{"id":3493,"date":"2020-04-27T16:47:04","date_gmt":"2020-04-27T14:47:04","guid":{"rendered":"http:\/\/www.mc-praha.cz\/mcp\/?p=3493"},"modified":"2020-04-27T18:11:38","modified_gmt":"2020-04-27T16:11:38","slug":"mezenchymalni-kmenove-bunky-a-jejich-potencial-v-lecbe-nemoci-covid-19","status":"publish","type":"post","link":"https:\/\/www.mc-praha.cz\/mcp\/mezenchymalni-kmenove-bunky-a-jejich-potencial-v-lecbe-nemoci-covid-19\/","title":{"rendered":"Mezenchym\u00e1ln\u00ed kmenov\u00e9 bu\u0148ky a jejich potenci\u00e1l v l\u00e9\u010db\u011b nemoci Covid 19"},"content":{"rendered":"

Mezenchym\u00e1ln\u00ed kmenov\u00e9 bu\u0148ky jsou z\u00e1rode\u010dn\u00e9 bu\u0148ky maj\u00edc\u00ed d\u00edky sv\u00fdm vlastnostem schopnost p\u0159etvo\u0159it se v\u00a0bu\u0148ky jin\u00e9. Bylo ale zji\u0161t\u011bno, \u017ee jsou tak\u00e9 schopn\u00e9 ovliv\u0148ovat jin\u00e9 bu\u0148ky, hlavn\u011b bu\u0148ky imunitn\u00edho syst\u00e9mu. To je d\u016fvod, pro\u010d se aktu\u00e1ln\u011b zkoum\u00e1 jejich vyu\u017eit\u00ed k\u00a0l\u00e9\u010db\u011b onemocn\u011bn\u00ed Covid-19. Doposud publikovan\u00e9 v\u00fdsledky vypadaj\u00ed velmi slibn\u011b.<\/p>\n

V\u00a0sou\u010dasn\u00e9 dob\u011b se hledaj\u00ed nov\u00e9 alternativy l\u00e9\u010dby onemocn\u011bn\u00ed Covid-19. V\u00ed se, \u017ee virus SARS-CoV-2 m\u016f\u017ee v\u00a0organismu hostitele vyvolat velmi intenzivn\u00ed reakci imunitn\u00edho syst\u00e9mu, kdy doch\u00e1z\u00ed k\u00a0nadm\u011brn\u00e9 produkci medi\u00e1tor\u016f z\u00e1n\u011btu – cytokin\u016f. To m\u00e1 za n\u00e1sledek tzv. cytokinovou bou\u0159i, kter\u00e1 m\u016f\u017ee zp\u016fsobit po\u0161kozen\u00ed org\u00e1n\u016f n\u00e1sledovan\u00e9 otoky, poruchou plicn\u00ed ventilace, syndromem akutn\u00ed dechov\u00e9 t\u00edsn\u011b (ARDS) a dal\u0161\u00edmi komplikacemi, potenci\u00e1ln\u011b vedouc\u00edmi a\u017e k \u00famrt\u00ed. Doposud se k\u00a0utlumen\u00ed cytokinov\u00e9 bou\u0159e pou\u017e\u00edvaj\u00ed hlavn\u011b glukokortikoidy, kter\u00e9 ale maj\u00ed celou \u0159adu ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f (osteopor\u00f3za, oslaben\u00ed imunity). Proto se aktu\u00e1ln\u011b zkou\u0161\u00ed terapie mezenchym\u00e1ln\u00edmi kmenov\u00fdmi bu\u0148kami (MSCs), o kter\u00fdch je zn\u00e1mo, \u017ee maj\u00ed tzv. imunomodula\u010dn\u00ed schopnost, co\u017e znamen\u00e1, \u017ee jsou schopny zm\u011bnit rozsah imunitn\u00ed reakce.<\/p>\n

Pro imunitn\u00ed reakci je d\u016fle\u017eit\u00e1 komunikace mezi bu\u0148kami imunitn\u00edho syst\u00e9mu, kterou zaji\u0161\u0165uj\u00ed ji\u017e zm\u00edn\u011bn\u00e9 cytokiny. Cytokiny produkovan\u00e9 jedn\u00edm typem bun\u011bk imunitn\u00edho syst\u00e9mu se specificky v\u00e1\u017eou na receptor jin\u00e9ho typu bun\u011bk imunitn\u00edho syst\u00e9mu, \u010d\u00edm\u017e doch\u00e1z\u00ed k\u00a0p\u0159enosu informace: jak se m\u00e1 bu\u0148ka chovat, jakou l\u00e1tku m\u00e1 uvolnit. Tady vstupuj\u00ed do hry MSCs, kter\u00e9 dok\u00e1\u017eou uvolnit l\u00e1tku, kter\u00e1 se nav\u00e1\u017ee na p\u0159\u00edslu\u0161n\u00fd receptor, \u010d\u00edm\u017e ho efektivn\u011b zablokuje, nedojde k\u00a0p\u0159ed\u00e1n\u00ed informace
\na c\u00edlov\u00e1 bu\u0148ka \u017e\u00e1dnou l\u00e1tku neuvoln\u00ed. D\u00e1le MSCs uvol\u0148uj\u00ed l\u00e1tky, kter\u00e9 ovliv\u0148uj\u00ed bu\u0148ky imunitn\u00edho syst\u00e9mu tak, \u017ee m\u00edsto proz\u00e1n\u011btliv\u00fdch faktor\u016f uvol\u0148uj\u00ed faktory protiz\u00e1n\u011btliv\u00e9.<\/p>\n

Dal\u0161\u00edm d\u016fvodem pro pou\u017eit\u00ed MSCs v\u00a0terapii Covid-19 je skute\u010dnost, \u017ee virus SARS-CoV-2 penetruje do hostitelsk\u00e9 bu\u0148ky tak, \u017ee se sv\u00fdm povrchov\u00fdm S\u00a0proteinem nav\u00e1\u017ee na angiotensin I converting enzyme 2 receptor (ACE2) na jej\u00edm povrchu. ACE2 receptor se vyskytuje u v\u011bt\u0161iny lidsk\u00fdch bun\u011bk, nejv\u00edce pak u bun\u011bk plicn\u00edch skl\u00edpk\u016f a endotelu kapil\u00e1r. A pr\u00e1v\u011b MSCs pat\u0159\u00ed mezi v\u00fdjimky, u kter\u00fdch bylo pomoc\u00ed genov\u00e9 exprese prok\u00e1z\u00e1no, \u017ee tento receptor na sv\u00e9m povrchu nevytv\u00e1\u0159ej\u00ed, tud\u00ed\u017e do nich virus nem\u016f\u017ee penetrovat.<\/p>\n

Zve\u0159ejn\u011bn\u00e9 v\u00fdsledky dvou studi\u00ed, kde byly k\u00a0terapii u pacient\u016f ve v\u00e1\u017en\u00e9m stavu po selh\u00e1n\u00ed jin\u00fdch l\u00e9\u010debn\u00fdch prost\u0159edk\u016f pou\u017eity MSCs, ukazuj\u00ed, \u017ee u pacient\u016f do\u0161lo v\u00a0rozmez\u00ed dn\u016f od aplikace k\u00a0v\u00fdrazn\u00e9mu zlep\u0161en\u00ed zdravotn\u00edho stavu. Sn\u00ed\u017eily se hladiny medi\u00e1tor\u016f z\u00e1n\u011btu, po\u010det b\u00edl\u00fdch krvinek se vr\u00e1til k\u00a0fyziologick\u00e9mu norm\u00e1lu a pacienti mohli b\u00fdt odpojeni od plicn\u00ed ventilace. Zd\u00e1 se tedy, \u017ee MSCs skute\u010dn\u011b mohou v\u00fdrazn\u011b sn\u00ed\u017eit z\u00e1n\u011btlivou odpov\u011b\u010f organismu a d\u00e1le i napom\u00e1haj\u00ed v\u00a0obnov\u011b bun\u011bk a org\u00e1n\u016f imunitn\u00edho syst\u00e9mu. V\u00a0plic\u00edch vede aktivita MSCs k\u00a0obnov\u011b epiteli\u00e1ln\u00edch bun\u011bk plicn\u00edch skl\u00edpk\u016f a t\u00edm k\u00a0obnov\u011b plicn\u00edch funkc\u00ed. Nav\u00edc p\u016fsob\u00ed i proti rozvoji plicn\u00ed fibr\u00f3zy.<\/p>\n

MSCs pou\u017e\u00edvan\u00e9 k bun\u011b\u010dn\u00fdm terapi\u00edm poch\u00e1zej\u00ed ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f p\u016fvodem z kostn\u00ed d\u0159en\u011b, ty se ov\u0161em jev\u00ed vhodn\u00e9 prim\u00e1rn\u011b k l\u00e9\u010db\u011b lok\u00e1ln\u00edch probl\u00e9m\u016f, nebo\u0165 kostn\u00ed d\u0159e\u0148 nen\u00ed na MSCs tak bohat\u00e1. K l\u00e9\u010db\u011b syst\u00e9mov\u00e9ho onemocn\u011bn\u00ed jak\u00fdm je Covid-19 jsou proto vhodn\u011bj\u0161\u00ed MSCs z tukov\u00e9 tk\u00e1n\u011b, amnia \u010di pupe\u010dn\u00edku.<\/p>\n

Pupe\u010dn\u00edkov\u00e9 MSCs jsou pro bun\u011b\u010dnou terapii Covid-19 nejperspektivn\u011bj\u0161\u00ed z\u00a0n\u00e1sleduj\u00edc\u00edch d\u016fvod\u016f:<\/p>\n

    \n
  1. Pupe\u010dn\u00edku je jeden z nejbohat\u0161\u00edch zdroj\u016f MSCs, na rozd\u00edl od ostatn\u00edch tk\u00e1n\u00ed obsahuj\u00edc\u00edch\u00a0MSCs se z\u00edsk\u00e1v\u00e1 neinvazivn\u00edmi metodami.<\/li>\n
  2. Pupe\u010dn\u00edkov\u00e9 MSCs se velmi rychle d\u011bl\u00ed.<\/li>\n
  3. Transplantovan\u00e9 pupe\u010dn\u00edkov\u00e9 MSCs nevyvol\u00e1vaj\u00ed u p\u0159\u00edjemc\u016f imunologickou reakci, proto\u017ee tvo\u0159\u00ed jen v\u00a0mal\u00e9 m\u00ed\u0159e (nebo v\u016fbec ne) molekuly, kter\u00e9 hlavn\u00ed histokompatiblin\u00ed komplex rozpozn\u00e1v\u00e1 jako antigenn\u00ed (ciz\u00ed).<\/li>\n<\/ol>\n

    Vhodnost pupe\u010dn\u00edkov\u00fdch MSCs k\u00a0bun\u011b\u010dn\u00e9 terapii Covid-19 jen podtrhuje skute\u010dnost, \u017ee z\u00a0aktu\u00e1ln\u011b sedmi b\u011b\u017e\u00edc\u00edch klinick\u00fdch studi\u00ed zab\u00fdvaj\u00edc\u00edch se vyu\u017eit\u00edm MSCs v\u00a0terapii tohoto onemocn\u011bn\u00ed \u010dty\u0159i zkoumaj\u00ed pr\u00e1v\u011b pupe\u010dn\u00edkov\u00e9 MSCs.<\/p>\n

    ATLURI, Sairam, Laxmaiah MANCHIKANTI a Joshua A. HIRSCH, 2020. Expanded Umbilical Cord Mesenchymal Stem Cells (UC-MSCs) as a Therapeutic Strategy In Managing Critically Ill COVID-19 Patients: The Case for Compassionate Use. Pain Physical Journal. 71-83. ISSN 2150-1149<\/p>\n

    LENG, Zikuan, Rongjia ZHU, Wei HOU, et al., 2020. Transplantation of ACE2- Mesenchymal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia. Aging and disease. 11(2). DOI: 10.14336\/AD.2020.0228. ISSN 2152-5250. Dostupn\u00e9 tak\u00e9 z: http:\/\/www.aginganddisease.org\/EN\/10.14336\/AD.2020.0228<\/a><\/p>\n

    LIANG, Bing, Junhui CHEN, Haiying WU, et al., 2020. Clinical remission of a critically ill COVID-19 patient treated by human umbilical cord mesenchymal stem cells. China<\/p>\n

    PROCKOP, Darwin J a Joo YOUN OH, 2012. Mesenchymal Stem\/Stromal Cells (MSCs): Role as Guardians of Inflammation. Molecular Therapy. 20(1), 14-20. DOI: 10.1038\/mt.2011.211. ISSN 15250016. Dostupn\u00e9 tak\u00e9 z: https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1525001616304452<\/a><\/p>\n

    PROMPETCHARA, Eakachai, Chutitorn KETLOY a Tanapat PALAGA, 2020. Immune responses in COVID-19 and potential vaccines: Lessons learned from SARS and MERS epidemic. Asian Pacific Journal of Allergy and Immunology. DOI: 10.12932\/AP-200220-0772. ISSN 0125877X. Dostupn\u00e9 tak\u00e9 z: http:\/\/apjai-journal.org\/wp-content\/uploads\/2020\/02\/Covid_AP-200220-0772.pdf<\/a><\/p>\n

    SHETTY, Ashok K, 2020. Mesenchymal Stem Cell Infusion Shows Promise for Combating Coronavirus (COVID-19)- Induced Pneumonia. Aging and disease. 11(2), 462-464. DOI: 10.14336\/AD.2020.0301. ISSN 2152-5250. Dostupn\u00e9 tak\u00e9 z: http:\/\/www.aginganddisease.org\/EN\/10.14336\/AD.2020.0301<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

    Mezenchym\u00e1ln\u00ed kmenov\u00e9 bu\u0148ky jsou z\u00e1rode\u010dn\u00e9 bu\u0148ky maj\u00edc\u00ed d\u00edky sv\u00fdm vlastnostem schopnost p\u0159etvo\u0159it se v\u00a0bu\u0148ky jin\u00e9. […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"image","meta":{"_uag_custom_page_level_css":""},"categories":[1],"tags":[],"uagb_featured_image_src":{"full":false,"thumbnail":false,"medium":false,"medium_large":false,"large":false,"1536x1536":false,"2048x2048":false,"boldthemes_grid":false,"boldthemes_grid_11":false,"boldthemes_grid_22":false,"boldthemes_grid_21":false,"boldthemes_grid_12":false,"boldthemes_latest_posts":false,"boldthemes_grid_gallery":false},"uagb_author_info":{"display_name":"Jbednar","author_link":"https:\/\/www.mc-praha.cz\/mcp\/author\/jbednar\/"},"uagb_comment_info":0,"uagb_excerpt":"Mezenchym\u00e1ln\u00ed kmenov\u00e9 bu\u0148ky jsou z\u00e1rode\u010dn\u00e9 bu\u0148ky maj\u00edc\u00ed d\u00edky sv\u00fdm vlastnostem schopnost p\u0159etvo\u0159it se v\u00a0bu\u0148ky jin\u00e9. […]","post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/3493"}],"collection":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/comments?post=3493"}],"version-history":[{"count":2,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/3493\/revisions"}],"predecessor-version":[{"id":3502,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/3493\/revisions\/3502"}],"wp:attachment":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/media?parent=3493"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/categories?post=3493"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/tags?post=3493"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}