想問一下有關幹細胞治療~~ 

對於小動物疾病有任何疑問或討論,以及照顧心得請盡量提出來,讓大家切磋分享

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文章Jeff Wang » 2012-07-23, 13:39

First, I have to say I have no pre set opinion on stem cells. I still try to search some more document, but so far, there is no enough evidence to let me endorse this treatment. I believe it could be a hope in future or near future. I just still have some more questions.
There are a lot of detail have been ignored here, For example, how and where do the stem cells be harvested, how do they be processed, what is the percentage of stem cells in the cells been processed, and how much amount we need to inject into the affected site and what stage of the arthritis we can handle with stem cell treatment will be ideal. I am still looking for answers. It is not a simple answer of yes or no for this treatment. It is similar to the total hip replacement, yes, it could be a way to solve the problem, but still count on the team which is really doing it.
Another question is: If I have 8000 cases in my hand, I can easily conduct a dozen of scientific paper. Not just 2. Give me a few more days to see what else I can find, please.

Jeff
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文章fifiyen » 2012-07-23, 20:23

翻譯如下,歡迎專業人士進行指正...

首先,我必須說我個人對幹細胞沒有預設任何的立場。
我仍然在找更多的資料 ,但是到目前為止,仍然沒有足夠的證據可以讓我來認同這種治療。
我相信在將來或未來它或許是一個希望。只是我仍然有些許的疑問。
在這裡仍然有很多細節是被忽略的,
例如,幹細胞是在那裡又如何獲得的?它們過程是如何?
在製作中要放置多少百分比的幹細胞在細胞裡?
要注入多少的幹細胞在患部以及又是在什麼樣階段是我們可以讓幹細胞治療關節炎的理想時機,我尚在尋找解答。
這種治療法不是一個yes或no如此簡單的答案,這就像是人工髖關節置換手術般,
是的,它是一種方法來解決問題,但這需要交給真正在操作這樣的團隊來處理的 。
另一個問題是:如果我手中有8000個案例的話,那我是可以很輕鬆的來處理個十來篇的科學報告。而不是僅有的2個。
請多給我些天的時間,讓我再看看可有什麼其他的東西被我找到。

美國愛屋王勢爵醫生
最後由 fifiyen 於 2012-07-25, 12:38 編輯,總共編輯了 2 次。
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文章amy » 2012-07-23, 21:39

感謝FIFI麻的翻譯.狗友會真是人才濟濟 :mrgreen: 讚~
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文章旺旺 » 2012-07-24, 11:20

如果是要取得衛生組織認可的醫療或是藥物必先經過嚴謹的臨床試驗,從phase I,phase II的報告中便可獲得王醫師所提出的疑問:包括此醫療或藥物的「毒性反應toxicity profile」這是很重要的基礎,關係到能否繼續下一個步驟,就是取得「醫療上的可考慮的使用劑量dose finding」,才能接著有更進階的臨床試驗(包括試驗藥物或與對照組之比較)來應證「如此劑量下的安全性及有效性safety & efficacy],到此些階段的試驗基於倫理ethical考量都不可能收納eroll大量個案.除非結果能證明這項醫療或是藥物試驗結果合乎科學性的應證scientific significance.而要能prove 取得scientific significance,光從「試驗的設計 protocol]便可得知. 一個不合乎科學應證的臨床試驗設計,其試驗結果最好的價值就是餵飽垃圾桶. 愈加閱讀動物(狗)的臨床試驗報告,愈是感到「這些試驗的價值不知為何物
:oops: 」,所幸不太理會了.愈加體會狗狗的醫療,關鍵點在於能否幸運遇到「有良知」如此簡單而已.
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文章Jeff Wang » 2012-08-17, 08:42

Here is the article I read in past few days. I typed some related paragraphs here.

Fortier and Travis Stem Cell Research & Therapy 2011,2:9
http://stemcellres.com/content/2/1/9

Stem cells in veterinary medicine

Abstract
The stem cell field in veterinary medicine continues to evolve rapidly both experimentally and clinically. Stem cells are most commonly used in clinical veterinary medicine in therapeutic applications for the treatment of musculoskeletal injuries in horses and dogs. New technologies of assisted reproduction are being developed to apply the properties of spermatogonial stem cells to preserve endangered animal species. The same methods can be used to generate transgenic animals for production of pharmaceuticals or for use as biomedical models. Small and large animals species serve as valuble modles for preclinical evaluation of stem cell application in human beings and in veterinary patients in ares such as spinal cord injury and myocardial infarction. However, these application have not been implemented in the clinical treatment of veterinary patients. Reviews on the use of animal models for stem cell research have been published recently. Therefore, in this review, animal model research will be reviewed only in the context of supporting the current clinical application of stem cells in veterinary medicine.

Below is the paragraphs regards in dog arthritis:

Adipose-derived stromal vascular fraction (AD-SVF) cells
The currently available technique uses a mixture of cells derived from adipose tissue surgically excised from horses of dogs. The AD-SVF cells are simply isolated and injected into the patient without a cell culture step. Compared with cultured BM-MSCs(Bone Marrow-derived Mesenchymal Stem Cells), this technique has the advantage of supplying cells in a short time period (48 hours), and it should be remembered that although there are a large number of nucleated cells retrieved from the adipose digest, only a small percentage of nucleated cells are stems cells. In humans, 0.7% to 5% of nucleated cells in the stromal vascular fraction are stem cells.

Cartilage injury/osteoarthritis
As mentioned above, AD-SVF cell application in an equine model of early OA failed to result in any detectable improvement in articular health. In fact, AD-SVF cells led to an increase in synovial fluid concentration of the proinflammatory cytokine tumor necrosis factor-alpha. In dogs, two reports of improved clinical signs of OA after treatment have been published. In a double-blinded study assessing the yse of AD-SVF cells in the hip joint of dogs, examining veterinarians (but not dog owners) reported signs of clinical improvement. In a second, uncontrolled study using AD-SVF cells for elbow OA, veterinarians and, to a lesser extent, owners both reported improvements in clinical signs. The disparity in the clinical benefits noted by owners in these studies investigation the use of AD-SVF cells in OA is unclear but perhaps suggests that any benefit of AD-SVF cell application can be seen only in more advanced cases of OA or that changes in lameness associated with elbow OA in comparison with those of hip OA are more easily perceived by owners.


You have to decide for your own dogs. You are the guarded angels to them.
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文章amy » 2012-08-18, 00:20

王醫師又給我們新的資訊了.
請各位英文好的朋友幫忙翻譯一下 :lol:
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文章zander » 2012-08-20, 11:50

王醫師提供的這篇研究,出自Stem Cell Research & Therapy期刊。附上連結,有興趣的人可以看原文:
http://stemcellres.com/content/pdf/scrt50.pdf

摘要翻譯,就不逐字逐句了.....


這篇研究主題是“幹細胞在動物醫學的角色”。

摘要:
不論是臨床上或基礎實驗研究,幹細胞在動物醫學領域都進展的相當快速,而目前幹細胞最常使用在臨床治療馬與狗的骨骼肌肉問題。相關的技術也被嘗試用於動物繁殖上(不論是為了保存即將滅絕的物種,或者是繁殖藥物研究所需的實驗動物)。動物的幹細胞研究,也為人體幹細胞治療提供一個可能的方向。然而,這些相關的幹細胞研究,都尚停留在實驗的階段,無法真的全面應用到臨床治療上。

與狗關節相關的段落摘錄如下:

1. AD-SVF細胞(源自脂肪組織的幹細胞):
目前可應用的AD-SVF細胞,來自於狗的脂肪組織細胞。與BM-MSC(骨髓幹細胞)相比,AD-SVF細胞的好處是不需要經過培養,缺點是所含的幹細胞比例可能較低(以人為例,脂肪組織萃取出來的有核細胞中,可能只有0.7-5%具有幹細胞能力)。
(註:不需要經過培養,代表從萃取到注射入動物體內所需的時間變短,也就是說相關的成本可能降低,也比較方便。但是,所含的幹細胞比例較低,也代表治療的效果可能較差。這部份當然需要經由往後的實驗去證明)

2. 軟骨受傷,骨關節炎:
在馬的研究上(這不是髒話 XD),AD-SVF細胞在治療早期關節炎並沒有特別效果,反而在關節液中測得更高濃度的TNF-alpha(註:TNF-alpha是一種發炎的指標,可能代表局部關節發炎更為顯著。人類研究上,TNF-alpha上升與關節發炎的關係是確定的,所以治療人的關節炎有一個重要的藥物,就是去抑制TNF-alpha)。至於狗的研究,則有兩篇報告顯示AD-SVF細胞可改善關節炎的臨床表現。第一個雙盲試驗為AD-SVF細胞用於狗髖關節的治療,獸醫師評估認為有臨床症狀的改善(但飼主並不覺得)。第二個研究則使用AD-SVF細胞治療肘關節,獸醫師與部份的飼主認為有症狀的改善。關於兩項研究結果差異的可能原因:
(1) AD-SVF細胞治療可能在較嚴重的關節炎會有稍微明顯的幫助。
(2) 飼主比較容易注意到肘關節炎的改善(跛行的狀況改善),而髖關節發炎的改善則比較不容易觀察到。
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