關節內注射間葉幹細胞於治療動物創傷性及退化性骨關節炎之實證醫學研究

Evidence-based Study of Intra-articular Mesenchymal Stem Cell Injection in Animals with Traumatic and Degenerative Arthropathies

蔡聲揚(Shen-Yang Tsai) ； 林慶順(Ching-Shwun Lin) ； 葉力森(Lih-Seng Yeh)

《臺灣獸醫學雜誌》 38卷3期 (2012/09) Pp. 183-189

https://doi.org/10.7009/TVJ.201209.0183

摘要

骨關節炎（osteoarthritis；OA），是一種非炎症性退化性的關節軟骨病變，目前並無有效逆轉關節炎病程的治療方式被發展出來。間葉幹細胞（mesenchymal stem cells）具有分化的能力，能夠藉由新生組織，達到適當修復及癒合的效果。本研究利用系統性文獻搜尋的方法，以實證醫學的角度，探討動物關節內注射間葉幹細胞於治療骨關節病之臨床成效。研究共納入11篇動物相關研究文獻，種別包含鼠、兔、豬、羊、馬及犬隻，以實證醫學指導原則，針對各文獻實驗設計及研究方法的品質做分級。結果顯示，雖然由於目前相關研究極少，且各研究間之實驗異質性大，無法進行統合分析提出一有效之結論；不過就個別研究成果來看，以關節內注射間葉幹細胞的治療方式，大多數結果仍顯示的確能在關節內進行某種程度的組織修復效果，其在臨床應用上具有潛力，值得進一步加以研究探討。

關鍵字

間葉幹細胞 ； 關節注射 ； 骨關節炎 ； 實證醫學

並列摘要

Osteoarthritis is a disease process associated with non-inflammatory, degenerative changes in the tissues of synovial joints and loss of articular cartilage. The poor regenerative capacity of cartilage and no available curative treatment options complicate satisfactory management of osteoarthritis. Recently, stem cell therapy plays an important role in regenerative medicine due to its capacity to differentiate into new tissue to achieve proper tissue repair. We systematically review the articles related to intra-articular mesenchymal stem cell injection in animals and consider them in the light of evidence-based (veterinary) medicine. A total of 11 studies from various animal species including rat, rabbit, pig, goat, horse and dog were included. The study materials, evaluation methods and primary outcome of each study were analysed along with the evaluation of the study design and grading of the study quality by use of an EBM scoring system. Evaluation of efficacy in published trials was hampered by the low number of studies and their heterogeneity nature, but most of individual study shows intra-articular stem cell injection could have positive therapeutic effect to a certain degree.

並列關鍵字

evidence based medicine ； intra-articilar injection ； mesenchymal stem cells ； osteoarthritis