کاربردهای سلول درمانی و ژن درمانی در آسیب های نخاعی

نوع مقاله : Review Article

نویسنده

دکترای تخصصی ژنتیک مولکولی، مرکز تحقیقات ژنتیک انسانی، دانشگاه علوم پزشکی بقیه‌اله الاعظم (عج)، تهران، ایران

چکیده

از سلول‌های بنیادی به دلیل تکثیر فراوان و خود بازسازی، روش امیدوار کننده‌ای در درمان آسیب‌های نخاعی به حساب می‌آید. به دلیل قابلیت‌های متعدد سلول‌های بنیادی، پیشرفت‌های فراوانی در زمینه‌ی ژن‌درمانی و به ویژه سلول‌درمانی در سه سطح آزمایشگاهی، پیش‌بالینی و بالینی تا کنون حاصل شده‌اند، اما به منظور این که این روش‌های درمانی در نهایت به سطح بالینی وارد گردند، باید یک سری موانع همچون موانع اخلاقی، تومورزایی، رد ایمنی، تمایز به سلول‌های غیر هدف و مشکلات مربوط به آزمایش‌های انسانی را پشت سر بگذارند. در این خصوص، راهبردهای بهینه‌سازی در زمینه‌ی مسیر، محل و زمان تزریق نیز صورت گرفته است. بررسی منابع نشان می‌دهد که هنوز سلول‌های بنیادی مزانشیمی نسبت به سایر انواع سلول‌های بنیادی جهت کاربردهای بالینی مزیت ویژه‌ای دارند، هر چند پیش‌بینی می‌شود در آینده‌ای نزدیک، روش تبدیل مستقیم سلول‌ها به یکدیگر، توانایی جایگزینی روش پیوند سلول‌های بنیادی مزانشیمی را داشته باشد. نظر به پاتوفیزیولوژی پیچیده‌ی آسیب‌های نخاعی، کاربرد ترکیبی از روش‌های درمانی به طور هم‌زمان (به طور مثال سلول‌درمانی، ژن‌درمانی و پیوند هم‌زمان چند نوع سلول در ترکیب با داربست‌های نانو) از چشم‌اندازهای مفید در درمان این بیماری محسوب می‌شود. در نهایت، به دلایل ایمنی مرتبط با روش‌های سلول‌درمانی و ژن‌درمانی آسیب‌های نخاعی واجب است که بیماران در درمان‌های تجربی خارج از آزمایش‌های بالینی رسمی شرکت ننمایند.

کلیدواژه‌ها

عنوان مقاله [English]

Cell Therapy and Gene Therapy in Spinal Cord Injuries

نویسنده [English]

  • Houri Edalat
PhD in Molecular Genetics, Human Genetics Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
چکیده [English]

Stem cells are counts as a promising tool for treating spinal cord injury (SCI), due to their high proliferation and self-renewal capacities. Many advances in the field of gene therapy and in particular cell therapy of SCI have been made at three levels of experimental, pre-clinical, and clinical practice, owing to the multiple capabilities of stem cells. But, in order to find a therapeutic approach to ultimately reach the clinical level, a number of barriers, such as ethical, tumorigenicity, immune rejection, differentiation to non-intended cells, and clinical-trial-associated problems must be resolved. Many strategies for optimization of the route, location, and time of cell administration have also been developed in this field. Literature reveals that mesenchymal stem cells (MSCs) have the most prominent benefit for clinical applications, compared with other types of stem cells. However, it appears that the recent method of in-vitro trans-differentiation of somatic cells has the potential to substitute the current beneficial MSC transplantation method, in the near future. According to the complex pathophysiology of SCI, the combination therapies (that is simultaneous application of different treatment approaches such as cell therapy, gene therapy, simultaneous application of several types of cells in combination with nanomaterial scaffolds, and ...) are considered to be more useful in SCI treatments rather than single therapies. Finally, it should be noted that due to the safety problems attributed to cell and gene therapy application, patients are not recommended to participate in experimental treatments other than formal clinical trials.

کلیدواژه‌ها [English]

  • Spinal cord injuries
  • Cell therapy
  • Gene therapy

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مجله دانشکده پزشکی اصفهان
دوره 36، شماره 501 - شماره پیاپی 501
آذر و دی 1397
صفحه 1297-1307

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سابقه مقاله

  • تاریخ دریافت: 12 آبان 1397
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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