分泌组联合间充质干细胞成功治疗创伤性轴索损伤。

Q3 Medicine
European journal of case reports in internal medicine Pub Date : 2025-03-10 eCollection Date: 2025-01-01 DOI:10.12890/2025_005111
Ahmad Faried, Yeremia Tatang, Gibran A Wibawa, Wahyu Widowati, Anindita P Distya
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引用次数: 0

摘要

外伤性轴索损伤(TAI)是一种头部损伤,以前称为弥漫性轴索损伤,是由直接机械力引起脑组织内多发分散病变(出血或非出血)引起的。尽管具有临床意义,但之前没有研究探索干细胞在TAI住院患者中的应用。本病例介绍了干细胞治疗TAI的疗效。病例描述:一名17岁的男孩头部因反复击打而严重受伤,导致昏迷。最初的CT和MRI扫描显示脑水肿,无出血性病变。t2加权轴向FLAIR成像显示胼胝体两个高强度病变,符合弥漫性轴索损伤II级。给予分泌组和脐带间充质干细胞(UCMSC)治疗。患者表现出运动功能和说话的改善,出院时没有神经功能缺陷。讨论:由于缺乏统一的理论,TAI的病理生理尚不清楚。从理论上讲,直接机械损伤不仅是原发性损伤的原因,而且神经代谢的生化变化也起着继发性损伤的作用。有两种主要的治疗选择。治疗方法可分为两大类:二次腋切开术靶向治疗和促进神经再生。多种治疗方案可促进微环境纠正和神经元再生,包括细胞和干细胞治疗及其代谢物。结论:在没有其他治疗方法的情况下,干细胞治疗是一种有希望的替代治疗方式。学习要点:一名昏迷一个月的创伤性脑轴索损伤(TAI)患者在分泌组治疗后4天内出现反应,并在间充质干细胞治疗后4天进一步改善并完全清醒。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Traumatic Axonal Injury Successfully Treated with Secretome Followed by Mesenchymal Stem Cells Therapy.

Introduction: Traumatic axonal injury (TAI), a head injury condition formerly known as diffuse axonal injury, results from direct mechanical forces causing multiple scattered lesions, either haemorrhagic or non-haemorrhagic, within brain tissue. Despite its clinical significance, no prior research has explored the use of stem cells in a TAI inpatient setting. This case presents the efficacy of stem cell therapy for TAI.

Case description: A 17-year-old boy sustained severe head injuries from repeated blows, resulting in a coma. Initial CT and MRI scans showed cerebral oedema without haemorrhagic lesions. T2-weighted axial FLAIR imaging showed two hyperintensity lesions in the corpus callosum, consistent with diffuse axonal injury grade II. Secretome and umbilical cord mesenchymal stem cell (UCMSC) therapy were administered. The patient showed improvement in motor function and speaking and was discharged without neurological deficits.

Discussion: The pathophysiology of TAI remains unclear because of a lack of unifying theory. It is theorised that not only is direct mechanical injury the cause of primary damage but biochemical changes in neuronal metabolism also play a role as secondary damage. Two main therapeutic options can be recognised. Treatment approaches fall into two categories: secondary axotomy-targeted therapy and promotion of neural regeneration. Multiple treatment options promote both microenvironment correction and neuronal regeneration, including cell and stem cell therapy along with its metabolite.

Conclusion: Stem cell therapy is promising as an alternative treatment modality in a case where there was no other optional therapy for TAI.

Learning points: A traumatic axonal head injury (TAI) patient in a coma for one month responded within four days of secretome therapy and further improved and became fully alert four days after mesenchymal stem cell treatment.

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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
166
审稿时长
8 weeks
期刊介绍: The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.
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