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干细胞疗法的“春天”渐行渐近 [复制链接]

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发表于 2012-2-2 11:17 |只看该作者 |倒序浏览 |打印
干细胞疗法的“春天”渐行渐近
' M% |  q9 ~! j- f——几十个干细胞疗法初步取得成功 * O7 e' B  q; W- [9 C( X
发布日期:2012-02-02  来源:科技日报
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% q) l$ E' _% n本报记者 刘霞 综合外电
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3 W* M. f( ^) L) a* B4 N# B    据英国《每日邮报》近日报道,一名医生把从胎儿那里提取的干细胞注入一名男性病患的大脑中,这些细胞随后上演了一出“变形记”并成为身体的一部分。当这名病人去世后,病理学家们发现,这名病人的软骨、皮肤和骨头都堆积在大脑内。
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    上述场景并非恐怖电影中的画面,而是切切实实发生在前奥运选手马克斯·特鲁克斯身上的惨剧,他因罹患帕金森氏症而接受了干细胞疗法。
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$ ^  F1 c% O: u4 u    这一结果让科学界倒吸一口冷气,也因此,科学家们在让干细胞疗法走向市场的过程中遭遇了诸多障碍。不过现在,他们的努力似乎有了回报。目前,有几十个成人干细胞疗法的临床实验先后结束,结果表明,实验初步取得了成功。科学家们表示,其中有些疗法有望于5年内进入市场。
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    捷报频传 大小公司蜂拥而至
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    美国干细胞技术公司Athersys公司首席执行官、非营利性组织再生医学联盟的主席吉尔·范·伯克勒表示:“几个成功就能真正改变干细胞治疗领域,我们现在越来越接近‘引爆点’了。” 6 }0 z: |( F% t; x6 B0 A

  m5 u: H, I+ |, h: X' z, S    其中一些干细胞临床实验主要是使用干细胞来治疗心脏病和炎症,这是医学界的最大市场。科学家们使用的干细胞源于脂肪、骨髓等成人组织,因而不会像从胎儿体内提取干细胞那样引发伦理争议。
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$ X- ~3 b4 {. J% T3 p    生技技术制药公司Aastrom Biosciences正在尝试使用干细胞疗法治疗下肢严重缺血(血液流向四肢时会严重受阻)的病人,他们也于近期在美国心脏病协会的年度大会上公布了该实验的中期结果,结果表明,干细胞疗法富有潜力。澳大利亚墨尔本再生医学公司Mesoblast进行的一个干细胞疗法的中期实验结果表明,其干细胞产品可将心脏病的发作频率并需要进行动脉清除手术的减少了78%。
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    Aastrom Biosciences的首席执行官蒂莫希·梅勒本表示:“实际上,我们现在正在研发干细胞产品。”该公司正尝试利用源于病人自己骨髓的细胞来治疗心血管疾病。
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    美国辉瑞制药有限公司、强生公司和瑞士制药商罗氏控股公司都是再生医学联盟的会员,该联盟旨在促进人们对该领域的认知。辉瑞公司有一个再生医疗部门,该部门正同Athersys合作一些小型的实验项目,他们想等干细胞疗法的实验结果最终出炉后再决定。 4 x; a7 r9 {' L1 K2 J! @5 m
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    尽管目前实验的大部分数据都还没有完全公布,但这已经引起了制药公司的注意。美国风险投资基金纳维塔斯资本公司的执行合伙人助保罗·施密特表示:“一旦实验结果被证实有效,很多大制药公司会因此将赌注压在Ⅱ期产品上。其实,这些制药公司现在就已经行动起来了,他们不断出席各种医学会议并同干细胞公司进行洽谈。” 2 \' z' K' R$ d' T* `5 V* i5 [& S

4 {; }" s1 m: O/ z$ b    美国立志资本合伙公司的斯蒂芬·马丁表示,最新的干细胞疗法有望让很多病人受益。他说:“我认为,临床试验将会取得非常重要的进展,但是,距离研制出一种公认的疗法还有很长的距离。”
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    各种干细胞“各显神通” ) R0 G( K6 F) \+ |! {
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    其实,干细胞已经在骨髓移植中使用了40年,其潜力在于它能修复身体组织、减少炎症、调控免疫系统,并在身体内的多个系统需要帮助时提供帮助。 4 j9 X( I8 `" ^0 g! F% Z
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    干细胞是身体的主控细胞,可以自我更新并成长为包括心脏、肌肉在内的特定的细胞类型。 . q5 T" j* `6 T- T7 J* o

# ?5 E# Z; \- I/ Q    胚胎干细胞非常独特,因为其能分化为身体内任意类型的成熟细胞,科学家们也一直认为其最有潜力制造出好的器官来代替病人受损的器官。但是,从胚胎中提取干细胞会破坏胚胎本身,而且,胚胎干细胞具有的无限分裂能力会导致人罹患干细胞癌或畸胎瘤。
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    因此,全球领先的胚胎干细胞公司、美国生物科技公司杰隆最近表示,它可能不会再支持干细胞研究,而将专注于研制抗癌药物,现在,该公司已经停止了其用干细胞治疗脊髓损伤的实验。 9 P! ~8 f9 z! ]+ z$ q; O

6 w  {3 v( B. A$ _    与胚胎干细胞不同的是,成人干细胞的分化能力有限,但是,成人干细胞显然能减少炎症并促进血管生成。另外,与传统药物相比,它们的优势在于能采用一种灵活且动态的方式对身体内的损伤作出反应。
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# z8 F# J. Y. |( s# N    全球医疗行业的领先企业之一、专注于慢性病及危重治疗领域的美国百特国际有限公司干细胞研究领域的负责人道格拉斯·罗索多表示:“成人干细胞似乎能被重新编程以修复身体受损的组织,而非新形成一个器官或一个组织。” * h) i- X# d, A& U% H# h
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    罗索多说:“我们使用的干细胞在促进心血管形成方面非常有效,但是,这些干细胞不擅长于制造出一个脑细胞。”
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4 A) o9 q- Z) J9 W. b& u    科学家们目前研发的这些干细胞疗法主要通过输液、注射或导管来进行。
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9 T$ U9 ?1 |0 N# e0 B    抗癌药物制造商赛尔细胞基因公司细胞疗法部门的首席执行官罗伯特·希拉里表示:“我们希望最终制造出一种每个病人都能接受的产品,而不是像移植手术那样需要考虑配型等问题。” ) s# Q- `* M6 I  r) y* Z1 S, x; D
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    不同的疾病需要使用不同类型的干细胞来进行治疗。例如,美国Cytori Therapeutics生物技术公司正在用脂肪细胞制造治疗心脏病的药物;赛尔细胞基因公司则在用胎盘细胞治疗克隆氏病(消化道各部分,特别是小肠部位持续而起伏不定的炎症)和风湿性关节炎。
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    科学家们也在探索胎儿细胞的用途,例如,神经干细胞公司正尝试使用流产的胎儿来治疗神经失常。
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    需要严苛的监管机制 9 ~- ]. I. |/ G3 V! o* L+ U$ F
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    随着干细胞疗法不断向前发展并通过临床测试,公司可能需要更多钱来进行下一步的研发工作。然而,他们面临的问题还不止于此。 , w2 P! n# k6 b1 i4 z& E2 t
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    这些公司并不知道这些干细胞药物如果想获得美国食品和药物管理局(FDA)等监管机构的批准,需要提供什么数据或结果。 . B" Z" I( n! a7 a: S9 G# W

! @$ X: T' n# {0 C* K    有人认为,使用病人自己的干细胞进行治疗面临的监管障碍可能低于从捐赠者那儿获取的干细胞进行治疗,因为前者几乎不存在细胞发生排斥的风险。
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    现在,人们并不知道该如何继续前进,只能摸着石头过河。Athersys公司的范·博克勒表示:“我们需要一个清晰、持续且严苛的调控框架。”
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沙发
发表于 2012-2-2 14:49 |只看该作者
看好干细胞治疗- y8 Y, X3 E* H% c7 y

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藤椅
发表于 2012-2-3 10:37 |只看该作者
前途是光明的,道路是曲折的。革命尚未成功,科学家们尚需继续努力。

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板凳
发表于 2012-2-3 23:24 |只看该作者
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本帖最后由 sunsong7 于 2012-2-3 23:27 编辑
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" y$ m) W) L# o& Y, _Stem cell therapy poised to transform medicine as dozens of clinical trials show early success
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  • Dozens of adult stem cell treatments are moving through clinical trials and showing early success: k/ G. B! L8 {2 S) s+ t

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0 _, L( j4 m1 }By Reuters Reporter
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# V; p2 D+ v/ F: N! i, \" H# B! h  T. gLast updated at 12:18 PM on 7th December 2011
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Blood drawn with a simple needle stick can be coaxed into producing stem cells, scientists revealed in 2010


& t% ?5 g2 d& k  \7 e( S A rogue surgeon injects stem cells from a foetus into a sick man's brain. The cells morph and form body parts. When the man dies, the pathologist finds cartilage, skin and bone clumped in his brain.
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The scene is not from a horror movie; it happened to Max Truex, a former Olympic runner who suffered from Parkinson's disease.
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+ R) k6 m' ], f! l- u6 R: u' C7 r% ? The case sent a chill through the scientific community when it came to light 15 years ago and typifies some of the hurdles researchers have faced while trying to bring stem cell therapies to the market.
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6 B* X3 [0 w4 M& q4 \$ u Now, it appears, their efforts are closer than ever to paying off.
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) P, P  v5 m& P+ R9 X8 z% c+ z Dozens of adult stem cell treatments are moving through clinical trials and showing early success, raising hopes that some could reach the market within five years.
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'It will only take a few successes to really change the field,' said Gil Van Bokkelen, chief executive of Athersys and chairman of the Alliance for Regenerative Medicine.2 g# a( a( d- v" v! L  }$ N4 b! b* ~
'As you see things getting closer and closer to that tipping point, you're going to see a frenzy of activity take place.'
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* h- w1 ?7 y' c5 ~. ?/ Q# k' W+ L3 e Many of the trials focus on heart disease and inflammatory conditions, some of the biggest markets in medicine. The cells used are derived from adult tissue such as fat, or bone marrow, thereby circumventing the ethical concerns raised by the use of cells derived from embryos.2 U. g' Q$ j3 x& j' p2 j8 a6 Y

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More... - y+ J( W" d4 h) s' p

- M$ Q/ {) q% p* U- m! d Data for the most part remains early, but as more results emerge, pharmaceutical companies are beginning to take note.
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'A lot of big companies are looking to place bets on some Phase II products once that data has been confirmed,' said Paul Schmitt, managing partner at Novitas Capital.
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'Even now they're attending all the medical meetings and talking to all the stem cell companies.'
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Steven Martin, from Aspire Capital Partners LLC [size=1.2em]said they were willing to be patients as the benefits from treatment could be enormous.
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* k7 G! a9 B- A0 R. D' My philosophy in the stem cell space is that it's very difficult at this point to pick the winners and losers,' he said.9 y* R4 t: i. H+ d7 j$ `
'We believe that over time there will be some very significant clinical progress, and valuations will improve, but we're still a long way from an approved therapy.'8 Z; H9 U6 B$ C" M+ a8 A& ~( [, m9 Y

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Venture firms are talking to all the stem cell companies and waiting for the breakthroughs that could change medicine forever


% q5 f& l7 o+ n+ f Aastrom Biosciences recently presented promising results from a mid-stage trial of its treatment for patients with critical limb ischemia, a disease in which blood flow to the extremities is restricted, at the American Heart Association's annual meeting.[size=1.2em]
& ?9 q7 N/ w: m* }. T# D& F A mid-stage trial from Australia's Mesoblast Ltd showed its stem cell product reduced the rate of heart attacks and the need for artery clearing procedures by 78 per cent./ l7 M, Z/ u0 r* @
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'We're actually developing products now,' said Timothy Mayleben, chief executive of Aastrom, which is using cells derived from a patient's own bone marrow to develop treatments for cardiovascular disease.
0 Y# Q8 K$ f6 R  |' s 'For the first time you are starting to see data being presented at major medical meetings.'% J0 a, _0 z9 K0 c4 j+ S
Pfizer Inc, Johnson & Johnson and Roche Holding AG are members of the Alliance for Regenerative Medicine, a nonprofit group that promotes awareness of the field. Pfizer has a regenerative medicine unit and a partnership with Athersys. But their projects are small as they want to wait to see data in hundreds of patients.( E4 U& U. c% t. P  M
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The promise of stem cells, which have been used for 40 years in bone marrow transplants, lies in their ability to repair tissue, reduce inflammation, regulate the immune system, and respond to calls for help from multiple places inside the body.! M+ W  w' K- W$ P3 _. }
Stem cells are the body's master cells - blank slates that renew themselves and mature into specific cell types in the heart, muscle and other organs.) X/ w# H* a  b/ E: f& k" W3 F, E

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Criticism: Harvesting stem cells from embryos requires the destruction of the embryo itself


5 h3 _9 a9 y8 ~' e# y* D; j Embryonic stem cells are uniquely capable of differentiating into every type of mature cell in the body, and were long viewed as the most promising for regenerating tissue.
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But harvesting stem cells from embryos requires the destruction of the embryo itself, a process opposed by conservative Christian groups. Moreover, their endless capacity to divide can lead to the formation of teratomas, or stem cell cancers.
4 a" q) k% w% j/ y Recently, Geron Corp, the world's leading embryonic stem cell company, said it could no longer fund its stem cell work and would focus on developing cancer drugs. It closed its trial for spinal cord injury.
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6 X8 }" {; T) m* f Unlike embryonic stem cells, adult stem cells have a more limited capacity to differentiate, but appear able to reduce inflammation and promote blood vessel formation. Furthermore, they can respond to damage in the body in a flexible and dynamic way, offering advantages over traditional drugs.
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; g0 T+ U  v! ~& e1 N8 {8 T0 D 'They seem to be preprogrammed to act some way in tissue repair, not to form an organ or a tissue,' said Douglas Losordo, head of stem cell research at Baxter International Inc, which is developing cell therapies for heart disease. . n4 h$ r0 P0 Q2 @
'The cells that we use are very effective at stimulating the formation of new blood vessels, but if I wanted to make a brain cell out of those cells they would not be very good at it.'/ l/ ^$ k* ?' Q
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These are the type of stem cell treatments, delivered by infusion, injection or catheter, that are being developed today.2 e# O, f! w9 G& b3 v4 _' M% [
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'We wanted to create a product that everyone could receive and not have to match every donor to every recipient,' said Robert Hariri, chief executive of Celgene's Cellular Therapeutics unit.) b- N. E  \. q- V# Z
Different types of stem cell are being used for different diseases. [size=1.2em]Cytori Therapeutics [size=1.2em]is developing a heart disease product derived from fat cells, for example, while Celgene is using placental cells for Crohn's disease and rheumatoid arthritis therapies.7 e1 \" A) x+ o7 v# d/ F7 D3 e
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Foetal cells are also being explored. Neuralstem Inc, for example, is developing treatments for neurological disorders from an aborted foetus.6 T- [( M  e8 K- M* l! h

' Y/ x2 D2 G- v0 h As cell therapies move further through clinical trials, companies will need more money, and funding is scarce.   e. X( N, Z. H% X! K# A
Yet even if companies remain afloat long enough to bring a product through late-stage clinical trials, it is unclear what regulators like the Food and Drug Administration will require in order to approve them.# s! m4 v1 P3 e3 S
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Some believe the regulatory hurdles for treatments derived from a patient's own cells will be lower than those where the cells come from donors, since there is less risk of cell rejection. However, no clear pathway has yet been established.
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'We need a clear, consistent and rigorous regulatory framework,' said Athersys's Van Bokkelen.: ~9 X; f0 j8 r# S: ?. a
'The FDA is actually willing to provide lots of guidance and assistance to sponsors, if you just ask them.'
, h) _- t/ E/ j7 L. ]6 Z2 y6 _http://www.dailymail.co.uk/health/article-2071076/Stem-cell-therapy-poised-shake-medicine-dozens-clinical-trials-early-success.html, `7 S; a% q4 o8 ^" A- x8 h0 N

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