K\u00a015.kv\u011btnu, Sv\u011btov\u00e9mu dni proti mozkov\u00e9 mrtvici, si p\u0159ipom\u00edn\u00e1me, \u017ee navzdory l\u00e9ka\u0159sk\u00fdm pokrok\u016fm akutn\u00ed c\u00e9vn\u00ed mozkov\u00e9 p\u0159\u00edhody ka\u017edoro\u010dn\u011b postihuj\u00ed miliony lid\u00ed. Pro minimalizaci n\u00e1sledk\u016f mrtvice je zcela z\u00e1sadn\u00ed rychl\u00e9 rozpozn\u00e1n\u00ed p\u0159\u00edznak\u016f a okam\u017eit\u00e9 poskytnut\u00ed adekv\u00e1tn\u00ed l\u00e9ka\u0159sk\u00e9 pomoci. O \u0161anci na \u00fasp\u011b\u0161n\u00fd n\u00e1vrat pacienta do b\u011b\u017en\u00e9ho \u017eivota rozhoduje i n\u00e1sledn\u00e1 p\u00e9\u010de, jej\u00ed\u017e efektivitu by mohla v\u00fdrazn\u011b zv\u00fd\u0161it aplikace kmenov\u00fdch bun\u011bk.<\/p>\n
P\u0159i mrtvici doch\u00e1z\u00ed k\u00a0ucp\u00e1n\u00ed c\u00e9v v\u00a0mozku krevn\u00ed sra\u017eeninou. V\u00a0d\u016fsledku toho nen\u00ed posti\u017een\u00e1 \u010d\u00e1st mozku z\u00e1sobena krv\u00ed, a tud\u00ed\u017e ani kysl\u00edkem. Mezi hlavn\u00ed projevy ataky mrtvice pat\u0159\u00ed bolest hlavy, rozmazan\u00e9 vid\u011bn\u00ed, nesrozumiteln\u00e1 \u0159e\u010d, slabost a ztr\u00e1ta koordinace t\u011bla. Kdy\u017e jsou bu\u0148ky dlouho neokysli\u010den\u00e9, odum\u00edraj\u00ed. Krevn\u00ed sra\u017eeninu je proto nutn\u00e9 co nejrychleji medikament\u00f3zn\u011b (nap\u0159\u00edklad s\u00a0pou\u017eit\u00edm rTPA \u2013 rekombinantn\u00ed tk\u00e1\u0148ov\u00fd aktiv\u00e1tor plazminogenu) odstranit. Lep\u0161\u00edch v\u00fdsledk\u016f je dosa\u017eeno, pokud je medikament\u00f3zn\u00ed l\u00e9\u010dba dopln\u011bna chirurgick\u00fdm odstran\u011bn\u00edm krevn\u00ed sra\u017eeniny. P\u0159i operaci mohou l\u00e9ka\u0159i p\u0159\u00edpadn\u011b c\u00e9vu vyztu\u017eit pomoc\u00ed kovov\u00e9ho implant\u00e1tu. Odstra\u0148ov\u00e1n\u00ed sra\u017eenin pomoc\u00ed l\u00e9k\u016f a chirurgie slou\u017e\u00ed k\u00a0obnov\u011b okysli\u010den\u00ed mozku, ale odum\u0159elou mozkovou tk\u00e1\u0148 obnovit nelze.<\/p>\n
Perspektivn\u011b by\u00a0v obdob\u00ed n\u00e1sledn\u00e9 p\u00e9\u010de o pacienty po mrtvici mohlo b\u00fdt v indikovan\u00fdch p\u0159\u00edpadech vyu\u017e\u00edv\u00e1no potenci\u00e1lu kmenov\u00fdch bun\u011bk, kter\u00e9 maj\u00ed schopnost se d\u011blit a vytv\u00e1\u0159et r\u016fzn\u00e9 typy tk\u00e1n\u00ed. V\u00a0sou\u010dasnosti prob\u00edhaj\u00ed klinick\u00e9 studie, kter\u00e9 testuj\u00ed efektivitu kmenov\u00fdch bun\u011bk p\u0159i\u00a0obnov\u011b neuron\u016f. Vyu\u017e\u00edvaj\u00ed se k\u00a0tomu neur\u00e1ln\u00ed kmenov\u00e9 bu\u0148ky schopn\u00e9 se d\u011blit a vytv\u00e1\u0159et identick\u00e9 dce\u0159in\u00e9 bu\u0148ky, nebo mezenchym\u00e1ln\u00ed kmenov\u00e9 bu\u0148ky, kter\u00e9 maj\u00ed schopnost diferenciace do r\u016fzn\u00fdch bun\u011b\u010dn\u00fdch typ\u016f, v\u010detn\u011b neur\u00e1ln\u00edch bun\u011bk. Ukazuje se, \u017ee kmenov\u00e9 bu\u0148ky dok\u00e1\u017eou vytv\u00e1\u0159et nov\u00e9 a nahradit odum\u0159el\u00e9 neurony a podporovat angiogenezi. V\u00a0m\u00edst\u011b po\u0161kozen\u00ed mohou krom\u011b tvorby nov\u00fdch neuron\u016f tak\u00e9 sni\u017eovat z\u00e1n\u011bt pomoc\u00ed p\u016fsobk\u016f, kter\u00e9 vylu\u010duj\u00ed.<\/p>\n
Prvn\u00ed klinick\u00e1 studie vyu\u017e\u00edvaj\u00edc\u00ed kmenov\u00e9 bu\u0148ky v\u00a0terapii mozkov\u00e9 mrtvice byla provedena t\u00fdmem britsk\u00fdch l\u00e9ka\u0159\u016f ji\u017e v\u00a0roce 2016. B\u011bhem operace zavedli neur\u00e1ln\u00ed kmenov\u00e9 bu\u0148ky p\u0159\u00edmo na posti\u017een\u00e9 m\u00edsto. V\u00fdsledkem byla lep\u0161\u00ed rekonvalescence pacienta. V americk\u00e9 klinick\u00e9 studii z roku 2019 byly k\u00a0l\u00e9\u010db\u011b mrtvice pou\u017eity mezenchym\u00e1ln\u00ed kmenov\u00e9 bu\u0148ky. Na rozd\u00edl od v\u00fd\u0161e uveden\u00e9 studie je l\u00e9ka\u0159i nezav\u00e1d\u011bli p\u0159\u00edmo na m\u00edsto po\u0161kozen\u00ed, ale pomoc\u00ed infuze do krevn\u00edho ob\u011bhu, kter\u00fdm se dostaly do mozku. Tato terapie vedla ke\u00a0zlep\u0161en\u00ed mozkov\u00fdch funkc\u00ed.<\/p>\n
V\u00a0sou\u010dasnosti prob\u00edh\u00e1 n\u011bkolik des\u00edtek studi\u00ed, kter\u00e9 zkoumaj\u00ed bezpe\u010dnost a efektivitu aplikace kmenov\u00fdch bun\u011bk v\u00a0l\u00e9\u010db\u011b mozkov\u00e9 mrtvice. O\u010dek\u00e1v\u00e1 se, \u017ee v bl\u00edzk\u00e9 budoucnosti se kmenov\u00e9 bu\u0148ky stanou sou\u010d\u00e1st\u00ed standardn\u00ed terapie pacient\u016f po mrtvici, kter\u00e1 urychl\u00ed rekonvalescenci a zlep\u0161\u00ed kvalitu jejich \u017eivota.<\/p>\n
Mgr. Lenka Gmiterkov\u00e1<\/p>\n
10. 5. 2023<\/p>\n
Zdroje:
\nKalladka D, Sinden J, Pollock K, et al. (2016): Human neural stem cells in patients with chronic ischaemic stroke (PISCES): a phase 1, first-in-man study. Lancet, 388, 787-796.<\/p>\n
Levy ML, Crawford JR, Dib N, Verkh L, Tankovich N, Cramer SC (2019): Phase I\/II study of safety and preliminary efficacy of intravenous allogeneic mesenchymal stem cells in chronic stroke. Stroke, 50, 2835-2841.<\/p>\n
Yan S-S, Campos de Souza S, Xie Z-D, Bao Y-X (2023): Research progress in clinical trials of stem cell therapy for stroke and neurodegenerative diseases. Ibrain, doi: 10.1002\/ibra.12095<\/p>\n","protected":false},"excerpt":{"rendered":"
K\u00a015.kv\u011btnu, Sv\u011btov\u00e9mu dni proti mozkov\u00e9 mrtvici, si p\u0159ipom\u00edn\u00e1me, \u017ee navzdory l\u00e9ka\u0159sk\u00fdm pokrok\u016fm akutn\u00ed c\u00e9vn\u00ed mozkov\u00e9 […]<\/p>\n","protected":false},"author":12,"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":"Ane\u017eka Klubalov\u00e1","author_link":"https:\/\/www.mc-praha.cz\/mcp\/author\/aklubalova\/"},"uagb_comment_info":0,"uagb_excerpt":"K\u00a015.kv\u011btnu, Sv\u011btov\u00e9mu dni proti mozkov\u00e9 mrtvici, si p\u0159ipom\u00edn\u00e1me, \u017ee navzdory l\u00e9ka\u0159sk\u00fdm pokrok\u016fm akutn\u00ed c\u00e9vn\u00ed mozkov\u00e9 […]","post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/4325"}],"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\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/comments?post=4325"}],"version-history":[{"count":1,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/4325\/revisions"}],"predecessor-version":[{"id":4327,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/4325\/revisions\/4327"}],"wp:attachment":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/media?parent=4325"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/categories?post=4325"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/tags?post=4325"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}