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自体树突状细胞治疗对糖尿病肾病(DKD)患者白蛋白尿及炎症生物标志物(白细胞介素-6、白细胞介素-10、肿瘤坏死因子α)影响的开放标签临床试验

英文原题:Open-Label Clinical Trial on the Impact of Autologous Dendritic Cell Therapy on Albuminuria and Inflammatory Biomarkers (Interleukin-6, Interleukin-10, Tumor Necrosis Factor α) in Diabetic Kidney Disease (DKD).

PubMed 2024/12/02(内容时间) Curr Issues Mol Biol Q2 · IF 4.1(JCR 2025)

研究概要

本研究表明DC疗法作为辅助治疗在降低DKD患者白蛋白尿方面具有潜力,需要进一步研究探索长期疗效、长期安全性和给药策略。

中文摘要

2型糖尿病(T2DM)的患病率在全球范围内不断上升,导致糖尿病肾病(DKD)的发病率增加,而DKD是终末期肾病(ESKD)的主要危险因素。本研究探讨自体树突状细胞(DC)治疗对DKD患者白蛋白尿及炎症生物标志物(IL-6、IL-10和TNF-α)的影响。在Gatot Soebroto陆军中央医院(RSPAD GS)开展了一项开放标签临床试验,纳入69例DKD门诊患者。每位受试者接受单次DC注射,并在基线及干预后4周评估尿白蛋白-肌酐比值(UACR)和炎症生物标志物。UACR每周测量一次,而eGFR、IL-6、IL-10和TNF-α水平在基线和第4周进行评估。结果表明,中位UACR从基线的250 mg/g显著降低至第1周的153 mg/g,并在4周内持续保持较低水平(p < 0.05)。未发现eGFR的显著变化(p = 0.478)。TNF-α水平也从2.16 pg/mL显著降低至1.92 pg/mL(p = 0.03),而IL-6(p = 0.83)和IL-10(p = 0.11)未见显著变化。UACR和TNF-α的降低提示,DC治疗可能通过主要抑制TNF-α的抗炎机制减轻白蛋白尿。IL-10水平无显著变化意味着抗炎作用并非由IL-10增强所介导。本研究表明DC治疗作为辅助治疗减少DKD患者白蛋白尿的潜力,尚需进一步研究探索长期疗效、长期安全性及给药策略。

展开英文摘要原文

The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide, leading to a higher incidence of diabetic kidney disease (DKD), a major risk factor for end-stage kidney disease (ESKD). This study investigates the effects of autologous dendritic cell (DC) therapy on albuminuria and inflammatory biomarkers (IL-6, IL-10, and TNF-α) in DKD patients. An open-label clinical trial was conducted with 69 DKD outpatients at the Gatot Soebroto Army Central Hospital (RSPAD GS). Each subject received a single DC injection, with evaluations of urinary albumin-creatinine ratio (UACR) and inflammatory biomarkers at baseline and 4 weeks post-intervention. UACR was measured weekly, while eGFR, IL-6, IL-10, and TNF-α levels were assessed at baseline and week 4. Results indicated a significant reduction in median UACR from 250 mg/g at baseline to 153 mg/g in week 1, with sustained lower levels over 4 weeks ( p < 0.05). No significant change of eGFR was found ( p = 0.478). TNF-α levels also significantly decreased from 2.16 pg/mL to 1.92 pg/mL ( p = 0.03), while IL-6 ( p = 0.83) and IL-10 ( p = 0.11) showed no significant change. The reduction in UACR and TNF-α suggests that DC therapy may alleviate albuminuria through anti-inflammatory mechanisms primarily suppressing TNF-α. No significant change in IL-10 levels implies that the anti-inflammatory effect is not mediated by IL-10 enhancement. This study demonstrates the potential of DC therapy as adjunct therapy to reduce albuminuria in DKD patients, with further research needed to explore long-term efficacy, long-term safety, and dosing strategies.

论文信息

作者
Jonny、Sitepu EC、Hernowo BA、Chiuman L、Lister INE、Putranto TA
单位
Faculty of Medicine, Dentistry, and Health Science, Universitas Prima Indonesia, Medan 20118, Indonesia.Indonesia
期刊
Current issues in molecular biology2024 Dec 2
原文标识
PubMed 39727944 · DOI 10.3390/cimb46120816