成体干细胞移植治疗急性心肌梗死的研究进展

干细胞治疗心血管疾病正处在起步阶段,在治疗急性心肌梗死方面已表现出传统方法无可比拟的优越性。骨髓干细胞、骨骼肌成肌细胞和内皮祖细胞等已被应用于心肌的再生。研究表明,干细胞可在梗死的心肌中分化形成有功能活性心肌、血管等组织,可改善心脏功能,但其作用机制尚不完全明了。本研究对成体干细胞移植治疗心肌梗死研究中取得的成就、有待解决的问题以及临床应用前景做一评述。     

骨髓成体干细胞在心血管疾病发病中的病理生理意义

成体干细胞研究的深入进一步揭示了一些常见心血管疾病的病理生理机制,它们既能参与心肌再生、血管形成和损伤动脉再内皮化等疾病的修复过程,也能促进动脉粥样硬化、再狭窄等疾病的进展过程。骨髓是成体干细胞研究较为深入的组织,本文就骨髓成体干细胞在常见心血管疾病发病中的生理和病理意义作一综述。     

成体心肌干细胞的研究进展

研究表明,成熟机体的心脏组织中,存在具有高度自我更新能力和特异性心肌分化潜能的成体心肌干细胞,其能够分化为心肌细胞、内皮细胞及平滑肌细胞等心脏结构细胞。成体心肌干细胞是目前被认为最有希望以完全心肌再生应用于缺血性心脏病及其他终末期心脏病替代治疗的干细胞类型。该文综述了成体心肌干细胞的定义和分布、分类和功能、在心肌微环境中的影响因素以及目前研究中存在的问题与展望。     

内源性心脏干/祖细胞活化的研究进展

随着现代生活方式的改变和老龄化的问题,心血管疾病已成为威胁人类健康的第一杀手。然而当前医疗诊治技术仍难以彻底改善心肌梗死后缺血性心肌病及心力衰竭患者的预后。干细胞的出现为心肌再生带来了新的希望。与其他成体干细胞相比,内源性心脏干细胞(CSCs)具有分化成心肌细胞和血管内皮细胞的潜能,可对受损心肌起到明显的修复作用。研究发现,心肌梗死后内源性CSCs的激活与多种因素有关。最近几年,内源性CSCs活化介导的心肌修复引起了研究人员极大的兴趣。本文将对CSCs激活所涉及的主要途径进行论述,以深化对内源性CSCs功能的理解。     

干细胞在心肌梗死治疗中的研究进展

细胞移植治疗的出现为众多心衰患者带来了新的希望,干细胞是主要的细胞来源。胚胎干细胞能分化为真正的心肌细胞,是心肌修复治疗中一种理想的细胞来源,但其受免疫和伦理学方面的限制；成体干细胞作为自体细胞移植治疗对研究者来说则具有很大的吸引力,但其分化潜能则不如胚胎干细胞。目前,用于基础研究和临床试验的成体干细胞主要来源于骨髓,且认为只有骨髓间充质干细胞能分化为心肌细胞。本文主要讨论了不同于细胞移植在受损心肌修复治疗中的作用。     

成体心肌干细胞的研究进展

近来的研究表明无论在正常还是病理情况下心室肌细胞中均存在处于分裂周期的细胞,即成体心脏内存在具有特异性心肌分化潜能的多能干细胞--成体心肌干细胞.本文综述了成体心肌干细胞的发现、特征、功能和目前研究中仍存在的问题与展望.     

骨髓干细胞移植治疗冠心病的研究进展

随着近年来干细胞研究技术的发展，越来越多的学者关注于应用成体干细胞自体移植治疗心血管疾病，本综述着重介绍有关骨髓间充质干细胞自体移植治疗急性心肌梗死以及心梗后心衰等心血管疾病的研究现状。     

骨髓间充质干细胞的研究进展及其应用前景

干细胞是一类具有自我更新和分化潜能的细胞群体,最新的分类方法是根据其来源将其分为四类:成体干细胞、胎儿干细胞、胚胎干细胞和核移植干细胞。胚胎性干细胞和成体干细胞除了来源不同,其最大的区别在于增殖能力和分化潜能的不同:胚胎性干细胞可无限增殖,而成体干细胞的增殖能力则有限;胚胎性干细胞分化潜能要较成体干细胞宽。成体干细胞的可塑性已经成为研究热点,目前有越来越多的实验结果都证实成体干细胞确实具有分化为多种细胞类型的潜能,因此成体干细胞成为生物医学领域中一个很好的研究手段,同时具有广阔的临床应用前景。成体骨髓来…     

骨髓成体干细胞在心血管疾病细胞替代治疗中的研究进展

骨髓成体干细胞移植在心血管疾病细胞替代治疗中已经显示了强大的优越性，但目前干细胞移植还存在发生严重并发症的可能。将来成体干细胞移植用于临床还有赖于干细胞体内增殖、分化调控机制的进一步阐明和大规模前瞻性、临床随机对照试验的验证。     

心肌再生研究进展

心肌再生作为心血管疾病的一种新的治疗方法 ,成为人们研究的热点之一 ,目前修复损伤或死亡的心肌采用的策略有促进心肌细胞的增殖、干细胞移植和干细胞动员等方法来 ,其中干细胞动员治疗心肌损伤以其方便、无创等优点可望为心肌再生治疗带来新的希望     

Bone Marrow Cells and Myocardial Regeneration

Hematopoietic stem cell (HSC) plasticity and its clinical application have been studied profoundly in the past few years. Recent investigations indicate that HSC and other bone marrow stem cells can develop into other tissues. Because of the high morbidity and mortality of myocardial infarction and other heart disorders, myocardial regeneration is a good example of the clinical application of HSC plasticity in regenerative medicine. Preclinical studies in animals suggest that the use of this kind of treatment can reconstruct heart blood vessels, muscle, and function. Some clinical study results have been reported in the past 2 years. In 2003, reports of myocardial regeneration treatment increased significantly. Other studies include observations on the cell surface markers of transplanted cells and treatment efficacy. Some investigations, such as HSC testing, have focused on clinical applications using HSC plasticity and bone marrow transplantation to treat different types of disorders. In this review, we focus on the clinical application of bone marrow cells for myocardial regeneration.     

Stammzelltherapie nach akutem Myokardinfarkt

Therapeutic successes in the area of stem cell research have opened up many new avenues for treating cardiovascular diseases, especially with respect to the prevention of the development of cardiac failure due to acute myocardial infarction or chronic coronary artery disease. Currently, the delivery of bone marrow-derived stem cells and circulating progenitor cells via the coronary artery, intravenous, the left ventricle (transendocardial) as well as directly into the heart muscle during cardiac bypass surgery (intramyocardial) is being investigated intensively for the treatment of acute myocardial infarction and chronic coronary artery disease. All application modes pursue the same objective of regenerating damaged myocardium. In clinical studies, the concept of myocardial regeneration by injection of adult autologous stem cells or circulating progenitor cells has been transferred. In the majority of controlled and randomised trials as well as in several meta-analysis the therapeutic impact of intracoronary stem cell application in myocardial infarction is affirmed by a beneficial effect of stem cells or progenitor cells on mortality and morbidity in patients with reduced cardiac function after acute myocardial infarction.     

Growth-factor-mediated cardiac stem cell activation in myocardial regeneration

The concept of an intrinsic regenerative capacity of the adult mammalian myocardium owing to the presence of cardiac stem cells (CSCs) in the atria and ventricles is starting to be accepted by the cardiovascular research community. The identification of this cell population has improved the prospects for developing successful clinical protocols for human myocardial regeneration. In the normal adult myocardium, only a small fraction of CSCs undergo amplification and differentiation to replace the parenchymal cells lost by normal wear and tear. Physiological or pathological stimuli cause substantial activation of CSCs, which is mediated by a paracrine feedback loop between myocytes and CSCs. In response to stress, the myocytes produce growth factors and cytokines, for which CSCs have receptors, and autocrine, self-sustaining activation of growth-factor production is simultaneously triggered in the CSCs. These findings from human and animal studies led us to test whether in situ activation of CSCs by growth factors would be as effective as transplantation of CSCs into the regenerating myocardium after ischemia in an animal model that has relevance to humans. In a porcine model, we produced extensive and functionally relevant myocardial regeneration. Here, we discuss the properties of endogenous myocardial stem cells that might be exploited to produce clinical myocardial regeneration without the need for cell transplantation.     

Role of stem cells in repair of liver injury:Experimental and clinical benefit of transferred stem cells on liver failure

Although the liver has a high regenerative capacity,as a result of massive hepatocyte death,liver failure occurs. In addition to liver failure,for acute,chronic and hereditary diseases of the liver,cell transplantation therapies can stimulate regeneration or at least ensure sufficient function until liver transplantation can be performed. The lack of donor organs and the risks of rejection have prompted extensive experimental and clinical research in the field of cellular transplantation. Transplantation of cell lineages involved in liver regeneration,including mature hepatocytes,fetal hepatocytes,fetal liver progenitor cells,fetal stem cells,hepatic progenitor cells,hepatic stem cells,mesenchymal stem cells,hematopoietic stem cells,and peripheral blood and umbilical cord blood stem cells,have been found to be beneficial in the treatment of liver failure.In this article,the results of experimental and clinical cell transplantation trials for liver failure are reviewed,with an emphasis on regeneration.     

自体骨髓间充质干细胞移植治疗心肌梗死的进展

心肌梗死可引起心肌细胞的丢失,进而引起心脏功能的下降,是心力衰竭最主要的病因。骨髓间充质干细胞（BM—MSCs）是一类具有横向分化为各系统器官和组织能力的干细胞,能补充丢失的心肌细胞并通过旁分泌等机制增强心功能,为心肌梗死提供一种全新的治疗方法,极具发展潜力。本文对BM—MSCs的分离培养、诱导因素、移植以及临床研究等方面进行了综述。     

Kardiales Tissue Engineering

BACKGROUND: Cardiac tissue engineering is a relatively new interdisciplinary approach to replace diseased cardiovascular tissues with vital structures based on autologous cells. VARIOUS FORMS: This includes the re-seeding of decellularized allogenic or xenogenic scaffolds with autologous cells, the fabrication of organoids based on artificial, biodegradable polymers, and cell transplantation in solid organs. FUTURE CLINICAL APPLICATION: Tissue engineering heart valves, vascular grafts, as well as transplantation of contractile cells or stem cells for myocardial regeneration are not far from their first clinical application. Even though the development of an entirely tissue engineered replacement heart is not yet conceivable, tissue engineering strategies will most likely lead to a significant improvement in the treatment of both acquired and congenital heart disease.     

细胞性心肌成形术研究进展

许多基本的心血管疾病发展到晚期会演变为充血性心力衰竭 ,尽管治疗手段已有了明显进步 ,但充血性心力衰竭仍然是一个主要并且将继续为人类关注的健康问题。充血性心力衰竭可使具有完整舒缩功能的心肌细胞数量减少 ,心肌结构完整性遭到破坏。心脏移植治疗终末期心力衰竭是金标准 ,但供体的不足限制了其临床广泛应用 ,就需要其它新方法来替代以挽救丧失的心肌细胞。细胞性心肌成形术被证明是一种行之有效的替代治疗方法。细胞性心肌成形术就是将包括自体心肌细胞在内的不同类型的细胞移植到宿主心肌组织中加固其结构和改善其功能。最近研究发现胚胎干细胞和成体干细胞均可以向心肌细胞方向分化。自体骨骼肌成肌细胞、内皮祖细胞等其它类型细胞同样成功地在宿主受损心肌组织中存活并增殖分化 ,改善宿主心脏功能。这里对目前细胞性心肌成形术的移植细胞类型作一综述。     

Cord blood transplantation and stem cell regenerative potential

The past 20 years of experience with umbilical cord blood transplantation have demonstrated that cord blood is effective in the treatment of a spectrum of diseases, including hematological malignancies, bone marrow failure, hemoglobinopathies, and inborn errors of metabolism. Cord blood can be obtained with ease and then safely cryopreserved for either public or private use without loss of viability. As compared to other unrelated donor cell sources, cord blood transplantation allows for greater human leukocyte antigen disparity without a corresponding increase in graft-vs.-host disease. Moreover, cord blood has a lower risk of transmitting infections by latent viruses and is less likely to carry somatic mutations than other adult cells. Recently, multiple populations of stem cells with primitive stem cell properties have been identified from cord blood. Meanwhile, there is an increasing interest in applying cord blood mononuclear cells or enriched stem cell populations to regenerative therapies. Accumulating evidence has suggested functional improvements after cord blood transplantation in various animal models for treatments of cardiac infarction, diabetes, neurological diseases, etc. In this review, we will summarize the most recent updates on clinical applications of cord blood transplantation and the promises and limitations of cell-based therapies for tissue repair and regeneration.