2011年10月24日 星期一

柏金遜病人佳音

現今醫學昌明,器官移植已是一般常見手術,毫不稀奇。不但器官能換,細胞也可以;最普遍的是輸血,所輸者,主要是紅血球(細胞)。血液中還有白血球,但這是不能輸的,因為會引起免疫系統相斥,有致命的風險。全世界的血庫都須用到特別的過濾設備,盡量清理掉白血球,但暫時還未有一個方法能達到百分百。另外一種普及的細胞移植是更換骨髓細胞,在技術方面,這樣做完全沒有問題,但經移植而進入病人的身體後,新來的骨髓細胞會向後者施以攻擊,這現象叫Graft- versus-Host Reaction。

一般來說,除非捐贈者與接受者是孖生兒,否則一定有排斥的問題。避開排斥的方法之一是,選用嬰兒臍帶血中的幹細胞。這些細胞還未能懂得分辨「我」和「非我」,故能乖乖地支持病人的需要。幹細胞是一種「百搭」細胞。將它們移植到胰,它們便會轉為胰細胞;移植到心臟,便能代替衰老的心肌細胞。不過,幹細胞的供應是一個很大的問題。最優質的幹細胞來自胚胎。本來,醫生可以從流產或墮胎過程中取得幹細胞,但這一定會引起道德上的爭議。有沒有一個兩全其美的解決辦法,一方面不會產生排斥,另一方面也不致惹出道德官司?有一個「橫式分化」(Transdifferentiation)的做法,可能可以做到。

在2010年,一組史丹福大學學者發現,若將三個屬於神經細胞的轉錄因子(Transcription Factor)塞入「基質成纖維細胞」,後者便會轉而成為神經細胞(Nature, Vol.463, pp .1035-1041)。在今年6月出版的《美國國家科學院學報》,一組瑞典學者進一步發現,若將三個轉錄因子增加為五個轉錄因子,那些由「基質成纖維細胞」轉變而成的神經細胞,會再而轉成「多巴胺神經細胞」(Proc. Natl. Acad. Sci. USA, Vol.108, pp.10343-10348),可用以修補柏金遜病人的神經。

顧小培博士<柏金遜病人佳音> (信報,10月10日)

2011年9月15日 星期四

'It was a miracle': Toddler saved by cord blood transplant in S.A.



SAN ANTONIO -- Her parents call her their “miracle child.” A South Texas baby has a second chance at life thanks to a successful cord blood transplant in San Antonio.

At 10 months old, Valentina DeLeon’s parents knew there was a problem. She weighed only 13 pounds. She was a sickly child with a frightening diagnosis: severe combined immune deficiency (SCID). It’s a rare disorder made famous by the so-called “Bubble Boy” in the 1970s.

 “She was super skinny,” recalled Valentina’s mother, Karina Chapa. “She was sick all the time. She was vomiting. She was throwing up all the time. She wasn’t eating.”
The child's Rio Grande Valley doctors sent her to Methodist Children’s Hospital in San Antonio.
Dr. Ka Wah Chan ordered high-dose chemotherapy for Valentina and then a cord blood transplant.
Donated cord blood from a stranger turned out to be a match for this baby in need. The cells helped create a new, stronger, normal immune system for a girl who faced a grim diagnosis without it.
“The cord blood is thrown away anyway,” Chan explained. “Nobody saves cord blood. But it can be used. And it can particularly be used in this type of situation when you can do a transplant and save a life.”

Today, five months after transplant, Valentina weighs more than 9 kilograms. That’s 21 pounds. Her doctors are cautiously optimistic about her long-term prognosis.
Valentina’s parents are finally able to take her home to the Valley. They’re grateful to the woman who donated a by-product of birth that used to be considered medical waste.
“It’s changed her life and it was a miracle,” Chapa said. “She’s alive and she’s healthy and I’m just thankful. Very thankful.”

Source: Kens 5-TV, 12th September 2011

2011年8月23日 星期二

Brother's stem cells could be gift of life

Stephanie Payne with Tayler, left, who has cystic fibrosis,
and his younger brother Jordan. Times photo Wayne Martin.
 LITTLE Jordan Payne doesn’t know it yet, but one day he could well be the key to saving his brother’s life.


The three-year-old’s big brother Tayler has cystic fibrosis (CF), a genetic condition that thickens the body’s mucus and blocks tiny tubes in various organs.

About one in 3000-3500 children in New Zealand are born with CF and need regular physiotherapy to keep their airways clear, prevent lung damage and reduce infection.

When Jordan was born his parents decided to save his umbilical cord blood, which is full of stem cells that could help with his brother’s illness in the future.

Watching Tayler tear around the house with his best mate in tow, it is easy to forget he has a life-threatening illness.

Twice a day the four-year-old is given chest percussion by his mum Stephanie, which involves tapping his chest to shift the mucus from his lungs.

“He’s a little star,” she says. “He just sits there and takes it all.

“But he’s at the stage where he asks why he has to have physio and Jordan doesn’t.”
A hand sanitiser unit positioned at the Paynes’ front door is a telling sign of the care the family takes to safeguard Tayler’s health.

When the little boy develops a cough or cold he has to be treated with antibiotics as soon as possible to stop the infection in its tracks.

“Cystic fibrosis is a lifetime illness,” says Stephanie.

“They are born with it and they carry it through for the rest of their lives. It’s not ‘if’ he ever gets unwell, it’s ‘when’.”

However, she and her husband Brett try to resist the urge to wrap their son up in cotton wool as much as possible, so he can have a normal childhood.

“Bacteria is a big concern,” Stephanie told the Times.

“You have to be mindful, but you can only do the best you can. And we’ve had a lot of luck with him.”

A few days a week Tayler goes to Superstart Pre-school in East Tamaki, which has been incredibly accommodating of his needs.

In the past, the centre has waived the family’s childcare fees and donated the same amount from its own pocket to the Cystic Fibrosis Association.

“They are just amazing,” says Stephanie. “The kindy has been so supportive. I feel he’s in such safe hands and they have an extremely good safety policy.”

The mum-of-three is running a fundraiser at the Pakuranga Scout Hall from 10am-2pm this Saturday to put the spotlight on Cystic Fibrosis Awareness Week, which runs from August 15-21.

It will feature a white elephant sale to raise money and awareness of CF, and a gala with entertainment such as bouncy castles, face painting, raffles and a sausage sizzle.
“Everything goes to the association,” says Stephanie. “Usually the money is used to buy equipment and medication. A nebuliser is really expensive, and its maintenance is expensive too.”

Quality household items, clothes and toys are being sought for the bric-a-brac sale at 474 Pakuranga Road, and they can be dropped off at Stephanie’s home.

“For me, it’s more important to raise awareness than money, because so many know so little – if anything – about cystic fibrosis,” she says.

“The hard thing is they look so well on the outside.”

She hopes advances in medicine will one day make use of Jordan’s banked stem cells and a difference to the life of her eldest son.

“I’m so optimistic about his future now,” she says.

“There’s a lot of research now, and the possibility of Jordan saving his life one day.
“You talk with other parents and you become more hopeful.”

Source: Times Newspapers, New Zealand,  8 August, 2011

2011年8月22日 星期一

康盛人生臍帶血庫 9月份講座

2011年8月1日 星期一

萬能幹胞製人工心肌 為「人工心臟」鋪路

港大李嘉誠醫學院幹細胞及再生醫學研究組總監李登偉及其研究團隊,獲研資局撥款6000萬元,利用5年時間研發「萬能幹細胞」製造「人工心臟」技術和安全性,為未來將「人工心臟」移植至人體鋪路。(尹錦恩攝)


為「人工心臟」鋪路

【明報專訊】研資局早前撥出約2.5億元作主題研 究,其中6000萬元撥作研究「萬能幹細胞複製人類心臟」。項目統籌港大李嘉誠醫學院幹細胞及再生醫學研究組總監李登偉指出,現已可透過培育「萬能幹細 胞」,以一個月時間製造出一條直徑1毫米的心肌,期望利用5年時間加強研究,為長遠製造首個「人工心臟」並移植人體鋪路。

李登偉說,人體器官各由不同細胞組成,其中腦部和心臟細胞無法增生。以心臟為例,若病人患上中風、心血管閉塞等疾病,將導致大量心臟細胞壞死,令其他細胞的工作量大增導致心衰竭,理論上只有器官移植才能根治問題,因此近年科學家致力研究「人工心臟」。

獲6000萬元研發

過 去10年,科學界利用病人的皮膚抽取細胞,培育出人工誘導的「萬能幹細胞」,並將之培育成不同器官的細胞。李登偉說,最新技術已成功將1000萬個心肌細 胞,利用生物工程技術,將細胞放入預先準備的「生物框架」,將細胞整齊排列並固定位置,砌成一條長幾毫米、直徑1毫米的心肌,並與正常心肌一樣可收縮心跳 及傳送心電;連同培育細胞的時間,約需1個月才能製造一條心肌。

他表示,現時成功在實驗室製造心肌,不等於已可造出「人工心臟」,以及立即移植至人體,「今次希望能解決製造『人工心臟』的一連串問題,包括研究如何確保人工心臟移植入人體後不會出現排斥問題,以至『人工心臟』的耐用性、安全可靠度等」。

研究團隊正着手設計「人工心臟」的藍圖,包括如何大規模培育不同器官的細胞,以至將細胞排列成器官亦是一大難題,研究團隊將在研究過程中改善現有儀器,甚至研發新儀器解決大量生產的問題。

現時幹細胞治療法只有骨髓移植一種,其他所謂幹細胞仍未廣為醫學界認同。李登偉估計,單是通過美國食品及藥物管理局審批,可能需時5至10年,現階段難以評估實際何時有望應用在人體身上。

資料來源: 明報, 新浪網 (2011年7月27日)

2011年7月26日 星期二

CordLife - <新手父母湊B工作坊>

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2011年7月7日 星期四

Lab-made organ implanted for first time

This is the artificial trachea, covered in the patient's cells.
This is the artificial trachea, covered in the patient's cells.
(CNN) -- For the first time, a patient has received a synthetic windpipe that was created in a lab with the patient's own stem cells and without using human donor tissue, researchers said Thursday.

Previous lab-generated transplants either used a segment of donor windpipe or involved tissue only, not an organ.

In a laboratory in London, scientists created a trachea, which is a tube-like airway that connects at the voice box and branches into both lungs.
On June 9, doctors implanted this synthetic windpipe into a 36-year-old man with late-stage tracheal cancer at Karolinska University Hospital in Stockholm. The patient is doing well and is expected to be released from the hospital Friday, said Dr. Paolo Macchiarini, professor of regenerative medicine there.

Tracheal cancers are extremely rare, accounting for less than 1% of all cancers.
After the patient's initial diagnosis in 2008, he had exhausted every treatment available, including chemotherapy, radiation and surgery, Macchiarini said. The patient, an Eritrean who had been studying in Iceland, is the subject of a BBC documentary airing Thursday in Sweden.
His tumor had almost blocked his windpipe, doctors said.

Rather than waiting for a transplant, his doctors suggested growing an organ. Scientists created a Y-shaped framework for the new trachea, modeling it after the specific shape of the patient's windpipe.

The form was made of polymers that had a spongy and flexible texture. Stiff rings around the tube mimicked the structure of a human trachea.

The form was then bathed in a solution containing the patient's stem cells "to get the cells to grow on the sponge material," said David Green, president of Harvard Bioscience. Stem cells can divide and turn into a range of cell types, including those in organs.

His company worked on the stem cell solution, which is seen as a pink liquid in the photo at left. The purpose was to "seed" the synthetic windpipe -- as you would seed a new lawn -- to grow on the structure.

"Stem cells from the own patient were growing inside and outside," Macchiarini said. "This structure was becoming a living structure."

The stem cells were given physical or chemical cues to create the desired type, Green said.
Once the cells were thriving on the form, the artificial trachea was implanted into the patient.
His body accepted the new trachea, and he even had a cough reflex two days after the surgery, Macchiarini said.
Three years ago, Macchiarini made headlines by implanting an artificial trachea created from donor tissue combined with stem cells from the recipient, Claudia Castillo, whose windpipe had been damaged by tuberculosis.

"The results were quite good, but unfortunately we were still dependent" on organ donation, which can take months, Macchiarini said.

Creating the synthetic structure for the trachea in the current case took 10 to 12 days, compared with waiting months for an organ donor, Macchiarini said.

Earlier this year, regenerative medicine scientists at Wake Forest University School of Medicine reported that they had engineered five urethras between March 2004 and July 2007.

They had used a small piece of each patient's own tissue from the bladder, then grew the cells in a lab onto a mesh scaffold shaped like a urethra.

This area of research remains somewhat controversial in medicine, because critics say this could lead to human cloning.

But Macchiarini said making these first artificial organs viable in patients opens doors for future transplants through the relatively new field of regenerative medicine.

"It's a beautiful international collaboration," he said about the recent effort that involved doctors and researches in Sweden, the United Kingdom and the United States. "If scientists and clinicians work together, we can help humanity."