同单位外科医生学术问题被调查，诺贝尔奖大会秘书长竟辞职

猴年第一消息：卡罗林斯卡研究院的外科医生Paolo Macchiarini因气管再造研究中的问题而被调查，而这一调查竟然导致同单位的在诺贝尔奖大会任秘书长的Urban Lendahl辞职。

相比爆发了震惊中外的张生家案的清华大学，这瑞典人办事也太认真了。

 

附：

Nobel Prize official resigns in wake of Macchiarini case

 

 

http://retractionwatch.com/2016/02/07/nobel-prize-official-resigns-in-wake-of-macchiarini-case/

 

The secretary general of the Nobel Assembly, the body responsible for choosing the Nobel Prizes, has resigned from his post because “he may be involved” in the Karolinska Institutet investigation of trachea surgeon Paolo Macchiarini.

Urban Lendahl, professor of genetics at the Karolinska, has also resigned as secretary general of the Nobel Committee in Physiology or Medicine. Here’s a statement released yesterday by the Nobel Assembly:

Today, Professor Urban Lendahl has announced that he resigns effective immediately and at his own request, from his position as Secretary General of the Nobel Assembly and the Nobel Committee in Physiology or Medicine at Karolinska Institutet. The Board of Karolinska Institutet has initiated an external investigation concerning the Macchiarini case. As Professor Lendahl anticipates that he may be involved in this investigation, he resigns from his position as Secretary General out of respect for the integrity of the Nobel Prize work. Any questions should be addressed to the Chairman of the Nobel Assembly, Professor Rune Toftgård, or the Chairman of the Nobel Committee, Professor Thomas Perlmann.

The Nobel Assembly is independent of the Karolinska Institutet and consists of 50 elected Professors from the Karolinska Institutet.

The Karolinska announced Friday that it was ordering a new external investigation of the case, prompted by new revelations in the media. A previous inquiry concluded that Macchiarini, whose contract at the Karolinska has not been renewed, acted in some cases “without due care,” but that his behavior “does not qualify as scientific misconduct.”

Lendahl advocated for Macchiarini’s hire by the Karolinska, according to Svenska Dagbladet, although the Nobel Assembly was not involved in the appointment, Nobel General Assembly chair Rune Toftgård told the newspaper.

Lendahl has been a member of the Nobel General Assembly since 2000, and was elected secretary general in late 2014. In an interview with Elsevier, one of whose journals Lendahl edits, he explained what the secretary general does:

On January 1, 2015, I started as the new Secretary-General for the Nobel Assembly at the Karolinska Institute, Stockholm, Sweden. The role of the Secretary-General is to see to that the process of selecting the Nobel Laureates runs smoothly and that the Nobel Assembly and Committee get all the necessary material and support so they can conduct their work.

The Nobel Assembly “has 50 voting members and is composed of professors in medical subjects at Karolinska Institutet,” according to the official website of the Nobels.

 

 

Karolinska orders new investigation of trachea surgeon Macchiarini

 

The Karolinska Institutet University Board announced today it was issuing a new external investigation of trachea surgeon Paolo Macchiarini, looking into questions about his recruitment and the handling of previous allegations of misconduct.

According to a press release:

The University Board deems such an inquiry to be an important part of restoring the confidence of the public, the scientific community, staff and students in the university.

The board hopes to appoint the investigative team, which will not consider “matters of a medical-scientific nature,” next week. The goal is to conclude the investigation by the summer.

There were many signs this was coming: Last week, KI announced it may reopen its previous misconduct inquiry, after a series of recent documentaries aired in Sweden raised a number of new allegations, such as suggesting Macchiarini operated on patients in Russia whose conditions were not life-threatening enough to warrant such a risky procedure.

During the previous inquiry, an external review concluded that Macchiarini had committed misconduct in seven papers; ultimately, KI’s vice-chancellor, Anders Hamsten, concluded that Macchiarini acted in some cases “without due care,” but that his behavior “does not qualify as scientific misconduct.”

Yesterday, Karolinska announced it would not extend Macchiarini’s current one-year research contract.

Macchiarini is world-renowned for performing a breakthrough surgery, creating tracheas from cadavers and patients’ own stem cells. However, some Karolinska surgeons eventually filed a complaint — alleging, for instance, Macchiarini had downplayed the risks of the procedure and not obtained proper consent.

Today’s release included some details about the nature of the investigation:

The investigation will be led by a highly experienced lawyer, who will subsequently be writing the final report. Well-qualified medical researchers, ideally not from Sweden, should assist in this work. The person tasked with leading the work will decide on who is to take part in the investigation and on what resources will be needed to bring the inquiry to a satisfactory conclusion. KI’s internal audit office, which answers direct to the University Board, will also be a resource available to the investigation.

It included the specific questions that will be considered:

The investigation will cover that which falls within the University Board’s sphere of responsibility, and will thus not be examining matters of a medical-scientific nature. Issues that that external investigation should consider are:

-Was any law broken or other formal transgression committed on Macchiarini’s recruitment or later during his period of employment at KI?

-Were adequate inquiries made in connection with his recruitment?

-Was sufficient effort made at a departmental and university management level to ensure that Macchiarini’s activities were conducted in a proper scientific manner with due respect to research ethics?

-Has his research been documented in a manner consistent with the rules and praxis in effect at KI?

-Has the division of responsibility between KI and Karolinska University Hospital been sufficiently clear, and has their collaboration been adequate from a research and clinical perspective?

-Has the chain of responsibility from department to Vice-Chancellor and the University Board been sufficiently effective?

-Was anything – or enough – done to ensure that Macchiarini’s extramural activities complied with KI’s scientific and ethical requirements?

-Were the allegations of scientific misconduct levelled against Macchiarini handled correctly?

-Why was Macchiarini’s employment contract extended in 2015 in spite of the obvious doubts there were about his activities?

The release concluded by reaffirming the board’s support for Vice Chancellor Anders Hamsten, who has been under pressure following the earlier decision:

The University Board has full confidence in Vice Chancellor Anders Hamsten and has urged him to remain in office during the investigation. Whether the outcome of the investigation will lead the board to change its stance in this respect is not a matter for speculation at present.

Hamsten said he appreciated the support:

I intend to continue as vice-chancellor of Karolinska Institutet with full force and energy, and to execute my responsibility in this situation in the best possible way….The decisions taken by the board are fully in line with what I myself believe must be done now.

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Misconduct found in 7 papers by Macchiarini, says English write-up of investigation

 

http://retractionwatch.com/2015/05/28/misconduct-found-in-7-papers-by-macchiarini-says-english-write-up-of-investigation/

The Karolinska Institutet in Sweden has released an English translation of an external review that found Paolo Macchiarini, a celebrated surgeon who is credited with creating tracheas from cadavers and patients’ own stem cells, committed misconduct in a series of papers describing the work.

You can read the entire report, news of which was first reported by Science, here. The investigator, Bengt Gerdin, of Uppsala University, considered a series of allegations about Macchiarini’s papers, and found a number of them lived up to the verdict of misconduct. There were seven affected papers, not six, as was reported last week based on the initial findings (reported in Swedish).

For instance, in a 2014 Nature Communications paper describing the procedure in rats, Gerdin found that the scientists erred when none of the listed authors could assume responsibility for a CT image showing rats with “a smooth and patent oesophagus” (the researcher who took it asked to be left off the author list when he disagreed with how it was being interpreted), among other issues:

…the principally most outstanding fault is that the authors have decided to present research results for which none of them can take responsibility. This is inconsistent with accepted research practice and therefore qualifies as misconduct, and the lead author (or in Nature Communication’s words “corresponding author”) bears the blame for this. The paper also contains a number of other weaknesses/faults in the presentation of the animal experiments that had been conducted. These experiments are presented so vaguely that it is surprising that a journal of Nature Communication’s calibre accepted the paper without demanding extensive clarifications, which should have been dealt with in an effective referee-process.

In a series of six papers describing the results of experiments with three human subjects, Gerdin concluded that several other incidents of misconduct had occurred:

To describe a clinical result after five months without conducting any examination of the patient at this point in time is significant; it is inconsistent with accepted scientific practice and therefore qualifies as misconduct (Paper 1).

To explicitly state that an ethical permit exists despite the absence of one is a false claim that affects the reliability of the research; this is a serious departure from accepted scientific practice and therefore qualifies as misconduct (Paper 1) .

To refer to paper 1 and make out that it accounts for a longer follow-up than actually was the case is false. This also applies to the actual description of the healing of the mucosa over the prosthesis, which in no way matches the accounts given in the medical records. In any case, it is an act of carelessness and a departure from accepted scientific practice and therefore qualifies as misconduct (Paper 2).

To describe the postoperative condition of a patient in such a way that leaves readers unable to make any other interpretation than that the postoperative conditions are good when in reality the patient has serious problems is to deliberately dress up the results. This is inconsistent with accepted scientific practice and therefore qualifies as misconduct, regardless of the fact that the paper’s main purpose is not purely clinical (Paper 3).

To state that the circumstances 12 months after the operation were good despite the patient being in an extremely serious clinical condition and to claim by way of excuse that no check was made of the patient’s status in the hospital records is significant; it is inconsistent with accepted scientific practice and therefore qualifies as misconduct (Paper 4).

To omit to mention that one of the reported patients had to undergo a new operation because of material failure was an active withholding of information and a dressing-up of the results. Such withholding of information is inconsistent with accepted scientific practice and therefore qualifies as misconduct (Paper 5).

To selectively describe certain minor postoperative problems while omitting the really major problems that led to the operated patient’s death is a false embellishment of the results. This constitutes active withholding of information, which is inconsistent with accepted scientific practice and therefore qualifies as misconduct (Paper 6).

According to a statement released May 27 by Karolinska Institutet, all co-authors of the papers Gerdin investigated have two weeks to respond. After that, the vice-chancellor will reach an official decision.

Macchiarini declined to comment when Retraction Watch asked him to respond to the report, but said he may once the vice-chancellor renders an official verdict.

This is one of two reviews commissioned by the Karolinska. The other cleared him of different misconduct allegations brought by Pierre Delaere. An investigation in Italy has also cleared him of most charges.

 

 

全球首例自体干细胞人造气管移植手术实施成功

　　近日，瑞典外科医生首次将一个完全“成长”于实验室中的人造气管成功移植入患者体内，使这位饱受折磨的患者重获新生。这个人造气管来自患者自身的干细胞，科学家将这些干细胞“栽培”在精心设计的Y形人造支架上，最终培育出可供移植的人造气管。一直以来，定制器官是科学家和患者的共同梦想，这一手术的成功无疑让人们看到了圆梦的曙光。然而，当人类有一天可以随意定制器官，梦魇也许也会接踵而至……

 

http://cn.nytimes.com/health/20121015/c15organ/

 

再生医学 科学家用病人自身细胞订做器官 HENRY FOUNTAIN 2012年10月15日

斯德哥尔摩——安德马里亚姆·贝耶恩(Andemariam Beyen)坐在医院的窗户旁，低斜的极地阳光照映着他的脸，他开始述说那段以为自己就要死去的时光。

两年半前贝耶恩在冰岛学习工程学，正是在那时，医生发现他的气管中长了一个高尔夫球大小的肿瘤。尽管进行了手术和放疗，肿瘤仍然继续进展。在2011年的春天，当贝耶恩来到瑞典再次就医时，他实际上已经没有多少选择了。“那时我就要死了，”他说：“很痛苦，太难受了”。

·         查看大图

Stefan Zimmerman

斯德哥尔摩卡罗林斯卡医学院的伊琳娜·吉利维奇(Irina Gilevich)正在塑形体气管上涂抹大鼠骨髓细胞。随后塑形体将放在营养液中，置入生物反应器中旋转，让细胞融为一体。

·        

Karolinska University Hospital/Reuters

这例首无前例的手术由卡罗林斯卡医学院的保罗·马基亚里尼医生完成，他创造了这种医疗手段。

·        

Stefan Zimmerman

安德马里亚姆·贝耶恩生了癌症肿瘤的气管，现在已由植入了他本人干细胞的人工气管取代。手术后，他的身体生成特化细胞，长在了气管内外。

但是卡罗林斯卡医学院(Karolinska Institute)的保罗·马基亚里尼(Paolo Macchiarini)医生有一个根治该病的想法。他希望通过塑型体和患者自己的细胞给贝耶恩先生构建一个新的气管。

几十年来再生医学的发展预示着未来能在实验室里培养替代器官（包括肝脏、肾脏甚至心脏），植入这样一个人造器官是再生医学界的首例。

最重要的是，这样的未来一直如同科幻小说里描述的一样。现在像马基亚里尼医生一样的研究者正在用一种特殊的方法构建器官，他们利用人自身的细胞并让躯体本身来完成大部分的工作。

“人体是如此美妙。我坚信我们必须以最合理的方式利用它，”马基亚里尼医生说。马基亚里尼医生目前负责管理这间组织工程领域领先的实验室。

到目前为止，科学家只能构建并移植少数几种器官，即相对简单的空腔脏器，例如膀胱和贝耶恩的气管。2011年6月，人造气管植入了贝耶恩的体内。全世界的科学家希望通过类似的技术制造更多更复杂的器官。北卡罗来纳州的维克森林大学(Wake Forest University)是人造膀胱的发源地，那里的研究者们正为人造肾脏、肝脏和其他器官而努力。中国和荷兰的一些实验室也在众多研究人造血管的机构之列。

制造这些新的人体器官与几十年前制造人工心脏的方式完全不同。那些很成熟的仪器设备到现在还暂时用于正在等候移植治疗的患者，但是归根到底机器还是机器。

组织工程师们旨在把这一件事变得更人性化。他们希望用细胞、血管和神经制造器官，使其成为身体的一个有活力、有功能的部分。有些专家，比如马基亚里尼医生，希望能做更多——利用机体的修复机制，通过它自己来重建器官。

研究者正在利用干细胞、基底细胞研究的进展，现在他们知道这些细胞能分化成特异的组织，例如肝脏或肺。他们正在了解更多称作“支架”(scaffolds)的复合物的知识，这种复合物能够像水泥一样将细胞支撑在合适的位置，并且也在为组织修复募集细胞方面发挥重要作用。

组织工程师们提醒说，他们所做的工作只是实验性的，并且花费相当高昂，创造复杂器官仍然需要很长的路要走。但是他们对最终实现的可能性越来越乐观。

“27年来，我越来越坚信这样做是可行的。”麻省总医院(Massachusetts General Hospital)组织工程与器官制造实验室主任、行业先驱约瑟夫·P·瓦坎(Joseph P. Vacanti)医生说道。

在贝耶恩先生的案例中，多孔的纤维材料上种植了取自骨髓的干细胞，由此制成了人工气管。置入生物反应器中一天半后，移植物即与贝耶恩的身体融为一体，代替了他的长有肿瘤的气管。生物反应器是类似于烤肉架的培养器，气管在当中旋转。

当马基亚里尼医生第一次提出该治疗方案的时候，听来似乎非常不切实际，贝耶恩对此表示怀疑。

“我告诉他，我宁愿再活三年就死，”他说，“我差点就回绝了，这种事情以前只在猪的身上成功过。但是他用一种非常科学的方法让我信服了。”

手术后15个月，现年39岁、来自厄立特里亚的贝耶恩没有肿瘤的烦恼，能够正常呼吸。他和妻子及两个孩子回到了冰岛，其中一岁的小儿子是他以为永远也不可能拥有的。在今年早些时候在斯德哥尔摩的随访中，他展示了胸部的长纵行疤痕，他声音嘶哑（放疗相关的后遗症），能够说流利的英语。

他说，自己正逐步恢复元气，有时还甚至能小跑一会儿。

“感觉很好，”贝耶恩说：“生活好多了”。

模仿自然

制作一个器官，得先知道自然是怎么创造它的。

这就是马基亚里尼医生实验室的研究员菲利普·荣格布鲁斯 (Philipp Jungebluth)做了以下工作的原因：他将一只心脏和一对肺脏装在了工作台的一只玻璃瓶中，并且连接上另一个装有清洗剂样液体的玻璃瓶。当清洗剂流过这些从实验鼠身上取出来的器官，带走其中有活性的细胞时，器官逐渐变得苍白。三天后细胞消失了，剩下一团闪亮的组织保有了器官的基本形状。

这些便是心脏和肺脏的天然支架复合体，即细胞外基质——由纤维蛋白和其它复合物构成错综复杂的三维网状物质，能够将各种细胞保持在恰当的位置并帮助细胞间的信号传递。

全世界许多实验室现在都在进行支架复合体的相关实验。在一些病例中目标是利用天然支架复合体本身组建新器官，譬如说，取一个供者的肺，去掉所有的细胞，将患者自己的细胞“种植”于其中。这一想法认为，相比于一个人工合成的支架复合体，还不如充分利用人体本身的支架复合体复制器官。

马基亚里尼医生和他的团队在2008年开始尝试，成功地将再生气管植入了12名患者的体内，他们中的大多数现在过上了正常的生活。因为供者自身的细胞已经移除，这个方法消除了移植的一个最主要的问题：异体组织被受体排斥的风险。但是这并没有解决一些同样很棘手的其他问题，例如：供者的气管可能大小不合适、受者必须等待去除供者气管并再植细胞的这段时间、需要的供者器官非常稀缺等等。

因此针对贝耶恩的病例，研究者决定制作一个塑型支架复合体，但是所有关于自体气管的工作都是有帮助的。“我们从零开始，学到了如此多的东西，”马基亚里尼医生说，“如果没有以往的经验，我们也许就无法做人工移植。”

量身定制

贝耶恩的合成支架复合体由伦敦大学学院(University College London)的科学家们构建的，利用他自己的气管作为模板。这是一个为其胸廓“量身定制”的高分子材料工程的精细作品。

但如果仅仅这样，它还仅是一个没有生命的多孔塑形体。为了成为能够工作的气管，这个塑形体之间的小缝隙需要填满那些最终能形成组织并有功能的细胞。并不是所有的细胞都能完成这项任务，马基亚里尼医生和他的团队从干细胞开始着手。

为了确保器官不会被排斥，细胞必须来自贝耶恩的自体，这同样也能避免那些使用胚胎干细胞会涉及到的一些伦理问题。贝耶恩的干细胞取自他的骨髓。这些细胞保存在营养液中，然后用移液管将细胞从支架复合体中剥离下来，就像给火鸡剥皮一样。

干细胞是机体用来组建和自身修复的一部分。它们一开始像一块空白的石板，但是能够分化成对特定组织或器官（例如气管）特异的细胞。近几年来，科学家在认识干细胞如何分化方面取得了巨大的进展。

这个斯德哥尔摩的团队希望在刺激干细胞生长药物的帮助下，种植在气管内的骨髓细胞能分化成器官内部及外部的相应细胞。但是马基亚里尼医生认为这个过程并没有如想象中那样进行。“我相信，细胞在放入了生物反应器两三天后就凋亡了，”他说，但是细胞在凋亡的时候释放出了化学物质，向机体发送信号，使得更多的细胞从骨髓通过血液循环到达了目的地，促进了整个修复过程。

至少这是马基亚里尼医生对这个过程的解释，“我们远没有理解整个过程，”他说，“差的远着呢。”

“如果它流血了，说明它成活了”

如果你不能咳嗽，你就死了。

这总结了气管的重要功能之一：将可能引起潜在致病感染的细菌和其他空气中的微粒阻挡在肺脏以外。一个正常的气管由特异性分化的细胞组成，包括那些能够产生黏液捕获微粒的细胞。而咳嗽能将黏液及微粒带出。

因此是否含有这些特化细胞成为检验这些组织工程制造出来的气管的方法之一。马基亚里尼医生早期在进行关于供体气管的研究时，将类似的来源于受者鼻腔的细胞种植于供者气管内。但是对于贝耶恩这个案例，马基亚里尼寄希望于干细胞分化成其他种类的细胞，从而布满气管的内部。

在手术五个月之后的2011年11月，贝耶恩的气管内部分长出了特化细胞。在之后的随访中，马基亚里尼医生注意到这一生长过程仍然非常活跃，并且没有感染的迹象。“而且他已经能够咳嗽了，”马基亚里尼说。

如果细胞存活下来，这意味着气管通过与产生特化细胞一样的方式生长出了由小血管组成的复杂网络。所有的组织都必须有这样的网络，这样每个细胞才能得到氧和营养。但是对于组织工程师们而言，生长出一个网络，或者说确保这个网络能继续生长，是一个巨大的挑战。

“一开始，我们认为最主要的障碍是供血问题，”瓦坎蒂医生说。瓦坎蒂医生的实验室一直致力于通过组织工程制造肝脏和其他器官。

贝耶恩的医生们有一个方法，可以来确定他的气管是否长出了血管网络系统。作为随访试验的一部分，他们故意轻微破坏了气管的内面。

“如果流血了，它便成活了，”马基亚里尼医生说。

贝耶恩的气管果真流血了。

下一个目标

贝耶恩先生希望有朝一日回到厄立特里亚，成为一名地热工程师。但是现在为了规律随访，他一直呆在离斯德哥尔摩很近的冰岛。

气管只含有他自己的细胞，因此他不需要吃药抑制自身免疫系统以防止排异反应。但是合成的支架复合体如同任何异物一样会让机体产生疤痕组织，而疤痕组织必须移除。虽然这并不是问题，但是贝耶恩并不知道何时他才能回家，或是他究竟能不能回家。“只有当他们告诉我，‘一切都很完美，你不需要进一步的治疗了’，我才能回家，”他说。

“没有人知道。我这是第一例。”

去年11月，也就是贝耶恩先生手术后五个月，马基亚里尼医生在另一个肿瘤病人克里斯托弗·莱尔斯(Christopher Lyles)体内植入了一个人造气管。他使用了一个改良的由更细的纤维组成的塑料支架复合体。莱尔斯在今年一月回到了美国马里兰州，三月份去世。他的家属并没有公布死因，但是马基亚里尼说移植物一直工作正常。

尽管遇到挫折，马基亚里尼医生还是在今年六月为俄罗斯的两名患者进行了类似的手术。他说，这两名患者都顺利出院了，现在情况良好。

马基亚里尼医生正在筹备进行更多的手术。但是他说，这种手术需要花费近50万美元，大家得找到更简便易行的方案。

因为这类手术的潜在需求量很大，“我们不能装模作样，假装我们已经能够离体种植这些特化细胞了，”他说。相反，他设想开发出更好的支架系统，不需要细胞就能植入体内，靠药物刺激机体将细胞运送到特定部位。

他的终极梦想是淘汰合成支架复合体，让药物使机体重建自身的支架复合体。

“不在患者身上大动干戈，”马基亚里尼医生说：“只是利用他的身体去创造自己的器官，这样就太棒了。”

 

 

答茉莉花儿

 (2009-02-05 00:48:27) http://blog.sina.com.cn/s/blog_502041670100bywe.html

有一叫“茉莉花儿”的网友在我博客（http://blog.sina.com.cn/im1）发评并留言如下：

茉莉花儿  2009年2月3日 09:43

什么时候拿出结论来，这种争议自然就没了!

茉莉花儿  2009年1月31日 12:40

自体干细胞已经用于移植气管了，这怎么解释呢？这不是ips用于临床的一种表现吗？ 

本人不知这“茉莉花儿”是何人和有何专长，但看模样（见她留下的图标）应是一个青纯可爱的少女。

 

出于爱美之心、也出于保护爱科少女不被科邪污染，我老夫也不怕世人笑话，厚着脸写这么一篇回信（没什么丑的，都是公开信）。

 

花儿：

你所（听）说的“自体干细胞已经用于移植气管了”实际上是这么回事：

有人把一从供体得到的气管去了表皮组织、之后把从病人干细胞长出的表皮组织包在了这供体来的气管，然后再把这换了皮的气管移植到了病人体内。

这不是iPS细胞用于临床的一种表现。因为它是用从病人正常干细胞长出的表皮组织来包供体来的气管。而iPS细胞实际上是把致癌基因加入正常干细胞后使它们变为“不死”的癌干细胞。目前还没人敢把iPS细胞用于人身上。

 

不过，你（被人误导而）产生误解是很正常的。不说你这个“嫩花”儿会中毒，就连我在美国当教授、搞了快20年的基因治疗后现在也做iPS细胞研究的“老花”同学在去年11月也发电子信给我报告这一（他认为很好的）消息。

 

我当时是这样回答我的老同学的：

 

如果有一个人说要卖个你一个“新车”，而你发现那“新车”只不过是一老车被涂上了一层新漆。你会买那“新车”吗？你会怎么看那卖车的人？

 

如果你要看“结论”，不用我争。你自己读一下我“老花”同学给我的报道此“移植气管”的原文吧（我只把关键部分加粗以便辩明真像）。

 

Doctors transplant windpipe with stem cells

By MARIA CHENG, AP Medical Writer Maria Cheng, Ap Medical Writer – 2 hrs 19 mins ago

AP – In this image released by the Hospital Clinic of Barcelona on Tuesday, Nov. 18, 2008, a patient's collapsed …

LONDON –Doctors have given a woman a new windpipe with tissue grown from her own stem cells, eliminating the need for anti-rejection drugs. "This technique has great promise," said Dr. Eric Genden, who did a similar transplant in 2005 at Mount Sinai Hospital in New York. That operation used both donor and recipient tissue. Only a handful of windpipe, or trachea, transplants have ever been done.

If successful, the procedure could become a new standard of treatment, said Genden, who was not involved in the research.

The results were published online Wednesday in the medical journal, The Lancet.

The transplant was given to Claudia Castillo, a 30-year-old Colombian mother of two living in Barcelona, suffered from tuberculosis for years. After a severe collapse of her left lung in March, Castillo needed regular hospital visits to clear her airways and was unable to take care of her children.

Doctors initially thought the only solution was to remove the entire left lung. But Dr. Paolo Macchiarini, head of thoracic surgery at Barcelona's Hospital Clinic, proposed a windpipe transplant instead.

Once doctors had a donor windpipe, scientists at Italy's University of Padua stripped off all its cells, leaving only a tube of connective tissue.

Meanwhile, doctors at the University of Bristol took a sample of Castillo's bone marrow from her hip. They used the bone marrow's stem cells to create millions of cartilage and tissue cells to cover and line the windpipe.

Experts at the University of Milan then used a device to put the new cartilage and tissue onto the windpipe. The new windpipe was transplanted into Castillo in June.

"They have created a functional, biological structure that can't be rejected," said Dr. Allan Kirk of the American Society of Transplantation. "It's an important advance, but constructing an entire organ is still a long way off."。。。。。。

 

如不信这新闻报道的“准确”，可看论文的原文（Lancet 372:2023-30, 2008）。但限于知识产权约束，我不能公示论文的全文，不过看其摘要也能说明问题（关键部分加粗以便辩明真像）。

 

Lancet. 2008 Dec 13;372(9655):2023-30. Epub 2008 Nov 18.

Clinical transplantation of a tissue-engineered airway.

Macchiarini P, Jungebluth P, Go T, Asnaghi MA, Rees LE, Cogan TA, Dodson A, Martorell J,Bellini S, Parnigotto PP, Dickinson SC, Hollander AP, Mantero S, Conconi MT, Birchall MA.

Department of General Thoracic Surgery, Hospital Clinic, Barcelona, Spain.

BACKGROUND: The loss of a normal airway is devastating. Attempts to replace large airways have met with serious problems. Prerequisites for a tissue-engineered replacement are a suitable matrix, cells, ideal mechanical properties, and the absence of antigenicity. We aimed to bioengineer tubular tracheal matrices, using a tissue-engineering protocol, and to assess the application of this technology in a patient with end-stage airway disease.

METHODS: We removed cells and MHC antigens from a human donor trachea, which was then readilycolonised by epithelial cells and mesenchymal stem-cell-derived chondrocytes that had been cultured from cells taken from the recipient (a 30-year old woman with end-stage bronchomalacia). This graft was then used to replace the recipient's left main bronchus.

FINDINGS: The graft immediately provided the recipient with a functional airway, improved her quality of life, and had a normal appearance and mechanical properties at 4 months. The patient had no anti-donor antibodies and was not on immunosuppressive drugs.

INTERPRETATION: The results show that we can produce a cellular, tissue-engineered airway with mechanical properties that allow normal functioning, and which is free from the risks of rejection. The findings suggest that autologous cells combined with appropriate biomaterials might provide successful treatment for patients with serious clinical disorders.

加附：

孙学军