骨髓基质干细胞移植治疗缺血性心脏病的研究进展

骨髓基质干细胞是一类具有自我复制和分化潜能的早期未分化细胞,体外用5-氮胞苷诱导后可以转化为心肌细胞,体内移植也可以向心肌细胞分化,并在一定程度上改善心功能,有望成为缺血性心脏病细胞移植理想的细胞来源。     

骨髓干细胞移植与缺血性心脏病

近些年来 ,国内外大量动物实验研究及临床应用研究表明 ,骨髓干细胞移植在缺血性心脏病治疗上具有极广阔的前景 ,从而为人类解决缺血性心脏病这一公共卫生问题带来新的希望。本文就骨髓干细胞移植在缺血性心脏病中应用进展作一综述。     

骨髓间充质干细胞逆转肝纤维化的研究进展

骨髓间充质干细胞是一种来源于骨髓基质的具有多向分化能力的干细胞,在特定条件下,可以分化为骨细胞、软骨细胞、脂肪细胞、神经元样细胞及肝细胞等.近年研究表明,骨髓间充质干细胞能抑制和减轻肝纤维化,并且具有免疫抑制和诱导免疫耐受的作用.因此,在细胞移植治疗终末期肝病方面具有广阔的临床应用前景.     

骨髓基质干细胞移植治疗脑缺血的研究进展

缺血性脑血管病严重威胁着人类健康,具有发病率高、致残率高和死亡率高等特点.目前脑缺血的治疗手段主要有溶栓、抗凝及应用神经保护剂等,但不能从根本上切实有效的修复受损脑组织.近年来骨髓基质干细胞被广泛应用于移植研究中,尤其是对于脑缺血等各种中枢神经系统疾病,更是成为研究的热点.作为细胞治疗的细胞来源之一,骨髓基质干细胞分化潜能好、来源丰富、不存在胚胎干细胞移植所带来的伦理学问题,又可用于自体移植,免除了宿主可能的免疫排斥反应,具有良好的应用前景[1].     

骨髓间质干细胞在缺血性心脏病中的应用

骨髓间质干细胞(MSCs)是一种多能造血于细胞,在一定诱导条件下,可分化为多种造血外组织细胞,如骨细胞、软骨细胞、 心肌细胞等,因此,在组织工程方面具有广泛的应用前景。近年来,MSCs在缺血性心脏病中的应用价值已得到证实和肯定,从而为 缺血性心脏病的治疗带来了新的契机。本文就骨髓间质干细胞在缺血性心脏病中的应用进行了回顾和展望。     

骨髓间充质干细胞治疗缺血性脑血管病研究进展

骨髓间充质干细胞是存在于骨髓中的一种具有跨胚层分化潜能的干细胞。近年来研究发现其可在中枢神经系统内存活并能分化为神经样细胞，在体外也可通过诱导向神经细胞转化，并对脑缺血、脑外伤等疾病的神经功能的缺损有改善作用。其取材方便、体外扩增迅速且能以多种途径移植包括静脉移植、脑内移植。故骨髓间充质干细胞在中枢神经系统损伤修复中的临床应用前景广阔。     

骨髓间充质干细胞及其在缺血性脑血管病中的应用

骨髓间充质干细胞是骨髓中的一群非造血干细胞，具有较强的自我更新能力和多向分化潜能，在体外不同诱导条件下可分化为骨细胞、神经细胞和平滑肌细胞等多种细胞。骨髓间充质干细胞已应用于缺血性脑血管病的治疗研究。文章对骨髓间充质干细胞及其在缺血性脑血管病中的应用做了综述。     

骨髓干细胞动员治疗冠心病

冠心病严重危害着人类的健康。目前的药物、介入治疗和冠脉搭桥术作为治疗冠心病的主要措施,尚未达到理想的目的。细胞治疗作为一种替代手段发挥相当的治疗作用。细胞治疗主要是指将具有分化潜能的自体或异体细胞移植入机体组织,在一定条件下使移植的细胞分化为所需类型的组织细胞,起到修复组织、恢复器官功能的作用。近年来,细胞治疗在冠心病方面的应用是研究的热点。骨髓干细胞动员有可能为冠心病的治疗开辟新的途径。骨髓干细胞是骨髓组织中的一群具有自我更新、多向分化和高度增殖能力的未分化成熟细胞。根据其特性和分化方向可进一步分为骨髓造血干细胞、骨髓内皮祖细胞和骨髓间充质干细胞。骨髓干细胞动员治疗冠心病为一种新的治疗方法,目前主要用于治疗缺心性心肌病,即心肌梗死,不论从其易行性、安全性来说都有着一定的优势。骨髓干细胞动员治疗冠心病的研究非常活跃,尽管如此,其安全性的问题仍存在争议。今后的研究方向应当是研究不同骨髓干细胞方向分化的细胞特征,进行高纯度骨髓干细胞动员,及骨髓干细胞动员的理论研究和实践。     

骨髓间充质干细胞免疫调节作用的研究进展

骨髓间充质干细胞（MSC）是骨髓中除造血干细胞以外的一种成体干细胞，具有自我更新、横向分化和免疫调节作用。MSC是一种能分泌多种细胞因子的较原始的骨髓基质细胞，具有基质细胞的特性，能支持造血，在适宜的条件下能增殖并被诱导分化成骨、软骨、脂肪、神经、心肌、肝脏等组织细胞。目前关于MSC对免疫系统作用的机制尚不十分清楚，本文对其免疫调节作用作一综述。     

大鼠骨髓间充质干细胞体外定向诱导分化为心肌样细胞的实验研究

目的研究大鼠骨髓间充质干细胞的体外培养及向心肌样细胞转化的条件。方法获取成年大鼠胫骨干骨髓,采用贴壁法进行间充质干细胞的培养、传代,观察经5-氮胞苷诱导后骨髓间充质干细胞的生长和分化。结果大鼠骨髓基质细胞贴壁呈集落生长,5-氮胞苷诱导骨髓基质细胞转化为心肌样细胞。结论骨髓基质细胞能够在体外被诱导分化为心肌样细胞,为自体心肌细胞移植提供了一种良好的来源。     

自体骨髓干细胞治疗缺血性心脏病的研究进展

缺血性心脏病是引起充血性心力衰竭的最主要原因。骨髓干细胞可再生心肌和血管,重建和代替坏死心肌,既改善了血供又解决了心肌细胞数量减少这一根本问题。作为缺血性心脏疾病治疗的新途径有着广阔的前景。本文综述了自体骨髓干细胞治疗缺血性心脏疾病的原理、治疗时机和几种治疗途径的研究进展。     

Implantation of bone marrow stem cells reduces the infarction and fibrosis in ischemic mouse heart

Myocardial infarction may cause sudden cardiac death and heart failure. Adult cardiac myocytes do not replicate due to lack of a substantive pool of precursor, stem, or reserve cells in an adult heart. Ventricular myocytes following myocardial infarction are replaced by fibrous tissue and this leads to congestive heart failure in severe cases. Anversa et al. described that resident cardiac stem cells are present in the heart, and can repair the damaged mycardium by myocyte regeneration. Recent findings suggest the feasibility of cardiac repair using cell transplantation. However, it remains controversial which cell types are the best for cell transplantation in the ischemic heart. In this study, we demonstrate that cultured bone marrow stromal cells (MSCs) and Lin(-) bone marrow cells upon transplantation differentiate into myocytes and endothelial cells in the ischemic heart, eventually reducing both infarct size and fibrosis.     

骨髓基质干细胞与心脏疾病

各种心脏疾病的临床治疗仍是困扰着临床医师的一大难题,目前针对心脏疾病的药物、介入和手术治疗的效果并不是很理想,而近年来,骨髓基质干细胞在心脏疾病方面应用成为一个新的研究亮点。现就骨髓基质干细胞移植在心脏疾病方面应用作一综述。     

Chirurgische intramyokardiale Stammzelltherapie bei chronischer Myokardischämie

Chronic ischemic heart disease patients are already being treated worldwide with bone marrow stem cells both in the context of clinical studies and in therapy trials. By combining this therapy with established revascularization procedures such as bypass surgery, a high level of patient safety can be achieved. To date, no stem cell-related cardiac complications following intramyocardial injection of bone marrow-derived stem cells during CABG (coronary artery bypass graft) surgery have been reported. The functional advantage conferred by surgical bone marrow stem cell therapy is a 7.2% increase in LVEF (left ventricular ejection fraction) compared to controls. Randomized placebo-controlled trials, like the German trial PERFECT, are needed to obtain a more evidence-based assessment of this therapy.     

Cell-based therapy for chronic ischemic heart disease--a clinical perspective

In patients with ischemic heart disease, the goal of cell therapy is to improve perfusion and function of the damaged heart muscle. For this review, we selected articles that reported the findings from the major clinical studies of cardiovascular stem cell therapy in patients with chronic ischemic heart disease. Because of the current status of development of clinical investigation in this field, all relevant studies were included. Initial clinical trials have shown that adult cell-based therapy is safe and may improve the quality of life and the functional status of patients with chronic myocardial ischemia. Adult bone marrow mononuclear cells have been most frequently used in cardiac cell therapy trials to date, but new cell types are now being assessed in both preclinical and clinical studies. Although not well defined, mechanisms underlying the benefits associated with cell therapy are most likely multiple and include a paracrine effect. Cell therapy in patients with chronic ischemic heart disease has been shown to be safe and feasible. Initial data have shown that cell therapy with autologous bone marrow cells is associated with modest functional improvements. This finding needs to be confirmed in subsequent phase 2 and 3 trials.     

骨髓间质干细胞的生物学特性及在缺血性卒中的应用

目前,缺血性卒中的治疗手段较为有限,在细胞治疗领域,一系列基础和临床研究表明,骨髓间质干细胞对缺血性卒中有治疗作用.文章就骨髓间质干细胞的生物学特性及治疗缺血性卒中的最新进展做了综述.     

骨髓基质干细胞向心肌细胞分化的研究进展

骨髓基质干细胞不仅有一定的自我更新能力,可以分化为骨、软骨和脂肪等多种类型的基质细胞,在一定外界环境条件下还能实现跨系统分化,分化成心肌细胞,是目前认为较有希望成为心肌梗死替代治疗的干细胞。现就骨髓基质干细胞的生物学特性、向心肌细胞分化的诱导因素及临床应用进展进行综述。     

Stem celltherapy for ischemic heart failure

As the prevalence and incidence of ischemic heart disease continue to increase, so does interest in ischemic heart failure management. Limitations of current therapies have led to research aimed at regenerating and repairing ischemically damaged myocardium through stem-cell therapy. Cell types being evaluated include embryonic stem cells, fetal and neonatal cardiomyocytes, skeletal myoblasts, bone marrow stem cells, peripheral blood CD34+ cells, endothelial progenitor cells, cardiac progenitor cells, and fibroblasts. Preclinical animal studies and promising early results of clinical trials now under way suggest that stem-cell therapy may soon become an important new tool in heart failure management.     

Role of adult bone marrow stem cells in the repair of ischemic myocardium: current state of the art

OBJECTIVE: To review the milestones in stem cell therapy for ischemic heart disease from early basic science to large clinical studies and new therapeutic approaches. MATERIALS AND METHODS: Basic research and clinical trials (systematic review) were used. The heart has the ability to regenerate through activation of resident cardiac stem cells or through recruitment of a stem cell population from other tissues, such as bone marrow. Although the underlying mechanism is yet to be made clear, numerous studies in animals have documented that transplantation of bone marrow-derived stem cells or circulating progenitor cells following acute myocardial infarction and ischemic cardiomyopathy is associated with a reduction in infarct scar size and improvements in left ventricular function and myocardial perfusion. RESULTS: Cell-based cardiac therapy has expanded considerably in recent years and is on its way to becoming an established cardiovascular therapy for patients with ischemic heart disease. There have been recent insights into the understanding of mechanisms involved in the mobilization and homing of the imported cells, as well as into the paracrine effect, growth factors, and bioactive molecules. Additional information has been obtained regarding new stem cell sources, cell-based gene therapy, cell-enhancement strategies, and tissue engineering, all of which should enhance the efficacy of human cardiac stem cell therapy. CONCLUSIONS: The recently published trials using bone marrow-origin stem cells in cardiac repair reported a modest but significant benefit from this therapy. Further clinical research should aim to optimize the cell types utilized and their delivery mode, and pinpoint optimal time of cell transplantation.