骨髓基质干细胞移植在脊髓损伤中的应用

1．概述 脊髓损伤是一种严重的中枢神经系统的创伤性疾病，病情严重的患者往往面临终生瘫痪。只有损伤较轻的患者才有机会恢复脊髓功能，多数患者的治疗效果很不理想，患者失去损伤节段以下的运动和感觉能力，严重影响患者的生活质量，给家庭和社会带来沉重负担。近年来细胞移植成为脊髓损伤治疗的研究热点，尤其是骨髓基质干细胞能够取材于成人自身的骨髓，避免了胚胎干细胞和神经干细胞所带来的伦理学和免疫排斥问题，并且容易增殖，这些优点使得骨髓基质干细胞成为极有前景的移植材料。     

骨髓干细胞移植治疗缺血性心脏病研究进展

骨髓干细胞移植为缺血受损心脏的细胞重建和功能恢复提供了具有里程碑意义的治疗策略.多种类型的干细胞被用于移植研究,其中骨髓干细胞移植最具潜力,已成为该领域的研究热点.     

自体骨髓干细胞移植治疗肝硬化的疗效观察

治疗终末期肝病,原位肝移植是最理想的手段,然而供体短缺、手术损伤大、术后的免疫排斥反应以及费用高昂等问题限制了肝移植技术的发展和临床应用。自体骨髓干细胞移植操作简便、有效、侵入性小且并发症少,具有重要的临床意义。我科2009年9月至2011年1月共收治严重肝硬化失代偿期患者8例,经自体骨髓干细胞移植,治疗效果良好     

骨髓干细胞移植治疗急性心肌梗死的初步研究

目的观察自体骨髓干细胞移植治疗急性心肌梗死的效果及可行性。方法22例急性心肌梗死患者在入院后随机分为骨髓干细胞移植组(n=6)和对照组(n=16)。干细胞移植组于入院后在常规治疗基础上加用自体骨髓干细胞经冠状动脉注入;对照组按急性心肌梗死常规方法治疗。于入院后第10 d,术后2、4、8周,分别对两组患者左心室射血分数(LVEF)进行观察,并行核素心肌灌注断层显像,测量心肌梗死面积。结果干细胞移植组术前及术后第两周与对照组的心功能及梗死面积无明显差别(P>0.05);术后第4周,患者心功能较第二周明显改善(P<0.01);第六周优于第四周(P<0.01);术后第八周与第六周无明显区别,但明显优于对照组。心肌梗死面积由术前的32.45%±6.5%下降至术后第4周26.23%±5.7%,第六周18.32%±5.34%;而对照组变化不明显(P>0.05)。结论自体骨髓干细胞移植可缩小心肌梗死的范围,有效改善心功能,有望为心肌梗死患者提供一种新的治疗方法和思路。     

移植骨髓间充质干细胞肝癌大鼠细胞凋亡及炎症因子的动态变化

BACKGROUND:Bone marrow mesenchymal stem cell transplantation has not been thoroughly reported on its effects on apoptosis in hepatoma carcinoma cells and inflammatory factor level. OBJECTIVE:To investigate the effect of rat bone marrow mesenchymal stem cells on dynamic change of inflammatory factors and cell apoptosis during hepatocarcinogenesis. METHODS:Sixty healthy Sprague-Dawley rats were divided randomly into healthy group (n=30), control group (n=30) and transplantation group (n=30). Healthy group was given ordinary feed and normal water, while other groups were given diethylnitrosamine solution in drinking water to induce liver cancer models. Then, rats in the transplantation group were subjected to bone marrow mesenchymal stem cell transplantation via the tail vein. Two weeks after cell transplantation, CXCL5, interleukin-8 and interleukin-6 levels were tested by ELISA, mRNA level of hepatocyte nuclear factor 1α detected by RT-PCR, expression of Bcl-2 and Bax in liver tissue measured by immunohistochemical method, and liver cancer cell apoptosis index detected by TUNEL technique. RESULTS AND CONCLUSION:After modeling, the expressions of CXCL5, interleukin-8 and interleukin-6 in the control group were significantly higher than those in the healthy group (P < 0.05), while these indexes were reduced significantly after bone marrow mesenchymal stem cell transplantation (P < 0.05) and close to the normal levels (P > 0.05). Bone marrow mesenchymal stem cell transplantation significantly up-regulated the mRNA level of hepatocyte nuclear factor 1α in the liver tissue that was decreased obviously after modeling (P < 0.05). In addition, the expression of Bcl-2 was reduced, while the expression of Bax and the apoptosis index increased significantly in the transplantation group compared with the control group (P < 0.05). These findings indicate that bone marrow mesenchymal stem cell transplantation contributes to hepatocyte differentiation and regeneration in liver cancer rats by reducing serum inflammatory factor levels and promoting apoptosis in hepatoma carcinoma cells.     

骨髓间质干细胞移植治疗兔缺血性心脏病

目的 探讨骨髓间质干细胞移植治疗缺血性心脏病的可行性。方法 由新西兰大白兔胸骨获取骨髓间充质干细胞并进行培养。结扎前降支，建立兔心肌梗死模型。将骨髓间质干细胞分别移植于心肌梗死区，用PET检查梗死区面积，监测左心室内压最大上升速度dp/dt来判定心功能。结果 细胞移植后心肌梗死区面积较移植前缩小，心功能较移植前明显改善。结论 移植骨髓间质干细胞能改善实验动物的心功能。     

自体骨髓干细胞移植治疗急性心肌梗死患者的护理

心肌梗死后心肌细胞数量大量减少，而心肌细胞又是终末分化的细胞，不能再生，已坏死的心肌必然被纤维组织所代替，存活的心肌细胞代偿性肥大，导致心室重塑。当前治疗心肌梗死的主要方法为：药物治疗、介入治疗及冠脉搭桥手术，均不能挽救已经发生坏死和凋亡的心肌细胞。骨髓干细胞为多潜能细胞，具有分化成为心肌细胞、血管内皮细胞和平滑肌细胞的潜能。自体骨髓干细胞移植技术作为21世纪最先进的技术之一，已被广泛地应用于临床。     

自体骨髓干细胞移植治疗心力衰竭的研究进展

细胞移植已为病损心脏细胞重建及衰竭心脏功能恢复提供了一种全新的治疗方法。骨髓干细胞具有自我更新、定向分化成为包括心肌细胞等多种组织细胞的潜能,其增殖分化能力能持续终生,已成为细胞移植治疗心力衰竭的主要细胞源。本文就自体骨髓干细胞治疗心力衰竭可行性、与其他移植细胞相比较的优势、临床应用现状及目前问题与展望作一综述。     

骨髓干细胞动员与移植治疗心肌梗死的比较

目的：比较骨髓干细胞动员与骨髓单个核细胞移植对兔心肌梗死的治疗作用，探讨更有效、更适用的干细胞治疗心肌梗死的方法。 方法： 将30只新西兰兔采用结扎前降支的方法复制心肌梗死模型，随机分为动员组、移植组和对照组，动员组（n=10）心梗后3 h开始皮下注射粒细胞集落刺激因子（G-CSF）30 μg·kg-1·d-1，连续使用5 d，第5 d抽取静脉血约10 mL，分离单个核细胞(BMCs)用5-溴脱氧尿嘧啶核苷（BrdU）标记后，经静脉注入动物体内。移植组（n=10）心梗后7-10 d，抽取骨髓3-5 mL,分离MNCs用BrdU标记，然后开胸将细胞移植至梗死区，对照组（n=10）不采取任何治疗措施。心梗后1周及5周采用超声心动图（UCG）检查心脏功能变化，5周时作血液动力学测定，取心脏作免疫组织化学鉴定。 结果： 心梗后5周，动员组左室射血分数（EF）明显高于1周时，移植组无变化，对照组显著下降。5周时动员组及移植组左室舒张末压（LVEDP）、+dp/dtmax和-dp/dtmax与对照组相比均有显著差异。动员组及移植组在心肌梗死区均发现有BrdU标记的阳性细胞，两组梗塞区血管密度明显高于对照组，但均未发现有新生的平滑肌细胞及心肌细胞。 结论： 骨髓干细胞动员及BMCs移植治疗心肌梗死，均能通过促进梗死区血管新生，明显改善心脏功能，骨髓干细胞动员可能为心肌梗死的治疗提供一种新的无创性手段。     

骨髓间充质干细胞在致敏与非致敏BALB/c小鼠造血干细胞移植中的应用

背景：造血干细胞移植对多种疾病具有治疗作用,但其取材不便,且细胞数量受年龄限制等原因,故而应用具有一定局限性。 目的：探索骨髓间充质干细胞在致敏与非致敏BALB/c小鼠造血干细胞移植中的应用价值。 方法：将BALB/c小鼠骨髓细胞在体外进行分离,采用贴壁培养的方法获得间充质干细胞,使用流式细胞仪对细胞表面的分子标记进行检测。应用异基因脾细胞输注方法建立致敏动物模型,用绿色荧光染料标记骨髓间充质干细胞,分别移植到致敏和非致敏的受体小鼠体内,并在移植后的不同时间点对间充质干细胞的归巢情况进行检测。对致敏BALB/c小鼠进行照射预处理,联合应用异基因骨髓细胞与同基因间充质干细胞移植,观察BALB/c小鼠的生存情况。 结果与结论：移植48 h后,间充质干细胞在致敏受体和非致敏受体小鼠分别归巢于脾脏和骨髓。在造血干细胞的移植实验中,致敏BALB/c小鼠接受异基因骨髓细胞与同基因骨髓间充质干细胞联合移植,结果显示致敏BALB/c小鼠全部在移植后12-15 d死亡,生存的中位时间是14 d,而仅接受异基因骨髓细胞移植的致敏BALB/c小鼠的中位生存时间为13 d。说明细胞移植后在致敏受体内间充质干细胞主要归巢为脾脏和骨髓,联合应用间充质干细胞移植对异基因造血干/祖细胞植入致敏受体体内并没有起到有效的促进作用。 中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

骨髓间充质干细胞在骨组织工程中的应用

间充质干细胞可以分化为成骨细胞、成纤维细胞、神经细胞等多种组织细胞。研究者从骨髓中分离提取骨髓间充质干细胞 ,并通过诱导和体外培养使之分化为成骨细胞 ,作为骨组织工程的种子细胞。     

A Biological Pacemaker Restored by Autologous Transplantation of Bone Marrow Mesenchymal Stem Cells

Objective：To restore cardiac autonomic pace function by autologous trans- plantation and committed differentiation of hone marrow mesenchymal stern cells, and explore the technique for the treatment of sick sinus syndrome. Methods ： Mesenchymal stern cells isolated from canine bone marrow were culture-expanded and differentiated in vitro by 5-azacytidine. The models of sick sinus syndrome in canines were established by ablating sinus node with radio-frequency technique. Differentiated mesenchymal stem cells labeled by BrdU were autologously transplanted into sinus node area through direct injection. The effects of autologous transplantation of mesenchymal stern cells on cardiac autonomic pace function in sick sinus syndrome models were evaluated by electrocardiography, pathologic and immunohistochemical staining technique. Results：There was distinct improvement on pace function of sick sinus syndrome animal models while differentiated mesenchymal stem cells were auto-transplanted into sinus node area. Mesenchymal stern cells transplanted in sinus node area were differentiated into similar sinus node cells and endothelial cells in vivo, and established gap junction with native cardiomyocytes. Conclusion ： The committed- induced mesenchymal stern cells transplanted into sinus node area can differentiate into a- nalogous sinus node cells and improve pace function in canine sick sinus syndrome models.     

大鼠肝移植术后受体骨髓间充质干细胞输注肝内示踪与标记方法比较

目的采用羧基荧光素二醋酸盐琥珀酰亚胺酯（carboxyfluorescin diacetate succinimidyl ester,CFSE）与溴化脱氧尿嘧啶核苷（5-bromo-2-deoxyuridine,Brdu）两种细胞标记物观测肝移植术后受体骨髓间充质干细胞（MSCs）肝内分布情况,并对两种方法进行比较。方法在已构建的DA-Lewis大鼠原位肝移植模型及提取培养Lewis大鼠MSCs的基础上分别用CFSE和Brdu对Lewis来源的MSCs进行标记．术中经门静脉输注．通过荧光显微镜和免疫组织化学法观测术后2mo内各时间点受体肝组织内MSCs的分布情况。结果CFSE细胞标记率约为（94．1±1．4）％。受体肝组织第1、7、14天内有CFSE标记的MSCs聚集,对照组第5天肝组织内发布的CFSE标记MSCs消失。Brdu细胞标记率约为（90．3±3．5）％。受体肝组织第14天、1个月、2个月可见Brdu阳性的MSCs分布,对照组相应时间点肝组织内未发现Brdu阳性的MSCs。结论CFSE和Brdu均为MSCs的良好标记物。CFSE标记细胞后荧光迅速减弱,适用于短期示踪。Brdu标记细胞后可维持较长时间．适用于长期示踪。两种标记方法均是MSCs较为简单有效的方法,实验显示受体MSCs大部分分布于移植肝脏。     

Bone Marrow Mesenchymal Stem Cells: Biological Properties and Their Role in Hematopoiesis and Hematopoietic Stem Cell Transplantation

Mesenchymal stem cells (MSCs) are multipotent adult stem cells that are present in practically all tissues as a specialized population of mural cells/pericytes that lie on the abluminal side of blood vessels. Originally identified within the bone marrow (BM) stroma, not only do they provide microenvironmental support for hematopoietic stem cells (HSCs), but can also differentiate into various mesodermal lineages. MSCs can easily be isolated from the BM and subsequently expand in vitro and in addition they exhibit intriguing immunomodulatory properties, thereby emerging as attractive candidates for various therapeutic applications. This review addresses the concept of BM MSCs via a hematologist’s point of view. In this context it discusses the stem cell properties that have been attributed to BM MSCs, as compared to those of the prototypic hematopoietic stem cell model and then gives a brief overview of the in vitro and vivo features of the former, emphasizing on their immunoregulatory properties and their hematopoiesis-supporting role. In addition, the qualitative and quantitative characteristics of BM MSCs within the context of a defective microenvironment, such as the one characterizing Myelodysplastic Syndromes are described and the potential involvement of these cells in the pathophysiology of the disease is discussed. Finally, emerging clinical applications of BM MSCs in the field of hematopoietic stem cell transplantation are reviewed and potential hazards from MSC use are outlined.     

Dysfunctional Bone Marrow Mesenchymal Stem Cells in Patients with Poor Graft Function after Allogeneic Hematopoietic Stem Cell Transplantation

Poor graft function (PGF) is a life-threatening complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and is characterized by defective hematopoiesis. Mesenchymal stem cells (MSCs) have been shown to support hematopoiesis, but little is known about the role of MSCs in the pathogenesis of PGF. In the current prospective case-control study, we evaluated whether the number and function of bone marrow (BM) MSCs in PGF patients differed from those in good graft function (GGF) patients. We found that BM MSCs from PGF patients expanded more slowly and appeared flattened and larger, exhibiting more apoptosis and senescence than MSCs from GGF patients. Furthermore, increased intracellular reactive oxygen species, p-p53, and p21 (but not p38) levels were detected in MSCs from PGF patients. Moreover, the ability of MSCs to sustain hematopoiesis was significantly reduced in PGF patients, as evaluated by cell number, apoptosis, and the colony-forming unit–plating efficiency of CD34⁺ cells. In summary, the biologic characteristics of PGF MSCs are different from those of GGF MSCs, and the in vitro hematopoiesis-supporting ability of PGF MSCs is significantly lower. Although requiring further validation, our study indicates that reduced and dysfunctional BM MSCs may contribute to deficient hematopoiesis in PGF patients. Therefore, improvement of BM MSCs may represent a promising therapeutic approach for PGF patients after allo-HSCT.     

骨髓间充质干细胞研究进展

骨髓间充质干细胞是骨髓中除造血干细胞外的另一类具有自我更新和多向分化潜能的干细胞,在特定的诱导条件下可向三个胚层的细胞分化。本文就骨髓间充质干细胞的生物学特性、分离培养、活体示踪标记方法、诱导分化等方面的研究进展做一综述。     

Hematopoietic Stem Cell Transplantation for Bone Marrow Failure Syndromes in Children

Bone marrow failure (BMF) syndromes include a broad group of diseases of varying etiologies, in which hematopoeisis is abnormal or completely arrested in one or more cell lines. BMF can be an acquired aplastic anemia (AA) or can be congenital, as part of such syndromes as Fanconi anemia (FA), Diamond Blackfan anemia, and Schwachman Diamond syndrome (SDS). In this review, we first address the evolution and current status of bone marrow transplantation (BMT) in the pediatric population in the most common form of BMF, acquired AA. We then discuss pediatric BMT in some of the more common inherited BMF syndromes, with emphasis on FA, in which experience is greatest. It is important to consider the possibility of a congenital etiology in every child (and adult) with marrow failure, because identification of an associated syndrome provides insight into the likely natural history of the disease, as well as prognosis, treatment options for the patient and family, and long-term sequelae both of the disease itself and its treatment.