幹細胞論壇

     根據衛生福利部統計，國人膝關節退化的盛行率約15%，推估有350萬人飽受膝關節疼痛之苦，五十歲的發生率為20至30%，七十歲以上則高達70%。且隨著運動風氣盛行，很多人的膝蓋常會不當使用，患者年齡層由60、70歲逐漸下降，更已出現30、40歲的患者，呈現越來越年輕化趨勢。

    退化性關節炎主要的症狀是疼痛、僵硬、腫大和變形，一生中，罹患退化性關節炎幾乎無法避免，依據健保署統計，每年有 2萬人須置換人工關節，才能行動自如。但現在已證實，可以利用間葉幹細胞達到軟骨再生的效果，改善關節退化。^1.2.3

    西班牙研究團隊發表 “使用自體間葉幹細胞治療膝關節炎的先導型臨床試驗”。針對12名慢性膝關節疼痛且對保守治療沒有反應的患者進行間葉幹細胞膝關節內注射，並追蹤1年觀察成效。結果顯示，注射間葉幹細胞至膝關節的方法簡單，不需要住院或手術，且可緩解疼痛，降低軟骨缺乏區域的比例，提升軟骨品質。⁴

Treatment of Knee Osteoarthritis With Autologous Mesenchymal Stem Cells: A Pilot Study

Background: Osteoarthritis is the most prevalent joint disease and a frequent cause of joint pain, functional loss, and disability. Osteoarthritis often becomes chronic, and conventional treatments have demonstrated only modest clinical benefits without lesion reversal. Cell-based therapies have shown encouraging results in both animal studies and a few human case reports. We designed a pilot study to assess the feasibility and safety of osteoarthritis treatment with mesenchymal stromal cells (MSCs) in humans and to obtain early efficacy information for this treatment.

Methods: Twelve patients with chronic knee pain unresponsive to conservative treatments and radiologic evidence of osteoarthritis were treated with autologous expanded bone marrow MSCs by intra-articular injection (40×106 cells). Clinical outcomes were followed for 1 year and included evaluations of pain, disability, and quality of life. Articular cartilage quality was assessed by quantitative magnetic resonance imaging T2 mapping.

Results: Feasibility and safety were confirmed, and strong indications of clinical efficacy were identified. Patients exhibited rapid and progressive improvement of algofunctional indices that approached 65% to 78% by 1 year. This outcome compares favorably with the results of conventional treatments. Additionally, quantification of cartilage quality by T2 relaxation measurements demonstrated a highly significant decrease of poor cartilage areas (on average, 27%), with improvement of cartilage quality in 11 of the 12 patients.

Conclusions: MSC therapy may be a valid alternative treatment for chronic knee osteoarthritis. The intervention is simple, does not require hospitalization or surgery, provides pain relief, and significantly improves cartilage quality.

資料來源：

1. http://paper.udn.com/udnpaper/POE0011/289550/web/

2. http://www.kmuh.org.tw/www/kmcj/data/9109/10.htm

3. http://www.tahsda.org.tw/newsletters/?p=2655

4. Transplantation . 95(12):1535-1541, June 27, 2013

編輯整理：幹細胞論壇部落格