RU2250773C1 - Method for treating the cases of allergic diseases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves introducing autologic mesenchyma trunk cells as a single intravenous drop dose or in the amount of 1 mln cells per 1 kg of patient body weight.

EFFECT: provided stable clinical remission.

Description

The invention relates to medicine, more specifically to allergology and immunology, and may find application in the treatment of allergic diseases of various origins.

According to WHO, at least 30% of the world's population is currently suffering from allergic diseases. This is associated with adverse environmental, industrial and other factors. Total allergization is not only in itself a cause of huge financial losses, but also inevitably leads to an exacerbation of other diseases, and also worsens their prognosis.

The treatment of allergic diseases is currently a serious problem. Modern medicine has a significant arsenal of medications and treatment regimens for skin manifestations of allergies (D.U. Fitzpatrick, D.L. Eling. Secrets of Dermatology // Transl. From English - M .; St. Petersburg: Publishing House BINOM - Nevsky Dialect, 1999. - S.57-156, S.377-418, S.455-468), as well as drugs for systemic exposure (Handbook of the therapist / Under the editorship of F.I. Komarov. - M .: Medicine, 1979, 656 p. ; Reference book of a general practitioner / N.P. Bochkov, V.A. Nasanova and others // Edited by N.R.Paleev. - M .: EKSMO-Press, 2001. - T.1 - p.306- 322). However, in more than half of patients, the effect of the use of any drug treatment regimen is incomplete and short-term.

Closest to the proposed method is a method of treating allergic diseases through the use of a combination of multidirectional drugs (Handbook of a general practitioner. // Edited by N.R. Paleev. - M .: EKSMO-Press. - 2001. - T.1.- C.306-322).

The method consists in carrying out specific and non-specific desensitization.

Specific desensitization is carried out by subcutaneous administration of the identified allergens in low titers after their chemical modification. The disadvantages of the method are the duration of treatment and a large number of injections. At the injection site of the allergen, painful infiltrates can occur, systemic reactions are possible (urticaria, asthma attacks, exacerbation of chronic infections). In severe somatic diseases, pregnancy, rheumatism, tuberculosis, malignant neoplasms, gastric ulcer and a number of other diseases, such treatment is contraindicated, since it causes an exacerbation of the disease. In more than half of allergy sufferers, the search for a specific antigen is unsuccessful, and some antigens do not exist in modified dosage forms.

Nonspecific desensitization for severe allergies is carried out in two stages. At the first stage, for the relief of acute manifestations of allergies, diuresis is forced (intravenously drip 1500-2000 ml of physiological saline, at the end of the infusion - 40 mg of intravenous or intramuscular lasex); stimulate intestinal motility (25% solution of magnesia by mouth). At the second stage, which continues until the clinical effect is achieved (7-12 days), calcium preparations are prescribed (10% calcium chloride solution - 1 time per day intravenously); enterosorbents (polyphepan per tablespoon 3 times a day), antihistamines (suprastin 1 tablet 3 times a day or telfast 1 tablet 1 time per day). In severe cases, treatment is supplemented with the introduction of prednisolone at 90 mg per day. The disadvantages of this type of treatment are: an incomplete and short-term effect, the need for long courses of treatment, a gradual decrease in effectiveness and the associated need for increased doses, the negative effect on many organs and systems, for example, in severe chronic diseases, pregnancy, malignant neoplasms, glucocorticoid hormones ( prednisone) are contraindicated.

The technical result of the present invention is to reduce the manifestations of allergic diseases and improve the quality of life of patients through the use of autologous mesenchymal stem cells (AMSC).

This result is achieved by the fact that in the treatment of allergies according to the invention, the patient is injected once intravenously with AMSK extracted from the biopsy of his bone marrow in the amount of 1 million cells per 1 kg of the patient’s body weight.

In recent years, AMSKs have begun to be used in the treatment of patients with cardiac pathology to improve tissue regeneration (Handbook of Cardiovascular Cell Transplantation. - Ed. N. M. Kipstidze et al. - 2004. - 425 p.).

AMSC is a fraction of highly purified own stem cells. To obtain AMSC, it is required to take 20-35 ml of bone marrow (the procedure is performed under local short-term intravenous anesthesia and lasts 10-15 minutes). Subsequently, the AMSC fraction is isolated from the bone marrow, typed and grown in a special medium. After 10-12 days from the start of cultivation, the amount of AMSK reaches 80-100 million, which is ten times higher than their content in the bone marrow. The reverse administration of AMSC is safe (own cells, the possibility of allergic reactions is excluded), the number of introduced cells allows us to expect a pronounced clinical effect.

The use of AMSK in the treatment regimen for RMP was prompted by observation of a patient admitted to the TsNIRRI clinic with a diagnosis of Coronary heart disease. Angina of tension and rest of the 3rd functional class. Atherosclerotic and post-infarction cardiosclerosis (myocardial infarction 1994, 1995, 2004). Condition after coronary artery bypass grafting (1996). Circulatory failure II.

In addition to cardiac pathology, the patient had a pronounced food polyallergy, which began about 12 years ago. The allergy was caused by various, often unknown, foods, and manifested itself in a confluent papular rash that occupied the skin of the chest, back, and forearms. The patient was constantly taking suprastin, periodically - prednisone.

The aim of the patient's admission was to conduct coronary angiography (CAT) to assess the state of the vessels of the heart and to select therapeutic tactics. When performing CAG, intracoronary administration of AMSK was planned to improve the functioning of the heart muscle. For this, a month before the present admission, 30 ml of bone marrow were taken from the patient and 100 million AMSKs were cultivated.

However, CAG was associated with a high risk of increased allergic reactions in response to the administration of a contrast medium. Therefore, it was decided to limit myself to the intravenous drip of AMSK at a dose of 76 million (1 million cells per 1 kg of patient body weight), which was performed in April 2004.

A completely unexpected effect from the introduction of AMSK was a decrease in skin manifestations of allergies, which began on the 5th day after administration. After two weeks, the skin rash completely disappeared, and the patient was able to refuse to take anti-allergic drugs, which he used for many years in almost constant mode.

In June 2004, the patient underwent CAT, which he underwent without adverse reactions and complications.

To date, the patient has no allergy manifestations, he eats a variety of foods, including eating foods and juices that previously inevitably caused a pronounced skin rash. Such persistent antiallergic action of AMSK allowed us to further use AMSK transplantation in patients with severe manifestations of allergy.

The essence of the method is illustrated by examples.

Example 1. Patient M., 59 years old, medical history No. 814, was admitted 17. 05. 2004 in the Department of new technologies of radiation therapy of the clinic TsNIRRI MH RF. The patient has been suffering from a food allergy for 20 years, which is manifested by a rash on the skin of the face, chest and back, accompanied by itching. Upon admission to the clinic, the patient had pronounced allergy manifestations in the form of a papular rash on his whole body, itching, runny nose, which worsened his general condition and significantly impaired sleep.

To remove allergic manifestations, a biotransplantation of his bone marrow was proposed.

For this purpose, on May 25, 2004, a patient was taken 30 ml of his own bone marrow and a culture of AMSC was grown, and on June 08, 2004 78 million AMSC (1 million cells per kg of body weight) were injected intravenously into a patient in 50 ml of nutrient suspension. The introduction of the patient suffered without reactions and complications. 12 million AMSKs were placed in a cryogenic storage for possible future use.

7 days after the introduction of AMSK, allergic skin manifestations in the patient stopped, which allowed him to further treat concomitant diseases of the cardiovascular system. Despite taking a sufficiently large number of drugs, the patient did not show any allergic manifestations, while earlier he practically could not drink a single tablet without additional administration of antihistamines.

Until now, the patient's condition and well-being are satisfactory. In case of an allergic reaction at any time of the year, the patient is asked to immediately contact the institute to stop it by the introduction of AMSK, located in the cryogenic storage of the institute.

Example 2. Patient K., 63 years old, medical history No. 517, was admitted February 16, 2004 to the Department of New Radiation Therapy Technologies at the TsNIRRI Clinic of the Ministry of Health of the Russian Federation, where, as a result of the examination, he was diagnosed with transitional bladder cancer T2N0M0. Among concomitant diseases - coronary heart disease, myocardial infarction in 1999, circulatory failure 2 degrees, hay fever. For 15 years, the patient suffered from severe allergies (“hay fever”) with annual spring exacerbations. Since the onset of allergic manifestations (March - April), the patient has been taking large doses of antihistamines (suprastin, tavegil) and glucocorticoid (prednisone, dexamethasone) drugs for 2-3 months. Against the background of such treatment, the manifestations of allergies (skin rash, shortness of breath, runny nose, skin hyperemia) decreased, but never completely disappeared.

In connection with pronounced concomitant diseases (severe cardiac pathology, as well as a pronounced allergy in the anamnesis) were contraindications for surgical and chemotherapeutic treatment. Therefore, the only method of treatment for this patient was the conduct of radiation therapy after removing the allergy by introducing him AMSK. The patient was offered biotransplantation of his own bone marrow.

For this, before the start of treatment, a patient was taken a 25 ml sampling of his own bone marrow and a culture of AMSK was grown. 03/19/2004 72 million AMSCs (1 million cells per kg of body weight) were administered to the patient intravenously in 50 ml of nutrient suspension. The introduction of the patient suffered without reactions and complications. 12 million AMSKs were placed in a cryogenic storage for possible future use.

On February 26, 2004, a course of radiation therapy was started, in standard mode, up to a total focal dose of 68 Gy.

The course of radiation treatment was completed in mid-April, when the patient already had signs of hay fever every year. This year, for the first time in 15 years, against the background of the treatment, there were no manifestations of allergies. To date, the patient's condition remains stable.

To date, the proposed method has been treated three patients with a positive effect. The resulting effect remains with them to the present.

Claims (1)

A method of treating allergic diseases by using therapeutic agents, characterized in that autologous mesenchymal stem cells are used as a therapeutic agent, which are administered once intravenously in an amount of 1 million cells per 1 kg of patient body weight.