为什么 20 百万对 40 数以百万计的干细胞都可以发挥强大作用——并且每种干细胞在 ALS 中都有意义
介绍
When a person or a family faces a diagnosis such as ALS (肌萎缩侧索硬化症), one of the first questions they ask is:
“What can be done to slow this down?”
过去二十年, 间充质干细胞 (间充质干细胞) have emerged as one of the most promising biological tools to 调节炎症, 保护神经元, and slow degeneration.
One of the most common questions patients ask is:
“Is 40 million stem cells better than 20 百万? Is twice the dose twice as effective?”
The answer is surprisingly nuanced — and understanding it can save patients both money and false expectations.
What are mesenchymal stem cells (间充质干细胞)?
Mesenchymal stem cells are special repair cells that live mainly in:
- 骨髓
- 脂肪组织
- 结缔组织
They have four remarkable abilities:
- They calm inflammation
- They protect neurons
- They release growth and healing signals
- They regulate the immune system
They do not replace neurons — instead, 他们 change the biological environment in which neurons live.
This is extremely important in ALS, because ALS is not just neuron death — it is a disease of:
- 慢性炎症
- immune mis-regulation
- toxic microenvironment
- 氧化应激
- blood-brain barrier dysfunction
MSCs target all of these.
How many MSCs are normally in your blood?
In a healthy adult:
- 有 thousands to tens of thousands of MSCs in the entire bloodstream at any moment
- In many people, there are almost none
These cells live mostly in tissues — not in blood.
So biologically speaking:
The natural concentration of MSCs in the blood is extremely low.
What happens when we inject 20–40 million MSCs?
When MSCs are given intravenously, we create a temporary flood of healing cells.
| Normal level | 1,000 – 50,000 间充质干细胞 |
|---|---|
| Therapeutic infusion | 20,000,000 – 40,000,000 间充质干细胞 |
这意味着:
- 20 million = thousands to tens of thousands times more
- 40 million = even higher
But here is the key truth:
Biology does not respond linearly.
More does not always mean proportionally better.
The Plateau Effect — Why More Cells Do Not Equal More Healing
在医学上, this is called a dose-response curve.
Let us visualize it:
Biological
Effect
|
100| _________
90| _/
80| _/
70| _/
60| _/
50| _/
40| _/
30| _/
20|_/
+-----------------------------
5 10 20 40 80
MSC Dose (Millions)
This curve shows something critical:
- 从 5 → 10 million = huge jump in effect
- 从 10 → 20 million = big jump
- 从 20 → 40 million = smaller jump
- 从 40 → 80 million = tiny jump
This is called the therapeutic plateau.
Once you pass a certain threshold, the body’s biological systems are already fully activated.
What MSCs actually do in ALS
MSCs do not “fix” neurons — they protect the ones that remain.
They do this by:
- Reducing toxic inflammation around motor neurons
- Suppressing autoimmune attack
- Increasing blood supply and oxygenation
- 释放神经营养因子 (脑源性神经营养因子, 神经生长因子, 血管内皮生长因子)
- Stabilizing the blood-brain barrier
- Protecting mitochondria inside neurons
Once these systems are turned on, doubling the cell dose does not double the effect.
So what is the real difference between 20M and 40M?
Clinically and biologically:
| 剂量 | What it does |
|---|---|
| 20 百万 | Reaches the therapeutic threshold for immune modulation, 神经保护, and inflammation control |
| 40 百万 | Extends and strengthens the same effects, giving more durability and more coverage |
In simple terms:
20 million turns the system ON
40 million keeps it ON longer and stronger
为什么 20 million is often ideal in early or slow ALS
In early-stage or slow-progressing ALS:
- Neurons are still present
- Inflammation is moderate
- Immune dysregulation is not extreme
所以 20 million MSCs:
- already create a massive biological shift
- already activate all healing pathways
- already slow the disease environment
使用 40 million here gives only modest extra benefit for much higher cost.
This is why many experienced clinicians prefer:
20 million for early or slow disease
It is efficient, powerful, and cost-effective.
为什么 40 million makes sense in late or aggressive ALS
In advanced or fast-progressing ALS:
- Inflammation is severe
- Immune activation is high
- Neurons are under heavy stress
- Tissue damage is widespread
这里, the system is harder to control.
所以 40 million MSCs:
- create a larger biological buffer
- provide longer-lasting immunomodulation
- deliver more neuroprotective signals
This is not because 20 million “doesn’t work” — it’s because the battlefield is bigger.
Think of it like fire suppression
If a small fire starts in a room:
- One fire extinguisher is enough
If a large fire is burning:
- You need many more
The mechanism is the same — only the scale changes.
Safety and compatibility
Because these are 自体间充质干细胞 (from the patient):
- No rejection
- No immune attack
- No genetic mismatch
- No tumor risk when properly prepared
This allows higher doses to be used safely when needed.
结论
20 million MSCs:
- Already exceed natural levels by thousands of times
- Already activate all key healing pathways
- Already provide most of the biological benefit
40 million MSCs:
- Extend and strengthen the same mechanisms
- Are most useful in aggressive, advanced disease
This is not about “more is better” — it is about using the right biological dose for the right stage of disease.
That is what truly personalized regenerative medicine means.
