中国组织工程研究Issue(45)：7279-7284,6.DOI:10.3969/j.issn.2095-4344.2014.45.012
脐带间充质干细胞移植治疗类风湿性关节炎患者Th1/Th2、Treg的变化
Variation of Th1/Th2 and Terg in rheumatoid arthritis patients undergoing umbilical cord mesenchymal stem cell transplantation
摘要
Abstract
BACKGROUND:Rheumatoid arthritis is an autoimmune disease, and traditional treatment methods are difficult to effectively solve the patient's lack of immune tolerance mechanisms. With the development of stem cel s in regenerative medicine, stem cel therapy has become a hot spot in the treatment of autoimmune diseases. <br> Currently, studies on cel transplantation for the treatment of rheumatoid arthritis are rarely reported. <br> OBJECTIVE:To study the influence of umbilical cord mesenchymal stem cel therapy on the changes of Th1/Th2 and Treg in rheumatoid arthritis patients, thereby seeking new therapies for rheumatoid arthritis. <br> METHODS:We selected 180 cases of rheumatoid arthritis, including 27 patients as control group undergoing non-steroidal anti-inflammatory drugs and anti-rheumatic drugs and 153 patients as cel treatment group undergoing intravenous infusion of 40 mL umbilical cord mesenchymal stem cel s at a density of 4×107. Dosing regimen was same in the two groups. The 76 of 153 patients accepted second cel therapy at 3-4 months after the first cel therapy. After fol ow-up of 3 and 6 months, clinical effectiveness evaluation (DAS28, HAQ, ACR20), rheumatoid factor, anti-CCP antibodies, T cel subsets, Th cytokine were detected;for patients with second cel therapy, T cel subsets and Treg were detected at 8 months after treatment. <br> RESULTS AND CONCLUSION:(1) At 3 months after treatment, the DAS28, HAQ and ACR20 scores were significantly lower in the cel treatment group than the control group (P<0.01). (2) At 3 and 6 months after cel therapy, the DAS28 and HAQ scores were significantly decreased in the cel treatment group (P<0.01), and these scores were decreased continuously after second cel therapy (P<0.01). (3) Interferon-γlevel in cel s did not change obviously at 3-6 months after treatment, but the interleukin-4 level was gradual y increased at 6 months after treatment (P<0.05). (4) The number of Treg cel s was significantly increased at 3-6 months after treatment (P<0.01), which was closely related to ACR, especial y ACR70 percentage (P<0.05);the ratio of CD4+Treg was increased significantly at 3 months after treatment (P<0.05), and this increasing trend was also maintained at 6 and 8 months after treatment, but there was no significant difference (P>0.05). (5) B cel levels were significantly decreased at 6 months after treatment (P>0.05);the rheumatoid factor value was significantly decreased at 3-6 months after treatment (P<0.05). (6) There was no change in anti-CCP antibody and interleukin-17 levels at 3-6 months after treatment. These findings indicate that after treatment with umbilical cord mesenchymal stem cel s, the Th1/Th2 tends to balance and Treg level is elevated in rheumatoid arthritis patients, which are directly related to clinical trials and symptomatic relief. Therefore, standard rheumatism medication combined with umbilical cord mesenchymal stem cel transplantation can improve immune network effects, adjust the immune tolerance and prevent il ness progress in rheumatoid arthritis patients.关键词
干细胞/移植/类风湿性关节炎/脐带间充质干细胞/治疗/Th1/Th2/TregKey words
arthritis, rheumatoid/umbilical cord/mesenchymal stem cel transplantation/T-Lymphocytes, regulatory/Th1-Th2 balance分类
医药卫生引用本文复制引用
王黎明,吉海杰,刘拥军,吴明远,王立华,李铭,白雯,钟占强,石军,周建军,黄士高,李娜..脐带间充质干细胞移植治疗类风湿性关节炎患者Th1/Th2、Treg的变化[J].中国组织工程研究,2014,(45):7279-7284,6.基金项目
军区医药卫生计划课题(CLZ12GA23)@@@@Funding:the Military Medical Health Plan, No. CLZ12GA23 （CLZ12GA23）
