Un estudio abierto en fase 2a, que administró células madre mesenquimales autólogas a pacientes con esclerosis múltiple secundaria progresiva, ha evidenciado mejoras estructurales, funcionales y fisiológicas en algunos criterios de valoración visual, después del tratamiento, lo que es sugestivo de neuroprotección.
El estudio tuvo como objetivo evaluar la seguridad y la eficacia de estas células como tratamiento potencial neuroprotector para la esclerosis múltiple secundaria progresiva. Los diez pacientes seleccionados padecían una afectación de las vías visuales (EDSS: 5,5-6,5).
La dosis media administrada fue de 1,6 × 106 células por kg de peso (rango: 1,1-2,0 × 106). Tras el tratamiento se evidenció mejoría en la agudeza visual y en la latencia de respuesta evocada visual, junto con un aumento en el área del nervio óptico. No se comunicó ningún efecto adverso grave.
Febrero 15/2012 (Neurologia.com)
Nota: Los lectores del dominio *sld.cu acceden al texto completo a través de Hinari.
Connick P, Kolappan M, Crawley C, Webber DJ, Patani R, Michell AW, et al.Autologous mesenchymal stem cells for the treatment of secondary progressive multiple sclerosis: an open-label phase 2a proof-of-concept study.The Lancet Neurology (doi:10.1016/S1474-4422(11)70305-2), Volume 11, Issue 2, Pages 150 – 156, Feb 2012
En: Noticias 
Un estudio del RECAVA muestra que los pacientes con daños en una sola arteria tienen el triple de células madre en sangre que los pacientes con dos o tres arterias afectadas.
Investigadores de la Red de Investigación Cardiovascular (RECAVA), perteneciente al Instituto de Salud Carlos III, han logrado medir por primera vez la relación entre el área cardíaca dañada por un infarto y la cantidad de células madre que circulan por la sangre para reparar la zona lesionada.
El estudio, publicado en la Revista Española de Cardiología, ha mostrado que los pacientes que presentaban daños en una sola arteria tenían el triple de células madre en sangre que los pacientes con dos o tres arterias afectadas.
“La lógica invitar a pensar que cuanto mayor es el número de arterias lesionadas, mayor será la cantidad de células madre en sangre destinadas a reparar el corazón; sin embargo, esta investigación demuestra que no es así”, explica el coordinador del trabajo, Manuel Jiménez Navarro, del Área del Corazón del Hospital Clínico Universitario Virgen de la Victoria de Málaga.
La cuantificación ha podido realizarse gracias a una técnica llamada citometría de flujo, que permite cuantificar la cantidad de anticuerpos que rodean a las células madre en la sangre. Los investigadores de RECAVA también cuantificaron los mediadores, es decir, las moléculas que se liberan cuando una zona del corazón sufre un infarto, y que reciben el nombre de citoquinas.
Dichas citoquinas actúan como señales que avisan a diferentes zonas del cuerpo, entre ellas la medula ósea, para que generen las células madre que deben ir a reparar la zona infartada.
El estudio muestra cómo los pacientes que han sufrido un infarto tienen más células madre circulantes en sangre que los pacientes libres de enfermedad, en una proporción de 14 a 1.
También la cantidad de mediadores que influyen en el proceso de liberación de células madres es mayor en los pacientes infartados respecto a los sanos, siendo en este caso la proporción de 8 a 1. En ambos casos las extracciones de sangre se realizaron en distintas fases tras el infarto con el objetivo de estudiar la cinética de liberación de estas células.
Revista Española de Cardiología
En: Noticias
Bone marrow mononuclear cells and acute myocardial infarction.Stem Cell Research & Therapy 2012, 3:2
Review
Bone marrow mononuclear cells and acute myocardial infarction
Samer Arnous1, Abdul Mozid1, John Martin1 and Anthony Mathur2*
* Corresponding author: Anthony Mathur a.mathur@qmul.ac.uk
Author Affiliations
1 Department of Cardiology, London Chest Hospital, Bonner Road, London E2 9JX, UK
2 Department of Cardiology, London Chest Hospital, Queen Mary University of London, Barts and the London NHS Trust, Bonner Road, London E2 9JX, UK
For all author emails, please log on.
Stem Cell Research & Therapy 2012, 3:2 doi:10.1186/scrt93
The electronic version of this article is the complete one and can be found online at: http://stemcellres.com/content/3/1/2
Published: 17 January 2012
© 2012 BioMed Central Ltd
Abstract
Stem cell transplantation is emerging as a potential therapy to treat heart diseases. Promising results from early animal studies led to an explosion of small, non-controlled clinical trials that created even further excitement by showing that stem cell transplantation improved left ventricular systolic function and enhanced remodelling. However, the specific mechanisms by which these cells improve heart function remain largely unknown. A large variety of cell types have been considered to possess the regenerative ability needed to repair the damaged heart. One of the most studied cell types is the bone marrow-derived mononuclear cells and these form the focus of this review. This review article aims to provide an overview of their use in the setting of acute myocardial infarction, the challenges it faces and the future of stem cell therapy in heart disease.
Introduction
Despite the recent advances in percutaneous intervention, drug and device therapy, patients with acute myocardial infarction (AMI) and resulting left ventricular impairment have 13% mortality at 1 year [1]. Following the loss of over one billion cardiomyocytes in a functionally significant MI, the overloaded surviving cardiomyocytes undergo abnormal remodelling, eventually leading to heart failure. This condition, a leading cause of death and disability in the developed world, is associated with 5-year mortality rates of up to 70% in symptomatic patients [2]. Current conventional therapies do not correct underlying defects in cardiac muscle cell number [3].
The only therapeutic option that currently addresses cardiomyocyte loss is heart transplantation. However, due to stringent selection criteria and chronic shortage of donor hearts, the vast majority of patients are deemed unsuitable or never receive a transplant. Therefore, preventing this progression post-MI is a major challenge requiring novel therapeutic strategies such as stem cell transplantation to improve the prognosis and quality of life for these patients.
The traditional view that the heart is a terminally differentiated organ has been challenged by the discovery of differentiation of stem cells into cardiomyocytes in animal and human hearts [4-7]. This in turn has led to the exciting possibility for regenerative therapy for cardiomyocyte loss after a MI. The demonstration of functional recovery of myocardium through cardiomyogenesis and neoangiogenesis in AMI in murine models by Orlic and colleagues [8] generated tremendous interest in the potential of bone marrow-derived stem cells. Since then, the cardiomyogenic ability of these cells has been challenged. However, studies continue to demonstrate improvement in cardiac function and reduction in infarct size. It should be noted that progenitor cells also contribute to cardiac repair by mechanisms beyond the growth of new cardiomyocytes and as such may offer an ‘indirect’ benefit.
Animal and human trials
The most promising and obvious cell type for the growth of new cardiomyocytes is the embryonic stem cell; however, considerable technical and ethical issues exist with these cells, which must be overcome before their successful use in humans. Adult stem cells are an attractive option to explore for transplantation as they are autologous, but their differentiation potential is more restricted than embryonic stem cells. Currently, the major sources of adult cells used for basic research and in clinical trials originate from the bone marrow. The bone marrow mononuclear subset is heterogeneous and comprises mesenchymal stem cells, haematopoietic progenitor cells and endothelial progenitor cells. The differentiation capacity of different populations of bone marrow-derived stem cells into cardiomyocytes has been studied intensively. The results are rather confusing and difficult to compare, since different isolation and identification methods have been used to determine the cell population studied. To date, only mesenchymal stem cells seem to form cardiomyocytes, and only a small percentage of this population will do so in vitro or in vivo. Pragmatically, the translation of the basic science into clinical research has followed a common pathway: injection of bone marrow-derived mononuclear cells (BMMNCs) as a source of stem cells into the heart. Table 1 provides a summary of clinical trials using BMMNCs in patients with acute MI.
Table 1. Clinical trials using autologous bone marrow mononuclear cells in patients with acute myocardial infarction
Trials with no sham bone marrow harvest or intracoronary re-infusion in the control group
In the first human trial, Strauer and colleagues [9] re-infused intracoronary BMMNCs 7 days after myocardial infarction (MI). The mean number of mononuclear cells was 2.8 × 107. There was a significant improvement in myocardial perfusion and a reduction in the infarct region in the cell therapy group. The Transplantation of Progenitor Cells and Regeneration Enhancement in Acute Myocardial Infarction (TOPCARE-AMI) investigators randomised patients into intracoronary infusion of BMMNCs or ex vivo expanded circulating progenitor cells 4 days after MI [10]. There was a significant improvement in global and regional left ventricular (LV) function in both groups and a beneficial effect on the post-infarction remodelling process manifest by a profound improvement in wall motion abnormalities in the infarct area and a significant reduction in end-systolic LV volume at 4 months post-MI. The LV ejection fraction (LVEF) further improved at 12 months, resulting in a total increase of 9.3% at 1 year [11]. Of interest, there was no difference between the two active treatment groups. The mean number of infused cells was 245 × 106, which contained haematopoietic progenitor, mesenchymal and stromal cells. However, a major limitation of both of these trials was the lack of a control group receiving sham bone marrow harvest or intracoronary re-infusion.
Another trial in which there was no sham procedure is the Autologous Stem-Cell Transplantation in Acute Myocardial Infarction (ASTAMI) trial, which included only patients with acute anterior MI. The intracoronary re-infusion of BMMNCs 4 to 8 days after infarction did not have a beneficial effect on LVEF compared to percutaneous coronary intervention (PCI) alone at 6 months [12]. This lack of beneficial effect may be explained by the different cell processing protocols used in this trial. Cell processing protocols may have a significant impact on the functional capacity of bone marrow-derived stem cells [13]. Comparison of different isolation protocols revealed a vastly reduced recovery of mononuclear cells and nullification of the neovascularisation capacity when the ASTAMI cell isolation and storage protocol was used [13].
The Bone Marrow Transfer to Enhance ST-Elevation Infarct Regeneration (BOOST) trial, a slightly larger trial, included 60 patients that were randomised to receive intracoronary BMMNCs or standard therapy 4.8 days after successful PCI following AMI. There was a significant improvement in global LVEF in the cell treatment group at 6 months without an effect on LV remodelling [14]. However, this improvement was not maintained at 18 months. The mean number of bone marrow cells that were infused contained 9.5 × 106 CD34+ and 3.6 × 106 haematopoietic colony-forming cells. The improvement in LVEF did not correlate with the number of CD34+ cells or haematopoietic colony forming cells. Again, a major limitation of the BOOST trial is that the control group did not undergo a sham bone marrow harvest or intracoronary infusion.
The first long-term study involving 62 patients who underwent intracoronary BMMNC transplantation 7 days post-AMI not only resulted in an early significant improvement in ejection fraction (EF) and infarct size, but there was also a significant reduction in mortality and improvement in exercise capacity compared to controls at 5 years [15].
Randomised controlled trials
The Transcatheter Transplantation of Stem Cells for Treatment of Acute Myocardial Infarction (TCT-STAMI) trial, which included a control group receiving a placebo infusion, showed a significant (approximately 5%) improvement in LVEF of patients receiving intracoronary BMMNCs at 6 months [16].
Intracoronary bone marrow derived progenitor cells in acute infarction (REPAIR-AMI), a large randomized double-blind controlled trial that included over 200 patients, showed an improvement in the primary endpoint in the treatment group that was an absolute change in global LVEF from baseline to 4 months, as measured by quantitative left ventricular angiography [17]. Furthermore, the pre-specified cumulative endpoint of death, MI, or revascularisation was significantly reduced, and this benefit was maintained at one year follow-up [18]. The mean increase in LVEF in the BMMNC group was 2.5% and there was an inverse relationship between the baseline EF and the degree of improvement. For example, patients with a baseline EF below the median value (48.9%) had an absolute increase in global EF that was three times higher than that in the placebo group. In contrast, the improvement in LVEF in patients with a baseline EF that was above the median value was non-significant (0.3%). The timing of cell infusion post-PCI also had an effect on the primary endpoint. Patients in whom the cells were infused ≥5 days post-PCI were the only ones who derived benefit.
By contrast, the LEUVEN-AMI study by Janssens and colleagues [19] showed that intracoronary re-infusion of BMMNCs within 24 hours of reperfusion was associated with a greater reduction in infarct size and improved regional systolic function, but no overall improvement in global left ventricular function compared to controls.
Trials that used two different cell populations
More recently, the Myocardial Regeneration by Intracoronary Infusion of Selected Population of Stem Cells in Acute Myocardial Infarction (REGENT) trial, which included patients with anterior MI, uniquely compared two cell types. Patients were randomized to receive intracoronary infusion of unselected (n = 80) or selected CD34+CXCR4+ (n = 80) BMMNCs, or to the control group (n = 40) [20]. Although patients in the treatment group had a 3% improvement in LVEF, this did not reach statistical significance. However, the primary endpoint analysis included 5 hours) may be more likely to have significant improvement of LVEF following the BMMNC infusion [20].
The timing of cell infusion may also play a role on the derived benefit. Although the REPAIR-AMI trial suggests that the enhanced improvement of the LVEF was confined to patients who were treated ≥5 days after primary PCI, the investigators of the HEBE and REGENT trials showed no interaction between the timing of cell infusion and derived benefit. The meta-analysis by Martin-Rendon and colleagues [22], however, showed that the benefit of stem cell therapy was even greater when the BMMNCs were infused >7 days after MI. The effect of timing on the beneficial effects of BMMNC administration is further supported by the study by Lai and colleagues [31] that showed that intracoronary BMMNC administration provided cardio-protection in a fashion similar to ishaemic preconditioning. This benefit was only seen when the myocardium had not been preconditioned by other means. An ongoing study at our centre, the REGENERATE-AMI (ClinicalTrial.gov NCT00765453), is designed to study the delivery of BMMNCs at very early time points (within 6 hours of PCI). The purpose of this design is to replicate the animal models where very early interventions lead to a significant (40%) improvement in cardiac function [8].
The dose of infused BMMNCs has varied between different trials with variable results. There appears to be a dose-dependent improvement in EF, with the benefit of BMMNCs only seen when doses higher than 108 are administered [22].
Direct (transdifferentiation) and indirect (paracrine and angiogenesis) effects of stem cells
To date, there is no direct clinical evidence that cellular cardiomyogenesis in fact occurs in the human heart after transplantation of progenitor cells, and over the past few years, various experiments using different types of stem cells have shown that 4 days after reperfusion (based on available evidence). Furthermore, given the seemingly small improvements that these trials have shown, the cost-effectiveness of cell therapy will also need to be addressed.
Two ongoing randomised controlled trials (TIME and late TIME studies) may help us understand whether the timing of cell administration plays an important role. The TIME study (Clinicaltrials.gov NCT00684021) is a trial designed to assess the effect of timing (3 versus 7 days) of BMMNC administration versus placebo in patients with acute MI. The LATE TIME study (Clinicaltrials.gov NCT00684060) will assess the effect of BMMNC administration 2 to 3 weeks after a MI.
Future cells
Animal and human studies have clearly shown that stem cell engraftment into the myocardium is associated with improvement in cardiac function; however, the quest for the optimal population of cells remains a challenge [85,86]. Embryonic stem cells are able to transform into cardiomyocytes and can replicate indefinitely, although ethical issues – their potential to form teratomas and the need for immunosuppressive therapy – have hindered their use in clinical trials. Furthermore, one of the major limitations of adult stem cells, including skeletal myoblasts and bone marrow-derived stem cells, is their limited ability to cross their lineage boundaries.
Fat tissue-derived multipotent stem cells [87], multi-potential cells from bone marrow or skeletal muscle [88,89], somatic stem cells from placental cord blood [90], and cardiac-resident progenitor cells [32,91] all show promising pre-clinical and some clinical applications.
Ultimately, cells that more closely resemble embryonic stem cells in their regenerative potential without the ethical issues provide an important future direction. A cell type that comes close, and is on the horizon of being tested for potential clinical application, is the inducible pluripotent stem cell (iPSC). iPSCs can be generated from adult human somatic cells by retroviral transduction [92], have similar differentiation potential and may provide an alternative to pluripotent embryonic stem cells.
The future of bone marrow stem cells
For the time being, it is important to establish whether the simple unfractionated bone marrow cell approach has clinical benefit, given the large number of studies that have been performed using this cell type without providing a clear answer. Meta-analysis suggests a positive effect on surrogate cardiac end-points in studies using BMMNCs to treat AMI. There is now a need to perform a large scale clinical trial using clinical hard end-points such as mortality to establish whether the positive effects seen on surrogate end-points can indeed translate to meaningful clinical benefits.
Abbreviations
AMI: acute myocardial infarction; ASTAMI: Autologous Stem-Cell Transplantation in Acute Myocardial Infarction; BMMNC: bone marrow-derived mononuclear cell; BOOST: Bone Marrow Transfer to Enhance ST-Elevation Infarct Regeneration; EF: ejection fraction; LV: left ventricular; LVEF: left ventricular ejection fraction; MI: myocardial infarction; PCI: percutaneous coronary intervention; REPAIR-AMI: Intracoronary bone marrow derived progenitor cells in acute infarction; SDF: stromal-cell-derived factor.
Competing interests
The authors have no relevant affiliations or financial involvement with any organisation or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript.
Acknowledgements
This work forms part of the research themes contributing to the translational research portfolio of Barts and the London Cardiovascular Biomedical Research Unit, which is supported and funded by the National Institute of Health Research.
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© 2012 BioMed Central Ltd unless otherwise stated. Part of Springer Science+Business Media.
ArticleYong Zhao1*, Zhaoshun Jiang2, Tingbao Zhao3, Mingliang Ye4, Chengjin Hu5,
Zhaohui Yin2, Heng Li6, Ye Zhang7, Yalin Diao4, Yunxiang Li4, Yingjian Chen5,
Xiaoming Sun5, Mary Beth Fisk8, Randal Skidgel9, Mark Holterman10, Bellur
Prabhakar11, Theodore Mazzone1
Abstract
Background
Inability to control autoimmunity is the primary barrier to developing a cure for
type 1 diabetes (T1D). Evidence that human cord blood-derived multipotent stem
cells (CB-SCs) can control autoimmune responses by altering regulatory T cells
(Tregs) and human islet β cell-specific T cell clones offers promise for a new
approach to overcome the autoimmunity underlying T1D.
Methods
We developed a procedure for Stem Cell Educator therapy in which a patient’s
blood is circulated through a closed-loop system that separates lymphocytes
from the whole blood and briefly co-cultures them with adherent CB-SCs before
returning them to the patient’s circulation. In an open-label, phase1/phase 2
study, patients (n = 15) with T1D received one treatment with the Stem Cell
Educator. Median age was 29 years (range: 15 to 41), and median diabetic
history was 8 years (range: 1 to 21).
Results
Stem Cell Educator therapy was well tolerated in all participants with minimal
pain from two venipunctures and no adverse events. Stem Cell Educator therapy
can markedly improve C-peptide levels, reduce the median glycated hemoglobin
A1C (HbA1C) values, and decrease the median daily dose of insulin in patients
with some residual β cell function (n = 6) and patients with no residual pancreatic
islet β cell function (n = 6). Treatment also produced an increase in basal and
glucose-stimulated C-peptide levels through 40 weeks. However, participants in the Control Group (n = 3) did not exhibit significant change at any follow-up.
Individuals who received Stem Cell Educator therapy exhibited increased
expression of co-stimulating molecules (specifically, CD28 and ICOS), increases
in the number of CD4+CD25+Foxp3+ Tregs, and restoration of Th1/Th2/Th3
cytokine balance.
Conclusions
Stem Cell Educator therapy is safe, and in individuals with moderate or severe
T1D, a single treatment produces lasting improvement in metabolic control. Initial
results indicate Stem Cell Educator therapy reverses autoimmunity and promotes
regeneration of islet β cells. Successful immune modulation by CB-SCs and the
resulting clinical improvement in patient status may have important implications
for other autoimmune and inflammation-related diseases without the safety and
ethical concerns associated with conventional stem cell-based approaches.
Trial registration: ClinicalTrials.gov number, NCT01350219
Authors
Paul W. Burridge, Gordon Keller, Joseph D. Gold, Joseph C. Wusend
Summary
Cardiovascular disease is a leading cause of death worldwide. The limited capability of heart tissue to regenerate has prompted methodological developments for creating de novo cardiomyocytes, both in vitro and in vivo. Beyond uses in cell replacement therapy, patient-specific cardiomyocytes may find applications in drug testing, drug discovery, and disease modeling. Recently, approaches for generating cardiomyocytes have expanded to encompass three major sources of starting cells: human pluripotent stem cells (hPSCs), adult heart-derived cardiac progenitor cells (CPCs), and reprogrammed fibroblasts. We discuss state-of-the-art methods for generating de novo cardiomyocytes from hPSCs and reprogrammed fibroblasts, highlighting potential applications and future challenges.
Published online before print January 23, 2012, doi: 10.1073/pnas.1113810109
PNAS January 23, 2012
Limin Maa,b,1, Yijun Yanga,1, Suresh C. Sikkaa,c, Philip J. Kadowitzc, Louis J. Ignarrod, Asim B. Abdel-Mageeda,c,2, and Wayne J. G. Hellstroma
Abstract
Porcine small intestinal submucosa (SIS) has been widely used in tunica albuginea (TA) reconstructive surgery. Adipose tissue-derived stem cells (ADSCs) can repair damaged tissue, augment cellular differentiation, and stimulate release of multiple growth factors. The aim of this rat study was to assess the feasibility of seeding ADSCs onto SIS grafts for TA reconstruction. Here, we demonstrate that seeding syngeneic ADSCs onto SIS grafts (SIS-ADSC) resulted in significant cavernosal tissue preservation and maintained erectile responses, similar to controls, in a rat model of bilateral incision of TA, compared with sham-operated animals and rats grafted with SIS graft (SIS) alone. In addition to increased TGF-β1 and FGF-2 expression levels, cross-sectional studies of the rat penis with SIS and SIS-ADSC revealed mild to moderate fibrosis and an increase of 30% and 40% in mean diameter in flaccid and erectile states, respectively. SIS grafting induced transcriptional up-regulation of iNOS and down-regulation of endothelial NOS, neuronal NOS, and VEGF, an effect that was restored by seeding ADCSs on the SIS graft. Taken together, these data show that rats undergoing TA incision with autologous SIS-ADSC grafts maintained better erectile function compared with animals grafted with SIS alone. This study suggests that SIS-ADSC grafting can be successfully used for TA reconstruction procedures and can restore erectile function.
Las células madre derivadas del tejido graso podrían ayudar a mejorar los injertos empleados en la reconstrucción del pene, según un estudio llevado a cabo por el grupo de Wayne Hellstrom, del Departamento de Urología del Centro de Ciencias de la Salud de la Universidad de Tulane, en Nueva Orléans, que se publica en Proceedings of the National Academy of Sciences (doi:10.1073/pnas.1113810109).
La submucosa del intestino delgado, un tejido de la matiz extracelular que recubre el intestino porcino, se ha empleado en la reconstrucción quirúrgica de varios órganos genitourinarios, incluido el pene.
El citado grupo ha implantado quirúrgicamente en el pene de las ratas injertos de la submucosa del intestino delgado, junto con células madre derivadas del tejido graso de los animales. Ocho semanas después del implante, los autores del trabajo evaluaron la función eréctil de las ratas y observaron una mejor respuesta en las ratas que recibieron células madre junto a los injertos que las que a solo se les implantó el injerto para la reconstrucción de pene.
El injerto también aumentó la circunferencia del pene de las ratas tratadas. Además, los análisis bioquímicos sugerían que las células madre derivadas de la grasa pueden contribuir a la restauración de los tejidos eréctiles favoreciendo el flujo sanguíneo y la contracción y estimulando la producción de óxido nítrico, que ayuda a mantener las erecciones.
La reconstrucción quirúrgica del pene se emplea para tratar diferentes enfermedades, como la de Peyronie, que se carateriza por el crecimiento fibroso alrededor de los tejidos eréctiles del pene y que produce dolor. Según los autores del trabajo, los injertos de la submucosa del intestino delgado con células madre derivadas de la grasa pueden ser una buena opción para mejorar los resultados de la reconstrucción del pene.
Hace casi un mes, un grupo multidisciplinar coordinado por Javier Romero, del Servicio de Urología, y Marcos Martín Díaz, de Cirugía Plástica, del Hospital Universitario 12 de Octubre, de Madrid, realizó una reconstrucción completa de pene con implante de prótesis a un paciente de 41 años de edad con carcinoma epidermoide en esa zona corporal.
Se trata de la primera intervención quirúrgica de este tipo efectuada en España, ya que existen antecedentes, pero en cirugías de cambio de sexo o no completas, sin prótesis, en caso de mutilación por motivos diversos. La reconstrucción del pene se hizo utilizando una pieza del tejido del propio paciente de la zona anterior del antebrazo derecho nutrida por una arteria y dos venas. Ese tejido fue enrollado a modo de dos cilindros, cada uno en un sentido. De este modo, una de las vueltas sirvió para la reconstrucción de la uretra y la otra para el forro externo cutáneo. El tejido fue implantado en la zona después de darle una estructura sanguínea propia y conectarlo a las arterias y vasos de la zona inguinal.
enero 23/2012 (Diario Médico)
Limin Ma, Yijun Yang, Suresh C. Sikka, Philip J. Kadowitz, Louis J. Ignarro, Wayne J. G. Hellstrom, et. al. Adipose tissue-derived stem cell-seeded small intestinal submucosa for tunica albuginea grafting and reconstruction. PNAS enero 23/2012.
En: Noticias
Iris de Armas Padrino
Granma 20 de enero
La terapia regenerativa ha beneficiado en diez provincias cubanas a más de tres mil pacientes, con resultados prometedores, informó en esta capital el Doctor en Ciencias profesor Porfirio Hernández, pionero en la Isla del novedoso proceder.
Hernández, coordinador nacional de la especialidad, explicó a la AIN que esos logros colocan a Cuba entre los primeros de la región en la introducción y extensión de los tratamientos con células madre.
El también subdirector de investigaciones del Instituto de Hematología e Inmunología (IHI) dijo que en la Isla la terapia celular se aplica en las especialidades de hematología, angiología, cardiología, ortopedia y estomatología, entre otras.
Consiste en utilizar células madre adultas para reconstituir o regenerar células diferentes a ellas.
Los implantes, obtenidos de la médula ósea o sangre periférica, se utilizan en el tratamiento de la insuficiencia arterial crónica, y también han demostrado su valía en afecciones cardiovasculares, periodontitis y en la ortopedia y traumatología.
Puntualizó que en esta última se emplea en fracturas óseas, necrosis de los huesos de la cadera y cabeza del fémur, y en los linfedemas de miembros inferiores, entre otras dolencias.
En el IHI, que ha centralizado las actividades en el banco de sangre, se han entrenado los recursos humanos del país en este proceder, iniciado allí en 2004 junto con especialistas del Hospital General Docente Enrique Cabrera y el pediátrico docente William Soler, y extendido a otros centros del país.
Además de la pronta recuperación del paciente, esta terapéutica es menos invasiva en la mayoría de los casos y brinda un significativo ahorro a la economía, ya que se realiza con métodos menos costosos y resultados positivos, precisó el doctor Hernández.
El científico cubano explicó que las células madre adultas no solo regeneran en el propio tejido, sino también son capaces de formar otros.
En: Noticias
