嗅鞘细胞移植治疗中枢神经系统损伤的理论研究及临床应用

进行中枢神经系统损伤修复的候选胶质细胞包括嗅鞘细胞、少突胶质前体细胞和许旺细胞。少突胶质前体细胞很难获得大量移植用供体细胞，许旺细胞很难穿透胶质瘢痕，从应用方面均不如嗅鞘细胞。离体培养中嗅鞘细胞极强的可塑性可能会使嗅鞘细胞适时改变自身形态，以适应体内复杂的微环境，有利于神经再生。嗅鞘细胞移植后对脊髓后根损伤后再生有一定作用，其作用大小可能与嗅鞘移植物的成分有关，细胞制备技术和混合细胞移植能影响嗅鞘细胞移植物的效果。虽然胎脑的免疫原性很低，但合理应用免疫抑制剂会使嗅鞘细胞的移植效果有所改观。嗅鞘细胞除了重建损伤通路外，还可能通过轴突发芽、在非突触部位释放单胺类物质、改善病变部位环境并帮助附近的残余神经纤维保存功能和活性等机制对中枢神经的功能发生作用。嗅鞘细胞的细胞生物学和移植后行为学的深入研究都会加快人们对脊髓损伤的理解，并对脊髓损伤的修复治疗产生重要的理论指导意义。

Theory and clinical application of olfactory ensheathing cell transplantation in treatment of central nervous system injury

The candidate donor cells for repairing the central nervous system included olfactory ensheathing cells, oligodendrocyte progenitor cells and Schwann cells. Among them, oligodendrocyte progenitor cells are difficult to collect in a large amount; Schwann cells are difficult to traverse glial scar, so olfactory ensheathing cells were the most appropriate groups. Olfactory ensheathing cells in vitro were flexible and of plasticity, thus were capable of adapting to the transplantation microenviroment and benefit for the neural regeneration. Olfactory ensheathing cells could improve the function after injury of spinal dorsal roots, which were probably related to the component of grafts. The proper preparation and mixed olfactory ensheathing cells could contribute to recovery of function. Although the low immunogen of fetal brain, the administration of immunosuppressant would be necessary. In spite of reconstruction of damaged pathway of nervous system, olfactory ensheathing cells were able to promoting sprout of fibers, release neurotransmitters at the non-synaptic sites and improve microenvironment of damaged sites as well, which compensated for the dysfunction in central nervous system injury. Insight into cell biological property and behavior after transplantation would help understand and exert theoretical influence on the repair of spinal cord injury.