{"id":35586,"date":"2020-08-26T00:56:13","date_gmt":"2020-08-25T16:56:13","guid":{"rendered":"https:\/\/case.ntu.edu.tw\/blog\/?p=35586"},"modified":"2020-08-21T13:04:03","modified_gmt":"2020-08-21T05:04:03","slug":"%e9%96%93%e8%b3%aa%e5%b9%b9%e7%b4%b0%e8%83%9e%e7%99%82%e6%b3%95%e7%82%ba%e9%87%8d%e7%97%87-covid-19-%e7%9a%84%e6%b2%bb%e7%99%82%e9%96%8b%e5%95%9f%e4%b8%80%e9%81%93%e6%9b%99%e5%85%89","status":"publish","type":"post","link":"https:\/\/case.ntu.edu.tw\/blog\/?p=35586","title":{"rendered":"\u9593\u8cea\u5e79\u7d30\u80de\u7642\u6cd5\u70ba\u91cd\u75c7 COVID-19 \u7684\u6cbb\u7642\u958b\u555f\u4e00\u9053\u66d9\u5149"},"content":{"rendered":"
\"\"
\u5716\u7247\u4f86\u6e90: pixabay<\/figcaption><\/figure>\n

\u9593\u8cea\u5e79\u7d30\u80de\uff08MSC\uff09\u5177\u6709\u986f\u8457\u7684\u6297\u767c\u708e\u548c\u514d\u75ab\u8abf\u7bc0\u7684\u80fd\u529b\uff0c\u9019\u662fMSC\u5728\u81e8\u5e8a\u8a66\u9a57\u6700\u91cd\u8981\u7684\u7126\u9ede\uff0c\u53ef\u65bc\u9ad4\u5916\u57f9\u990a\u7684\u7279\u6027\u986f\u793a\u5176\u61c9\u5177\u6709\u66f4\u5ee3\u6cdb\u7684\u61c9\u7528\u7bc4\u570d\uff0c\u53ef\u7528\u7684\u91ab\u7642\u7528\u9014\u4ecd\u5728\u6301\u7e8c\u958b\u767c\u4e2d\uff0c\u76ee\u524d\u5df2\u5617\u8a66\u7528\u4f86\u6cbb\u7642COVID-19\u3002\u5118\u7ba1MSC\u7814\u7a76\u9818\u57df\u7684\u4e0d\u65b7\u64f4\u5927\u548c\u767c\u5c55\uff0c\u5df2\u53ef\u5728\u5404\u7a2e\u81e8\u5e8a\u74b0\u5883\u8a66\u9a57\u4f7f\u7528MSC\u9032\u884c\u7d30\u80de\u6cbb\u7642\uff0c\u4f46\u4ecd\u61c9\u8b39\u614e\u8a55\u4f30\u75c5\u4eba\u7684\u9700\u8981\u3001\u6cbb\u7642\u5229\u76ca\u53ca\u6f5b\u5728\u98a8\u96aa\uff0c\u4e26\u89c0\u5bdf\u9810\u5f8c\u60c5\u6cc1\uff0c\u800c\u6069\u6148\u7642\u6cd5\u6b63\u53ef\u63d0\u4f9b\u4e00\u500bCOVID-19\u91cd\u75c7\u60a3\u8005\u7684\u53ef\u80fd\u6cbb\u7642\u9078\u64c7\u3002<\/strong><\/span><\/p>\n

\u64b0\u6587\uff0f\u9673\u6df5\u9293<\/strong><\/p>\n

\u25cf\u9593\u8cea\u5e79\u7d30\u80de\u7684\u8a8d\u8b58<\/strong><\/span><\/p>\n

\u9593\u8cea\u5e79\u7d30\u80de\uff08mesenchymal stem cell, multipotential stromal cell, mesenchymal stromal cell, mesenchymal progenitor cell, MSC\uff09\u6e90\u65bc\u80ce\u5152\u65e9\u671f\u767c\u80b2\u7684\u4e2d\u80da\u5c64\uff0c\u662f\u6709\u5206\u5316<\/a>\u6f5b\u80fd\u7684\u7d30\u80de\u7fa4\uff0c\u5c6c\u65bc\u591a\u529f\u80fd\u5e79\u7d30\u80de\uff0c\u5177\u6709\u9ad8\u5ea6\u81ea\u6211\u589e\u751f\u53ca\u591a\u91cd\u5206\u5316\u7684\u80fd\u529b\uff0c\u53ef\u5206\u5316\u70ba\u591a\u7a2e\u7d30\u80de\uff0c\u5982\u795e\u7d93\u3001\u9aa8\u9abc\u3001\u8102\u80aa\u3001\u808c\u8089\u53ca\u5167\u81df\u7d30\u80de\u7b49\u3002MSC\u4f86\u6e90\u6700\u591a\u7684\u662f\u9aa8\u9ad3\u8154\uff0c\u5176\u6b21\u662f\u81cd\u5e36\u8840\u3001\u8102\u80aa\u7d44\u7e54\u53ca\u95dc\u7bc0\u6db2\u7b49\uff0c\u6240\u542b\u6700\u91cd\u8981\u7684\u8fa8\u8b58\u6297\u539f\u662f\u4e3b\u8981\u7d44\u7e54\u76f8\u5bb9\u6027\u8907\u5408\u9ad4I\u53caII (major histocompatibility complex class I and II; MHC I, II)\u3002MSC\u53ef\u6291\u5236\u7d30\u80de\u6bd2\u6027T\u7d30\u80de\uff08cytotoxic T cell, Tc\uff09\u7684\u589e\u751f\u53ca\u8abf\u7bc0CD4\uff0b\u3001CD8\uff0b\u7684\u6d3b\u6027\uff0c\u4e26\u63d0\u9ad8\u8abf\u7bc0\u6027T\u7d30\u80de\uff08regulatory T cell\uff09\u7684\u6578\u91cf\u4ee5\u964d\u4f4e\u514d\u75ab\u7d30\u80de\u7684\u904e\u5ea6\u8868\u73fe\uff0c\u4ea6\u9593\u63a5\u6291\u5236\u6a39\u7a81\u7d30\u80de\uff08dendritic cell, DC\uff09\u4f7f\u5176\u6e1b\u5c11\u5206\u6ccc\u5f15\u8d77\u767c\u708e\u53cd\u61c9\u7684\u7d30\u80de\u6fc0\u7d20\uff08cytokine\uff09\uff0c\u4e14\u5176\u6297\u539f\u6027\u6bd4\u5176\u4ed6\u5e79\u7d30\u80de\u5c0f\uff0c\u8f03\u4e0d\u6613\u5f15\u8d77\u79fb\u690d\u9ad4\u5c0d\u6297\u5bbf\u4e3b\u75be\u75c5\uff08graft versus host disease, GVHD\uff09\u3002\u6b64\u5916\uff0cMSC\u53ef\u65bc\u9ad4\u5916\u57f9\u990a\u4e26\u5206\u5316\u6210\u5176\u4ed6\u7d30\u80de\uff0c\u5728\u6d3b\u9ad4\u5167\u80fd\u8f49\u79fb\u5230\u53d7\u50b7\u7684\u4f4d\u7f6e\uff0c\u91cb\u653e\u51fa\u591a\u7a2e\u86cb\u767d\u8cea\uff0c\u8abf\u7bc0\u514d\u75ab\u53cd\u61c9\u3001\u6e1b\u5c11\u767c\u708e\u3001\u4fc3\u9032\u50b7\u53e3\u7652\u5408\u53ca\u6291\u5236\u7d30\u80de\u6b7b\u4ea1\uff0c\u7528\u65bc\u7d44\u7e54\u8207\u5668\u5b98\u7684\u518d\u751f\u4fee\u5fa9\u3002<\/p>\n

\u25cf\u958b\u767c<\/strong>MSC<\/strong>\u4f5c\u70ba\u5c0d\u6297<\/strong> COVID-19<\/strong>\u7684\u7b56\u7565<\/strong><\/span><\/p>\n

MSC\u7642\u6cd5\u5df2\u88ab\u8b49\u660e\u53ef\u4f5c\u70ba\u6025\u6027\u547c\u5438\u7a98\u8feb\u75c7\u5019\u7fa4\uff08acute respiratory distress syndrome, ARDS\uff09\u60a3\u8005\u5b89\u5168\u6709\u6548\u7684\u65b0\u578b\u5c0d\u6297SARS-CoV-2\u7684\u7b56\u7565\u3002\u5177\u6709\u514d\u75ab\u8abf\u7bc0\u3001\u518d\u751f\u548c\u6297\u767c\u708e\u7279\u6027\u7684MSC\u5df2\u88ab\u63d0\u51fa\u4f5c\u70ba\u6cbb\u7642\u7684\u65b9\u6cd5\uff0c\u4e26\u5df2\u958b\u59cb\u4e86\u6cbb\u7642COVID-19\u7684\u81e8\u5e8a\u8a66\u9a57\uff0c\u79d1\u5b78\u5bb6\u5df2\u7d93\u61c9\u7528\u4e86\u4e00\u7cfb\u5217\u4e0d\u540c\u7684\u7d30\u80de\u4f86\u6e90\u3001\u5291\u91cf\u3001\u7d66\u85e5\u7b56\u7565\u548c\u76ee\u6a19\u75c5\u60a3\u7fa4\u9ad4\uff0c\u521d\u6b65\u767c\u73feMSC\u79fb\u690d\u5f8c\uff0c\u6703\u5927\u91cf\u5728\u80ba\u90e8\u7a4d\u7d2f\uff0c\u767c\u63ee\u7684\u514d\u75ab\u8abf\u7bc0\u4f5c\u7528\u53ef\u4ee5\u4fdd\u8b77\u80ba\u6ce1\u4e0a\u76ae\u7d30\u80de\u3001\u6062\u5fa9\u80ba\u5fae\u74b0\u5883\uff08pulmonary microenvironment\uff09\u3001\u9810\u9632\u80ba\u7e96\u7dad\u5316\u53ca\u6cbb\u6108\u80ba\u529f\u80fd\u969c\u7919\u3002\u7136\u800c\uff0c\u76ee\u524d\u5c1a\u672a\u6b63\u5f0f\u6279\u51c6MSC\u7528\u65bc\u9810\u9632\u6216\u6cbb\u7642COVID-19\uff0c\u81e8\u5e8a\u8a66\u9a57\u4ecd\u5728\u9032\u884c\u4e2d\u3002<\/p>\n

\u57282020\u5e74\uff0c\u4e2d\u570b\u7814\u7a76\u4eba\u54e1\u4ee5\u975c\u8108\u6ce8\u5c04\u7684\u65b9\u5f0f\u6295\u8207MSC\u52307\u540dCOVID-19\u60a3\u8005\u4ee5\u7814\u7a76MSC\u79fb\u690d\u662f\u5426\u5177\u6709\u7642\u6548\u3002\u4ed6\u5011\u6301\u7e8c\u8a55\u4f30\u60a3\u8005\u7684\u81e8\u5e8a\u6cbb\u7642\u7d50\u679c\uff08clinical outcome\uff09\u3001\u767c\u708e\u7684\u8b8a\u5316\u3001\u514d\u75ab\u529f\u80fd\u6c34\u5e73\u548c\u4e0d\u826f\u53cd\u61c914\u5929\uff0c\u89c0\u5bdf\u5230MSC\u53ef\u4ee5\u6539\u5584\u6240\u6709\u60a3\u8005\u7684\u81e8\u5e8a\u75c7\u72c0\uff0c\u4e14\u672a\u6709\u4efb\u4f55\u4e0d\u826f\u53cd\u61c9\u3002\u8a66\u9a57\u6578\u64da\u986f\u793a\u79fb\u690dMSC\u5f8c\uff0c\u5468\u570d\u6dcb\u5df4\u7d30\u80de\u589e\u52a0\uff0cC\u53cd\u61c9\u86cb\u767d\uff08reactive protein\uff09\u6e1b\u5c11\uff0c\u800c\u4e14\u539f\u672c\u56e0\u904e\u5ea6\u6d3b\u5316\u800c\u5206\u6ccc\u7d30\u80de\u6fc0\u7d20\u7684CXCR3 + CD4 + T\u7d30\u80de\uff08\u8f14\u52a9T\u7d30\u80de\uff0cTh cell\uff09\u3001CXCR3 + CD8 + T\u7d30\u80de\uff08Tc cell\uff09\u53caCXCR3 +\u81ea\u7136\u6bba\u624b\uff08natural killer, NK\uff09\u7d30\u80de\u57283\u52306\u5929\u5167\u6d88\u5931\uff0c\u53e6\u5916\u8abf\u7bc0\u6027DC\u7684\u6578\u91cf\u5247\u6025\u901f\u589e\u52a0\u3002\u6b64\u5916\uff0c\u8207\u5b89\u6170\u5291\u7d44\u6bd4\u8f03\uff0cMSC\u6cbb\u7642\u7d44\u7684\u816b\u7624\u58de\u6b7b\u56e0\u5b50\u03b1\uff08tumor necrosis factor \u03b1, TNF-\u03b1\uff09\u6c34\u5e73\u964d\u4f4e\u4e14\u6297\u767c\u708e\u7684\u767d\u8840\u7403\u4ecb\u7d20-10\uff08interleukin-10, IL-10\uff09\u6fc3\u5ea6\u5347\u9ad8\u3002\u81e8\u5e8a\u8a66\u9a57\u7d50\u679c\u767c\u73feCOVID-19\u60a3\u8005\u7684\u9810\u5f8c\uff08prognosis\uff09\u986f\u8457\u6539\u5584\uff0c\u539f\u56e0\u53ef\u80fd\u662fMSC\u8abf\u7bc0\u767c\u708e\u53cd\u61c9\u53ca\u4fc3\u9032\u7d44\u7e54\u518d\u751f\u4fee\u5fa9\uff0c\u53ef\u898bMSC\u79fb\u690d\u61c9\u8a72\u662f\u5b89\u5168\u6709\u6548\u7684\uff0c\u7279\u5225\u662f\u5c0d\u91cd\u75c7\u60a3\u8005\u3002<\/p>\n

\u57282020\u5e74\uff0c\u7f8e\u570b\u7814\u7a76\u4eba\u54e1\u6839\u64da\u51a0\u72c0\u75c5\u6bd2SARS-CoV-2\u7684\u75c5\u539f\u6027\uff0c\u6558\u8ff0\u4f7f\u7528MSC\u6cbb\u7642COVID-19\u7684\u81e8\u5e8a\u8b49\u64da\u53ca\u63a1\u7528\u6069\u6148\u7642\u6cd5<\/strong>\uff08compassionate use \u6216 expanded access\uff09\u7684\u9700\u8981\u3002\u4ed6\u5011\u767c\u73fe\u6b63\u5728\u7814\u7a76\u4e2d\u7684\u81cd\u5e36\u9593\u8cea\u5e79\u7d30\u80de\uff08umbilical cord mesenchymal stem cell, UC-MSC\uff09\u5728\u6cbb\u7642COVID-19\u6642\u53ef\u4ee5\u767c\u63ee\u4f5c\u7528\u3002\u7531\u65bcCOVID-19\u7684\u6cbb\u7642\u5fc5\u9808\u4f9d\u8cf4\u60a3\u8005\u81ea\u8eab\u7684\u514d\u75ab\u7cfb\u7d71\uff0c\u5982\u679c\u70ba\u4e86\u6bba\u6b7b\u75c5\u6bd2\u800c\u904e\u5ea6\u523a\u6fc0\u514d\u75ab\u7cfb\u7d71\uff0c\u4fbf\u6703\u5f15\u767c\u8a31\u591a\u767c\u708e\u56e0\u5b50\u7522\u751f\uff0c\u9032\u800c\u5c0e\u81f4\u56b4\u91cd\u7684\u7d30\u80de\u6fc0\u7d20\u98a8\u66b4\uff08cytokine storm\uff09\uff0c\u53ef\u80fd\u6703\u640d\u5bb3\u5668\u5b98\uff0c\u4e26\u9020\u6210\u6c34\u816b\u3001\u6c23\u9ad4\u4ea4\u63db\u529f\u80fd\u969c\u7919\u3001ARDS\u3001\u6025\u6027\u5fc3\u81df\u50b7\u5bb3\u53ca\u4e8c\u6b21\u611f\u67d3\uff08secondary infection\uff09\u7b49\uff0c\u751a\u81f3\u5c0e\u81f4\u75c5\u4eba\u6b7b\u4ea1\u3002\u6839\u64da\u4f7f\u7528UC-MSC\u6cbb\u7642COVID-19\u7684\u7d50\u679c\u986f\u793a\uff0c\u5df2\u6709\u6709\u9650\u8b49\u64da\u8b49\u660eUC-MSC\u80fd\u907f\u514d\u7d30\u80de\u6fc0\u7d20\u98a8\u66b4\u767c\u751f\uff0c\u6545\u6069\u6148\u7642\u6cd5\u61c9\u53ef\u7528\u65bc\u91cd\u75c7\u60a3\u8005\u4ee5\u964d\u4f4e\u767c\u75c5\u7387\u548c\u6b7b\u4ea1\u7387\u3002<\/p>\n

\u25cf\u6700\u53ef\u80fd\u7684<\/strong>MSC<\/strong>\u6cbb\u7642\u9078\u64c7\uff0d\uff0d\u6069\u6148\u7642\u6cd5<\/strong><\/span><\/p>\n

\u73fe\u968e\u6bb5MSC\u6cbb\u7642\u61c9\u7528\u65bc\u5c0d\u6297 COVID-19\u6700\u6709\u53ef\u80fd\u7684\u9078\u64c7\u61c9\u662f\u7d93\u904e\u7279\u5225\u6279\u51c6\u7684\u6069\u6148\u7642\u6cd5\uff0c\u5c0d\u65bc\u7acb\u5373\u5371\u53ca\u751f\u547d\u6216\u56b4\u91cd\u75be\u75c5\u7684\u60a3\u8005\u800c\u8a00\uff0c\u6069\u6148\u7642\u6cd5\u662f\u7372\u5f97\u7814\u7a76\u6027\u91ab\u7642\u7522\u54c1\u4f7f\u7528\u8a31\u53ef\u7684\u6700\u4f73\u9014\u5f91\uff0c\u5305\u62ec\u5316\u5b78\u85e5\u54c1\uff0c\u751f\u7269\u85e5\u54c1\u6216\u91ab\u7642\u5668\u6750\u3002\u9019\u4e9b\u7814\u767c\u4e2d\u7684\u91ab\u7642\u7522\u54c1\u5c1a\u672a\u7372\u5f97\u6838\u51c6\uff0c\u4e14\u5c1a\u672a\u78ba\u8a8d\u5176\u7279\u5b9a\u7528\u9014\u7684\u5b89\u5168\u6027\u53ca\u6709\u6548\u6027\uff0c\u4ea6\u53ef\u80fd\u6703\u5f15\u8d77\u4e0d\u78ba\u5b9a\u7684\u526f\u4f5c\u7528\u3002\u7136\u800c\uff0c\u5728\u6a5f\u69cb\u5be9\u67e5\u59d4\u54e1\u6703\uff08institutional review board, IRB\uff09\u7684\u56b4\u683c\u5be9\u67e5\u53ca\u76e3\u7763\uff0c\u4e26\u5728\u75c5\u60a3\u77e5\u60c5\u540c\u610f\u7684\u689d\u4ef6\u4e0b\uff0c\u53ef\u5728\u6c92\u6709\u985e\u4f3c\u6216\u7b26\u5408\u9700\u6c42\u7684\u6cbb\u7642\u9078\u64c7\u6642\uff0c\u7533\u8acb\u4f7f\u7528\u9019\u4e9b\u91ab\u7642\u7522\u54c1\u9032\u884c\u6cbb\u7642\uff0c\u4f46\u61c9\u7b26\u5408\u7279\u5b9a\u7684\u689d\u4ef6\uff08\u88681\uff09\u3002<\/p>\n

\"\"<\/p>\n

\u53c3\u8003\u8cc7\u6599\uff1a<\/strong><\/p>\n

    \n
  1. Leng Z, Zhu R, Hou W, Feng Y, Yang Y, Han Q, Shan G, Meng F, Du D, Wang S, Fan J, Wang W, Deng L, Shi H, Li H, Hu Z, Zhang F, Gao J, Liu H, Li X, Zhao Y, Yin K, He X, Gao Z, Wang Y, Yang B, Jin R, Stambler I, Lim LW, Su H, Moskalev A, Cano AC. Transplantation of ACE2- mesenchymal stem cells improve the outcome of patients with COVID-19 pneumonia. Aging Dis 2020, 11:216-228.<\/li>\n
  2. Atluri S, Manchikanti L, Hirsch JA. Expanded umbilical cord mesenchymal stem cells (UC-MSCs) as a therapeutic strategy in managing critically Ill COVID-19 patients: The case for compassionate use. Pain Physician. 2020, 23(2): E71-E83.<\/li>\n
  3. US FDA website. Available from: https:\/\/www.fda.gov\/news-events\/public-health-focus\/expanded-access<\/a><\/li>\n
  4. EMA website. Available from: https:\/\/www.ema.europa.eu\/en\/human-regulatory\/research-development\/compassionate-use<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

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