人脐带间充质干细胞治疗慢性HIV感染者的回顾性研究

目的明确人脐带间充质干细胞(human umbilical cord-derived mesenchymal stem cells,UC-MSC)治疗慢性HIV感染者的长期安全性和有效性。方法回顾性分析2009年3月—2012年7月在我院接受UC-MSC治疗的57例慢性HIV感染者随访3年的资料。根据UC-MSC治疗前CD4+T淋巴细胞水平,将所有患者分为≤200个/mm3组(免疫重建失败组)和200个/mm3组(免疫重建成功组)。分析UC-MSC治疗的长期安全性和有效性。结果 2组患者接受UC-MSC治疗1、2、3年,其外周血CD4+T淋巴细胞计数及CD4/CD8比值均较基线水平显著升高。进一步分析发现,免疫重建失败组UC-MSC治疗1年和2年的有效率(以CD4+T淋巴细胞计数较基线水平升高30%为有效)显著高于免疫重建成功组。2组随访中未发现明显不良事件,安全性好。结论 UC-MSC治疗慢性HIV感染者3年安全性好,可显著持续升高外周血CD4+T淋巴细胞计数和CD4/CD8比值,UC-MSC治疗免疫重建失败患者疗效更为显著。本研究提示慢性HIV感染者免疫重建失败可能是UC-MSC治疗的适应证。

Retrospective study on human umbilical cord-derived mesenchymal stem cell treatment for patients with chronic HIV infection

Objective To investigate the long-term safety and efficacy of human umbilical cord-derived mesenchymal stem cells （UC-MSC） treatment for patients with chronic HIV infection. Methods The data of 3-year follow-up for 57 patients with chronic HIV infection treated in our hospital from Mar. 2009 to Jul. 2012 were analyzed retrospectively. According to the CD4＋ T lymphocyte counts prior to UC-MSC treatment, these patients were divided into two groups, ≤200 cells/mm3 group （immunological non-responder group） and ＆gt;200 cells/mm3 group （immunological responder group）. The long-term safety and efficacy of UC-MSC treatment were analyzed. Results peripheral CD4＋ T lymphocyte counts and the ratio of CD4/CD8 at 1-year, 2-year and 3-year UC-MSC treatment were found to increase significantly as compared with baseline level. Further analysis indicated that 1-year and 2-year therapeutic efficacy （defined as a 30% increase of CD4＋T lymphocyte counts as compared with baseline level） in immunolo-gical non-responder group was significantly higher than that in immunological responder group. UC-MSC treatment was found to be safe as no significant side effects occurred in the two groups during 3-year follow-up period. Conclusions UC-MSC treatment is well tolerant for 3 years. Peripheral blood CD4＋ T lymphocyte counts and the ratio of CD4/CD8 increase significantly, and UC-MSC treatment is more effective in improvement of CD4＋T lymphocyte counts in immunological non-responders. This study suggests that immunological non-response to HAART may be an indication of UC-MSC treatment in patients with chronic HIV infection.