幹細胞論壇

美國芝加哥西北大學與西北紀念醫院的研究團隊，日前發表慢性心絞痛的第二期臨床試驗結果: 利用病患自身的CD34+造血幹細胞，注入心臟受損的部位，於六個月後可有效減緩心絞痛的心肌壞死程度，並持續增強病患的運動能力，減緩胸悶程度。這項發現已刊登在"美國心臟協會"的線上期刊。

這項試驗對象為167位患有心絞痛的病患，以每公斤注入10萬顆自體骨髓造血幹細胞做治療，總共注射心肌壞死的10個區域。造血幹細胞能促進血球生成與血管新生，因此能降低心肌細胞的缺氧現象。六個月後，病患的受損程度由10.9降為6.8，病患的運動耐受程度也持續增加，不論是行走或起立，無明顯的胸痛現象。

過去心絞痛有賴於血管繞道手術或藥物治療，先前幹細胞的研究多針對急性心絞痛，並用心臟成體幹細胞做治療，而這次利用造血幹細胞的臨床試驗，具有更顯著的效果，維持改善的情形。

Cardiac injections of hematopoietic stem cells can help relieve refractory chest pain, a large phase II study determined

A relatively low dose of patients' own CD34-positive stem cells reduced weekly angina episodes to 6.8, compared with 10.9 among placebo-treated patients at six months (P=0.020), Douglas W. Losordo, MD, of Northwestern Memorial Hospital and Northwestern University in Chicago, and colleagues found.

Those benefits persisted out to one year, along with a substantial boost in exercise capability, they reported online in Circulation Research: Journal of the American Heart Association.

The study is the first randomized U.S. trial of stem cells for chronic angina, as research has focused more on the acute heart attack setting.

But the CD34-positive cells used in the study are routinely used during treatment of certain types of cancer, where they are known as hematopoietic stem cells. These cells boost both bone marrow function and blood vessel formation, which presumably cuts down on the cardiac ischemia that causes angina.

Stem cell therapies for the heart remain experimental except in South Korea, which last week became the first in the world to approve clinical use in acute myocardial infarction.

http://www.medpagetoday.com/Cardiology/AcuteCoronarySyndrome/27458