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目的观察临床级脐带间充质干细胞(clinical grade umbilical cord mesenchymal stem cell,UC-MSC)治疗放射性肺纤维化(radiation-induced pulmonary fibrosis,RPF)的安全性和有效性。方法从2014年1月至2016年6月共入组8例RPF患者,其中2例乳腺癌,6例肺癌。通过支气管镜对RPF病灶部位灌洗后单次注入脐带间充质干细胞(1×10~6/kg),观察治疗前及治疗后第3天、3个月、6个月的临床症状、血液指标和圣乔治呼吸问卷(St George’s respiratory questionnaire,SGRQ)、6 min步行距离(six-minute walk distance,6MWD)、肺功能指标、相关炎症因子、CT肺密度的变化情况。结果 8例患者均能耐受UC-MSC治疗,6例患者自觉气促、咳嗽等症状有所好转,圣乔治呼吸问卷评分有差异(P<0.05),血常规、C反应蛋白、肝肾功指标治疗前后无明显变化,转化生长因子-β1(transforming growth factor-β1,TGF-β1)在治疗后有下降趋势,但差异无统计学意义(P>0.05),CT肺密度自身治疗前后比较有下降。结论 UC-MSC治疗RPF对患者的肝肾等主要脏器无损害,且能够减轻患者的临床症状和降低肺纤维化密度,但其确切的治疗效果及机制需更加严谨的研究进一步证实。
Objective To investigate the safety and efficacy of clinical grade umbilical cord mesenchymal stem cells (UC-MSCs) in the treatment of radiation-induced pulmonary fibrosis (RPF). Methods From January 2014 to June 2016, a total of 8 RPF patients were enrolled in the study. Among them, 2 were breast cancer and 6 were lung cancer. Umbilical cord mesenchymal stem cells (1 × 10 ~ 6 / kg) were infused into the RPF lesion through bronchoscopy. The clinical symptoms, blood and blood samples were observed before and 3 days, 3 months and 6 months after treatment. Indicators and St George’s respiratory questionnaire (SGRQ), 6-minute walk distance (6MWD), pulmonary function indicators, related inflammatory cytokines and CT lung density. Results All 8 patients were able to tolerate UC-MSCs. Six patients had spontaneous shortness of breath, cough and other symptoms improved, St. George’s Respiratory Questionnaire scores were significantly different (P <0.05), blood routine, C-reactive protein There was no significant difference between before and after treatment (P> 0.05). The levels of transforming growth factor-β1 (TGF-β1) decreased after treatment, but there was no significant difference decline. Conclusion The treatment of RPF by UC-MSC has no harm to the liver and kidney and other major organs of patients, and can reduce the clinical symptoms and reduce the density of pulmonary fibrosis. However, its exact therapeutic effect and mechanism need to be further confirmed.