大鼠脂肪源性干细胞的分离培养及鉴定

背景：脂肪源性干细胞在体外易于培养,增殖快,具有多向分化潜能。 目的：构建一种体外分离培养SD大鼠脂肪源性干细胞的方法,并对其部分生物学特性与表型进行分析。 方法：切取SD大鼠腹股沟脂肪垫,应用胶原酶Ⅰ消化,分离大鼠脂肪源性干细胞,进行体外培养、传代,倒置显微镜观察细胞的生长增殖及形态变化,诱导成骨、成脂,分别行碱性磷酸酶、茜素红、von Kossa染色及油红O染色,绘制生长曲线及用流式细胞仪检测细胞表面标记。 结果与结论：体外培养的脂肪源性干细胞呈梭形,增殖活跃,传代后形态均一,多次传代后细胞仍保持较强增殖能力,生长曲线呈“S”型。成骨诱导实验组碱性磷酸酶、茜素红、von Kossa染色阳性;成脂诱导实验组油红O染色阳性;对照组均为阴性。细胞CD29,CD44,CD105表达阳性,CD31,CD45表达阴性。提示SD大鼠腹股沟脂肪垫分离的脂肪源性干细胞在体外易于分离培养和传代扩增,特定条件下可诱导分化为成骨细胞和脂肪细胞,并表达间充质干细胞相关的表型。     

体外诱导脐血间充质干细胞分化为成骨细胞

背景：脐血间充质干细胞在特定的诱导条件下可以分化成为多种类型的细胞,易于体外培养扩增,但脐血中间充质干细胞的建立时间长、频率低是其主要缺点。 目的：体外分离培养脐血间充质干细胞,并诱导其向成骨细胞方向分化。 设计、时间及地点：细胞学体外观察,于2008-06/2009-01在青岛大学医学院试验室完成。 材料：脐血取自足月正常分娩的产妇,由青岛市立医院妇产科提供。 方法：采用percoll密度梯度法体外分离培养人脐血间充质干细胞,当细胞汇合90%单层细胞后胰蛋白酶消化传代。取第3代脐血间充质干细胞,以1×106密度接种,当细胞达50%~60%融合时,加入含0.1 μmol/L地塞米松、10 mmol/L β-甘油磷酸钠、50 μmol/L维生素C的DMEM成骨细胞诱导液;对照组加入普通低糖DMEM培养液培养。 主要观察指标：倒置显微镜下观察细胞生长及增殖情况,流式细胞仪检测细胞表面标志物的表达,细胞生长曲线分析,透射电镜观察细胞超微结构,von Kossa染色和碱性磷酸酶染色检测向成骨细胞诱导分化情况。 结果：原代培养的脐血间充质干细胞形态与骨髓间充质干细胞相似,传代后细胞形态均一,呈梭形旋涡状排列。第3代脐血间充质干细胞高表达CD29,CD44,CD13,不表达CD34。生长潜伏期为两三天,第三四天进入对数增殖期,1个月后进入平台期。胞核呈类圆形或不规则形,核膜清晰,有一两个核仁,染色质较粗,胞质中细胞器丰富,细胞表面有微绒毛。第3代脐血间充质干细胞成骨诱导7 d后逐渐汇合呈铺路石状,14 d后von Kossa染色出现钙化结节,碱性磷酸酶染色呈阳性;对照组未见钙化结节,碱性磷酸酶染色呈阴性。 结论：采用percoll密度梯度法可成功从人脐血中分离出间充质干细胞,并在体外诱导分化为成骨细胞。     

人脐血间充质干细胞的体外成骨

背景：用免疫细胞阴性筛选法可以排除造血干细胞对于间充质干细胞生长的影响,较快的获得具有表达间充质干细胞的细胞群。 目的：探讨人脐静脉血间充质干细胞向成骨样细胞分化的能力。 方法：用免疫磁珠阳性筛选法分离脐血间充质干细胞后进行培养。取P2代细胞行成骨诱导分化。 结果与结论：人脐血间充质干细胞贴壁生长,长梭形,3周长满瓶底,传代后细胞增殖迅速。细胞表型为高表达CD44+,CD29+和CD166+。在成骨诱导后碱性磷酸酶染色阳性,Von-Kossa染色提示钙化结节形成。提示脐血间充质干细胞能够在体外分化为成骨样细胞。     

成人骨髓间充质干细胞培养条件优化及多向分化的能力

背景：成人骨髓中间充质干细胞数量少,要使其能够更好地应用于组织工程和细胞治疗,就必须建立成熟、简便、有效的分离培养扩增体系。 目的：建立成人骨髓间充质干细胞最佳培养方法,并观察诱导其向成脂肪、成骨及软骨细胞分化结果。 方法：分别采用密度梯度离心法和全骨髓培养法,分离培养成人骨髓间充质干细胞,通过光镜观察细胞形态,绘制生长曲线比较不同培养方法对骨髓间充质干细胞的影响;免疫荧光法鉴定表面抗原CD34、CD44和CD105的表达。不同诱导培养基诱导成人骨髓间充质干细胞,采用油红O、茜素红染色以及阿利新蓝染色检测成脂、成骨和成软骨诱导情况。 结果与结论：全骨髓培获得的骨髓间充质干细胞,其增殖能力和生长特性明显优于密度梯度离心法;细胞表面抗原CD44、CD105强阳性,CD34阴性;经过诱导培养,油红O、茜素红染色以及阿利新蓝染色均为阳性,证明全骨髓培养法获得细胞具有更强的生长增殖能力,并具有向脂肪,骨和软骨等组织多向分化的潜能。     

骨髓间充质干细胞成脂和成骨分化过程中Wnt信号通路的调控效应*

背景：骨髓间充质干细胞的成脂肪分化与成骨分化比例的失衡与许多骨疾病密切相关,而近些年发现Wnt信号通路在调控骨髓间充质干细胞的分化方向中起重要作用。 目的：通过Wnt信号通路PCR基因芯片观察大鼠骨髓间充质干细胞分化为脂肪细胞和成骨细胞后相关基因表达的变化,寻找Wnt信号通路中调控骨髓间充质干细胞分化的靶基因。 方法：采用大鼠第3代骨髓间充质干细胞分别进行成骨诱导和成脂诱导,7 d后用Trizol萃取培养瓶中的细胞总RNA,倒置显微镜下观察骨髓间充质干细胞形态特征及成骨诱导后和成脂诱导后细胞形态特征。采用Wnt信号通路PCR芯片(大鼠)进行基因芯片检测,以未诱导组为对照,计算成脂肪诱导,成骨诱导后相关基因上调/下调的比值。 结果与结论：①倒置显微镜下观察,传3代后可获得均一性较高的骨髓间充质干细胞,骨髓间充质干细胞经成骨诱导后向成骨细胞方向分化,经成脂诱导后向脂肪细胞方向分化。②与未诱导组相比,骨髓间充质干细胞成脂诱导后Wnt信号通路表达上调的基因(Dkk-1,kremen,FZD1,FZD7)等15个(ratio>2),下调的基因(sFrp 5,β-catenin,Dvl3,Tcf7)等16个(ratio<0.5)。成骨诱导后,Wnt信号通路表达上调的基因(Dkk1,kremen,β-catenin,Wnt11)6个,表达下调的基因(sFrp5,sFRP4,Fzd1)等15个。提示Wnt信号通路在骨髓间充质干细胞成脂细胞分化和成骨细胞分化中发挥重要作用。     

脐血间充质干细胞分离扩增及向成骨与脂肪细胞的分化

背景：和骨髓间充质干细胞相比，脐血间充质干细胞取材方便，其免疫原性较低，能耐受更大程度上的HLA配型不符，分离出的间充质干细胞纯度更高。 目的：分析新生儿脐血间充质干细胞体外分离、纯化、扩增，以及向成骨及脂肪细胞定向诱导分化的方法与条件。 设计、时间及地点：观察性实验，于2004-09/2005-11在四川大学华西医院生物治疗国家重点实验室，干细胞与组织工程研究室完成。 材料：胎龄37~40周的新生儿脐血。 方法：以Ficoll-HyPaque 淋巴细胞分离液密度梯度法、沉降红细胞后密度梯度法及CD34+免疫磁珠负选法分离脐血单个核细胞。将分离获得的单个核细胞采用L-DMEM培养基+体积分数0.1胎牛血清或MesencultTM培养基+体积分数0.1胎牛血清进行间充质干细胞培养传代，获得的第3代集落生长细胞进行流式细胞仪表面抗原测定，并诱导其向成骨、脂肪细胞分化。 主要观察指标：①脐血间充质干细胞的鉴定。②经茜素红染色及油红染色证实其诱导分化。 结果：经沉降红细胞后密度梯度离心分离的单个核细胞，使用MesencultTM培养基+体积分数0.1胎牛血清培养成功率高，第3代可出现明显的集落生长，而另两种方法分离培养的细胞则难以形成集落；集落细胞表面抗原测定表达CD29，CD59，D71，不表达CD34，CD45及HLA-DR等分子。成骨定向诱导分化的集落细胞经茜素红染色胞浆中出现有大量的钙沉积，成脂肪定向诱导分化的集落细胞油红染色示胞浆充满油滴空泡。 结论：使用MesencultTM培养基+体积分数0.1胎牛血清培养由甲基纤维素沉降脐血红细胞后密度梯度离心分离的单个核细胞培养成功率高，第3代可出现明显的集落生长。经诱导后可分化为成骨细胞和脂肪细胞。     

人脐带间充质干细胞分离培养及成骨分化*

背景：目前,人们对间充质干细胞的观察研究多采用扫描电镜、透射电镜和倒置显微镜等,但是这几种方法对观察细胞膜超微结构及细胞骨架的研究则有不足之处。 目的：探讨并优化人脐带间充质干细胞体外获取及培养增殖的方法并鉴定;应用原子力显微镜观察其向成骨诱导过程中超微结构的变化。 方法：用酶消化法分离培养人脐带间充质干细胞,通过传代培养,扩增。体外向骨方向诱导分化,并通过碱性磷酸酶钙钴法染色、茜素红染色鉴定其分化能力。流式细胞仪检测人脐带间充质干细胞免疫表型;诱导过程中利用原子力显微镜的高空间分辨率从可视化的角度观察其在诱导前后细胞表面超微结构的变化。 结果与结论：采用酶消化法能有效分离纯化人脐带间充质干细胞。接种24 h,贴壁细胞形态多为长梭形,多边形或成纤维细胞样形态,大小均一。流式细胞仪分析第3代细胞均表达CD29、CD44 、CD105,不表达CD34、CD45和HLA-DR。经成骨诱导分化4周后,碱性磷酸酶染色呈强阳性,茜素红染色可见明显钙结节;通过原子力显微镜对分化前后的细胞骨架分析：未分化的干细胞其细胞骨架的微管突出不明显,分化后的细胞骨架其微管明显突出,并呈平行分布状态。     

大鼠骨髓间充质干细胞体外增殖与多向分化的能力

背景：生理条件下机体内多数骨髓间充质干细胞增殖并不明显,然而在一定刺激下可表现出旺盛的有丝分裂活动,具有很强的增殖倍增能力,且体外实验表明其具有多向分化潜能。 目的：进一步验证体外分离培养的大鼠骨髓间充质干细胞生长增殖与多向分化潜能。 方法：全骨髓法体外分离培养大鼠骨髓间充质干细胞,贴壁筛选法进行纯化,倒置相差显微镜下观察细胞形态及生长特征,MTT法绘制细胞生长曲线,免疫组化法对细胞表面干细胞标志CD44进行鉴定。取传至第4代细胞,分别用成骨、成软骨、成脂肪和成神经诱导剂予以培养,通过碱性磷酸酶染色、Ⅱ型胶原免疫组化染色、油红O染色、NeuN抗体免疫组化染色进行分化能力鉴定。 结果与结论：分离培养的细胞呈长梭形或多边形,细胞生长曲线呈S形,群体倍增时间约为31 h,免疫细胞化学染色后CD44呈阳性表达,CD34呈阴性。第4代骨髓间充质干细胞成骨诱导2周后出现钙盐沉积,成软骨诱导培养2周后Ⅱ型胶原检测呈阳性,成脂肪诱导培养2周后在细胞的胞浆内充满大量红色脂肪滴,成神经诱导6 h后细胞出现突起,类似神经元的轴突和树突纤维,NeuN免疫组化染色呈阳性。表明体外培养的大鼠骨髓间充质干细胞生长增殖能力旺盛,可向成骨细胞、软骨细胞、脂肪细胞、神经元样细胞方向分化。     

流动优化骨髓间充质干细胞的分化状况

背景：间充质干细胞在成体动物骨髓中含量极低。 目的：观察成年大鼠骨髓间充质干细胞经生理范围流动切应力作用后,其体外生长规律、增殖及定向分化为成骨细胞及脂肪细胞的能力。 方法：在体外取得SD大鼠骨髓原代间充质干细胞,利用平板流室系统加载1 Pa切应力,对其进行培养及扩增,并分别向成骨细胞及脂肪细胞定向诱导。 结果与结论：原代间充质干细胞为长梭形或多角形,集落样生长;经流动加载并传代后细胞生长速度加快,不以集落方式生长,而是均匀分布。细胞体积明显增大,多数为长梭形或多角形;生长曲线显示各代细胞有类似的生长规律;激光共聚焦显微镜显示CD44和CD90阳性,CD31及CD45阴性;向成骨细胞及脂肪细胞诱导14 d后,Von Kossa染色及油红O染色均为阳性,流动优化后骨髓间充质干细胞保持了体外大量增殖及多向分化潜能。     

兔骨髓间充质干细胞的体外培养及多向诱导分化

髓间充质干细胞的分离获取及培养鉴定一直以来仍无统一标准和定论。 目的：体外获取兔骨髓间充质干细胞、纯化、扩增,同时研究其生物学特性及多向分化潜能。 方法：采用贴壁筛选法分离培养兔骨髓间充质干细胞,观察其增殖和生长特性,绘制生长曲线;倒置相差显微镜、苏木精-伊红染色及碱性磷酸酶染色观察细胞形态;并向成骨细胞、软骨细胞和血管内皮细胞多向诱导分化,分别采用钙结节茜素红染色、甲苯胺蓝染色和荆豆凝集素染色鉴定。 结果与结论：经贴壁筛选法得到的骨髓间充质干细胞性状稳定,为纺锤状,呈克隆样生长,碱性磷酸酶染色弱阳性;经成骨、成软骨、成血管内皮细胞诱导培养的骨髓间充质干细胞,表现出相应细胞的形态特征和生物学特征。提示,全骨髓培养法取材方便,骨髓间充质干细胞增殖能力强,在适宜条件下能够多向分化。     

Treatment Considerations in Anticonvulsant Monotherapy

Summary: The long-standing practice of polypharmacy in treating epilepsy is giving way to use of monotherapy. Monotherapy can improve seizure control as well as reduce the risk of serious idiosyncratic reactions, dose-related side effects, and complex drug interactions. Monotherapy also offers improved compliance and cost-effectiveness. The basis of monotherapy is accurate diagnosis and assessment of the patient's seizure type(s), followed by selection of a single appropriate anticonvulsant drug. Many patients currently treated with multiple anticonvulsants can be successfully converted to monotherapy with a carefully monitored program in which troublesome and redundant drugs are gradually withdrawn from the therapeutic regimen.     

Diagnostic Difficulties and Treatment Implications

Summary: Differentiation between types of epileptic seizures has been aided in recent years by the introduction of intensive neurodiagnostic techniques and the development of increasingly detailed classification systems. Paradoxically, these developments have not simplified the task of matching the appropriate antiepileptic drug to a particular seizure type. It is reasonable to assume that anticonvulsant drugs will have different effects on different types of seizures, but faulty, circular reasoning can enter the picture if one also assumes that responses of seizures to different drugs signify different seizure types. There are several examples of differential diagnoses that can fall prey to this problem, including the diagnosis between partial seizures with secondary generalization and generalized tonic-clonic seizures, and the diagnosis between complex partial seizures and absence seizures with automatisms, among others. Considerations of etiology in future classification systems can further complicate the problem: should one then choose an anticonvulsant drug on the basis of individual seizure type or on the basis of the type of epilepsy? Ramifications of this issue extend even to the drug approval process. Official sanction is not given for use of a drug for a seizure type not included in the original efficacy studies, even if later scientific evidence shows that seizure type to be related to a type that is included. New trials must be undertaken. These problems arise from how we choose to classify seizures.     

Cognitive Dysfunction Associated with Antiepileptic Drug Therapy

Summary: Epilepsy is frequently associated with cognitive dysfunction. However, the reasons for this correlation are unclear. Possible influential factors include patient age; duration, frequency, etiology, and type of seizures; hereditary factors; psychosocial issues; and antiepileptic drug (AED) therapy. Whereas many of these factors are beyond the physician's control, AED therapy is one element that can be addressed in treatment decisions by recognizing the potential cognitive effects of particular AEDs. For example, phenobarbital impairs memory and concentration; phenytoin affects attention, problem solving ability, and performance of visuomotor tasks. In contrast, carbamazepine may affect concentration, while valproate would appear to have minimal effects on cognition. Moreover, cognitive effects of AEDs are amplified with coadministration of multiple anticonvulsants (polytherapy). A review of studies on the cognitive effects of monotherapy with AEDs, as opposed to those of polytherapy, provides evidence that drug-related cognitive dysfunction can be reversed if patients are switched to a simpler therapeutic regimen. Future research should be directed toward developing reliable measures for assessing and monitoring cognition, and understanding the particular cognitive side effects of each AED. Physicians also need to revise their opinions about which side effects are "tolerable" for epileptic patients.     

Dextromethorphan: Cellular Effects Reducing Neuronal Hyperactivity

Summary: Dextromethorphan is a dextrorotary morphinan without affinity for opioid receptors, commonly used as an antitussive medication. During the past 5 years, interest in the compound and its demethylated derivative, dextrorphan, has been revived because additional neuroprotective and an-tiepileptic properties were found in in vitro studies, animal experiments, and a few clinical cases. Both morphinans are able to inhibit N -methyl-D-aspartate (NMDA) receptor channels and voltage-operated calcium and sodium channels with different potencies. The inhibition of the NMDA receptor is believed to be the predominant mechanism of action responsible for the anticonvulsant and neuroprotective properties of the compounds.     

Carbamazepine Efficacy in Adults With Partial and Generalized Tonic-Clonic Seizures

Summary: Carbamazepine and phenytoin are drugs of choice in initial monotherapy for adult partial and secondarily generalized tonic-clonic seizures. These designations reflect the results of the Veterans Administration Epilepsy Cooperative Study Group of 1985. An earlier comparative study of carbamazepine and phenytoin by Ramsay and associates found both drugs equally effective in controlling new-onset seizures. Among the advantages of carbamazepine is that it causes relatively few cognitive and dysmorphic side effects. Its disadvantages are its unavailability in parenteral formulation and its metabolic autoinduction. The latter must be compensated for by planned dosage increases to maintain therapeutic plasma steady-state levels during the first 2 or 3 months of treatment. Carbamazepine is judged a drug of choice in the treatment of these secondarily generalized tonic-clonic seizures, and the drug of choice in children, adolescents, and women susceptible to the dysmorphic side effects associated with other anticonvulsant agents.     

Etiologic and Preventive Aspects of Epilepsy in the Child–Bridging the Gap Between Laboratory and Clinic

Summary: Four broad categories of basic phenomena are pertinent to developing ways to prevent epilepsy. These include mechanisms of epileptogenesis, ictal initiation and temporary entrainment by the seizure discharge of normally functioning brain, seizure propagation, and control mechanisms that function both to restrain the cascade of epileptic events culminating in a seizure and to arrest the epileptic event and restore the interictal state. In newborns and children, hypoxia-ischemia is a major factor leading to epileptogenesis, and several schemes are proposed to classify, quantify, and prevent hypoxic-ischemic encephalopathy. Control mechanisms must be better understood in order to develop prophylactic recommendations for epilepsy, and an experimental model of "kindling antagonism" may increase our understanding of these. Programs of prevention of seizures in children will evolve only if basic researchers and clinicians work productively together to develop an adequate understanding of factors important in epileptogenesis and antiepileptogenic control mechanisms.     

Pediatric Epilepsy Surgery

Summary: The use of implantable arrays of epidural electrodes has made it possible to carry out extraoperative electrocorticography (ECoG) and functional localization in the awake child. This has permitted cortical excisions that are determined by criteria similar to those obtained during surgical procedures performed under local anesthesia in adults. In addition, the method also permits simultaneous ECoG and video monitoring during the child's symptomatic seizures, providing additional important localizing information that is impractical to obtain in operations under local anesthesia. We report our experience with 75 children, ages 5 months to 15 years, whom we have managed with epidural electrode arrays. The method of extraoperative ECoG is described and illustrative cases are presented to demonstrate its feasibility and utility in children. In addition, we call attention to gliomas as a common cause of chronic focal seizures in children. Of 49 children undergoing resection and followed for from 1 to 14 years (mean of 5.8 years), 32 (65%) are either seizure free or have had a significant reduction in seizure frequency that has unambiguously improved their quality of life. The results are analyzed further by relating the surgical outcome to each of the pathologic entities that caused the seizures. This analysis reveals the variety of neurological conditions that commonly cause intractable focal seizure disorder in children and distinguishes those pathologic entities in which the seizure disorder is apt to respond to surgical intervention from those that will not.     

Predisposing and Causative Factors in Childhood Epilepsy

Summary: We review information from large studies of defined populations, examining the role of known factors and especially of prenatal and perinatal factors in contributing to nonfebrile seizure disorders of early childhood. We depend especially, but not exclusively, on the recently completed analyses from the Collaborative Perinatal Project of the National Institute of Neurological and Communicative Disorders and Stroke, the NCPP. About 4% of children in the NCPP who had at least one non-febrile nonsymptomatic seizure by the age of 7 years had a previous seizure during acute neurologic illness, such as meningitis or during the acute illness after trauma. Many such seizures should potentially be preventable. Of children with seizures, 10% had had a neonatal seizure and 13% had had a febrile seizure. Among the hundreds of prenatal and perinatal factors explored as predictors of childhood seizure disorders, the principal predictors identified were congenital malformations of the fetus, cerebral and noncerebral; family history of certain neurologic disorders; and neonatal seizures. In agreement with the British National Child Development Study, labor and delivery factors in the NCPP appeared to contribute very little to childhood seizure disorders. Maldevelopment, rather than damage at birth to an initially intact nervous system, appeared to be the more common mechanism. Most seizure disorders of early childhood remained unexplained by the large set of prenatal and perinatal characteristics examined.     

Anticonvulsant Drugs and Cognitive Function: A Review of the Literature

Summary: Alterations of cognitive function are separate from disturbances of behavior seen in association with epilepsy. The nature of the cognitive disability may to a certain extent depend on the seizure type. Partial seizures, mainly derived from a temporal lobe focus, impair memory tasks, while generalized seizures seem to have more effect on attentional abilities. A number of studies, reviewed in this paper, suggest that anticonvulsant drugs further impair cognitive function. Maximal impairments are seen in patients receiving polytherapy: rationalization of polytherapy improves cognitive abilities. Studies in children and adults have allowed differentiation of the effects of various commonly used antiepileptic agents. Maximal cognitive deficits are seen with. phenytoin, while phenobarbital and sodium valproate induce moderate disturbances, and carbamazepine seems relatively free from such toxicity. Further research is needed on the interrelationship between types of seizure disorders, types of anticonvulsant medications, and cognitive function.