间充质干细胞移植治疗心血管疾病的应用与进展

背景：间充质干细胞因其具有自我更新、向不同组织分化及免疫调节功能,而被作为治疗急性心肌梗死、心力衰竭等心血管疾病的有效的方法之一。目的：从间充质干细胞的生物特性,转分化能力、免疫调节、心脏修复的作用机制以及间充质干细胞用于治疗心血管疾病早期的临床实验资料做一简要阐述。方法：以“间充质干细胞、免疫调控、心肌梗死、心力衰竭”,“MSCs,Immunomodulation,myocardial infarction,heart  failure”为检索词,应用计算机检索维普(VIP)期刊全文数据库及Pubmed 数据库。排除与研究目的无关和内容重复者。保留35篇文献做进一步分析。结果与结论：间充质干细胞作为理想的种子细胞,除了具备自我更新、多向分化潜能之外,还具有免疫调节功能,避免同种异体移植或异种移植引起的免疫排斥反应。它可以向心肌细胞及脉管系统分化,通过旁分泌作用分泌一系列的细胞活素类物质及生长因子,并且动员内在的心肌干细胞,从而起到改善心功能,诱导逆向重塑,降低心梗面积的作用。相关的临床实验也显示了移植间充质干细胞的可行性和有效性。

Mesenchymal stem cells: Biological characteristics and therapeutic implications for cardiovascular diseases

BACKGROUND:The application of mesenchymal stem cells is an effective method for treatment of cardiac diseases, such as acute myocadial infarction and heart failure, owing to their self-renewal, multi-lineage differentiation and immunomodulation. OBJECTIVE:To summarize the current understanding of biological characteristics, translational findings, immunomodulation, mechanism underlying cardiac function repair of mesenchymal stem cells as well as clinical data regarding mesenchymal stem cells for early cardiovascular disease.METHODS:A computer-based online retrieval was performed to search papers in VIP periodical full-text database and PubMed database using the key words MSCs, immunomodulation, myocardial infarction, heart failure in Chinese and English. After excluding objective-independent papers, 35 papers were included for further analysis. RESULTS AND CONCLUSION:Mesenchymal stem cells are a kind of ideal cells with the capacity of self-renewal, multi-lineage differentiation, and immunomodulation, as well as being free of immunological rejection due to allotransplantation or xenotransplantation. Mesenchymal stem cellssecrete bioactive levels of soluble factors (growth factors and cytokines) by paracrine secretion and recruit endogenous cardiac stem cells. These characteristics make mesenchymal stem cells to differentiate into cardiomyocytes and promote angiogenesis, which can reverse remodeling and reduce the area of myocardial infarction. Recently, some related clinical trials also showed the feasibility and effectiveness of transplantation of mesenchymal stem cells, which provide a solid theoretical foundation for stem cells used in cardiovascular diseases.