人脐带间充质干细胞体外扩增和向神经元样细胞定向诱导分化的研究

目的探讨人脐带间充质干细胞(MSCs)的体外分离、纯化、扩增和向神经元样细胞的定向诱导分化,以期为脐带MSCs的神经移植提供理论依据。方法无菌条件下收集剖宫产新生儿脐带,酶消化法获取MSCs,进行培养。用流式细胞仪检测MSCs的表面标志。取扩增3,5,10代的MSCs分别向神经元样细胞诱导,用免疫组化和RT-PCR法检测神经元样细胞特异性标志。结果脐带富含MSCs,且脐带MSCs(UCMSCs)强表达CD13、29、CD44、CD105,弱表达CD106,不表达CD34、CD11a、CD14、CD33、CD45。神经条件培养基诱导后的细胞平均有70%左右呈现典型的神经元样表型。免疫组化法检测发现不同代数的MSCs经诱导后均表达nestin,NSE,NeuN,NF-M,弱表达GFAP。RT-PCR显示诱导后NSEmRNA表达增加。结论MSCs存在于人脐带中,并且在体外有较强的增殖能力,特定条件下能够分化为神经元样细胞。     

无血清神经培养基体外培养大鼠骨髓源性神经干细胞

背景：传统的胚胎来源和脑来源的神经干细胞由于取材困难,并受伦理道德的约束,应用受到极大限制。 目的：拟利用无血清神经培养基体外培养大鼠骨髓源性神经干细胞。 方法：抽取大鼠股骨和胫骨的骨髓,采用全骨髓培养及贴壁筛选法分离培养骨髓间充质干细胞,流式细胞仪检测细胞周期及细胞免疫表型,油红O染色及茜素红染色鉴定其成骨、成脂能力。取传至4~6代的大鼠骨髓间充质干细胞,加入含表皮生长因子、碱性成纤维生长因子、B27的DMEM/F12无血清神经培养基进行诱导,采用免疫荧光染色及流式细胞仪予以鉴定。 结果与结论：P5骨髓间充质干细胞(91.5±3.1)%处于G1期,高表达CD90及CD29,不表达CD45及CD34,成脂诱导后在胞质中可见桔红色脂滴,成骨诱导后可见黑色矿化结节。骨髓源性神经干细胞巢蛋白免疫荧光染色呈阳性,流式细胞仪检测其阳性率为(97.2±1.1)%,NSE,β-Tubulin,GFAP及MAP-2抗原免疫荧光染色均呈阳性表达。表明在无血清神经培养基中加入特定生长因子,骨髓间充质干细胞可诱导为神经干细胞;在体外适当条件下,骨髓源性神经干细胞具有增殖和分化为神经元、星形胶质细胞及少突胶质细胞的能力。     

人脐带沃顿胶间充质干细胞与脑肿瘤干细胞的共培养**

背景：人脐带沃顿胶间充质干细胞满足了国际细胞治疗协会规定的间充质干细胞的特点,能够向骨、软骨、脂肪、肌肉、神经细胞诱导分化并支持其他干细胞的扩增,对免疫系统有良好的耐受性,对肿瘤有定向迁徙性。 目的：观察人脐带沃顿胶间充质干细胞与脑肿瘤干细胞体外共培养后,脑肿瘤干细胞的生物学变化。 方法：以原位法培养人脐带沃顿胶间充质干细胞,以酶消化法培养人脑肿瘤组织脑肿瘤干细胞,以细胞传代法获取第3代细胞。应用不添加任何生长因子的无血清培养基将两种细胞在24孔板中进行直接共培养。第3,7天应用流式细胞术检测细胞CD133表达;应用免疫荧光法检测贴壁细胞巢蛋白和胶质纤维酸性蛋白表达;将第3天离心所得的共培养上清液重悬第3代脑肿瘤干细胞并与正常培养悬浮的第3代脑肿瘤干细胞置入96孔板中,应用酶标仪检测两组细胞生长曲线的差异。 结果与结论：两种细胞共培养后在倒置显微镜下可见脑肿瘤干细胞球随着培养时间的增加出现分解、贴壁、分化现象;贴壁的脑肿瘤干细胞免疫荧光染色胶质纤维酸性蛋白和巢蛋白均阳性。恶性程度高的脑肿瘤组织培养的脑肿瘤干细胞表达CD133量越高,而与沃顿胶间充质干细胞共培养后随着时间的变化均出现CD133表达量降低。共培养3 d的上清液培养的脑肿瘤干细胞与正常培养基培养的脑肿瘤干细胞相比,增殖明显受到抑制。结果显示沃顿胶间充质干细胞与脑肿瘤干细胞体外共培养后可限制脑肿瘤干细胞表面标记物CD133的阳性率以及细胞增殖能力并促使其分化。     

体外大鼠骨髓间充质干细胞多向分化潜能的研究

目的研究体外大鼠骨髓间充质干细胞向神经细胞等不同组织细胞多向分化的潜能。方法从SD大鼠股骨骨髓中获得间充质干细胞,原代培养后1∶2传代,传至第5代后分为普通传代培养组、神经细胞诱导组、成骨细胞诱导组和脂肪细胞诱导组。倒置相差显微镜下观察各组细胞生长情况、形态变化以及矿化结节和脂肪细胞的形成;流式细胞检测第5代大鼠骨髓间充质干细胞表面抗原CD29、CD44、CD90、CD31、CD34、CD45;免疫组织化学检测普通传代培养组和神经细胞诱导组细胞巢蛋白、微管相关蛋白-2、胶质纤维酸性蛋白和神经元特异性烯醇化酶等神经细胞相关蛋白的表达情况。结果大鼠骨髓间充质干细胞呈贴壁生长,细胞扩增至第5代时形态趋于一致,呈梭形。大鼠骨髓间充质干细胞表面抗原CD29(99.83%)、CD44(99.77%)、CD90(99.86%)均呈阳性表达,CD31(0.83%)、CD34(1.78%)、CD45(2.90%)无表达。在体外,普通传代培养细胞仅巢蛋白呈阳性表达;由神经细胞诱导的细胞巢蛋白、微管相关蛋白-2、胶质纤维酸性蛋白和神经元特异性烯醇化酶均呈阳性表达,且形态类似神经细胞;由成骨细胞诱导的细胞质内可见矿化结节形成;由脂肪细胞诱导的细胞质内出现多个猩红色呈簇状的脂肪滴。结论大鼠骨髓间充质干细胞易于提取、纯化和扩增,可于体外自发表达神经干细胞标志蛋白,并可通过诱导向神经细胞、成骨细胞及脂肪细胞分化。提示骨髓间充质干细胞不仅具有多向分化潜能,而且可能具有自发向神经干细胞分化的特性。     

脐带间充质干细胞分离、鉴定与神经分化

目的原代分离培养脐带间充质干细胞（UCMSCs），并就其向神经细胞方向分化潜能予以研究，为脑创伤后神经组织再生修复提供理论依据。方法采用原代贴壁培养法分离培养人UCMSCs，取第4代UCMSCs进行流式细胞术检测UCMSCs表面特异标志物表达；经神经诱导后应用细胞免疫荧光技术检测神经胶质细胞标志物胶质纤维酸性蛋白（GFAP）表达和神经元标志物神经元特异性烯醇化酶（NSE）、微管相关蛋白（MAP-2）表达。结果流式细胞术结果显示UCMSCs强表达CD29、CD44、CD105，极低表达CD31、CD34、CD45，检测结果符合人UCMSCs特征。细胞免疫荧光结果显示UCMSCs经诱导后GFAP阳性表达率为56．23％，NSE阳性表达率为22．15％，MAP-2阳性表达率为27．34％。结论采用原代细胞贴壁培养法可成功分离培养人UCMSCs，在适当诱导条件下，UCMSCs可实现向神经细胞方向的成功分化，为脑创伤后神经组织修复、再生提供可能。     

体外培养人骨髓间充质干细胞向表皮细胞分化及表皮细胞角蛋白的表达

背景：动物实验已经证实骨髓间充质干细胞体外诱导可分化为表皮细胞。 目的：观察体外培养条件下人骨髓间充质干细胞向表皮细胞的分化及表皮细胞角蛋白表达。 方法：采用Ficoll-Paque密度梯度离心法提取人胚胎骨髓间充质干细胞,以免疫细胞化学及流式细胞仪测定细胞表面CD33、CD34标记物进行鉴定。取第3代骨髓间充质干细胞以30%条件培养基诱导其向表皮细胞分化,免疫细胞化学染色观察诱导后细胞形态与细胞角蛋白水平变化。 结果与结论：采用密度梯度离心法从人胚胎骨髓中分离培养得到细胞成分均一的骨髓间充质干细胞。骨髓间充质干细胞经体外诱导后,出现细胞角蛋白19表达阳性细胞,说明骨髓间充质干细胞在体外诱导后可能发生向表皮细胞分化。     

预诱导与全反式维甲酸并脑源性神经营养因子体外诱导骨髓基质干细胞向神经元样细胞的分化

背景：骨髓基质干细胞可定向诱导分化为神经元样细胞,但目前培养的方法尚不统一。 目的：采用预诱导与全反式维甲酸和脑源性神经营养因子为培养体系,拟在体外诱导大鼠骨髓基质干细胞向神经细胞分化。 设计、时间及地点：细胞学体外观察,于2007-12/2008-06在新疆医科大学第一附属医院医学研究中心干细胞室完成。 材料：清洁级雄性SD大鼠2只,由新疆医科大学动物试验中心提供。 方法：采用贴壁法体外分离培养大鼠骨髓基质干细胞,经反复传代细胞逐渐纯化。取生长状态良好的第3代骨髓基质干细胞,按8×107 L-1密度接种后,改换含10 μg/L碱性成纤维细胞生长因子、20 μg/L表皮生长因子的神经干细胞培养体系进行预诱导,48 h后去除预诱导液,加入含10 μg/L脑源性神经生长因子、1 μmol/L全反式维甲酸的神经干细胞培养体系定向诱导骨髓基质干细胞分化为神经细胞。以未诱导的骨髓基质干细胞作为对照。 主要观察指标：流式细胞仪检测第3代骨髓基质干细胞表面标志的表达,诱导后免疫荧光染色和流式细胞仪检测巢蛋白阳性的表达,免疫荧光染色鉴定神经元特异性烯醇化酶和胶质纤维酸性蛋白的表达。 结果：第3代骨髓基质干细胞CD29,CD44表达率分别为97.1%,99%,CD45表达率为0.5%,CD34呈阴性表达。预诱导48 h后巢蛋白阳性率为24%,而对照组仅为4.6%。诱导48 h后,巢蛋白染色呈阳性,并可见大量神经元特异性烯醇化酶和胶质纤维酸性蛋白阳性细胞出现;对照组均呈阴性表达。 结论：神经干细胞培养体系联合全反式维甲酸与脑源性神经生长因子,可在体外高效、稳定地诱导骨髓基质干细胞转化为神经元样细胞,并进一步向神经元和神经胶质细胞方向分化。     

肝细胞生长因子与成纤维生长因子联合诱导人脐带间充质干细胞向肝样细胞的分化

背景：成纤维生长因子可促进间充质干细胞增殖、贴壁生长,但对其诱导间充质干细胞向肝细胞分化的实验报道为数不多。当肝细胞生长因子质量浓度达1 μg/L时,可促进肝细胞有丝分裂,它是正常肝细胞最强的促有丝分裂剂。 目的：体外分离培养人脐带间充质干细胞,拟揭示其生物学特性及在细胞因子联合诱导下向肝样细胞分化的能力。 设计、时间及地点：细胞学体外观察,于2008-08/2009-04在暨南大学血研所完成。 材料：脐带取自健康足月胎儿,产妇对实验知情同意,由广州华侨医院提供。肝细胞生长因子、成纤维生长因子为美国Peprotech产品。 方法：Ⅳ型胶原酶消化+差速贴壁法分离培养人脐带间充质干细胞,取传至第3代细胞,进行细胞表面抗原分析、细胞周期测定,检测其成脂、成骨能力。取第5代细胞,调整细胞密度为5×109 L-1,分为2组：对照组用含体积分数为5%胎牛血清的DMEM/F12培养液培养;诱导组在其基础上,添加20 μg/L肝细胞生长因子、10 μg/L成纤维生长因子联合诱导其向肝样细胞分化。 主要观察指标：人脐带间充质干细胞的生物学特性,人脐带间充质干细胞体外向肝样细胞的分化情况。 结果：成功从人脐带中分离并纯化得到间充质干细胞,第3代细胞92.2%处在G0/G1期;表达CD29,CD44,CD105,不表达造血细胞标志CD34,CD45;油红O染色后胞浆中呈现红色颗粒,碱性磷酸酶染色后细胞质呈黑色,具有成脂、成骨能力。经肝细胞生长因子、成纤维生长因子联合诱导10 d后,RT-PCR及Western blot检测结果显示细胞表达肝细胞特异性抗原甲胎蛋白、白蛋白,对照组均呈阴性表达。 结论：人脐带中含有丰富的间充质干细胞,其具有较强的多向分化潜能,经肝细胞生长因子与成纤维生长因子联合诱导后,易向肝样细胞分化。     

Wnt信号分子诱导骨髓间充质干细胞向神经元样细胞分化

间充质干细胞可向神经方向转化,但分子机制目前不清楚。 目的：观察Wnt3a和Wnt5a在骨髓间充质干细胞向神经细胞分化过程中的作用。 方法：体外分离培养大鼠骨髓间充质干细胞,传代后通过形态学和流式细胞仪检测细胞表面标志物CD14,CD44,CD9,CD34,CD45表达。采用碱性成纤维细胞生长因子分别联合Wnt3a和Wnt5a的诱导方案,免疫组织化学法和RT-PCR检测Wnt3a、Wnt5a在骨髓间充质干细胞向神经样细胞分化过程中的作用。 结果与结论：骨髓间充质干细胞为长梭形,表面标志物CD9,CD44高表达,CD34,CD45低表达。诱导后细胞Wnt3a诱导组巢蛋白,神经元特异性烯醇化酶呈阳性,而胶质纤维酸性蛋白无明显表达,细胞活力良好。Wnt5a诱导组巢蛋白呈弱阳性表达,而神经元特异性烯醇化酶及胶质纤维酸性蛋白阴性。RT-PCR结果显示Wnt3a诱导组巢蛋白在诱导前后均有表达,神经元特异性烯醇化酶在诱导后5 d可见明显的扩增条带,10 d后更加明显。胶质纤维酸性蛋白在诱导10 d后出现较弱的扩增条带。提示Wnt3a分子能够促进体外培养的间充质干细胞向神经元样细胞分化。     

脐血间充质干细胞体外扩增和向神经元样细胞的定向诱导*

背景：骨髓间充质干细胞存在取材困难、供体有限、可能病毒污染等缺陷,限制了其临床应用,而目前已证实间充质干细胞不仅存在于骨髓,还存在于外周血,尤其是脐血。 目的：探讨人脐血间充质干细胞的体外分离、扩增纯化方法及其神经分化潜能。 设计、时间及地点：应用研究,体外细胞学观察,于2005-10/2007-10在南方医科大学神经生物学教研室完成。 材料：新鲜脐血来自南方医科大学南方医院足月剖宫产新生儿脐带,取脐血前征得新生儿监护人的知情同意。 方法：无菌条件下收集脐血,去除红细胞,采用低糖DMEM/F12进行培养;取扩增第3或4代的人脐血间充质干细胞,培养基中添加碱性成纤维细胞生长因子、表皮生长因子和全反式维甲酸。 主要观察指标：用流式细胞仪检测贴壁细胞的表面标志;用免疫组化法检测诱导后细胞神经元特异性烯醇化酶、巢蛋白、神经元特异性核内抗原和神经丝蛋白表达。 结果：人脐血间充质干细胞强表达CD13、CD 29、CD44和CD105,弱表达CD106,不表达CD34、CD11a、CD14、CD33和CD45。培养基添加神经营养因子诱导后的细胞呈现典型的神经元样表型,诱导后高表达巢蛋白、神经元特异性烯醇化酶、神经元特异性核内抗原和神经丝蛋白。 结论：人脐血富含间充质干细胞,分离培养后于培养基添加神经营养因子能够分化为神经元样细胞。     

Epilepsy and anomalies of neuronal migration: MRI and clinical aspects

Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.     

Hepatic Considerations in the Use of Antiepileptic Drugs

Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.     

Vascular Malformations and Epilepsy: Clinical Considerations and Basic Mechanisms

Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Carbamazepine Efficacy and Utilization in Children

Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.