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Cellular Therapy For Pulmonary Tuberculosis

Specialists of the Central Scientific Research Institute of Tuberculosis (Russian Academy of Medical Sciences) and the Medical Radiological Research Center (Russian Academy of Medical Sciences) have been developing for three years a treatment mode for pulmonary tuberculosis stable forms.

The mode, on top of traditional complex therapy, includes stem cells intravenous injection to the patient, the stem cells being educed from his/her own marrow (mesenchymal stem cells). Clinical observations have proved that in such a way tubercular process can be stopped with practically incurable patients and their state of health can be improved significantly.

The researchers are studing twenty seven patients with stable forms of pulmonary tuberculosis. Pathogenes of these forms are resistant to the majority of antituberculous drugs, including the most active ones. In essence, these patients feel as the people ill with consumption did in the 19th century. Their lungs gradually decay, and the patients pose constant danger to people around as they excrete mycobacteria - tuberculosis pathogenes. Marrow (mesenchymal) stem cells can restore injured pulmonary tissues and increase patients’ resistivity to infection. They possess the property of differentiating into the cells of bone stock, cartilaginous tissue, adipose tissue and some other tissues – including the cells of healthy respiratory epithelium.

To get the stem cells, the patient underwent sternal puncture or iliac bone puncture. The obtained marrow cells were cultivated, (mesenchymal) stem cells being educed and reproduced in the course of cultivation. Transplantation required 150-200 million cells that were injected intravenously to the patient. In the majority of cases, the procedure did not cause complications, and annoying sensations (moderate temperature, ache, a worn out feeling), if any, were over on the next day. The researchers observed 16 patients for 18 to 24 months, and 11 patients – for at least six months. Within the first five months, all patients felt better: dyspnea reduced, asthenia and indisposition were almost over. Twenty four patients gained weight significantly and noted revitalization and burst of energy. Patients’ indicies of blood noticeably improved.

Three to four months after the transplantation, twenty patients ceased to excrete mycobacteria, this meaning that the active process in the lungs had stopped. According to the tomographic imaging research data, chronic cavities in the pulmonary tissue healed up with 11 patients; cavities in both lungs (that had existed for two years) closed with one of the patients. Inflammatory changes in the lungs dissolved with 15 patients, the lysis cavities partly closed or decreased in size.

At present, 9 patients out of 16, who were injected stem cells 18 to 24 month ago, demonstrate steady remission of tubercular process, the inflammatory changes dissolving and destructive changes disappearing in the lungs, the researchers observed considerable positive dynamics with 6 patients. Only in one case out of 16, the mesenchymal stem cells transplantation effect resulted only in a short-term improvement. The patients who underwent cells transplantation several months ago, continue their treatment, the efficiency of which may be judged 12 to 15 months later.

Although mechanisms of stem cells action are not quite clear yet, the results are promising and they allow to count on new prospects in treatment of stable forms of tuberculosis.

Nadezda Markina | alfa
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