Стволовые клетки пуповинной крови: перспективы трансплантации в неврологической практике
- Авторы: Газизов И.М.1, Измайлов А.А.1, Елагина Э.А.2, Сафиуллов З.З.1
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Учреждения:
- Казанский государственный медицинский университет
- ООО «Авиценна-Эндокринология»
- Выпуск: Том LVI, № 2 (2024)
- Страницы: 181-196
- Раздел: Обзоры
- Статья получена: 07.02.2024
- Статья одобрена: 30.04.2024
- Статья опубликована: 16.07.2024
- URL: https://journals.eco-vector.com/1027-4898/article/view/626625
- DOI: https://doi.org/10.17816/nb626625
- ID: 626625
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Аннотация
Пуповинная кровь прошла долгий путь от клеточных/тканевых отходов, получаемых после родов, до ценного биологического материала с широким регенераторным потенциалом. На сегодняшний день гемопоэтические стволовые клетки пуповинной крови наравне с костным мозгом и мобилизованной периферической кровью применяют в рамках медицинского стандарта для лечения гемобластозов и наследственных заболеваний крови. Накапливается всё больше экспериментальных данных о возможности применения клеточных фракций пуповинной крови для лечения негематологических заболеваний и, в частности, заболеваний центральной нервной системы. Актуальной проблемой клеточной терапии болезней центральной нервной системы, включающих ишемические и травматические повреждения, а также нейродегенеративные заболевания, остаётся выбор клеточного материала для нейротрансплантации. Стволовые или зрелые соматические клетки, подготовленные для нейротрансплантации, должны иметь предсказуемые и воспроизводимые характеристики, отвечающие поставленной терапевтической цели: трофическое и/или нейропротективное действие для повышения жизнеспособности нейронов в области повреждения; стимулирование роста и миелинизации аксонов; восстановление клеточного матрикса или дифференцировка в заданном направлении для замещения утраченного пула клеток головного или спинного мозга. Тот факт, что в составе пуповинной крови присутствуют не только гемопоэтические, но и различные негемопоэтические стволовые клетки с широким регенераторным потенциалом, стал основой активного использования этих клеток для нейротрансплантации. В предлагаемом обзоре приведены исторические сведения о внедрении в практическую медицину пуповинной крови, её клеточном составе и клинических применениях различных типов стволовых клеток для лечения болезней центральной нервной системы у детей, таких как ишемическая энцефалопатия, инсульт, кровоизлияния в мозг, детский церебральный паралич, аутизм, а у взрослых — для лечения инсульта, травмы спинного мозга и нейродегенеративных заболеваний.
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Об авторах
Ильназ Марселевич Газизов
Казанский государственный медицинский университет
Email: ilnazaziz@mail.ru
ORCID iD: 0000-0003-3396-8643
SPIN-код: 4219-6480
канд. мед. наук, доц., зав. каф., каф. нормальной анатомии
Россия, КазаньАндрей Александрович Измайлов
Казанский государственный медицинский университет
Email: gostev.andrei@mail.ru
ORCID iD: 0000-0002-8128-4636
SPIN-код: 9629-8511
канд. мед. наук, зав. лабораторией молекулярной и клеточной медицины
Россия, КазаньЭльмира Абдулхаковна Елагина
ООО «Авиценна-Эндокринология»
Email: elaginabsk@yandex.ru
ORCID iD: 0000-0002-4598-1688
SPIN-код: 1440-4782
преподаватель, клин. мед. психолог
Россия, КазаньЗуфар Зуфарович Сафиуллов
Казанский государственный медицинский университет
Автор, ответственный за переписку.
Email: redblackwhite@mail.ru
ORCID iD: 0000-0003-4577-3448
SPIN-код: 6987-9144
канд. мед. наук, доц., каф. нормальной анатомии
Россия, КазаньСписок литературы
- Knudtzon S. In vitro growth of granulocytic colonies from circulating cells in human cord blood // Blood. 1974. Vol. 43. P. 357–361.
- Nakahata T., Ogawa M. Hemopoietic colony-forming cells in umbilical cord blood with extensive capability to generate mono- and multipotential hemopoietic progenitors // J Clin Invest. 1982. Vol. 70. P. 1324–1332. doi: 10.1172/jci110734
- Broxmeyer H.E., Douglas G.W., Hangoc G., et al. Human umbilical cord blood as a potential source of transplantable hematopoietic stem/progenitor cells // Proc Natl Acad Sci USA. 1989. Vol. 86. P. 3828–3832. doi: 10.1073/pnas.86.10.3828
- Gluckman E., Broxmeyer H.A., Auerbach A.D., et al. Hematopoietic reconstitution in a patient with Fanconi’s anemia by means of umbilical-cord blood from an HLA-identical sibling // N Engl J Med. 1989. Vol. 321. P. 1174–1178. doi: 10.1056/NEJM198910263211707
- Kohn D.B., Weinberg K.I., Nolta J.A., et al. Engraftment of gene-modified umbilical cord blood cells in neonates with adenosine deaminase deficiency // Nat Med. 1995. Vol. 1, N. 10. P. 1017–1023. doi: 10.1038/nm1095-1017
- Solves P., Mirabet V., Roig R. Volume reduction in routine cord blood banking // Curr Stem Cell Res Ther. 2010. Vol. 5. P. 362–366. doi: 10.2174/157488810793351703
- Akel S., Regan D., Wall D., et al. Current thawing and infusion practice of cryopreserved cord blood: The impact on graft quality, recipient safety, and transplantation outcomes // Transfusion. 2014. Vol. 54. P. 2997–3009. doi: 10.1111/trf.12719
- Ademokun J., Chapman C., Dunn J., et al. Umbilical cord blood collection and separation for haematopoietic progenitor cell banking // Bone Marrow Transplant. 1997. Vol. 19. P. 1023–1028. doi: 10.1038/sj.bmt.1700788
- Reboredo N.M., Diaz A., Castro A., Villaescusa R.G. Collection, processing and cryopreservation of umbilical cord blood for unrelated transplantation // Bone Marrow Transplant. 2001. Vol. 26. P. 1263–1270. doi: 10.1038/sj.bmt.1702728
- Neuhoff S., Moers J., Rieks M., et al. Proliferation differentiation, and cytokine secretion of human umbilical cord blood-derived mononuclear cells in vitro // Exp Hematol. 2007. Vol. 35, N. 7. P. 1119–1131. doi: 10.1016/j.exphem.2007.03.019
- Pranke P., Failace R.R., Allebrandt W.F., et al. Hematologic and immunophenotypic characterization of human umbilical cord blood // Acta Haematol. 2001. Vol. 105. P. 71–76. doi: 10.1159/000046537
- Harris D., Schumacher M., Locascio J., et al. Phenotypic and functional immaturity of human umbilical cord blood T lymphocytes // Proc Natl Acad Sci USA. 1992. Vol. 89. P. 10006–10010. doi: 10.1073/pnas.89.21.10006
- D’Arena G., Musto P., Cascavilla N., et al. Flow cytometric characterization of human umbilical cord blood lymphocytes: Immunophenotypic features // Haematologica. 1998. Vol. 83. P. 197–203.
- Ballen K.K., Wilson M., Wuu J., et al. Bigger is better: maternal and neonatal predictors of hematopoietic potential of umbilical cord blood units // Bone Marrow Transplant. 2001. Vol. 27, N. 1. P. 7–14. doi: 10.1038/sj.bmt.1702729
- Cervera A., Lillo R., García-Sánchez F., et al. Flow cytometric assessment of hematopoietic cell subsets in cryopreserved preterm and term cord blood, influence of obstetrical parameters, and availability for transplantation // Am J Hematol. 2006. Vol. 81, N. 6. P. 397–410. doi: 10.1002/ajh.20598
- Broxmeyer H.E. Biology of cord blood cells and future prospects of enhanced clinical benefit // Cytotherapy. 2005. Vol. 7, N. 3. P. 209–218. doi: 10.1080/14653240510027190
- Ali H., Bahbahani H. Umbilical cord blood stem cells — potential therapeutic tool for neural injuries and disorders // Acta Neurobiol Exp. 2010. Vol. 70. P. 316–324.
- Kogler G., Sensken S., Airey J., et al. A new human somatic stem cell from placental cord blood with intrinsic pluripotent differentiation potential // J Exp Med. 2004. Vol. 200, N. 2. P. 123–135. doi: 10.55782/ane-2010-1804
- Mcguckin P., Forraz N., Baradez M., et al. Production of stem cells with embryonic characteristics from human umbilical cord blood // Cell Prolif. 2005. Vol. 38. P. 245–255. doi: 10.1111/j.1365-2184.2005.00346.x
- Paton M., McDonald C., Allison B., et al. Perinatal brain injury as a consequence of preterm birth and intrauterine inflammation: Designing targeted stem cell therapies // Front Neurosci. 2017. Vol. 11, N. 200. P. 1–12. doi: 10.3389/fnins.2017.00200
- Erices A., Conget P., Minguell J.J. Mesenchymal progenitor cells in human umbilical cord blood // Br J Haematol. 2000. Vol. 109, N. 1. P. 235–242. doi: 10.1046/j.1365-2141.2000.01986.x
- Abbott A. Doubt cast over tiny stem cells // Nature. 2013. Vol. 499. P. 390. doi: 10.1038/499390a
- Podesta M., Bruschettini M., Cossu C., et al. Preterm cord blood contains a higher proportion of immature hematopoietic progenitors compared to term samples // PLoS One. 2015. Vol. 10, N. 9. Р. e0138680. doi: 10.1371/journal.pone.0138680
- Gluckman E. Milestones in umbilical cord blood transplantation // Blood Rev. 2011. Vol. 25. P. 55–59. doi: 10.1016/j.blre.2011.06.003
- Behzad-Behbahani A., Pouransari R., Tabei S.Z., et al. Risk of viral transmission via bone marrow progenitor cells versus umbilical cord blood hematopoietic stem cells in bone marrow transplantation // Transplant Proc. 2005. Vol. 37. P. 3211–3212. doi: 10.1016/j.transproceed.2005.07.007
- Broxmeyer H., Hangoc G., Cooper S., et al. Growth characteristics and expansion of human umbilical cord blood and estimation of its potential for transplantation in adults // Proc Natl Acad Sci USA. 1992. Vol. 89. P. 4109–4113. doi: 10.1073/pnas.89.9.4109
- Gluckman F., Rocha V. History of the clinical use of umbilical cord blood hematopoietic cells // Cytotherapy. 2005. Vol. 7. P. 219–227. doi: 10.1080/14653240510027136
- Vaziri H., Dragowska W., Allsopp R.C., et al. Evidence for a mitotic clock in human hematopoietic stem cells: Loss of telomeric DNA with age // Proc Natl Acad Sci USA. 1994. Vol. 91. P. 9857–9860. doi: 10.1073/pnas.91.21.9857
- Aggarwal S., Pittenger M.F. Human mesenchymal stem cells modulate allogeneic immune cell responses // Blood. 2005. Vol. 105. P. 1815–1822. doi: 10.1182/blood-2004-04-1559
- Gatina D.Z., Gazizov I.N., Zhuravleva M.N., et al. Induction of angiogenesis by genetically modified human umbilical cord blood mononuclear cells // Int J Mol Sci. 2023. Vol. 24, N. 5. 4396. doi: 10.3390/ijms24054396
- Garbuzova-Davis S., Willing A.E., Zigova N., et al. Intravenous administration of human umbilical cord blood cells in a mouse model of amyotrophic lateral sclerosis: Distribution, migration, and differentiation // J Hematother Stem Cell Res. 2003. Vol. 12, N. 3. P. 255–270. doi: 10.1089/152581603322022990
- Islamov R.R., Rizvanov A.A., Mukhamedyarov M.A., et al. Symptomatic improvement, increased life-span and sustained cell homing in amyotrophic lateral sclerosis after transplantation of human umbilical cord blood cells genetically modified with adeno-viral vectors expressing a neuro-protective factor and a neural cell adhesion molecule // Curr Gene Ther. 2015. Vol. 15, N. 3. P. 266–276. doi: 10.2174/1566523215666150126122317
- Koerbling M., Estrov R.Z., Champlin R., Shpall E. Umbilical cord blood-derived cells for tissue repair // Cytotherapy. 2005. Vol. 7, N. 3. P. 258–261. doi: 10.1080/14653240510027145
- Neuhoff S., Moers J., Rieks M., et al. Proliferation, differentiation, and cytokine secretion of human umbilical cord blood-derived mononuclear cells in vitro // Exp Hematol. 2007. Vol. 35, N. 7. P. 1119–1131. doi: 10.1016/j.exphem.2007.03.019
- Fan C.G., Zhang Q.J., Tang F.W., et al. Human umbilical cord blood cells express neurotrophic factors // Neurosci Lett. 2005. Vol. 380, N. 3. P. 322–325. doi: 10.1016/j.neulet.2005.01.070
- Yang J., Ren Z., Zhang C., et al. Safety of autologous cord blood cells for preterms: A descriptive study // Stem Cells Int. 2018. Vol. 15. Р. 5268057. doi: 10.1155/2018/5268057
- Yang W.Z., Zhang Y., Wu F., et al. Safety evaluation of allogeneic umbilical cord blood mononuclear cell therapy for degenerative conditions // J Transl Med. 2010. Vol. 3, N. 8. P. 75–81. doi: 10.1186/1479-5876-8-75
- Liu J., Sun W., Liu C., Na Q. Umbilical cord blood-derived exosomes in maternal-fetal disease: A review // Reprod Sci. 2023. Vol. 30, N. 1. P. 54–61. doi: 10.1007/s43032-022-00879-1
- Hashimoto S., Kato K., Kai S., et al. Adverse events caused by cord blood infusion in Japan during a 5-year period // Vox Sang. 2023. Vol. 118, N. 1. P. 84–92. doi: 10.1111/vox.13379
- Rizk M., Aziz J., Shorr R., Allan D.S. Cell-based therapy using umbilical cord blood for novel indications in regenerative therapy and immune modulation: An updated systematic scoping review of the literature // Biol Blood Marrow Transplant. 2017. Vol. 23, N. 10. P. 1607–1613. doi: 10.1016/j.bbmt.2017.05.032
- Gunn A.J., Laptook A.R., Robertson N.J., et al. Therapeutic hypothermia translates from ancient history in to practice // Pediatr Res. 2017. Vol. 81, N. 1–2. P. 202–209. doi: 10.1038/pr.2016.198
- Wassink G., Gunn E.R., Drury P.P., et al. The mechanisms and treatment of asphyxial encephalopathy // Front Neurosci. 2014. Vol. 8, N. 8. P. 1–11. doi: 10.3389/fnins.2014.00040
- Cotten C.M., Murtha A.P., Goldberg R.N., et al. Feasibility of autologous cord blood cells for infants with hypoxic-ischemic encephalopathy // J Pediatr. 2014. Vol. 164. P. 973–979. doi: 10.1016/j.jpeds.2013.11.036
- Tsuji M., Sawada M., Watabe S., et al. Autologous cord blood cell therapy for neonatal hypoxic-ischaemic encephalopathy: A pilot study for feasibility and safety // Sci Rep. 2020. Vol. 10, N. 1. 4603. doi: 10.1038/s41598-020-61311-9
- Raju T.N., Nelson K.B., Ferriero D., Lynch J.K. Ischemic perinatal stroke: summary of a workshop sponsored by the National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke // Pediatrics. 2007. Vol. 120. P. 609–616. doi: 10.1542/peds.2007-0336
- Lehman L.L., Rivkin M.J. Perinatal arterial ischemic stroke: Presentation, risk factors, evaluation, and outcome // Pediatr Neurol. 2014. Vol. 51, N. 6. P. 760–768. doi: 10.1016/j.pediatrneurol.2014.07.031
- Sun J., Allison J., McLaughlin C., et al. Differences in quality between privately and publicly banked umbilical cord blood units: A pilot study of autologous cord blood infusion in children with acquired neurologic disorders // Transfusion. 2010. Vol. 50. P. 1980–1987. doi: 10.1111/j.1537-2995.2010.02720.x
- Min K., Song J., Kang J.Y., et al. Umbilical cord blood therapy potentiated with erythropoietin for children with cerebral palsy: A double-blind, randomized, placebo-controlled trial // Stem Cells. 2013. Vol. 31, N. 3. P. 581–591. doi: 10.1002/stem.1304
- Sun J.M., Song A.W., Case L.E., et al. Effect of autologous cord blood infusion on motor function and brain connectivity in young children with cerebral palsy: A randomized, placebo-controlled trial // Stem Cells Transl Med. 2017. Vol. 6. P. 2071–2078. doi: 10.1002/sctm.17-0102
- Huang L., Zhang C., Gu J., et al. A randomized, placebo-controlled trial of human umbilical cord blood mesenchymal stem cell infusion for children with cerebral palsy // Cell Transplant. 2018. Vol. 27. P. 325–334. doi: 10.1177/0963689717729379
- Maenner M.J., Warren Z., Williams A.R., et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years — autism and developmental disabilities monitoring network, 11 Sites, United States, 2020 // MMWR Surveill Summ. 2023. Vol. 72. P. 1–14. doi: 10.15585/mmwr.ss7202a1
- Lv Y.T., Zhang Y., Liu M., et al. Transplantation of human cord blood mononuclear cells and umbilical cord-derived mesenchymal stem cells in autism // J Transl Med. 2013. Vol. 11. P. 196. doi: 10.1186/1479-5876-11-196
- Li Q., Chen C.F., Wang D.Y., et al. Transplantation of umbilical cord blood mononuclear cells increases levels of nerve growth factor in the cerebrospinal fluid of patients with autism // Genet Mol Res. 2015. Vol. 14, N. 3. P. 8725–8732. doi: 10.4238/2015.July.31.21
- Dawson G., Sun J.M., Davlantis K.S., et al. Autologous cord blood infusions are safe and feasible in young children with autism spectrum disorder: Results of a single-center phase I open-label trial // Stem Cells Transl Med. 2017. Vol. 6, N. 5. P. 1332–1339. doi: 10.1002/sctm.16-0474
- Murias M., Major S., Compton S., et al. Electrophysiological biomarkers predict clinical improvement in an open-label trial assessing efficacy of autologous umbilical cord blood for treatment of autism // Stem Cells Transl Med. 2018. Vol. 7, N. 11. P. 783–791. doi: 10.1002/sctm.18-0090
- Carpenter K.L.H., Major S., Tallman C., et al. White matter tract changes associated with clinical improvement in an open-label trial assessing autologous umbilical cord blood for treatment of young children with autism // Stem Cells Transl Med. 2019. Vol. 8, N. 2. P. 138–147. doi: 10.1002/sctm.18-0251
- Chez M., Lepage C., Parise C., et al. Safety and observations from a placebo-controlled, crossover study to assess use of autologous umbilical cord blood stem cells to improve symptoms in children with autism // Stem Cells Transl Med. 2018. Vol. 7. N. 4. P. 333–341. doi: 10.1002/sctm.17-0042
- Szpecht D., Szymankiewicz M., Nowak I., Gadzinowski J. Intraventricular hemorrhage in neonates born before 32 weeks of gestation-retrospective analysis of risk factors // Childs Nerv Syst. 2016. Vol. 32. P. 1399–1404. doi: 10.1007/s00381-016-3127-x
- Gotardo J.W., Volkmer N.F.V., Stangler G.P., et al. Impact of peri-intraventricular haemorrhage and periventricular leukomalacia in the neurodevelopment of preterms: A systematic review and meta-analysis // PLoS ONE. 2019. Vol. 14. Р. e0223427. doi: 10.1371/journal.pone.0223427
- Ahn S.Y., Chang Y.S., Sung S.I, Park W.S. Mesenchymal stem cells for severe intraventricular hemorrhage in preterm infants: Phase I dose-escalation clinical trial // Stem Cells Transl Med. 2018. Vol. 7. P. 847–856. doi: 10.1002/sctm.17-0219
- Lee T.K., Lu C.Y., Tsai S.T., et al. Complete restoration of motor function in acute cerebral stroke treated with allogeneic human umbilical cord blood monocytes: Preliminary results of a phase I clinical // Trial Cell Transplant. 2021. Vol. 30. P. 1–7. doi: 10.1177/09636897211067447
- Kang K.S., Kim S.W., Oh Y.H., et al. A 37-year-old spinal cord-injured female patient, transplanted of multipotent stem cells from human UC blood, with improved sensory perception and mobility, both functionally and morphologically: A case study // Cytotherapy. 2005. Vol. 7, N. 4. P. 368–373. doi: 10.1080/14653240500238160
- Liu J., Han D., Wang Z., et al. Clinical analysis of the treatment of spinal cord injury with umbilical cord mesenchymal stem cells // Cytotherapy. 2013. Vol. 15, N. 2. P. 185–191. doi: 10.1016/j.jcyt.2012.09.005
- Ichim T.E., Solano F., Lara F., et al. Feasibility of combination allogeneic stem cell therapy for spinal cord injury: A case report // Int Arch Med. 2010. Vol. 3. P. 30. doi: 10.1186/1755-7682-3-30
- Yao L., He C., Zhao Y., et al. Human umbilical cord blood stem cell transplantation for the treatment of chronic spinal cord injury: Electrophysiological changes and long-term efficacy // Neural Regen Res. 2013. Vol. 8, N. 5. P. 397–403. doi: 10.3969/j.issn.1673-5374.2013.05.002
- Zhu H., Poon W., Liu Y., et al. Phase I–II clinical trial assessing safety and efficacy of umbilical cord blood mononuclear cell transplant therapy of chronic complete spinal cord injury // Cell Transplant. 2016. Vol. 25, N. 11. P. 1925–1943. doi: 10.3727/096368916X691411
- Smirnov V.A., Radaev S.M., Morozova Y.V., et al. Systemic administration of allogeneic cord blood mononuclear cells in adults with severe acute contusion spinal cord injury: Phase 1/2a pilot clinical study-safety and primary efficacy evaluation // World Neurosurg. 2022. Vol. 161. P. 319–338. doi: 10.1016/j.wneu.2022.02.004
- Ghen M.J., Roshan R., Roshan R.O., et al. Potential clinical applications using stem cells derived from human umbilical cord blood // Reproductive BioMedicine Online. 2006. Vol. 13, N. 4. P. 562–572.
- Meng M., Liu Y., Wang W., et al. Umbilical cord mesenchymal stem cell transplantation in the treatment of multiple sclerosis // Am J Transl Res. 2018. Vol. 10, N. 1. P. 212–223.
- Gong D., Wang W., Yuan X., et al. Long-term clinical efficacy of human umbilical cord blood mononuclear cell transplantation by lateral atlanto-occipital space puncture (Gong’s puncture) for the treatment of multiple system atrophy // Cell Transpl. 2022. Vol. 31. P. 1–6. doi: 10.1177/09636897221136553
- Kim H.J., Cho K.R., Jang H., et al. Intracerebroventricular injection of human umbilical cord blood mesenchymal stem cells in patients with Alzheimer’s disease dementia: A phase I clinical trial // Alzheimer's Research and Therapy. 2021. Vol. 13, N. 1. P. 154. doi: 10.1186/s13195-021-00897-2
- Master Y.L., Tian B.W.M., Jin M.X.F., et al. A clinical research of 11 cases of human umbilical cord mesenchymal stem cells for curing senile vascular dementia // Transpl Immunol. 2022. Vol. 74. P. 101669. doi: 10.1016/j.trim.2022.101669
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