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作者：孝文 来源：新浪科技 发布时间：2011-11-11 $ w: l3 T$ ]* H" U: P- P0 A) i
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北京时间11月11日消息，据美国《连线》杂志报道，在美国五角大楼的资助下，匹兹堡大学的研究小组利用猪细胞为士兵再生肌肉。一些猪细胞，一次外科手术再加上严格的日常锻炼构成了伤员再生肌肉的三大要素。目前，这项研究已取得引人注目的进展。* s6 @$ \9 D, [
& D( a" d8 k4 ?. X( P |在首次进行临床试验后短短几个月，他们已经为4名士兵进行了手术，并且培训了一批来自美国各地的外科医生，掌握这项技术。研究负责人斯蒂芬-巴迪拉克博士表示，如果继续按照这种速度进展下去，临床试验将在24个月内结束，这项技术将成为整形外科医生和外伤外科医生的一种标准疗法。- t/ n8 Y" h; j5 q- E0 o
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这种技术下的肌肉再生并不像火蜥蜴那样神奇，但也非常令人感到吃惊。匹兹堡大学的研究成果意味着，在这个10年内，数千名在作战期间患上严重肌肉损失的士兵可能战胜破坏性损伤——将终生忍受慢性疼痛、残疾煎熬，除了截肢外没有可行性治疗手段——身体机能将至少提高25%。对于平民，这项研究成果更是具有不可估量的作用。借助于这项技术，不得不实施截肢手术的外伤和健康问题，例如车祸、火灾、癌症或者糖尿病末梢血管疾病，将不再给患者造成无法挽回的损伤。
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五角大楼三军再生医学研究所实施了一系列超前的研究计划，巴迪拉克和匹兹堡大学再生医学研究所的同事只是参与者之一。三军再生医学研究所投入2.5亿美元进行研究，试图让再生医学成为主流。军方高官已加快“骨接合剂”临床试验步伐，以取代金属螺丝和金属板，同时加快复杂的面部和手部移植研究。目前，美国已经进行了几例这种手术。
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: B: ]5 w- ~. ~7 W& F3 _. A利用巴迪拉克研发的技术进行组织再生的发展前景2007年首次登上媒体头版头条，当时他宣布成功利用基于猪膀胱细胞的混合物再生了小部分指尖。肌肉组织再生采取了类似的方式。外科医生首先向患者植入所谓的“细胞外基质”，形象地说就是一种“细胞胶水”，主要成分是来自于猪膀胱的生长因子蛋白。这些蛋白触发患者自身的干细胞，使其进入指定区域，启动组织再生和修复过程——成熟的肌肉通常无法做到这一点。通过与强化康复计划相结合，锻炼初生的肌肉，患者的身体不仅可以恢复基本的肌肉组织，同时还可以恢复保证肌肉正常工作的腱和神经。7 S* U2 I$ G0 Q/ E" E: N$ O
6 l) f5 u& i: d' ?3 j巴迪拉克说：“患者需要积极配合治疗，他们需要做很多工作。我们实施的治疗绝不是将一个模子放入腿里而后等待那么简单。这些士兵的肌肉损失达到60%和70%，为了重新过上正常的生活，他们愿意做任何事情。”) h1 q. A" E0 q" P2 I8 D
/ o& o( @4 j$ w+ x8 \ F, X在再生指尖后短短4年，巴迪拉克研发的技术又恢复了患者失去的组织。现在，他的小组正在庆祝这一具有里程碑意义的成就。他们征募的第一位进行临床试验的患者是一名老兵，被临时爆炸装置炸伤，失去了小腿前胫骨的大部分肌肉。目前，这名老兵已经完成手术以及术后为期6个月的康复治疗。巴迪拉克在提到这名患者时说：“他的恢复情况良好。借助于我们研发的技术，患者无需进行切除手术，肢体也能很好地发挥功能，远远超过受伤后的情况。”
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, f$ @9 K$ a6 P7 l: J! w2008年，美国海军陆战队下士以赛亚-赫南德兹成为巴迪拉克真正的实验鼠。赫南德兹失去了右侧的四头肌。随着在这两个病例身上取得成功，巴迪拉克研发的技术毫无疑问地将改变这一医学领域的面貌。赫南德兹在2011年初表示：“我现在体重减轻，经常做一些运动，感觉好极了。”他希望能够再次应征入伍，执行作战任务。- g* X( e2 B. p
# v, B) M$ ~3 j3 _' O不久后，将有更多与赫南德兹类似的患者接受这种疗法。目前，再生医学研究所仍在招募给定身体部位肌肉损失至少达到25%(被研究人员称之为“大量损失”)或者需要接受截肢手术的现役士兵和老兵。在伊拉克和阿富汗，有超过50%的伤兵属于破坏性组织损伤，他们不用担心找不到渴望接受这种疗法的志愿者。巴迪拉克在提到这项技术时说：“根据我们掌握的情况，这项技术的表现非常出色。它的需求量巨大，我们会尽自己最大可能帮助遭受严重肌肉损失的伤兵。”
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' m3 F0 V' z; e6 {% q0 n* Z `Pentagon Regrowing Soldiers’ Muscles From Pig Cells , D% I8 X" v2 v$ e' |2 Y; i
A few pig cells, a single surgery and a rigorous daily workout: They’re the three ingredients that patients will need to re-grow fresh, functional slabs of their own muscle, courtesy of Pentagon-backed science that’s already being used to rebuild parts of people.
1 f$ z- U. e) _( F8 w. JThe research team behind the project, based out of the University of Pittsburgh, has made remarkably swift progress: Mere months after starting their first-ever clinical trial, they’ve already operated on four soldiers and are now training groups of surgeons from across the country in perfecting the approach. If progress continues at this pace, the trial will wrap in 24 months and the technique will become “a standard of care for orthopedists and trauma surgeons,” according to Dr. Stephen Badylak, head of the initiative.6 j/ q4 p8 z- x, ~3 Z0 n/ e8 J
It isn’t quite salamander territory, but it’s astonishingly close. The Pittsburgh team’s research means that, within this decade, the thousands of soldiers who’ve suffered major muscle loss during this decade’s wars can overcome devastating impairment — a life sentence of chronic pain, disability and no viable treatment short of amputation — and experience at least a 25 percent improvement in physical function. For civilians, the impact would incalculable. The kinds of trauma and health problems that now cause amputation, from car accidents and fires to cancer or diabetic peripheral vascular disease, would no longer cause irreparable damage.- i0 t# v( {) r1 o' ~7 ^! @/ ~4 Q
Badylak and colleagues at the University of Pittsburgh’s McGowan Institute for Regenerative Medicine are only one of several groups leading far-out research projects that are part of the Pentagon’s Armed Forces Institute of Regenerative Medicine (AFIRM), a massive, $250 million undertaking meant to quickly usher regenerative medicine into the mainstream. Already, military brass have fast-tracked clinical trials for “bone cement” to replace metal screws and plates and accelerated the sophistication of face and hand transplants — a handful of which have now been conducted in the United States.
6 B7 ?+ u! n6 f& j! o9 n, AThe tantalizing prospect of regrowing tissue using Badylak’s technique first made headlines in 2007, when he announced the successful regrowth of a small portion of fingertip using a concoction based on cells derived from a pig’s bladder. His approach with muscle tissue is similar: Surgeons start by implanting what’s called an extracellular matrix, a sort of “cellular glue,” whose key components are growth factor proteins from pig bladders. Those proteins trigger the body’s own stem cells to flock to the area and initiate the process of tissue growth and wound repair — which adult muscles normally wouldn’t do. Combined with an intensive rehab program to essentially “exercise” the nascent muscle, the body is able to restore not only basic muscle tissue, but the tendons and nerves that are necessary for function.+ S1 p5 C2 X6 Q* T o) E1 }
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2 }, S; M- X8 B/ o/ ~( z“The patient needs to do their part, and that involves a lot of work — we aren’t just putting a cast on the leg and waiting,” Badylak said. “But these soldiers coming in with 60, 70 percent muscle loss, they’ll do anything to get their lives back.”/ B5 i% {, Z8 a. @
Now, only four years after Badylak’s fingertip achievement suggested his technique could restore lost tissue, his team is celebrating a notable milestone: The first patient enrolled in their trial, a veteran who lost the majority of the anterior tibial muscle in his lower leg during an IED attack, has today graduated from the requisite six-month rehabilitation program that follows surgery. “He’s doing great,” Badylak says of the unnamed patient, who has yet to be identified. “What would have been an amputation is now somebody with a limb that works much, much better than it did after the injury.”
9 ]; I1 W; o5 t7 u, ?3 d& ~And if this patient’s results are anything like those of Marine Corporal Isaias Hernandez, a U.S. soldier who served as Badylak’s veritable guinea pig in 2008, after he returned from deployment missing 70 percent of his right quadriceps, the procedure is no doubt poised to transform medicine.
M8 M9 k- X6 M6 }/ }2 a6 `( B# J% O6 s+ ?“I’ve been losing weight and playing sports,” Hernandez said earlier this year, adding that he expected to re-enlist and deploy again. “It feels pretty good.”! w2 L# A! ?( q$ a$ y; m
More will soon have the chance to undergo the treatment: The Institute is still recruiting soldiers and veterans missing at least 25 percent of the muscle mass in a given area — described as “a massive loss” by researchers — or qualify for limb amputation. Given that more than 50 percent of injuries in Iraq and Afghanistan have resulted in this kind of devastating tissue damage, they should have no shortage of eager volunteers.3 [" ~; }: O, e9 h. j3 B) I
“From what we’re seeing, it works,” Badylak said of the technique. “And there’s a huge need here. So of course, we’re being as aggressive rolling it out as we can.”
; T1 z8 j$ y* R& d" {Photo: courtesy of McGowan Institute for Regenerative Medicine
6 E7 f0 C: J6 @http://www.wired.com/dangerroom/2011/11/regenerative-medicine-muscles/# _- Q) z0 k+ [ ]- i5 \- _
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发表于 2011-11-11 17:32
发表于 2011-11-11 22:55
