WO2013125674A1 - 脂肪細胞を含む細胞製剤 - Google Patents
脂肪細胞を含む細胞製剤 Download PDFInfo
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- WO2013125674A1 WO2013125674A1 PCT/JP2013/054483 JP2013054483W WO2013125674A1 WO 2013125674 A1 WO2013125674 A1 WO 2013125674A1 JP 2013054483 W JP2013054483 W JP 2013054483W WO 2013125674 A1 WO2013125674 A1 WO 2013125674A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
- A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
- A61K35/35—Fat tissue; Adipocytes; Stromal cells; Connective tissues
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
- A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K35/00—Medicinal preparations containing materials or reaction products thereof with undetermined constitution
- A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
- A61K35/28—Bone marrow; Haematopoietic stem cells; Mesenchymal stem cells of any origin, e.g. adipose-derived stem cells
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/38—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
- A61L27/3804—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells characterised by specific cells or progenitors thereof, e.g. fibroblasts, connective tissue cells, kidney cells
- A61L27/3834—Cells able to produce different cell types, e.g. hematopoietic stem cells, mesenchymal stem cells, marrow stromal cells, embryonic stem cells
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/38—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
- A61L27/3839—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells characterised by the site of application in the body
- A61L27/3843—Connective tissue
- A61L27/3852—Cartilage, e.g. meniscus
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/38—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
- A61L27/3839—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells characterised by the site of application in the body
- A61L27/3873—Muscle tissue, e.g. sphincter
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- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
- A61L27/36—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix
- A61L27/38—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells
- A61L27/3886—Materials for grafts or prostheses or for coating grafts or prostheses containing ingredients of undetermined constitution or reaction products thereof, e.g. transplant tissue, natural bone, extracellular matrix containing added animal cells comprising two or more cell types
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- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
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- A61P19/04—Drugs for skeletal disorders for non-specific disorders of the connective tissue
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- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
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- A61L2430/00—Materials or treatment for tissue regeneration
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- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L2430/00—Materials or treatment for tissue regeneration
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- A61L2430/00—Materials or treatment for tissue regeneration
- A61L2430/30—Materials or treatment for tissue regeneration for muscle reconstruction
Definitions
- the present invention relates to a cell preparation useful for alleviating pain caused by a disease at an interosseous junction and treating the disease.
- the present invention also relates to a cell preparation useful for repairing degenerated or damaged muscle.
- Hyaluronic acid injection, adipocyte transplantation, etc. are known as means for increasing the volume of soft tissue in humans, and are widely used in the fields of cosmetic surgery such as facial wrinkle removal, depression treatment, breast reconstruction, and plastic surgery.
- the treatment with hyaluronic acid injection is easy, but the injected hyaluronic acid is absorbed in about half a year, so that there is a problem that the effect is insufficient.
- fat cells may be necrotized or absorbed in vivo after transplantation. For this reason, there is a drawback that re-operation is required or, in some cases, scarring occurs.
- adipose stem cells In order to eliminate these drawbacks, transplantation of adipose stem cells has been proposed, and methods for efficiently separating adipose stem cells have been developed (see, for example, Patent Documents 1 and 2).
- adipose stem cells By transplanting adipose stem cells, the cell colonization rate after transplantation has been improved, and a certain effect on soft tissue regeneration has been observed.
- an adipose stem cell obtained by such a method may contain impurities, which may cause fat cell necrosis or lumping (calcification) after transplantation.
- Adipocytes are generally obtained by liposuction, but the aspirated fat is a mixture containing various impurities in addition to adipocytes and adipose stem cells.
- Examples of impurities to be removed from such a mixture include blood (particularly erythrocytes), dead and active cells, and senescent cells. On the other hand, it is subjected to centrifugation using a syringe equipped with a weight filter described in Patent Document 3, and impurities that cause calcification and fat necrosis are collected from a mixture containing fat cells and adipose stem cells collected by liposuction.
- a method of injecting the removed cell preparation Condensed Rich Fat: CRF (registered trademark)
- CRF registered trademark
- adipocytes and adipose stem cells that are safe and have excellent colonization properties are being provided.
- transplantation of adipocytes and adipose stem cells has been mostly applied to soft tissue regeneration.
- the effectiveness of these cells for the relief of joint pain and tissue regeneration in joints has been fully investigated.
- the present inventor has found that when fat cells are injected into a patient complaining of joint pain, the symptoms are alleviated at an early stage and the effect is sustained. Furthermore, it has been found that when adipocytes and adipose stem cells are injected in combination, bone tissue and cartilage tissue in the joint are efficiently regenerated in addition to the relief of the joint pain. The present inventor has also found that damaged muscle is repaired by administering a cell preparation containing adipocytes and mesodermal stem cells to the site of muscle damage. The present invention has been completed as a result of further research based on these findings.
- the present invention provides a cell preparation of the following aspect, a method for relieving pain at an interosseous joint, a tissue regeneration method for an interosseous joint, a muscle repairing method, and the like.
- Item 1. A cell preparation for treating diseases of an interosseous junction, including adipocytes.
- Item 2. Item 2. The cell preparation according to Item 1, further comprising mesodermal stem cells.
- Item 3. Item 2. The cell preparation according to Item 1, wherein the mesodermal stem cell is an adipose stem cell.
- Item 4. Item 2. The cell preparation according to Item 1, wherein 1 to 10 mesodermal stem cells are contained per fat cell.
- Item 5. Item 2.
- the cell preparation according to Item 1 wherein the fat cells are cells that have been irradiated with ⁇ rays.
- Item 6. Item 2. The cell preparation according to Item 1, wherein the disease of the interosseous junction is any one selected from the group consisting of spinal diseases, joint diseases, autoimmune diseases, and osteonecrosis.
- Item 7. Use of a cell preparation containing adipocytes for the manufacture of a therapeutic agent for diseases of the interosseous joint.
- a method for alleviating pain at an interosseous joint comprising a step of administering a cell preparation containing an adipocyte to an interosseous joint of a patient having a disease at the interosseous joint.
- Item 10. A tissue regeneration method for an interosseous joint, comprising a step of administering a cell preparation containing an adipocyte and a mesodermal stem cell to an interosseous joint of a patient having an interosseous joint disease.
- Item 11 A cell preparation for muscle repair comprising adipocytes and mesodermal stem cells.
- Item 12. The cell preparation according to Item 11, wherein the mesodermal stem cell is an adipose stem cell.
- Item 13. Item 12.
- Item 12. The cell preparation according to Item 11, wherein the fat cells are cells that have been irradiated with ⁇ -rays.
- Item 15. Use of a cell preparation comprising adipocytes and mesodermal stem cells for the manufacture of a preparation for muscle repair.
- Item 16. A cell preparation comprising adipocytes and mesodermal stem cells used for muscle repair.
- a method for repairing a muscle comprising a step of administering a cell preparation containing an adipocyte and a mesodermal stem cell to a muscle injury site of a patient having muscle injury.
- the cell preparation containing fat cells of the present invention slippage of joints and the like is improved by fat cells and ECM (extracellular matrix) existing around fat cells, and joint pain can be relieved at an early stage.
- ECM extracellular matrix
- the effect excellent in the pain relief resulting from the disease of an interjunction part can be acquired.
- by injecting the cell preparation of the present invention into an intervertebral disc or the like it plays the role of a cushion and has the effect of improving (improving) the movement of the vertebral body.
- the joint pain alleviating effect of the cell preparation of the present invention lasts for a long time.
- the pain caused by the disease of the interosseous junction is alleviated by the adipocytes, while bone tissue and cartilage tissue caused by mesoderm stem cells are reduced.
- tissue regeneration in a joint such as a soft tissue is promoted.
- the cell preparation of the present invention containing adipocytes and mesoderm stem cells is more effective for the treatment of diseases of the interosseous junction.
- the cell preparation of the present invention containing adipocytes and mesodermal stem cells has an excellent repair effect on muscles damaged by muscle degeneration or muscle resection by surgery.
- pain due to muscle damage can be relieved at an early stage, which contributes to improvement of QOL (Quality of Life) of patients.
- adipocytes and mesodermal stem cells contained in the cell preparation of the present invention can be directly separated and concentrated from aspirated fat and the like without going through a cell culture step, they must come into contact with the outside air. Can be prepared without. Therefore, there is no worry about infectious diseases.
- the cell preparation of the present invention is usually prepared using adipocytes and mesodermal stem cells collected from patients who need treatment for diseases of interosseous joints or muscle repair, immune rejection reaction It is safe without problems.
- FIG. 1 (a) is an X-ray photograph showing the left knee joint of subject A before administration of the cell preparation
- FIG. 1 (b) is the left knee joint of subject A about one month after administration of the cell preparation
- FIG. 2A is an X-ray photograph showing the left and right knee joints of subject B before administration of the cell preparation
- FIG. 2B is the left and right knee joints of subject B about one month after administration of the cell preparation.
- FIG. FIG. 3 is a typical example of an MR image showing that bone cell regeneration is promoted by administration of a cell preparation, and osteonecrosis is improved and disappeared.
- Cell preparation The present invention provides a cell preparation for treating the following diseases of the interosseous joint and a cell preparation for muscle repair. Hereinafter, each cell preparation will be described in detail.
- the present invention provides a cell preparation for treating diseases of interosseous joints, characterized by containing adipocytes.
- a fat cell is a cell that has the function of synthesizing, storing, and releasing fat, and that forms adipose tissue.
- Adipocytes do not undergo cell division because they are completely differentiated.
- the fat cells include white fat cells and brown fat cells. In the present invention, any of these may be used, or a mixture of both may be used.
- the origin of adipocytes is not particularly limited.
- mammalian adipocytes preferably primate adipocytes, more preferably human adipocytes are used.
- as fat cells only fat cells can be used alone, but a mixture of extracellular matrix (ECM) existing around fat cells and fat cells may be used.
- ECM extracellular matrix
- the collected adipose tissue may be used as it is as the adipocyte, or one obtained by removing the extracellular matrix from the collected adipose tissue may be used.
- Adipocytes are collected from adipose tissue.
- the method for collecting adipose tissue is not particularly limited, and can be appropriately selected from conventionally known methods. Examples thereof include liposuction, lipotomy, and defatting. Collection by liposuction is preferable because it is relatively easy and minimally invasive.
- the method for obtaining fat cells from the collected fat is not particularly limited, but preferably the following 2. The method described in the preparation method of a cell formulation is mentioned.
- the cell preparation for treating a disease of the interosseous joint of the present invention may further contain mesodermal stem cells.
- mesodermal stem cells tissue regeneration at the interosseous junction is promoted, and the therapeutic effect of the cell preparation of the present invention is further enhanced.
- the mesodermal stem cells used in the cell preparation of the present invention mainly mean intermediate stem cells that differentiate into cells belonging to mesodermal tissues such as bone, cartilage, myocardium and fat.
- the origin of mesodermal stem cells is not particularly limited, and for example, mammalian mesodermal stem cells, preferably primate mesodermal stem cells, more preferably human mesoderm stem cells are used.
- mesodermal stem cells include adipose stem cells, bone marrow stem cells, hematopoietic stem cells, and the like, and these stem cells can be obtained from each tissue according to the type of cells according to a conventionally known method.
- the mesodermal stem cells are preferably exemplified by adipose stem cells.
- Adipose stem cells can be collected from adipose tissue.
- the adipose tissue that is the source of adipose stem cells can be collected by any of the methods such as liposuction, lipectomy, degreasing, etc., similar to the above-mentioned adipocytes, but prevents outflow and damage of adipose stem cells, From the viewpoint that it can be collected more safely, liposuction is preferred.
- the method for obtaining adipose stem cells from the collected fat is preferably 2.
- the method described in the preparation method of a cell formulation is mentioned.
- the cell preparation of the present invention contains mesodermal stem cells
- the content of the mesodermal stem cells in the cell preparation is not particularly limited as long as the therapeutic effect on the disease of the interosseous joint is obtained. Although it is considered that a higher therapeutic effect can be obtained as the content of the germ layer stem cell is larger, for example, at least one mesodermal stem cell, preferably 5 or more, more than one adipocyte. Preferably 1-10, more preferably 5-10.
- the number of mesodermal stem cells contained per 1 mL of the cell preparation is usually 100,000 or more, preferably 150,000 or more, more preferably 150,000 to 200,000.
- the preparation of the cell preparation of the present invention by using self-derived adipocytes (and mesodermal stem cells) for the purpose of autotransplantation, immune rejection can be avoided in addition to early improvement of symptoms.
- the preparation of the cell preparation of the present invention using an adipocyte (and mesoderm stem cell) derived from another person is not limited.
- adipocyte and mesoderm stem cell
- Mesodermal stem cells are usually cells that do not have immunogenicity, but those subjected to the treatment may be used if necessary.
- adipose tissue contains adipocytes and adipose stem cells. Therefore, as a cell preparation containing adipocytes and adipose stem cells, the collected adipose tissue may be used as it is, and impurities (for example, an anesthetic solution (injected at the time of adipose collection) ( So-called Tumecent liquid), aged adipocytes, blood, tissue fluid, etc.) removed, or impurities and some adipocytes removed from collected adipose tissue may be used.
- impurities for example, an anesthetic solution (injected at the time of adipose collection) ( So-called Tumecent liquid), aged adipocytes, blood, tissue fluid, etc.
- impurities and some adipocytes removed from collected adipose tissue may be used.
- the method for preparing the cell preparation include methods (a) to (c) described later.
- conventionally known pharmaceutically acceptable carriers, excipients, anti-inflammatory agents, analgesics, immunosuppressants and the like can be added to the cell preparation of the present invention as necessary.
- collagen, fibroblasts, growth factors, growth factors, cytokines, etc. may be added as long as the effects of the present invention are not impaired.
- tissue regeneration such as PRP (Platelet Rich Plasma)
- PRP Platinum Rich Plasma
- an angiotensin II receptor antagonist such as losartan
- the regeneration effect of the cartilage tissue is further enhanced.
- VEGF vascular endothelial growth factor
- BMPs bone morphogenetic protein
- the cell preparation for treating a disease of the interosseous joint of the present invention has an excellent therapeutic effect on the disease of the interosseous joint.
- the interosseous joint refers to the connecting part of the bone, by cartilage or a combination of cartilage and a fibrous connective tissue, a synovial connection connected by a synovium that wraps the cartilage and joint capsule, and a fibrous connective tissue In the present invention, it refers to a portion having mobility that is connected by a cartilage connection and a synovial connection.
- the interosseous joint examples include a spinal joint, a knee joint, an ankle joint, a toe joint, a hip joint, a wrist joint, an elbow joint, a shoulder joint, a finger joint, an acromioclavicular joint, and a sacroiliac joint.
- soft tissues such as ligaments and meniscus
- a disc intervertebral disc
- diseases of the interosseous joint include hernia (prolapse), deformation, degeneration, inflammation, etc.
- spinal diseases such as intervertebral disc herniation, osteoarthritis, etc .; osteoarthritis (degenerative Hip arthritis, knee osteoarthritis, etc.), joint diseases such as chronic arthropathy; autoimmune diseases such as rheumatoid arthritis; osteonecrosis such as idiopathic osteonecrosis of the knee joint, femoral head necrosis, etc.
- Preferred examples include intervertebral hernia, osteoarthritis, chronic arthropathy, idiopathic osteonecrosis of the knee joint, and femoral head necrosis.
- the dosage of the cell preparation of the present invention is not particularly limited as long as the therapeutic effect on the disease of the interosseous joint is obtained, the size of the administration site, the site of the disease, the degree of the disease, the sex of the patient, although it can be appropriately set depending on the physique and the like, examples include 100,000 to 4,000,000, preferably 200,000 to 2,000,000, and more preferably 200,000 to 1,000,000 in terms of the number of fat cells.
- the dosage is 0.5 to 20 mL, preferably 1 to 10 mL, more preferably 1 to 5 mL. It is done.
- 1-20 mL of cell preparation preferably 1-10 mL, more preferably 5-10 mL can be administered to the knee joint.
- 0.5-20 mL of cell preparation preferably 1-15 mL, more preferably 1-2 mL can be administered to the intervertebral disc.
- Examples of the administration method include, but are not limited to, a method of injecting into a disease site (for example, joint space, intervertebral disc (intervertebral disc), etc.) of the interosseous joint using a syringe, a cannula, or the like.
- a disease site for example, joint space, intervertebral disc (intervertebral disc), etc.
- the injection site is stimulated by the tip of the injection needle or cannula, so that a further excellent therapeutic effect can be obtained.
- the method of stimulation is not particularly limited, for example, when injecting a cell preparation, a cannula whose tip is cut obliquely is rotated back and forth and left and right to stimulate the injection site.
- the cell preparation of the present invention When the cell preparation of the present invention is administered to a patient having these diseases, it may be administered after treatment by a known method as necessary.
- the prolapsed intervertebral disc is removed by a conventionally known method such as PLDD (Percutaneous Laser Disc Decompression), and then the cell preparation of the present invention can be administered (injected).
- the pain (joint pain) resulting from the disease of the interosseous joint is alleviated by the action of the fat cells contained in the cell preparation of the present invention, and when the mesodermal stem cells are contained, the interosseous junction is caused by the function of the cells. Bone tissue, cartilage tissue, soft tissue, etc. in the part are regenerated.
- (1-2) Cell preparation for muscle repair The present invention provides a cell preparation capable of repairing muscle at the site of muscle injury, comprising adipocytes and mesodermal stem cells.
- adipocytes and mesoderm stem cells used in the cell preparation for muscle repair of the present invention are used to treat the above-mentioned “(1-1) interosseous joint disease”.
- a cell preparation containing adipocytes and adipose stem cells that are mesodermal stem cells is exemplified. Examples of methods for obtaining adipose stem cells include the following 2. The method described in the preparation method of a cell formulation is mentioned.
- adipocytes and mesodermal stem cells in addition to adipocytes and mesodermal stem cells, conventionally known pharmaceutically acceptable carriers, excipients, anti-inflammatory agents, analgesics, immunosuppressants, etc. Can be added.
- collagen, fibroblasts, growth factors, growth factors, cytokines, etc. may be added as long as the effects of the present invention are not impaired.
- TGF ⁇ 1 transforming growth factor ⁇ 1
- the cell preparation for muscle repair of the present invention exhibits an excellent muscle repair effect when applied to a muscle damage site.
- muscle damage includes cases where the muscle is removed by surgery or trauma.
- the site and type of muscle to which the cell preparation of the present invention is applied are not particularly limited.
- skeletal muscles such as trunk muscles (including upper and lower limb muscles and pectoralis major muscles); smoothness of bladder sphincters and the like Muscle; myocardium.
- the cell preparation of the present invention For example, by administering the cell preparation of the present invention to the muscle damage site of the upper limb, pain due to muscle damage is relieved at an early stage, and further, the muscle is repaired to enable ROM (range of motion) of the upper limb. Expansion and improvement of motor function.
- the cell preparation of the present invention to the bladder sphincter of a patient exhibiting urinary incontinence due to weakness or damage of the bladder sphincter, urination, etc., the urinary incontinence and urine leakage Such problems can be solved safely and easily.
- the present invention can also be applied to a muscle injury site of a patient having a muscular disease such as myocardial infarction, ischemia reperfusion injury, muscular dystrophy (for example, Duchenne muscular dystrophy (DMD)), myositis (myopathy).
- a muscular disease such as myocardial infarction, ischemia reperfusion injury, muscular dystrophy (for example, Duchenne muscular dystrophy (DMD)), myositis (myopathy).
- the pain can be relieved at an early stage by administering the cell preparation for muscle repair of the present invention to the site of muscle damage.
- a pain relieving effect is considered to be due to fat cells contained in the cell preparation for muscle repair.
- the dose when using the cell preparation of the present invention for the purpose of muscle repair is not particularly limited as long as the muscle repair effect can be obtained, and the size of the administration site, the site of the disease, the degree of the disease, the patient's It can be set as appropriate according to gender, physique and the like.
- the dose per unit volume of 10 mL of injured muscle is 100 to 4 million, preferably 200 to 2 million, more preferably 200 to 1 million in terms of the number of fat cells.
- the cell preparation obtained by the following method (c) including steps (1c) and (2c) is used, for example, 0.5 to 20 mL, preferably 1 to 10 mL, more preferably 1 per 10 mL unit volume of damaged muscle. Up to 5 mL.
- the administration method in the case of using the cell preparation of the present invention for the purpose of muscle repair is not particularly limited, and a conventionally known administration method can be adopted.
- a method of injecting into a muscle injury site with a syringe, cannula, etc. can be mentioned.
- fat cells can be collected, separated and concentrated as necessary, and prepared as the cell preparation of the present invention.
- a cell preparation containing adipocytes and mesodermal stem cells it is also possible to use a cell sample collected as a mixture of these cells. Collect each cell individually, and then mix both.
- the cell preparation of the present invention may be used.
- the mesodermal stem cell is an adipose stem cell
- it can be prepared from the same tissue as the adipocyte at the same time and is convenient. It is preferable. More simply, adipose tissue containing these cells may be used.
- the following methods (a) to (c) are exemplified as preferable methods.
- the preparation of the cell preparation of the present invention from a tissue other than fat is not limited, and the preparation of the cell preparation of the present invention from a tissue other than adipose tissue (for example, blood, bone marrow fluid, muscle, etc.).
- the cell preparation of the present invention can be prepared by appropriately setting conditions in consideration of the type and properties of the cells.
- the methods (a) to (c) will be described in detail.
- Method (a) for preparing the cell preparation of the present invention includes the step (1a) of removing a liquid fraction from the collected fat to obtain a cell fraction.
- the collected fat refers to a mixture of a cell fraction and a liquid fraction derived from adipose tissue collected from adipose tissue by liposuction, lipotomy, degreasing, and the like.
- the cell fraction contains adipocytes, adipose stem cells, and impurities (blood cells, dead / alive cells, senescent cells, etc.).
- the liquid fraction includes a tumecent liquid, a cell tissue liquid, and the like.
- the separation of the liquid fraction and the cell fraction can be carried out simply by allowing the collected fat to stand and allowing the cell fraction to settle.
- the method for removing the liquid fraction is not particularly limited, and examples thereof include decantation and suction. Moreover, you may perform centrifugation, filtration, etc. as needed.
- the conditions for centrifugation and filtration are not particularly limited as long as they do not damage fat cells and adipose stem cells and can remove impurities.
- 700 to 2500 ⁇ g for 1 to 15 minutes, preferably 2000 to 2200 ⁇ g for 5 A condition of ⁇ 10 minutes is mentioned.
- the collected fat is subjected to a mesh filter having a hole size of, for example, 10 to 300 ⁇ m, preferably 10 to 150 ⁇ m, more preferably 10 to 100 ⁇ m, and still more preferably 15 to 20 ⁇ m.
- the mixture of fat cells and adipose stem cells can be obtained on the filter by removing blood, tissue fluid, anesthetic (tumecent solution) and the like administered to the site where the fat is collected.
- a container including such a mesh filter may be filled with collected fat containing impurities and subjected to centrifugation.
- adipose tissue containing adipocytes (including extracellular matrix) and adipose stem cells from which the liquid fraction has been removed can be obtained, and this can be used as the cell preparation of the present invention.
- Method (b) for preparing the cell preparation of the present invention comprises the following steps. (1b) a step of removing a liquid fraction from the collected fat to obtain a cell fraction; and (2b) separating adipocytes and adipose stem cells from at least a part of the cell fraction obtained in the step (1b). Process.
- step (1b) is as described in the above method (1a).
- all the cell fraction obtained in step (1b) is subjected to the treatment of step (2b), and only the separated adipocytes are separated.
- the adipose stem cells are separated from at least a part, preferably half, of the cell fraction obtained in step (1b), and further separated in step (1b). ) To obtain the cell preparation containing adipocytes and adipose stem cells.
- examples of the method for separating adipose stem cells include the method described in Patent Document 1. More specifically, a proteolytic enzyme is added to the cell fraction in order to facilitate separation of adipocytes and adipose stem cells by decomposing bonds between cells.
- proteolytic enzymes include collagenase, trypsin, lipase and the like, and one kind selected from these may be used alone, or two or more kinds may be used in combination.
- the method for separating fat cells and adipose stem cells from the cell fraction treated with the enzyme is not particularly limited and may be appropriately selected from conventionally known methods, and examples thereof include centrifugation and filtration. Centrifugation conditions are not particularly limited as long as they can be separated without damaging fat cells and adipose stem cells. For example, 100 to 500 ⁇ g for 1 to 20 minutes, preferably 100 to 300 ⁇ g for 5 to 5 minutes. A condition of 10 minutes is mentioned. By subjecting to such centrifugation, adipose stem cells are obtained as a precipitate, and the adipocytes are concentrated in the supernatant.
- the cell fraction or suspension thereof is passed through a mesh filter having a hole size of 10 to 100 ⁇ m, preferably 10 to 50 ⁇ m, more preferably 15 to 20 ⁇ m.
- Adipose stem cells can be obtained on top, and adipocytes can be obtained in the filtrate.
- the enzyme-treated adipocytes and adipose stem cells are preferably subjected to a washing treatment after separation, and washing can be performed with a phosphate buffer solution (PBS), physiological saline, Ringer's solution, dextran, or the like.
- PBS phosphate buffer solution
- the washing treatment may be repeated a plurality of times as necessary, and may be subjected to centrifugation as necessary when cells are collected after washing. Centrifugation may be performed according to the conditions employed when separating adipocytes and adipose stem cells from the enzyme-treated cell fraction.
- the cell preparation of the present invention obtained by using the fat cells obtained by the present method (b) has an excellent effect on alleviating pain caused by the disease of the interosseous joint.
- this method (b) includes the step (3b) of mixing the cell fraction obtained in the step (1b) and the adipose stem cell obtained in the step (2b) after the step (2b). May be included.
- the cell fraction obtained in step (1b) and the adipose stem cells obtained in step (2b) can be mixed to obtain a cell preparation containing adipocytes and adipose stem cells.
- the cell preparation thus prepared contains a high amount of adipose stem cells and is effective not only for the relief of pain caused by diseases of the interosseous joint, but also excellent for tissue regeneration of the interosseous joint. It is effective.
- such a cell preparation containing adipocytes and adipose stem cells has an excellent muscle repairing effect on damaged muscles, and also has an excellent effect on alleviating pain caused by muscle damage.
- Method (c) The method (c) for preparing the cell preparation of the present invention is as follows: (1c) removing the liquid fraction from the collected fat to obtain a cell fraction; and (2c) removing impurities from the cell fraction obtained in the step (1c) to concentrate adipocytes and adipose stem cells. Obtaining a product.
- step (1c) is as described in the above method (1a).
- impurities are removed from the cell fraction and concentrated.
- the method for removing and concentrating impurities is not particularly limited, and can be appropriately selected from conventionally known methods. However, for convenience, the method is broken by using, for example, a syringe equipped with a weight filter described in Patent Document 3. Impurities such as free oil, dead and active cells, and senescent cells released from fat cells are removed, and a healthy fat cell and adipose stem cell concentrate is obtained.
- a syringe is commercially available. Specifically, a syringe manufactured for LIPOMAX-SC (manufactured by Medikan Corp., Seoul, Korea) is exemplified.
- the collected fat is filled in a syringe equipped with a filter inside, and the fat is separated into a liquid fraction and a cell fraction by centrifugation, and free oil (drained oil) is further separated by a filter. ) Are separated.
- the liquid fraction separated here is not completely separated in the step (1c) but is mixed in the cell fraction. That is, in the syringe, free oil in the upper layer, a concentrate of fat cells and adipose stem cells in the intermediate layer, and a liquid fraction in the lower layer are separated, and a healthy fat cell and adipose stem cell concentrate by discarding other than the intermediate layer And can be used as the cell preparation of the present invention.
- the cell preparation obtained in this manner has selected and concentrated healthy adipocytes and adipose stem cells, it is less likely to cause necrosis, calcification, etc. after transplantation, It is more useful for treatment and repair of damaged muscles and relief of pain due to muscle damage.
- Centrifugation conditions for separating the fat into a liquid fraction and a cell fraction are not particularly limited as long as impurities, fat cells, and adipose stem cells can be separated without damaging adipocytes and adipose stem cells. Although not limited, for example, conditions of 700 to 2500 ⁇ g for 1 to 15 minutes, preferably 2000 to 2200 ⁇ g for 5 to 10 minutes can be mentioned.
- the pore size of the filter is not particularly limited as long as fat cells and adipose stem cells do not pass through and impurities can pass through.
- the pore size of the filter is 10 to 300 ⁇ m, preferably 10 to 150 ⁇ m, more preferably 10 to 100 ⁇ m. More preferably, it is 15 to 20 ⁇ m.
- adipocytes and adipose stem cells were separated from at least a part of the concentrate obtained in step (2c), and the obtained adipose stem cells were further obtained in the step (2c).
- a step (3c ′) of mixing with the concentrate may be included.
- the method for separating adipose stem cells is as described for step (2b) of method (b) above.
- adipose stem cells when adipose stem cells are separated using a proteolytic enzyme, it is usually about 700,000 or more, preferably about 1.5 million or more, more preferably 1 cc of the concentrate obtained in step (2c). Can obtain about 2 million or more adipose stem cells.
- the cell preparation prepared through this step (3c ′) contains adipose stem cells at a higher concentration in addition to the selection and concentration of healthy adipocytes. In addition, it has an even better therapeutic effect on the repair of damaged muscles.
- the adipocytes separated in this step (3c ′) can be used as the cell preparation of the present invention after washing. Since the adipocytes obtained here are selected and concentrated as healthy adipocytes, the adipocytes are more effective in alleviating pain caused by diseases at the interosseous junction or muscle damage.
- the fat cells in the obtained concentrate are refined, and the refined fat cells and adipose stem cells are separated as a mixture (3c ′′). May be included.
- a fat cell can be refined by a method usually employed in the art, and is not particularly limited. For example, if necessary, a fat cell is cut with a drill or the like, Isolate the mixture of adipose stem cells. As the separation method, the above-mentioned centrifugation conditions can be employed.
- the concentrate may be filled in a syringe and subjected to refinement and centrifugation of adipocytes.
- the free oil and the mixture of micronized adipocytes and adipose stem cells are separated in the syringe, so that the free oil can be discarded to obtain a mixture of micronized adipocytes and adipose stem cells. it can.
- a cell preparation containing fine fat cells and adipose stem cells at a high concentration can be prepared through such a separation step.
- the fine fat cells refer to fat cells having a size that can pass through an injection needle of 26 to 30 gauge, preferably 18 to 30 gauge.
- the treatment for refining fat cells can be performed at least once, preferably 1 to several times, more preferably 1 to 2 times.
- adipose stem cells are separated from at least a part of the mixture of the refined adipocytes and adipose stem cells obtained in the step (3c ′′), and the obtained adipose stem cells are concentrated in the step (2c).
- a step (4c ′′) of mixing with the product may be included.
- the method for separating adipose stem cells is as described for step (2b) of method (b) above.
- the adipocytes obtained by separating the adipose stem cells in this step (4c ′′) can be used as a cell preparation containing the adipocytes of the present invention after washing.
- the washing can be performed by the same method as the washing treatment performed on the adipose stem cells described above. Since the fat cells obtained here are selected and enriched with healthy, refined fat cells, the fat cells are more effective in relieving pain caused by diseases of the interosseous joint and muscle damage. It is.
- this method (c) by using the syringe described in Patent Document 3, all the steps can be performed without bringing the cells into contact with the outside air.
- a syringe described in Patent Document 3 is fitted with a cannula or the like, filled with fat collected by liposuction, and directly subjected to removal of impurities, concentration treatment, and the like to obtain a cell preparation.
- this method (c) can also be carried out using a commercially available kit. Specific examples of such a kit include LIPOMAX-SC (manufactured by MEDIKAN Corp.). Is done.
- the cell preparation of the present invention can be obtained by any of the above methods, the method (b) or (c) is preferred, the method (c) is more preferred, and the method (c) is more preferred.
- a cell preparation containing finely divided adipocytes prepared through (3 ′′) or step (4 ′′) is preferable.
- the cell preparation containing micronized adipocytes obtained through the step (4 '') of the method (c) contains impurities at a high concentration and contains fine adipose fat cells, It has a remarkable effect on the treatment of diseases of the interosseous joint (especially pain relief).
- the cell preparation containing finely divided adipocytes and adipose stem cells obtained through the step (3 ′′) of the method (c) contains adipose stem cells at a high concentration in addition to finely divided healthy adipocytes.
- Such a cell preparation can exert a significantly more excellent effect on the treatment of diseases of the interosseous joint and muscle repair.
- the present invention relates to a method for alleviating pain caused by a disease of an interosseous joint, comprising the step of administering a cell preparation containing a fat cell to an interosseous joint of a patient having an interosseous disease, A method of alleviating pain at an interosseous joint is provided.
- a therapeutically effective amount of a cell preparation is administered to a patient in need of pain relief at the interosseous joint.
- the dosage form is not particularly limited, and can be appropriately selected from conventionally known methods according to the position, range, age of the patient and the like where pain relief is expected.
- Tissue regeneration method of interosseous joint includes a step of administering a cell preparation containing adipocytes and mesodermal stem cells to an interosseous joint of a patient having an interosseous disease.
- the present invention provides a tissue regeneration method for an interosseous joint.
- tissue regeneration method of the present invention a therapeutically effective amount of a cell preparation is administered to a patient in need of tissue regeneration.
- the dosage form is not particularly limited, and can be appropriately selected from conventionally known methods according to the type, position, range, age of the patient, and the like of the tissue expected to be regenerated.
- Muscle Repair Method provides a muscle repair method comprising the step of administering a cell preparation containing adipocytes and mesodermal stem cells to a muscle injury site of a patient having muscle damage.
- a therapeutically effective amount of cell preparation is administered to the site of muscle injury in a patient in need of muscle repair.
- the administration form is not particularly limited, and can be appropriately selected from conventionally known methods according to the position, range, age of the patient and the like where muscle repair is expected.
- the present invention provides the use of a cell preparation containing adipocytes for the production of a therapeutic agent for an interosseous joint disease, and a cell preparation containing adipocytes used for the treatment of an interosseous joint disease. Furthermore, the present invention provides use of a cell preparation containing adipocytes and mesodermal stem cells for the production of a muscle repair agent, and a cell preparation containing adipocytes and mesodermal stem cells used for muscle repair. Adipocytes, mesoderm stem cells, cell preparations, interosseous joint diseases, muscle damage, etc. are as described above.
- the mixture was separated into three layers by centrifugation, an upper layer (free oil), an intermediate layer (adipocytes and adipose stem cells), and a lower layer (liquid fraction such as cell tissue fluid). Then, the concentrate of fat cells and adipose stem cells was obtained by leaving only the intermediate layer in the syringe and discarding the upper and lower layers. A gelling process was performed on the concentrate to refine relatively large adipocytes. The jelliing treatment was performed 1 to 3 times. For jelliing, use a drill (FillerGeller cutter: manufactured by MEDIKAN) to cut and refine fat cells, and further centrifuge at 2200 ⁇ g for 5 minutes to contain fine fat cells and adipose stem cells A mixture was obtained. The mixture thus obtained was used in the following Test Examples 2 to 5 as a cell preparation containing finely divided adipocytes and adipose stem cells.
- a drill FrillerGeller cutter: manufactured by MEDIKAN
- adipose stem cells were extracted.
- a 0.4% aqueous solution of proteolytic enzyme (trade name: Collagenase; manufactured by Worthington Biochemical Corp.) in the same amount as the mixture is added and gently added.
- proteolytic enzyme trade name: Collagenase; manufactured by Worthington Biochemical Corp.
- step (iv) Next, about 50 mL of dextran (manufactured by Otsuka Pharmaceutical Co., Ltd.) was added to 2-3 mL of the precipitate (concentrate of adipose stem cells) obtained in step (iii), and after gently shaking, Adipose stem cells were washed by centrifuging at 200 ⁇ g for 5 minutes and discarding the supernatant. This operation was repeated three times. The adipose stem cell concentrate obtained by this step was used in the comparative control group of Test Example 1 below. In addition, the supernatant containing adipocytes obtained in step (iii) was subjected to the same washing treatment, and then used as an adipocyte (and extracellular matrix) in Test Example 1 below.
- dextran manufactured by Otsuka Pharmaceutical Co., Ltd.
- the adipocytes (including extracellular matrix) obtained in the above step (iv) were administered to a subject having osteoarthritis of the knee, and the change in symptoms was observed.
- the subjects were 2 women (4 cases (both subjects had disease in both knee joints): average age 68.5 years).
- the fat collected from the lower abdomen of each subject was used.
- the amount of fat collected was 102 mL and 95 mL, respectively.
- Adipocytes (including extracellular matrix) were obtained from the collected fat according to the method for preparing a cell preparation, and 7 mL was injected into each subject's knee joint.
- hyaluronic acid (Smony (manufactured by Chugai Pharmaceutical Co., Ltd.): 2.5 mL), or fat obtained in the above step (iv), was compared with another two subjects having osteoarthritis of the knee.
- Stem cells (7 mL) were injected into the knee joint (the fat collection sites were all in the lower abdomen; the fat collection amounts were 102 mL and 95 mL, respectively).
- Test Example 1 when injection into the knee joint was performed, the tip of the cannula was rotated back and forth and left and right to stimulate the injection site.
- knee joint pain was reduced from the day of injection, and the effect was sustained for about one month.
- the relief effect of the knee joint pain was clearly expressed from the early stage, and the pain relief effect was also remarkable.
- the adipose tissue obtained in the above step (i) was administered to a subject having knee osteoarthritis, and changes in symptoms were observed.
- the subjects were 3 women (6 cases (each subject had diseases in both knee joints): average age 69.7 years).
- the fat collected from the lower abdomen of each subject was used.
- the amount of fat collected was 95 mL, 100 mL, and 105 mL, respectively.
- Adipose tissue was obtained from the collected fat according to step (i) of the method for preparing a cell preparation, and 7 mL was injected into each subject's knee joint.
- hyaluronic acid (Smony (manufactured by Chugai Pharmaceutical Co., Ltd.): 2.5 mL) was injected into the knee joint as another control subject having osteoarthritis of the knee.
- Test Example 2 when injecting into the knee joint, the operation of stimulating the injection site by rotating the tip of the cannula back and forth and left and right was not performed.
- Test Example 3 Tissue regeneration effect on osteoarthritis Fine adipocytes and adipose stem cells prepared in the above step (i) for 9 women with osteoarthritis of the knee (14 cases: average age 68.7 years)
- a cell preparation (5 to 10 mL, containing about 750,000 to 2 million adipose stem cells) was injected into the knee joint using a cannula with an obliquely cut tip.
- Table 1 below shows the site of the disease, the specific site of liposuction, the amount of collected fat, the amount of cell preparation injected, and the presence or absence of an operation that stimulates the injection site by rotating the tip of the cannula back and forth and left and right It is.
- Table 1 below summarizes the treatment results for each subject, the measurement results of the knee joint space, and the evaluation results according to the Kellgren & Lawrence classification, which are the evaluation criteria for the X-ray findings of knee osteoarthritis.
- FIGS. 1 shows X-ray photographs of the left knee joint lateral joint space taken by subject A before and about one month after the injection of the cell preparation.
- FIG. 2 shows X-ray photographs of the medial joint space of the left and right knee joints of subject B taken before and after injection of the cell preparation about 1 month after injection.
- the left knee joint of the subject A had a joint space of 2.0 m before the treatment (FIG. 1 (a)), and up to 3.3 mm in about one month after the treatment. Enlarged (FIG. 1 (b)). More specifically, before the treatment, when it was IV of Kellgren & Lawrence classification, the symptoms improved to II in about one month after the treatment.
- the left and right knee joints of subject B had a joint space of 0 mm before treatment (FIG. 2 (a)), and expanded to 2.6 mm approximately one month after treatment. (FIG. 2 (b)). More specifically, before the treatment, when it was IV of Kellgren & Lawrence classification, the symptoms improved to II in about one month after the treatment.
- tissue regeneration in the knee joint was promoted by injecting a cell preparation containing finely divided adipocytes and adipose stem cells into the knee joint of a subject having knee osteoarthritis. It was shown that.
- tissue regeneration was observed in the X-ray photograph of the subject into which the adipose stem cells were injected as the comparative control group of Test Example 1, the progress of the tissue regeneration and the improvement of the symptom were improved by the subject A. It was clearly slower than B and B.
- Test Example 4 Tissue regeneration effect on osteonecrosis
- three subjects A, B and J of Test Example 3 who had osteonecrosis were refined in the above step (i).
- a cell preparation containing adipocytes and adipose stem cells (containing about 7 to 2 million 5-10 mL adipose stem cells) was injected into the osteonecrosis site.
- Table 3 below shows the disease site, specific site of liposuction, the amount of collected fat, and the amount of cell preparation injected for subject J.
- the knee joint MR image of the subject A is shown in FIG. 3 as a representative example.
- Test Example 5 Muscle repair effect For subjects having quadriceps injury, deltoid brachial muscle injury or greater pectoral muscle injury (4 men: average age 37.8 years, 20 women: average age 33.8 years)
- the cell preparation (10-50 mL, containing about 4 to 20 million adipose stem cells) containing the micronized adipocytes and adipose stem cells prepared in i) was injected into the site where the muscle was damaged.
- fat collected from the lower abdomen or thigh of the subject (amount of collected fat: 50 to 200 ml) was used.
- the range of motion (ROM: Range of Motion) of the upper limbs was expanded and the improvement of the motor function was observed in all subjects. That is, it was shown that the muscle was repaired by administering the cell preparation to the site of muscle damage.
- adipocytes and mesodermal stem cells such as adipose stem cells are used in combination, the mesodermal stem cells are retained in the affected area by the action of the adipocytes (including extracellular matrix), and the mesodermal stem cells are engrafted. It is thought that efficiency and organization regeneration efficiency are improved.
- the cell preparation of the present invention has an excellent effect in the treatment of diseases of the interosseous joint and muscle repair.
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Abstract
Description
項1.脂肪細胞を含む、骨間接合部の疾患を治療するための細胞製剤。
項2.更に、中胚葉系幹細胞を含む、項1に記載の細胞製剤。
項3.前記中胚葉系幹細胞が脂肪幹細胞である、項1に記載の細胞製剤。
項4.脂肪細胞1個に対して中胚葉系幹細胞が1~10個含まれる、項1に記載の細胞製剤。
項5.前記脂肪細胞がγ線照射された細胞である、項1に記載の細胞製剤。
項6.前記骨間接合部の疾患が、脊椎疾患、関節疾患、自己免疫疾患及び骨壊死症からなる群より選択されるいずれか1種である、項1に記載の細胞製剤。
項7.骨間接合部の疾患の治療剤の製造のための脂肪細胞を含む細胞製剤の使用。
項8.骨間接合部の疾患の治療に使用される脂肪細胞を含む細胞製剤。
項9.脂肪細胞を含む細胞製剤を、骨間接合部の疾患を有する患者の骨間接合部に投与する工程を含む、骨間接合部の疼痛を緩和する方法。
項10.脂肪細胞及び中胚葉系幹細胞を含む細胞製剤を、骨間接合部の疾患を有する患者の骨間接合部に投与する工程を含む、骨間接合部の組織再生方法。
項11.脂肪細胞及び中胚葉系幹細胞を含む、筋肉修復用細胞製剤。
項12.前記中胚葉系幹細胞が脂肪幹細胞である、項11に記載の細胞製剤。
項13.脂肪細胞1個に対して中胚葉系幹細胞が1~10個含まれる、項11に記載の細胞製剤。
項14.前記脂肪細胞がγ線照射された細胞である、項11に記載の細胞製剤。
項15.筋肉修復用製剤の製造のための脂肪細胞及び中胚葉系幹細胞を含む細胞製剤の使用。
項16.筋肉修復に使用される脂肪細胞及び中胚葉系幹細胞を含む細胞製剤。
項17.脂肪細胞及び中胚葉系幹細胞を含む細胞製剤を、筋肉損傷を有する患者の筋肉損傷部位に投与する工程を含む、筋肉修復方法。
本発明は、以下の骨間接合部の疾患を治療するための細胞製剤、及び筋肉修復用細胞製剤を提供する。以下、各細胞製剤について詳述する。
本発明は、脂肪細胞を含むことを特徴とする、骨間接合部の疾患を治療するための細胞製剤を提供する。
本発明は、脂肪細胞及び中胚葉系幹細胞を含むことを特徴とする、筋肉損傷部位において筋肉を修復することが可能な細胞製剤を提供する。
本発明においては、脂肪細胞を採取し、必要に応じて分離、濃縮を行い、本発明の細胞製剤として調製することができる。また、脂肪細胞と中胚葉系幹細胞を含む細胞製剤を調製する場合には、これらの細胞の混合物として採取したものを使用してもよく、それぞれの細胞を個別に採取し、その後、両者を混合して本発明の細胞製剤としてもよい。例えば、中胚葉系幹細胞が脂肪幹細胞である場合には、脂肪細胞と同じ組織から同時に調製でき簡便であるため、脂肪組織から脂肪細胞と脂肪幹細胞の混合物を得て、本発明の細胞製剤とすることが好ましい。また、より簡便には、これらの細胞を含む脂肪組織を使用してもよい。
本発明の細胞製剤を調製する方法(a)は、(1a)採取された脂肪から液体画分を除去し、細胞画分を得る工程を含む。
本発明の細胞製剤を調製する方法(b)は、下記工程を含むことを特徴とする。
(1b)採取された脂肪から液体画分を除去し、細胞画分を得る工程;及び
(2b)前記工程(1b)で得られた細胞画分の少なくとも一部から脂肪細胞と脂肪幹細胞を分離する工程。
本発明の細胞製剤を調製する方法(c)は下記:
(1c)採取された脂肪から液体画分を除去し、細胞画分を得る工程;ならびに
(2c)前記工程(1c)で得られた細胞画分から不純物を除去し、脂肪細胞及び脂肪幹細胞の濃縮物を得る工程、を含む。
本発明は、脂肪細胞を含む細胞製剤を、骨間接合部の疾患を有する患者の骨間接合部に投与する工程を含むことを特徴とする、骨間接合部の疼痛を緩和する方法を提供する。
本発明は、脂肪細胞及び中胚葉系幹細胞を含む細胞製剤を、骨間接合部の疾患を有する患者の骨間接合部に投与する工程を含むことを特徴とする、骨間接合部の組織再生方法を提供する。
本発明は、脂肪細胞及び中胚葉系幹細胞を含む細胞製剤を、筋肉損傷を有する患者の筋肉損傷部位に投与する工程を含むことを特徴とする、筋肉修復方法を提供する。
本発明は、骨間接合部の疾患の治療剤の製造のための脂肪細胞を含む細胞製剤の使用、骨間接合部の疾患の治療に使用される脂肪細胞を含む細胞製剤を提供する。更に、本発明は、筋肉修復剤の製造のための脂肪細胞及び中胚葉系幹細胞を含む細胞製剤の使用、ならびに筋肉修復に使用される脂肪細胞及び中胚葉系幹細胞を含む細胞製剤を提供する。脂肪細胞、中胚葉系幹細胞、細胞製剤、骨間接合部の疾患、筋肉損傷等に関しては前述の通りである。
細胞製剤の調製には、LIPOMAX-SC(Medikan Corp.製,韓国 ソウル)キットを使用した。本細胞製剤の調製工程においては、細胞を全く外気に触れさせることなく行うことが可能であった。具体的な方法は以下の通りである。
上記工程(iv)で得られた脂肪細胞(細胞外基質を含む)を、変形性膝関節症を有する被験者に投与し、症状の変化を観察した。
被験者は女性2名(4症例(両被験者共に両膝関節に疾患あり):平均年齢68.5歳)であった。脂肪は、各被験者の下腹部から採取されたものを使用した。脂肪採取量はそれぞれ102mL、95mLであった。採取された脂肪から上記細胞製剤の調製方法に従って脂肪細胞(細胞外基質を含む)を得て、各被験者の膝関節にそれぞれ7mL注入した。また、変形性膝関節症を有する別の2名の被験者を比較対照群として、ヒアルロン酸(スベニール(中外製薬(株)製):2.5mL)、又は上記工程(iv)において得られた脂肪幹細胞7mL(脂肪採取部位はいずれも下腹部;脂肪採取量は、それぞれ102mL、95mL)を膝関節に注入した。本試験例1においては、膝関節に注入を行う際、カニューレの先端を前後左右に回転させて注入部位を刺激する操作は行わなかった。
上記工程(i)で得られた脂肪組織を、変形性膝関節症を有する被験者に投与し、症状の変化を観察した。なお、被験者は女性3名(6症例(各被験者とも両膝関節に疾患あり):平均年齢69.7歳)であった。脂肪は、各被験者の下腹部から採取されたものを使用した。脂肪採取量はそれぞれ95mL、100mL、105mLであった。採取された脂肪から上記細胞製剤の調製方法の工程(i)に従って脂肪組織を得て、各被験者の膝関節にそれぞれ7mL注入した。また、変形性膝関節症を有する別の1名の被験者を比較対照として、ヒアルロン酸(スベニール(中外製薬(株)製):2.5mL)を膝関節に注入した。本試験例2においては、膝関節に注入を行う際、カニューレの先端を前後左右に回転させて注入部位を刺激する操作は行わなかった。
変形性膝関節症の女性9名(14症例:平均年齢68.7歳)に対して、上記工程(i)で調製された微細化された脂肪細胞及び脂肪幹細胞を含む細胞製剤(5~10mL、脂肪幹細胞を約75万~200万個を含む)を、先端が斜めにカットされたカニューレを用いて膝関節に注入した。疾患部位、脂肪吸引の具体的な部位、採取された脂肪の量、細胞製剤の注入量、カニューレの先端を前後左右に回転させることにより注入部位を刺激する操作の有無については下表1に示される。各被験者に対する処置、膝関節裂隙の計測結果、及び変形性膝関節症のX線所見の評価基準となっているKellgren&Lawrence分類による評価結果を下表1に要約する。
被験者A
施術時年齢72歳 女性
既往症:変形性膝関節症(左膝)
細胞製剤5mLを左膝関節に注入した。細胞製剤の注入前及び注入から約1か月後に撮影した被験者Aの左膝関節外側関節裂隙のX線写真を図1に示す。
施術時年齢60歳 女性
既往症:変形性膝関節症(左右両膝)
細胞製剤それぞれ7mLずつを左右の膝関節に注入した。細胞製剤の注入前及び注入から約1か月後に撮影した被験者Bの左右膝関節内側関節裂隙のX線写真を図2に示す。
治療当日~5日以内(平均2日)で全被験者において膝関節の疼痛が顕著に改善し、その後も疼痛改善状態が持続していた。また、杖歩行をしていた2名は杖なしで歩行することができた。さらに、立ち上がり困難の2名は立ち上がり可能になり、全被験者で歩行が顕著に改善した。
変形性膝関節症に加え、骨壊死を合併していた試験例3の被験者A、B及びJの3名に対し、上記工程(i)で調製された微細化された脂肪細胞及び脂肪幹細胞を含む細胞製剤(5~10mL脂肪幹細胞を約75~200万個を含む)を、骨壊死部位に注入した。被験者Jに関し、疾患部位、脂肪吸引の具体的な部位、採取された脂肪の量、細胞製剤の注入量について下表3に示す。また、被験者Aの膝関節MR画像を代表例として図3に示す。
大腿四頭筋損傷、上腕三角筋損傷又は大胸筋損傷を有する被験者(男性4名:平均年齢37.8歳、女性20名:平均年齢33.8歳)に対し、上記工程(i)で調製された微細化された脂肪細胞及び脂肪幹細胞を含む細胞製剤(10~50mL、脂肪幹細胞を約400~2000万個を含む)を、筋肉を損傷している部位に注入した。細胞製剤の調製には、被験者の下腹部又は大腿部から採取された脂肪(脂肪採取量:50~200ml)を使用した。
以上より、脂肪細胞を変形性膝関節症の患者の患部に注入すると、骨間接合部の疾患に起因する痛みを早期に緩和することができ、しかもその効果が長期に亘って持続することが示された(試験例1)。また、脂肪組織を注入した場合には、試験例1と同様に早期に痛みが緩和され、その効果の持続がより一層長期に亘って持続した(試験例2)。更に、微細化された脂肪細胞及び中胚葉系幹細胞(脂肪幹細胞)を高濃度で含む細胞製剤を患部に注入することにより、前述の疼痛緩和効果に加えて、患部組織の再生が促された(試験例3)。しかも、脂肪幹細胞のみを注入した場合(試験例1の比較対照群)と、微細化された脂肪細胞及び脂肪幹細胞を含む細胞製剤を注入した場合(試験例3)を比較すると、微細化された脂肪細胞及び脂肪幹細胞を含む細胞製剤を注入した場合には、組織再生効果が相乗的に高められた。また、微細化された脂肪細胞及び脂肪幹細胞を含む細胞製剤を骨壊死部位(試験例4)に注入すると、壊死していた部分の骨組織の再生が認められた。更に、脂肪細胞及び中胚葉系幹細胞を筋肉損傷部位に投与することにより筋肉が修復されることが示された(試験例5)。脂肪細胞と、脂肪幹細胞のような中胚葉系幹細胞とを組合せて用いると、脂肪細胞(細胞外基質を含む)のはたらきによって、中胚葉系幹細胞が患部に保持され、中胚葉系幹細胞の生着効率や組織再生効率が高められると考えられる。
Claims (17)
- 脂肪細胞を含む、骨間接合部の疾患を治療するための細胞製剤。
- 更に、中胚葉系幹細胞を含む、請求項1に記載の細胞製剤。
- 前記中胚葉系幹細胞が脂肪幹細胞である、請求項1に記載の細胞製剤。
- 脂肪細胞1個に対して中胚葉系幹細胞が1~10個含まれる、請求項1に記載の細胞製剤。
- 前記脂肪細胞がγ線照射された細胞である、請求項1に記載の細胞製剤。
- 前記骨間接合部の疾患が、脊椎疾患、関節疾患、自己免疫疾患及び骨壊死症からなる群より選択されるいずれか1種である、請求項1に記載の細胞製剤。
- 骨間接合部の疾患の治療剤の製造のための脂肪細胞を含む細胞製剤の使用。
- 骨間接合部の疾患の治療に使用される脂肪細胞を含む細胞製剤。
- 脂肪細胞を含む細胞製剤を、骨間接合部の疾患を有する患者の骨間接合部に投与する工程を含む、骨間接合部の疼痛を緩和する方法。
- 脂肪細胞及び中胚葉系幹細胞を含む細胞製剤を、骨間接合部の疾患を有する患者の骨間接合部に投与する工程を含む、骨間接合部の組織再生方法。
- 脂肪細胞及び中胚葉系幹細胞を含む、筋肉修復用細胞製剤。
- 前記中胚葉系幹細胞が脂肪幹細胞である、請求項11に記載の細胞製剤。
- 脂肪細胞1個に対して中胚葉系幹細胞が1~10個含まれる、請求項11に記載の細胞製剤。
- 前記脂肪細胞がγ線照射された細胞である、請求項11に記載の細胞製剤。
- 筋肉修復用製剤の製造のための脂肪細胞及び中胚葉系幹細胞を含む細胞製剤の使用。
- 筋肉修復に使用される脂肪細胞及び中胚葉系幹細胞を含む細胞製剤。
- 脂肪細胞及び中胚葉系幹細胞を含む細胞製剤を、筋肉損傷を有する患者の筋肉損傷部位に投与する工程を含む、筋肉修復方法。
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JPWO2020009147A1 (ja) * | 2018-07-04 | 2021-03-11 | 正典 佐伯 | 幹細胞濾液製剤及びその調製方法 |
JP6999196B2 (ja) | 2018-07-04 | 2022-01-18 | 正典 佐伯 | 幹細胞濾液製剤及びその調製方法 |
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CN111671774A (zh) | 2020-09-18 |
EP2818173B1 (en) | 2021-09-22 |
US20150044179A1 (en) | 2015-02-12 |
SG10201800017RA (en) | 2018-02-27 |
JPWO2013125674A1 (ja) | 2015-07-30 |
EP2818173A1 (en) | 2014-12-31 |
KR102159844B1 (ko) | 2020-09-24 |
KR20140129184A (ko) | 2014-11-06 |
SG11201405110TA (en) | 2014-11-27 |
RU2746915C2 (ru) | 2021-04-22 |
CA2865383C (en) | 2022-04-26 |
JP5572777B2 (ja) | 2014-08-13 |
CA2865383A1 (en) | 2013-08-29 |
RU2014138500A (ru) | 2016-04-10 |
EP2818173A4 (en) | 2015-11-04 |
CN104203257A (zh) | 2014-12-10 |
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