清中CP和IgG较治疗前明显下降,差异有统计学意义(P＜0.01);采用HGF基因修饰的自体BMSCs治疗的患者胸片和肺部CT提示有不同程度好转,肺纹理较治疗前减少、清晰,双肺结节影较治疗前缩小,边缘较治疗前清晰,结节影密集及分布均较治疗前有所减少.结论 自体BMSCs移植治疗矽肺对临床症状改善有一定效果,HGF基因修饰的自体BMSCs可使小结节影缩小,略有变淡,肺纹理较治疗前减少.

Investigating the treatment of silicosis with autologous bone marrow-derived mesenchymal stem cells

Objective To explore the safety and curative effects of autologous bone marrow-derived mesenchymal stem cells (BMSCs) in the treatment of silicosis.Methods The protocol was approved by the Ethics Committee of the hospital,and ten patients with silicosis who had given written consent were enrolled in this study.BMSCs isolated from 100 ml of bone marrow for each case were purified and cultured,In each case the 3rd generation of qualified BMSCs (5×107) were intravenously administered weekly for 3 weeks.Three cases among 10 patients were treated with BMSCs modified by hepatocyte growth factor (HGF) gene.The clinical symptoms,chest films,chest CT,pulmonary functions,T cells,serum IgG and ceruloplasmin (CP) were observed in 6 or 9 months after treatment.Results No obvious sub-effect was observed in cases treated with BMSCs,the clinical symptoms (such as cough,sputum and chest tightness) basically disappeared in 9 months after treatment.Pulmonary function tests showed that FVC increased from 71.2％±17.0％ to 84.0％±10.9％ (P＜0.01) and FEV10 increased from 67.5％±17.7％ to 80.6％±14.9％ (P＜0.01).The levels of serum CP and IgG significantly decreased (P＜0.01).Further,the chest films and CT in cases treated with autologous BMSCs modified by HGF gene were improved to different extent.Conclusion Treatment with autologous BMSCs modified by HGF gene exhibit a beneficial effect on silicosis.