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【bio-news】成人干细胞进展：第一个组织工程气管移植成功

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Adult Stem Cell Breakthrough: First Tissue-engineered Trachea Successfully Transplanted

http://www.sciencedaily.com/releases/2008/11/081119092939.htm

ScienceDaily (Nov. 18, 2008) — The first tissue-engineered trachea (windpipe), utilising the patient's own stem cells, has been successfully transplanted into a young woman with a failing airway. The bioengineered trachea immediately provided the patient with a normally functioning airway, thereby saving her life.

These remarkable results provide crucial new evidence that adult stem cells, combined with biologically compatible materials, can offer genuine solutions to other serious illnesses.

In particular, the successful outcome shows it is possible to produce a tissue-engineered airway with mechanical properties that permit normal breathing and which is free from the risks of rejection seen with conventional transplanted organs. The patient has not developed antibodies to her graft, despite not taking any immunosuppressive drugs. Lung function tests performed two months after the operation were all at the better end of the normal range for a young woman.

The pan-European team from the universities of Barcelona, Bristol, Padua and Milan report on this pioneering work in an article in The Lancet.

The loss of a normal airway is devastating, but previous attempts to replace large airways have met serious problems. The 30-year-old mother of two, suffering from collapsed airways following a severe case of TB, was hospitalised in March 2008 with acute shortness of breath rendering her unable to carry out simple domestic duties or care for her children. The only conventional option remaining was a major operation to remove her left lung which carries a risk of complications and a high mortality rate.

Based on successful laboratory work previously performed by the team, and given the urgency of the situation, it was proposed that the lower trachea and the tube to the patient's left lung (bronchus) should be replaced with a bioengineered airway based on the scaffold of a human trachea.

A seven-centimetre tracheal segment was donated by a 51-year-old transplant donor who had who had died of cerebral haemorrhage. Spain has a policy of assumed consent for organ donation. Using a new technique developed in Padua University, the trachea was decellularised over a six-week period so that no donor cells remained.

Stem cells were obtained from the recipient's own bone marrow, grown into a large population in Professor Martin Birchall's lab at the University of Bristol, and matured into cartilage cells (chondrocytes) using an adapted method originally devised for treating osteoarthritis by Professor Anthony Hollander at the University of Bristol.

The donor trachea was then seeded with chondrocytes on the outside, using a novel bioreactor which incubates cells, developed at the Politecnico di Milano, Italy, allowing them to migrate into the tissue under conditions ideal for each individual cell type. In order to replicate the lining of the trachea, epithelial cells were seeded onto the inside of the trachea using the same bioreactor.

Four days after seeding, the graft was used to replace the patient's left main bronchus. The operation was performed in June 2008 at the Hospital Clinic, Barcelona, by Professor Paolo Macchiarini of the University of Barcelona.

Professor Macchiarini, lead author on the paper, said: "We are terribly excited by these results. Just four days after transplantation the graft was almost indistinguishable from adjacent normal bronchi. After one month, a biopsy elicited local bleeding, indicating that the blood vessels had already grown back successfully".

Martin Birchall, Professor of Surgery at the University of Bristol, added: "Surgeons can now start to see and understand the very real potential for adult stem cells and tissue engineering to radically improve their ability to treat patients with serious diseases. We believe this success has proved that we are on the verge of a new age in surgical care".

Anthony Hollander, Arthritis Research Campaign Professor of Rheumatology and Tissue Engineering at the University of Bristol, concurred: "This successful treatment manifestly demonstrates the potential of adult stem cells to save lives".

The patient, Claudia Castillo, a young woman from Colombia but now living in Spain, had no complications from the operation and was discharged from hospital on the tenth post-operative day. She has remained well since and has a normal quality of life. She is able to care for her children, walk up two flights of stairs and occasionally go out dancing in the evenings.

--------------------------------------------------------------------------------

Journal reference:

Paolo Macchiarini et al. Clinical transplantation of a tissue-engineered airway. The Lancet, Early Online Publication, 19 November 2008 [link]
Adapted from materials provided by University of Bristol.

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2008-11-20 08:49 浏览 : 902 回复 : 6

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ludong_0 编辑于 2008-11-20 09:29

• 医院合并，有实力的和嘴炮的谁会更容易留下来？

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本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。

2008-11-20 13:35

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Adult Stem Cell Breakthrough: First Tissue-engineered Trachea Successfully Transplanted
成人干细胞的突破：首次组织工程气管移植成功
http://www.sciencedaily.com/releases/2008/11/081119092939.htm
ScienceDaily (Nov. 18, 2008) — The first tissue-engineered trachea (windpipe), utilising the patient's own stem cells, has been successfully transplanted into a young woman with a failing airway. The bioengineered trachea immediately provided the patient with a normally functioning airway, thereby saving her life.
科学日报（2008年11月18日）——首次利用患者自身的干细胞形成的组织工程气管（气道）已成功地移植到一名气道损坏的年轻女子。该生物工程气管立即为该患者提供了正常功能的气道，从而挽救了她的生命。
These remarkable results provide crucial new evidence that adult stem cells, combined with biologically compatible materials, can offer genuine solutions to other serious illnesses.
这些显著的成果为我们提供了重要的新证据，它表明成人干细胞与生物相容性材料相结合，能够为其他严重的疾病提供真正的解决办法。
In particular, the successful outcome shows it is possible to produce a tissue-engineered airway with mechanical properties that permit normal breathing and which is free from the risks of rejection seen with conventional transplanted organs. The patient has not developed antibodies to her graft, despite not taking any immunosuppressive drugs. Lung function tests performed two months after the operation were all at the better end of the normal range for a young woman.
尤其是，该成果表明人们有可能制造出一个具备机械性能的组织工程气道，它保证正常的呼吸功能而且可以免于发生传统器官移植常见的排斥风险。尽管没有采用任何免疫抑制药物，该患者仍没有产生针对她的移植物的抗体。手术后两个月行肺功能测试显示所有指标都处在年轻女子正常肺功能范围的更佳水平。
The pan-European team from the universities of Barcelona, Bristol, Padua and Milan report on this pioneering work in an article in The Lancet.
由来自巴塞罗那、布里斯托尔、帕多瓦和米兰等城市的大学组成的泛欧洲团队在《柳叶刀》上报道了这一开创性的工作。
The loss of a normal airway is devastating, but previous attempts to replace large airways have met serious problems. The 30-year-old mother of two, suffering from collapsed airways following a severe case of TB, was hospitalised in March 2008 with acute shortness of breath rendering her unable to carry out simple domestic duties or care for her children. The only conventional option remaining was a major operation to remove her left lung which carries a risk of complications and a high mortality rate.
虽然失去正常的气道是灾难性的，但以往试图置换大气道的做法都遇到了巨大的困难。这位30岁的两个孩子的母亲在一次严重的肺结核后便遗留下了塌陷的呼吸道，她于2008年3月因急性呼吸窘迫而被送进医院，表现为不能进行简单的家务或照顾她的孩子们。剩下的唯一传统选择就是进行一次大手术切除她的左肺，这将要担当发生并发症的风险和高的死亡率。
Based on successful laboratory work previously performed by the team, and given the urgency of the situation, it was proposed that the lower trachea and the tube to the patient's left lung (bronchus) should be replaced with a bioengineered airway based on the scaffold of a human trachea.
基于该团队前期进行的成功的实验室工作，并鉴于情况的紧迫性，有人提议应将通向该患者左肺的低级气管和支气管替换为基于人类气管支架的生物工程气管。
A seven-centimetre tracheal segment was donated by a 51-year-old transplant donor who had died of cerebral haemorrhage. Spain has a policy of assumed consent for organ donation. Using a new technique developed in Padua University, the trachea was decellularised over a six-week period so that no donor cells remained.
一位死于脑出血的51岁的移植供者捐献了一段七厘米长的气管节段。西班牙有一个关于捐赠器官的默认同意政策。利用帕多瓦大学研发的一种新技术，对该气管进行了六个多星期去细胞处理，以至于不会残留供者细胞。
Stem cells were obtained from the recipient's own bone marrow, grown into a large population in Professor Martin Birchall's lab at the University of Bristol, and matured into cartilage cells (chondrocytes) using an adapted method originally devised for treating osteoarthritis by Professor Anthony Hollander at the University of Bristol.
干细胞取自受者自身的骨髓，并在英国布里斯托尔大学马丁•伯查尔教授的实验室内实现细胞数大量增长，随后应用英国布里斯托尔大学安东尼•霍兰德教授从治疗骨关节炎中改进的方法使其分化成熟为软骨细胞。
The donor trachea was then seeded with chondrocytes on the outside, using a novel bioreactor which incubates cells, developed at the Politecnico di Milano, Italy, allowing them to migrate into the tissue under conditions ideal for each individual cell type. In order to replicate the lining of the trachea, epithelial cells were seeded onto the inside of the trachea using the same bioreactor.
然后应用意大利米兰理工大学研发的一种培养细胞的新型生物反应器，在捐赠气管的外面种植上软骨细胞，该生物反应器在理想情况下可以让细胞迁移到适合于各单个细胞类型的组织内。为了复制出气管的衬里，应用同一生物反应器将上皮细胞种植进气管内表面。
Four days after seeding, the graft was used to replace the patient's left main bronchus. The operation was performed in June 2008 at the Hospital Clinic, Barcelona, by Professor Paolo Macchiarini of the University of Barcelona.
种植完成四天后，该移植物被用来替换患者的左主支气管。该手术由巴塞罗那大学的Paolo Macchiarini教授于2008年6月在巴塞罗那医院门诊部完成。
Professor Macchiarini, lead author on the paper, said: "We are terribly excited by these results. Just four days after transplantation the graft was almost indistinguishable from adjacent normal bronchi. After one month, a biopsy elicited local bleeding, indicating that the blood vessels had already grown back successfully".
Macchiarini教授是该论文的第一作者。他说：“我们为这些成果而感到非常兴奋。移植术后仅仅四天，移植物就与相邻正常支气管几乎毫无区别。一个月后，活检时引起局限性出血，这表明血管已经成功地重新生长。”
Martin Birchall, Professor of Surgery at the University of Bristol, added: "Surgeons can now start to see and understand the very real potential for adult stem cells and tissue engineering to radically improve their ability to treat patients with serious diseases. We believe this success has proved that we are on the verge of a new age in surgical care".
英国布里斯托尔大学外科学马丁•伯查尔教授补充说：“外科医生们现在就可以开始看到并理解成人干细胞的真实潜力与组织工程将从根本上改善他们治疗某些严重疾患的能力。我们认为这一成功事例已证明我们正处在一个外科处理新时代的边缘。”
Anthony Hollander, Arthritis Research Campaign Professor of Rheumatology and Tissue Engineering at the University of Bristol, concurred: "This successful treatment manifestly demonstrates the potential of adult stem cells to save lives".
英国布里斯托尔大学风湿病学和组织工程关节炎研究课题教授安东尼•霍兰德与此意见一致，“这次成功的治疗明确地表明成人干细胞在挽救生命方面的潜力。”
The patient, Claudia Castillo, a young woman from Colombia but now living in Spain, had no complications from the operation and was discharged from hospital on the tenth post-operative day. She has remained well since and has a normal quality of life. She is able to care for her children, walk up two flights of stairs and occasionally go out dancing in the evenings.
患者（克劳迪亚•卡斯蒂略）是一名来自哥伦比亚的年轻女子，但现在生活在西班牙。她没有发生任何手术并发症并于手术后第十天出院。她身体状态一直保持良好并且有着正常的生活质量。她现在能够照料她的孩子、爬两层楼梯、偶尔晚上还外出去跳舞。
--------------------------------------------------------------------------------
Journal reference:
参考期刊：
Paolo Macchiarini et al. Clinical transplantation of a tissue-engineered airway. The Lancet, Early Online Publication, 19 November 2008 [link]
Adapted from materials provided by University of Bristol.
Paolo Macchiarini等.组织工程气管的临床移植.柳叶刀,前期网上发布,2008年11月19日[ 链接]
改编自布里斯托尔大学所提供的材料。

2008-11-22 19:05

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梦在远方编辑于 2008-11-22 19:10

• 我的心酸读研路

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成人干细胞的突破：首次组织工程气管移植成功
科学日报（2008年11月18日）——首次利用患者自身的干细胞形成的组织工程气管（气道）已成功地移植到一名气道损坏的年轻女子。该生物工程气管立即为该患者提供了正常功能的气道，从而挽救了她的生命。
这些显著的成果为我们提供了重要的新证据，它表明成人干细胞与生物相容性材料相结合，能够为其他严重的疾病提供真正的解决办法。
尤其是，该成果表明人们有可能制造出一个具备机械性能的组织工程气道，它保证正常的呼吸功能而且可以免于发生传统器官移植常见的排斥风险。尽管没有采用任何免疫抑制药物，该患者仍没有产生针对她的移植物的抗体。手术后两个月行肺功能测试显示所有指标都处在年轻女子正常肺功能范围的更佳水平。
由来自巴塞罗那、布里斯托尔、帕多瓦和米兰等城市的大学组成的泛欧洲团队在《柳叶刀》上报道了这一开创性的工作。
虽然失去正常的气道是灾难性的，但以往试图置换大气道的做法都遇到了巨大的困难。这位30岁的两个孩子的母亲在一次严重的肺结核后便遗留下了塌陷的呼吸道，她于2008年3月因急性呼吸窘迫而被送进医院，表现为不能进行简单的家务或照顾她的孩子们。剩下的唯一传统选择就是进行一次大手术切除她的左肺，这将要担当发生并发症的风险和高的死亡率。
基于该团队前期进行的成功的实验室工作，并鉴于情况的紧迫性，有人提议应将通向该患者左肺的低级气管和支气管替换为基于人类气管支架的生物工程气管。
一位死于脑出血的51岁的移植供者捐献了一段七厘米长的气管节段。西班牙有一个关于捐赠器官的默认同意政策。利用帕多瓦大学研发的一种新技术，对该气管进行了六个多星期去细胞处理，以至于不会残留供者细胞。
干细胞取自受者自身的骨髓，并在英国布里斯托尔大学马丁•伯查尔教授的实验室内实现细胞数大量增长，随后应用英国布里斯托尔大学安东尼•霍兰德教授从治疗骨关节炎中改进的方法使其分化成熟为软骨细胞。
然后应用意大利米兰理工大学研发的一种培养细胞的新型生物反应器，在捐赠气管的外面种植上软骨细胞，该生物反应器在理想情况下可以让细胞迁移到适合于各单个细胞类型的组织内。为了复制出气管的衬里，应用同一生物反应器将上皮细胞种植进气管内表面。
种植完成四天后，该移植物被用来替换患者的左主支气管。该手术由巴塞罗那大学的Paolo Macchiarini教授于2008年6月在巴塞罗那医院门诊部完成。
Macchiarini教授是该论文的第一作者。他说：“我们为这些成果而感到非常兴奋。移植术后仅仅四天，移植物就与相邻正常支气管几乎毫无区别。一个月后，活检时引起局限性出血，这表明血管已经成功地重新生长。”
英国布里斯托尔大学外科学马丁•伯查尔教授补充说：“外科医生们现在就可以开始看到并理解成人干细胞的真实潜力与组织工程将从根本上改善他们治疗某些严重疾患的能力。我们认为这一成功事例已证明我们正处在一个外科处理新时代的边缘。”
英国布里斯托尔大学风湿病学和组织工程关节炎研究课题教授安东尼•霍兰德与此意见一致，“这次成功的治疗明确地表明成人干细胞在挽救生命方面的潜力。”
患者（克劳迪亚•卡斯蒂略）是一名来自哥伦比亚的年轻女子，但现在生活在西班牙。她没有发生任何手术并发症并于手术后第十天出院。她身体状态一直保持良好并且有着正常的生活质量。她现在能够照料她的孩子、爬两层楼梯、偶尔晚上还外出去跳舞。
--------------------------------------------------------------------------------
参考期刊：
Paolo Macchiarini等.组织工程气管的临床移植.柳叶刀,前期网上发布,2008年11月19日[ 链接]
改编自布里斯托尔大学所提供的材料。

2008-11-22 19:12

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