Stem cells against resistant forms of tuberculosis
WHO estimates that in Eastern Europe, Asia and South Africa, approximately 450,000 people are diagnosed with multidrug-resistant tuberculosis, and in about half of the cases, the disease does not respond to existing treatments.
Mycobacterium tuberculosis causes an inflammatory reaction in the lung tissue, which leads to disruption of the immune system and tissue damage. It is known that mesenchymal stem cells of the bone marrow migrate to the areas of lung tissue damage and contribute to their recovery. Moreover, they are able to modulate the immune response and increase the effectiveness of the destruction of mycobacteria.
Within the framework of phase 1 of a clinical study conducted in Minsk on the basis of the Republican Scientific and Practical Center of Pulmonology and Phthisiology, 30 patients were once injected with about 10 million mesenchymal stem cells isolated from their own patient's bone marrow and cultured in laboratory conditions within 4 weeks after the start of the traditional treatment protocol. All patients had microbiologically confirmed diagnoses of multidrug-resistant tuberculosis or extensively drug-resistant tuberculosis. The age of the patients ranged from 21 to 65 years.
According to the head of the study, Professor Markus Maeurer from the Karolinska Institute, Sweden, traditional treatment protocols for resistant forms of tuberculosis consist in the use of combinations of highly toxic antibiotics. The new approach, involving the introduction of own mesenchymal stem cells isolated from the patient's bone marrow, is safe, promotes the restoration of lung tissue damage and increases the likelihood of cure.
In general, the introduction of cells was well tolerated by patients. During the 6-month follow-up period, none of them had any serious adverse reactions. The most common side effects of severity 1 and 2 were: increased cholesterol levels in the blood (14 patients), nausea (11 patients) and lymphopenia and diarrhea (10 patients).
Further analysis of the results showed that 16 out of 30 patients who received an injection of mesenchymal stem cells were found to be cured of tuberculosis after 18 months. In the control group, whose patients had the appropriate diagnoses and underwent therapy according to the traditional protocol, only 5 out of 30 recovered.
According to Professor Maurer, in order to confirm the safety and effectiveness of auxiliary stem cell therapy in the treatment of resistant forms of tuberculosis, it is necessary to conduct a phase 2 clinical trial with a longer follow-up period and the participation of more patients. The procedure for obtaining and administering autologous mesenchymal bone marrow stem cells is relatively simple and, subject to the success of the next stage of clinical research, it may find its place in clinical practice in the near future.
Article by Aliaksandr Skrahin et al. Autologous mesenchymal stromal cell infusion as adjunct treatment in patients with multidrug and extensively drug-resistant tuberculosis: an open-label phase 1 safety trial published in The Lancet Respiratory Medicine.
Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru based on Medical Xpress materials:
Early signs that patient's own bone-marrow stem cells could treat multi-drug resistant tuberculosis.
09.01.2014