Dmitrii Ivolgin. Centre of Regenerative Medicine Organization on the
Transcription
Dmitrii Ivolgin. Centre of Regenerative Medicine Organization on the
St. Petersburg North-western region Moscow Helsinki 13,000,000 13,000,000 10,000,000 Rubles 9,000,000 Economical crisis 12,000,000 11,000,000 11,000,000 6,000,000 5,000,000 400,000 II quarter III quarter IV I quarter quarter II quarter III quarter Year period IV I quarter quarter II quarter III quarter Collection, processing and storage of different stem cells types for regenerative medicine Cells isolation and expansion for clinical application in different areas of medicine Hi-tech diagnostic techniques, including genetic testings Quality management Organizing the activities of CBB in order to collect umbilical cord blood units which can be effectively administer in the field of regenerative medicine. Utilization of modern CB processing methods Double centrifugation Automated separation Semiautomated separation CB Processing method NC, х106 cell/ml Double Centrifug. (n = 797) 39,2** Automated (n = 1012) 43,3** SemiAutomated (n = 78) 42,3** FDA requirement s (2,5293,1) (12,5- 95) TNC, х106 cells CD34+ Totally х106 cell/ CD34+, ml х106 cells Viability (%) 860,0* 73,04** 0,09** 1,95 98,6** 905,3* 81,9** 0,11 2,1 99,2** (50,02000,0) (247,11950,0) TNC recovery (%) (47,3-98,2) (65,1-97,6) 891,8* 81,7** (8,5-83,5) (669,0-17 87,1) ≥ 5.0 x 108 unit HPC-C (61,7-94,4) (0,0020,31) **(0,0050,375) 0,1 (0,003-0,4 ) (0,05-6,65 ) (0,09-7,5) 1,9 (96,6-100, 0) (96,6-100, 0) 99,1** (0,07-6,8) (96,5-100, 0) ≥ 1.25 x 106 unit HPC-C ≥ 85% TNC (befofe and after processing) AB0 blood group and Rh-factor CD34+ cells (flow cytofluorometry) Viability (flow cytofluorometry) Markers of infections (ELISA, PCR) Sterility (bacteriological tests) CFU-assay HLA-typing low and high resolution Genetic passport Analysis of thelomeres length (flow-FISH) What: peripheral blood of mother with circulating fetal DNA How: Real-time PCR When: From 7-10 week of gestation Sex determination of fetus Fetal Rh-factor determination (negative mothers Rh) Complex of methods is using: MLPA MRC-Holland Multiplex ligation-dependent probe amplification Screening of deletions, interlocations and gene sequence mutations PCR Identification of major gene-mutations, verification of MLPAdetected polymorphisms Sequence analysis Identification of gene sequence Deletions, duplications, etc. which cannot be recognized by routine karyotyping 2-5 Mb length Variability from 1 to 10th of genes 22q11 – Di George’s syndrome Williams syndrome Angelman syndrome 1p36 syndrome Smith-Magenis syndrome 17q21 syndrome Microdeletion of subthelomeric region 4p 5p-minus syndrome (cat’s cry syndrome) Rubinstein-Taybi syndrome Langer-Giedion syndrome Genotype CCR5 Absolute number Relative number, % WT/WT 2835 81,33 WT/delta32 612 17, 56 del32/delta32 39 1,12 Totally 3486 100 224 bp Number of СD34+: 4 8х10 Number of СD34+: 4 1600х10 Bone marrow Research projects Adipose tissue Traumatology Umbilical cord blood Umbilical cord Autoimmune diseases (multitiple sclerosis, diabetes, Crohn's disease) Regenerative therapy (toxic hepatitis) Date Status Insulin rate HA1c, Mmol/L 25.07.2014 Dry mouth, weakness, excessing sweating 20 85,9 18 71,3 16 54,6 Gain weight +3 kg, 01.08.2014 appetite and general state improvement Good general state, reinitiation of 05.09.14 exersices, working capability increasing Before 24 h. after MSC infusion 1 month after MSC infusion Reference range Т- cells (CD3+ CD19-) rel. 60,2 70,7 61,75 52 – 76 % Т- cells (CD3+ CD19-) abs. 667 1636 1301 950 – 1800 cells/μL Т - helpers (CD3+ CD4+) rel. 16,46 36,6 26 31 – 46 % Т- helpers (CD3+ CD4+) abs. 206,45 847 544 570 – 1100 cells/μL CTL (CD3+ CD8+) rel. 38,84 28,9 34,4 23 – 40 % CTL (CD3+ CD8+) abs. 487 668 723 450 – 850 cells/μL Immunoregulatory index (Тh/CТL) 0,4 0,8 0,8 1,4 – 1,7 T-NK cells (CD3+ CD16+ CD56+) rel. 9,6 2,4 4 0,1 – 8 % T-NK cells (CD3+ CD16+ CD56+) abs. 220 55 89 5 – 200 cells/μL NK cells(CD3- CD16+ CD56+) rel. 28,76 17,5 19,5 9 – 19 % NK cells (CD3-CD16+ CD56+) abs. 460,65 404 431 180 – 420 cells/μL B cells (CD3- CD19+) rel. 10,5 10,3 11,2 6 – 18 % B cells(CD3- CD19+) abs. 131,7 238 236 150 – 450 cells/μL T cells CD3+ HLA DR+ (late activation) rel. 20,5 0–5% T cells CD3+ HLA DR+ (late activation) abs. 257 0 – 120 cells/μL MNC Intermittent claudication and constant pain at rest disappeared in 1.5 months Numbness and extremity coldness in the area of the foot went away in 3 months After 5 months, there was a pulsation on the dorslim of foot arteria. Patients getting past any distance pain-free Sex: ♂ - 14 Age: min – 21 y. ♀ - 18 max – 90 y. DS: Dysarthrosis and long-lasting non-healing long bone fracture; Intra-articular displaced condyle of thibia fracture closed ankle fracture; closed splintered long bone diaphysis fracture; Proximal femoral fracture; subdermal Achilles tendon injury. soft tissue prolapse osteoarthrosis 9 months post fracture – consolidation of fracture… … avasular necrosis… 6 months post adipose tissue MSC application 64 y.o. ♀ 6 week Before After operation 1 year 12 week Fibroblasts of human derma Cell line categorized in Pokrovsky SCB and SIL of Cell Technologies NorthWest State Medical University n/a I.I. Mechnikov 3-4 days 5-8th passage liquid culture with 250 000 cells/ml of gel concentration RESEARCH INSTITUTE OF EMERGENCY MEDICINE 67 patients ( adult 24 – 78 y.o.) Application: Burns of boiling water, hot oil, contact and flame burns, trophic sores, diabetic foot. Notification: Use of the drug only after the suppression of vegetating of pathogenic microorganisms in the wounds and remove dead tissue Applying gel with fibroblasts to burns (II, IIIa degree) on donor sites above the area of the mesh graft to sores Thermal burn IIIа degree Thermal burn IIIа degree After 7 days of allofibroblasts applications After 9 days of allofibroblasts applications Transplanted sieve graft (coefficient of plastics 1/2-1/4), coated with a layer of gel with allofibroblasts After 4 days. Edema and discharge is absence Partial epithelialization of autotransplatat perforation zones After 7 days epithelialization of autotransplatat perforation zones 1. Hydroxyethyl cellulose polymer (non-toxic, water soluble, does not cause chromosomal aberrations. The optimum concentration of the gel - 1% - does not disturb the adhesive properties of fibroblasts) 2. Allogeneic human fibroblasts (250 000 cell/ml) 3. Fixation on the lesion place – Lomatuell, Lohmann&Raucher