Intratracheal Administration of Umbilical Cord Blood-Derived Mesenchymal Stem Cells in a Patient with Acute Respiratory Distress Syndrome

Umbilical cord blood (UCB)-derived mesenchymal stem cells (MSCs) have been introduced as a possible therapy in acute lung injury and acute respiratory distress syndrome (ARDS). This case history is reported of a 59-yr-old man who was treated with MSCs in the course of ARDS and subsequent pulmonary fibrosis. He received a long period of mechanical ventilation and weaning proved difficult. On hospital day 114, he underwent the intratracheal administration of UCB-derived MSCs at a dose of 1 × 10⁶/kg. After cell infusion, an immediate improvement was shown in his mental status, his lung compliance (from 22.7 mL/cmH₂O to 27.9 mL/cmH₂O), PaO₂/FiO₂ ratio (from 191 mmHg to 334 mmHg) and his chest radiography over the course of three days. Even though he finally died of repeated pulmonary infection, our current findings suggest the possibility of using MSCs therapy in an ARDS patient. It is the first clinical case of UCB-derived MSCs therapy ever reported.     

Human Umbilical Cord Mesenchymal Stem Cells Reduce Fibrosis of Bleomycin-Induced Lung Injury

Acute respiratory distress syndrome is characterized by loss of lung tissue as a result of inflammation and fibrosis. Augmenting tissue repair by the use of mesenchymal stem cells may be an important advance in treating this condition. We evaluated the role of term human umbilical cord cells derived from Wharton’s jelly with a phenotype consistent with mesenchymal stem cells (uMSCs) in the treatment of a bleomycin-induced mouse model of lung injury. uMSCs were administered systemically, and lungs were harvested at 7, 14, and 28 days post-bleomycin. Injected uMSCs were located in the lung 2 weeks later only in areas of inflammation and fibrosis but not in healthy lung tissue. The administration of uMSCs reduced inflammation and inhibited the expression of transforming growth factor-β, interferon-γ, and the proinflammatory cytokines macrophage migratory inhibitory factor and tumor necrosis factor-α. Collagen concentration in the lung was significantly reduced by uMSC treatment, which may have been a consequence of the simultaneous reduction in Smad2 phosphorylation (transforming growth factor-β activity). uMSCs also increased matrix metalloproteinase-2 levels and reduced their endogenous inhibitors, tissue inhibitors of matrix metalloproteinases, favoring a pro-degradative milieu following collagen deposition. Notably, injected human lung fibroblasts did not influence either collagen or matrix metalloproteinase levels in the lung. The results of this study suggest that uMSCs have antifibrotic properties and may augment lung repair if used to treat acute respiratory distress syndrome.An enduring problem in respiratory and critical medicine is the treatment of acute respiratory distress syndrome (ARDS)/acute lung injury, a condition that is characterized by refractory hypoxemia in patients with bilateral lung infiltrates in the absence of pulmonary edema.¹ A National Institutes of Health study estimated the incidence of acute respiratory distress syndrome/acute lung injury to be 75 per 100,000 population in the United States with 40 to 60% mortality.² ARDS may be the end result of several conditions that directly injure the lung such as pneumonia, pulmonary contusion, inhalational injury, and near drowning.³ Generic injury to the lung results in damage to the epithelial and endothelial cells and a compromised alveolar-capillary barrier. There is exudation of fluid into the alveolar space followed by inflammatory cells, a process driven by cytokines such as interleukin (IL)-8, tumor necrosis factor (TNF)-α and IL-1. The progression of acute lung injury to fibrosis portends a poor prognosis and may be observed as early as 5 to 7 days after injury.⁴ Many strategies have been directed at augmenting repair of ARDS. These include improved ventilation techniques, surfactant therapy, vasodilators, and anti-inflammatory agents.¹ Notably, there has been an increasing focus on the acceleration of resolution by epithelial restitution and the consequent reduction in fibrosis of ARDS.To this end, new stem cell therapies have raised the possibility of improving lung repair. Mesenchymal stem cells (MSCs)⁵ are multipotent and differentiate into a range of cell types and are being tested for their regenerative potential, particularly in myocardial infarction and some neurodegenerative disorders.⁶ MSCs are adherent cells and a common MSC immuno-phenotype can be identified in cells from many sources including bone marrow, umbilical cord blood, and adult organs.⁷The role of MSCs in the treatment of lung injury has been the subject of several studies. Indeed, MSCs have displayed the potential to improve lung function in pulmonary disease through several mechanisms. Murine bone marrow MSCs (bmMSCs) have been shown to selectively home to sites of injury through the chemokine receptor CXCR4 and chemokine, Stromal derived factor as well as Flk surface receptors^8,9 and improved respiratory capacity in bleomycin, lipopolysaccharide, and monocrotaline-induced models of lung injury.^10,11,12 Furthermore, both in vivo and in vitro studies have shown that murine and human bmMSCs and human umbilical cord blood cells may differentiate into cells with markers of lung epithelium.^13,14 Aguilar et al supported the safety profile of human MSCs by demonstrating that murine bmMSCs but not human bmMSCs differentiated into osteosarcomas when injected into the lung.¹⁵Based on these studies, we hypothesized that MSCs derived from the Wharton’s jelly of the umbilical cord (uMSCs) would repair lung injury and prevent fibrosis. The umbilical cord is derived from the extraembryonic mesoderm and develops from the proximal epiblast during the formation of the embryonic primitive streak.¹⁶ The umbilical cord contains two arteries and a vein that are surrounded by a matrix rich in hyaluronic acid known as Wharton’s jelly (WJ). Recently, groups have cultured MSCs from the WJ of the umbilical cord and differentiated them in vitro into several tissue types.^17,18 These cells have the advantage of ready availability, do not require invasive bone marrow biopsies, and are more plentiful than umbilical cord blood-derived MSCs. In the present study, we examined the therapeutic potential of uMSCs in a bleomycin-induced model of lung injury that shares many features in common with the phenotype of ARDS in human subjects.     

脐带源间充质干细胞治疗帕金森病的临床研究

目的 探讨脐带源间充质干细胞(human umbilical cord mesenchumal stem cells,HUMSCs)移植治疗帕金森病患者神经功能的疗效.方法 取胎儿脐带组织体外培养扩增并进行鉴定,将3 ～6 mL含有细胞5×106～1×107的细胞悬液,通过颈动脉移植途径植入10例帕金森病患者体内.每周1次,移植3次后,对患者进行移植前后帕金森病统一评分量表(UPDRS)和改良的Webster评分,并评估移植后不良反应.结果 脐带源间充质干细胞贴壁成漩涡状生长,CD73,CD90,CD105呈阳性表达;CD14,CD19,CD34,CD45,HLA-DR呈阴性表达.经颈动脉移植后,患者移植前后UPDRS评分具有显著性差异(P＜0.01),Webster评分有效改善患者行走姿势、震颤程度,自主运动及坐、起运动能力得到提高.结论 患者移植HUMSCs后能够有效控制帕金森病的发病进程,有效改善受损的脑组织功能,提高患者生活质量.     

人脐血间充质干细胞培养及其生物学特性的研究

目的建立人脐血间充质干细胞体外分离培养的最佳条件,并观察其生物学特性。方法在无菌条件下抽取人脐血,用密度梯度离心的方法获得脐血单个核细胞,接种含10%胎牛血清的IMDM培养基中。对单个核细胞行贴壁培养后,进行细胞形态学观察,细胞生长、细胞周期分析及细胞凋亡检测,免疫细胞化学鉴定。结果采用Percoll(1.073g/ml)分离的脐血间充质干细胞(mesenchymal stem cells,MSCs)大小较为均匀,呈梭形或星形的上皮样细胞,传代培养后的细胞体积较大,成纤维样细胞逐渐增多。细胞生长曲线测定表明接种后第5d细胞进入指数增生期,至第9d进入平台期;流式细胞术证明G2+S期细胞为14.8%;免疫细胞化学染色结果表明42.0%细胞为CD45阳性。结论体外分离培养脐血间充质干细胞生长稳定,可作为组织工程的种子细胞。     

Promising Outcome of Umbilical Cord Blood Transplantation in Patients with Multiple Comorbidities

The hematopoietic cell transplantation–specific comorbidity index (HCT-CI) has been recently proposed to predict the probability of nonrelapse mortality (NRM) and overall survival (OS) in allogeneic hematopoietic stem cell transplantation (HSCT). However, the usefulness of the HCT-CI in single-unit umbilical cord blood transplantation (UCBT) remains unclear. We investigated the impact of the HCT-CI on the clinical outcomes of allogeneic HSCT in a single-center retrospective study including 53 recipients of UCBT (UCBT group) and 90 recipients of other HSCT (non-UCBT group). In the non-UCBT group 2-year OS rates for HCT-CI score <?3 and?≥3 were 67% (n?=?74; 95% confidence interval [CI], 54% to 78%) and 26% (n?=?16; 95% CI, 7% to 51%), respectively (P?=?.001). In the UCBT group these rates were 66% (n?=?39; 95% CI, 48% to 79%) and 69% (n?=?14; 95% CI, 36% to 87%), respectively (P?=?.73). In the non-UCBT group 1-year NRM rates for HCT-CI score <?3 and?≥3 were 14% (95% CI, 6.4% to 22%) and 37% (95% CI, 14% to 61%), respectively (P?=?.02). In the UCBT group these rates were 6.1% (95% CI, 3.4% to 24%) and 7.7% (95% CI, .4% to 29%), respectively (P?=?.78). Using multivariate analysis we showed that HCT-CI score ≥ 3 was significantly associated with lower OS (hazard ratio, 3.06; 95% CI, 1.47 to 6.38; P?=?.003) and higher NRM (hazard ratio, 2.87; 95% CI, 1.18 to 6.96; P?=?.02) for the non-UCBT group. UCBT showed good OS with low incidence of NRM, even in patients with high HCT-CI scores. Altogether, we propose single-unit UCB to be a promising stem cell source for improving survival in patients with multiple comorbidities.     

人脐血MSCs的生物学特性及其向神经细胞分化的研究进展

脐血间充质干细胞是从脐带血中分离和培养的一种多潜能成体干细胞,具有自我更新和多向分化潜能,在一定条件下可以分化成为神经细胞。脐血间充质干细胞的这些特性吸引了许多学者用它来治疗神经系统疾病如神经退行性疾病,神经损伤和中风等,并取得了一定进展。本文就脐血间充质干细胞的分离纯化和培养方法、生物学特性以及向神经细胞的分化作一简要综述。     

干细胞移植治疗脊髓损伤的实验研究进展

目的:探讨脊髓损伤后干细胞移植对神经功能恢复的作用机制及临床疗效.方法:检索国内外报道的实验大鼠脊髓损伤造模后干细胞移植的相关文献,对实验结果进行综合分析,评估大鼠神经功能恢复效果.结果:胚胎干细胞、神经干细胞、骨髓间充质干细胞、许旺细胞、嗅鞘细胞移植到受损脊髓实验大鼠后可分化成不同功能类型的神经细胞,能释放促进宿主神经元再生的营养因子,重建轴突的连续性.结论:脊髓损伤后干细胞移植可重建脊髓神经传导的连续性,预示着干细胞在脊髓损伤的治疗中具有良好的应用前景.     

Mesenchymal Stem Cells versus Mesenchymal Stem Cells Combined with Cord Blood for Engraftment Failure after Autologous Hematopoietic Stem Cell Transplantation: A Pilot Prospective,Open-Label,Randomized Trial

Engraftment failure (EF) after autologous hematopoietic stem cell transplantation is a serious complication. We prospectively evaluated the effects and safeties of mesenchymal stem cells (MSCs) alone and MSCs combined with cord blood (CB) for EF. Twenty-two patients were randomized to receive MSCs (MSC group; n = 11) or MSCs plus CB (CB group; n = 11). Patients with no response (NR) to MSCs received the therapeutic schedule in the CB group, and those patients with partial response (PR) in the MSC group and patients without complete remission (CR) in the CB group received another cycle of MSC treatment. Patients who did not achieve CR after 2 cycles of treatments received other treatments, including allogeneic HSCT. After the first treatment cycle, response was seen in 7 of 11 patients in the MSC group and in 9 of 11 in the CB group (P = .635), with a significant difference in neutrophil reconstruction between the 2 groups (P = .030). After 2 treatment cycles, 16 patients achieved CR, 3 achieved PR, and 3 had NR. No patient experienced graft-versus-host disease (GVHD). With a median follow-up of 345 d (range, 129 to 784 d) post-transplantation, 18 patients remained alive and 4 had died (3 from primary disease relapse and 1 from cytomegalovirus pneumonia). The 2-year overall survival, disease-free survival, and cumulative incidence of tumor relapse post-transplantation were 75.2% ± 12.0%, 79.5% ± 9.4%, and 20.5% ± 9.4%, respectively. Our data indicate that the 2 strategies are effective for EF and do not result in GVHD or increase the risk of tumor relapse, but the MSC plus CB regimen has a superior effect on neutrophil reconstruction.     

Preserved Hippocampal Glucose Metabolism on 18F-FDG PET after Transplantation of Human Umbilical Cord Blood-derived Mesenchymal Stem Cells in Chronic Epileptic Rats

Human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) may be a promising modality for treating medial temporal lobe epilepsy. ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) is a noninvasive method for monitoring in vivo glucose metabolism. We evaluated the efficacy of hUCB-MSCs transplantation in chronic epileptic rats using FDG-PET. Rats with recurrent seizures were randomly assigned into three groups: the stem cell treatment (SCT) group received hUCB-MSCs transplantation into the right hippocampus, the sham control (ShC) group received same procedure with saline, and the positive control (PC) group consisted of treatment-negative epileptic rats. Normal rats received hUCB-MSCs transplantation acted as the negative control (NC). FDG-PET was performed at pre-treatment baseline and 1- and 8-week posttreatment. Hippocampal volume was evaluated and histological examination was done. In the SCT group, bilateral hippocampi at 8-week after transplantation showed significantly higher glucose metabolism (0.990 ± 0.032) than the ShC (0.873 ± 0.087; P < 0.001) and PC groups (0.858 ± 0.093; P < 0.001). Histological examination resulted that the transplanted hUCB-MSCs survived in the ipsilateral hippocampus and migrated to the contralateral hippocampus but did not differentiate. In spite of successful engraftment, seizure frequency among the groups was not significantly different. Transplanted hUCB-MSCs can engraft and migrate, thereby partially restoring bilateral hippocampal glucose metabolism. The results suggest encouraging effect of hUCB-MSCs on restoring epileptic networks.     

人脐血间充质干细胞的培养条件比较

目的摸索人脐血间充质干细胞（mesenchymal stem cell,MSC）的培养条件。方法根据不同采血量、首次换液时间、胎龄、不同培养基对样本分组，比较不同培养条件对脐血中的间充质干细胞原代生长的影响，以流式细胞仪对培养出的间充质干细胞进行细胞表面标志检测。结果在相同条件下，取10ml的脐血能较大程度培养出间充质干细胞；观察首次换液时间在培养后96h较为合适，延长换液时间有利于数量不占优势的单核细胞充分贴壁：早产胎儿的脐血培养出的间充质干细胞成功率较高；胎牛血清的质和量决定了培养成功与否。培养出的间充质干细胞不表达造血细胞系的标志（CD34、CD45、CD14）及内皮细胞的标志（CD106），强表达CD29、CD44、CD13。结论样本量、首次换液时间、胎龄、培养基的质和量对MSCs的成活、生长有关键作用。     

Transplantation and Tracking of the Human Umbilical Cord Mesenchymal Stem Cell Labeled with Superparamagnetic Iron Oxide in Deaf Pigs

The purpose of this study was to establish a safe and effective approach to label the human umbilical cord mesenchymal stem cells (UC-MSCs) derived from the Wharton's Jelly with superparamagnetic iron oxide (SPIO) nanoparticles as a cell tracer. The cytotoxicity of the SPIO was screened in vitro by cytochemical experiments. The results showed the new infection protocol of SPIO-Lip2000 mixture had high efficiency and the optimal labeling concentration was a 50 μg/ml SPIO suspension. Transmission electron microscope (TEM) confirmed the distribution of the intracellular SPIO. We transplanted the labeled UC-MSCs into the sensorineural hearing loss (SNHL) minipigs at 1 week after noise exposure. Auditory brainstem response results demonstrated the transplantation of UC-MSCs was an efficient therapy for SNHL. The positive sediments in cochlear blood vessels, the bony wall of scala tympani, and spiral ganglion nerve fibers were found in the stem cell recipients' cochlea. We did not detect iron elements in the inner/outer hair cells' stereocilia, cuticular plate, or pillar cells from the basal to apex turns of the stem cell recipients' cochlea. In addition, TEM found SPIO in the medulla oblongata and the cerebrum in the SNHL minipigs after stem cell transplantation. In conclusion, we established a safe and effective approach to labeled human UC-MSCs derived from Wharton's Jelly by using SPIO nanoparticles as a cell tracer in vitro and in vivo. This protocol showed a wide promising application in stem cell therapy and tracing in vivo for experiments with large mammals. Anat Rec, 303:494–505, 2020. © 2019 American Association for Anatomy     

Transplantation of Mesenchymal Stem Cells for Acute Spinal Cord Injury in Rats: Comparative Study between Intralesional Injection and Scaffold Based Transplantation

Experimental stem cell therapy for spinal cord injury (SCI) has been extensively investigated. The selection of effective cell transplantation route is also an important issue. Although various types of scaffold have been widely tried as a carrier of stem cells to the injured spinal cord, there was little comparative study to investigate the efficacy of transplantation comparing with conventional transplantation route. A total of 48 Sprague-Dawley rats were subjected to standardized SCI, followed by transplantation of allogeneic mesenchymal stem cells (MSCs), either via intralesional injection (IL group), or via the poly (lactic-co-glycolic acid) (PLGA) scaffold (IP group) or chitosan scaffold (IC group). Engraftment and differentiation of the transplanted cells, expression of neurotrophic factors in the injured spinal cord, and functional recovery were compared with those of the control group. The mean numbers of engrafted MSCs in the IL, IP, and IC groups were 20.6 ± 0.7, 25.6 ± 1.7 and 26.7 ± 1.8 cells/high power filed (HPF), respectively. Results showed higher success rate of MSCs engraftment in the scaffold groups compared to the IL group. Expression of neuroprotective growth factors in the SCI lesions showed no significant differences between the IL, IP, and IC groups. The mean Basso, Beattie and Bresnahan locomotor scales at 6 weeks post-transplantation in the IL, IP, IC, and control groups were 7.9 ± 1.1, 7.9 ± 2.1, 8.7 ± 2.1, and 2.9 ± 1.0, respectively. The functional improvement was most excellent in the IC group. The scaffold based MSC transplantation for acute SCI presented the better cell engraftment and neuroprotective effect compared to the intralesional injection transplantation.     

GM1体外诱导人脐带血间充质干细胞分化为神经样细胞研究

目的 研究单唾液酸四己糖神经节苷脂通过体外诱导人脐带间充质干细胞分化为神经样细胞并探索其最佳诱导浓度.方法 取足月妊娠剖宫产健康胎儿的脐带,剔除脐动脉和脐静脉,用酶消化法获得MSCs,贴壁培养,采用流式细胞技术行细胞表型检测.扩增后,取第4代细胞,分为A、B、C、D、E5组,前4组为实验组,E组为对照组,实验组各组GM1浓度分别为:A组50μg/mL、B组100μg/mL、C组150μg/mL、D组200μg/mL,诱导液用L-DMEM培养基配制,对照组仅使用L-DMEM培养基.观察5组诱导人脐带血间质干细胞向神经样细胞分化的作用,每60min观察细胞诱导前后的形态,在第360min时采用免疫细胞染色法检测胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、神经丝蛋白(neurofilaments protein H,NF-H)以及神经元特异性标记物微管结合蛋白-2(microtubule associated protein 2,MAP-2)的表达情况,并计算阳性细胞率.结果 ①大部分原代细胞在接种9h后贴壁,呈多边形、菱形,之后变为长梭形,细胞开始以漩涡、放射状生长.②P3、P5和P10代细胞表面的分子标记经流式细胞术检测发现,均表达CD105、CD90和CD73,却不表达HLA-DR、CD19、CD11b、CD45以及CD34.③诱导至第360分钟后,实验组各组细胞均有神经样细胞出现,表现为细胞胞体收缩成椭圆形,伸出较长突起,以双极细胞居多.免疫细胞化学检测显示实验组各组NF-H、MAP-2表达阳性,胶质纤维酸性蛋白GFAP表达为阴性,C组(150μg/mL)细胞NF-H、MAP-2阳性表达率最高.对照组细胞诱导前后变化不明显.结论 GM1可以诱人脐带间充质干细胞向神经样细胞分化,150μg/mL为最合适诱导剂量.     

Effects of Transplantation with Marrow-Derived Mesenchymal Stem Cells Modified with Survivin on Renal Ischemia-Reperfusion Injury in Mice

Purpose

To determine whether renal injury induced by ischemia-reperfusion (I/R) could be further improved by mesenchymal stem cells (MSCs) modified with survivin.

Materials and Methods

Lentiviral vectors were used to introduce the survivin gene into MSCs and the MSCs modified with survivin were transplanted into established mice models of renal I/R injury. Seven days later, serum creatinine (Scr) and blood urea nitrogen (BUN) were measured and the survival of MSCs was determined. Hematoxylin and eosin staining was used to assess renal pathological change. The expressions of hepatocyte growth factor (HGF) and basic fibroblast growth factor (bFGF) in kidney tissue were detected by western blot.

Results

Mice transplanted with survivin-modified MSCs demonstrated good renal function recovery with Scr and BUN decline close to normal levels and improvement of renal I/R injury repair. Additionally, the survival of transplanted MSCs modified with survivin was enhanced and the expression of HGF and bFGF in kidney tissue was increased.

Conclusion

Our results demonstrated that MSCs engineered to over-express survivin could enhance their therapeutic effect on renal I/R injury in mice, probably via the improved survival ability of MSCs and increased production of protective cytokines in ischemic tissue.     

The Effect of Umbilical Cord Blood Derived Mesenchymal Stem Cells in Monocrotaline-induced Pulmonary Artery Hypertension Rats

Pulmonary arterial hypertension (PAH) causes right ventricular failure due to a gradual increase in pulmonary vascular resistance. The purposes of this study were to confirm the engraftment of human umbilical cord blood-mesenchymal stem cells (hUCB-MSCs) placed in the correct place in the lung and research on changes of hemodynamics, pulmonary pathology, immunomodulation and several gene expressions in monocrotaline (MCT)-induced PAH rat models after hUCB-MSCs transfusion. The rats were grouped as follows: the control (C) group; the M group (MCT 60 mg/kg); the U group (hUCB-MSCs transfusion). They received transfusions via the external jugular vein a week after MCT injection. The mean right ventricular pressure (RVP) was significantly reduced in the U group after the 2 week. The indicators of RV hypertrophy were significantly reduced in the U group at week 4. Reduced medial wall thickness in the pulmonary arteriole was noted in the U group at week 4. Reduced number of intra-acinar muscular pulmonary arteries was observed in the U group after 2 week. Protein expressions such as endothelin (ET)-1, endothelin receptor A (ERA), endothelial nitric oxide synthase (eNOS) and matrix metalloproteinase (MMP)-2 significantly decreased at week 4. The decreased levels of ERA, eNOS and MMP-2 immunoreactivity were noted by immnohistochemical staining. After hUCB-MSCs were administered, there were the improvement of RVH and mean RVP. Reductions in several protein expressions and immunomodulation were also detected. It is suggested that hUCB-MSCs may be a promising therapeutic option for PAH.

Graphical Abstract

相似文献   

Preclinical Study of Cell Therapy for Osteonecrosis of the Femoral Head with Allogenic Peripheral Blood-Derived Mesenchymal Stem Cells

PurposeTo explore the value of transplanting peripheral blood-derived mesenchymal stem cells from allogenic rabbits (rPBMSCs) to treat osteonecrosis of the femoral head (ONFH).ResultsAfter mobilization, the cultured rPBMSCs expressed mesenchymal markers of CD90, CD44, CD29, and CD105, but failed to express CD45, CD14, and CD34. The colony forming efficiency of mobilized rPBMSCs ranged from 2.8 to 10.8 per million peripheral mononuclear cells. After local transplantation, survival of the engrafted cells reached at least 8 weeks. Therein, BMP-2 was up-regulated, while PPAR-γ mRNA was down-regulated. Additionally, bone density and bone trabeculae tended to increase gradually.ConclusionWe confirmed that local transplantation of rPBMSCs benefits ONFH treatment and that the beneficial effects are related to the up-regulation of BMP-2 expression and the down-regulation of PPAR-γ expression.     

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.     

人脐血间充质干细胞体外诱导分化为类雪旺细胞的初步研究

目的:体外定向诱导人脐血间充质干细胞(HUCBMSCs),分化为类雪旺细胞(SC-like).方法:(1)采用Ficoll密度梯度离心法分离健康产妇脐带血中单个核细胞进行体外培养,用流式细胞术检测细胞表达的表面抗原CD90,SH2,CD34和CD45.(2)第3次传代所得的HUCBMSCs,加入加有β-巯基乙醇(β-ME)、全反式黄酸(RA)、Forskolin、b-FGF、PDGF、HRG的含10%胎牛血清(FBS)的低糖DMEM培养基(L-DMEM)诱导,7 d后免疫组织化学染色法检测.结果:(1)HUCBMSCs在体外培养以梭形细胞为主;流式细胞仪检测显示,细胞高表达表面抗原CD90和SH2,低表达表面抗原CD34和CD45.(2)诱导7 d后,细胞免疫组化显示,GFAP阳性率为81.88%±2.43%.结论:在一定条件下,HUCBMSCs可以在体诱导分化为SC-like,组成人工神经,移植修复周围神经缺损.     

慢性心功能不全时经主动脉移植干细胞的可行性研究

心肌梗死或/和慢性心功能不全时,心脏干细胞移植是一项颇有应用前景的新的治疗技术。但是,对于非缺血性心脏病所致的慢性心功能不全,目前所采用的移植路径有一定的局限性。本试验拟研究慢性心功能不全时,封堵主动脉窦上部经主动脉根部移植干细胞是否可行。阿霉素所致的慢性心功能不全兔模型,采用双球囊封堵主动脉窦上部经主动脉根部自体移植骨髓单核细胞,4周后评价心功能。在封堵主动脉窦上部经主动脉根部移植干细胞时,无1例因移植手术死亡。双球囊充盈时造影显示,主动脉窦显影良好,大部分情况下,左、右冠状动脉可显影。骨髓单核细胞移植4周后,左室射血分数改善明显(P=0 .0 34)。所以,慢性心功能不全时,封堵主动脉窦上部经主动脉根部移植干细胞安全可行。