脂肪干细胞在同种异体复合组织移植中的作用及其临床应用展望

同种异体复合组织移植是临床修复重建的重要手段,但术后长期应用免疫抑制剂所导致的副作用仍是亟待解决的难题,细胞治疗联合传统免疫抑制剂治疗有望解决这一难题。间质干细胞,特别是脂肪干细胞,被认为可用于延长移植物存活及改善免疫排斥情况的发生。其在同种异体复合组织移植中发挥的作用包括旁分泌免疫调节因子抑制免疫排斥反应、诱导调节性T细胞产生、形成嵌合体诱导免疫耐受,以及改善移植过程中缺血再灌注损伤等。但是,该方法要真正应用于临床前,相关问题如使用剂量、时机及安全性等仍需经过进一步深入研究。

Effectiveness and Clinical Perspectives of Adipose Derived Stem Cell Based Therapy in Vascularized Composite Allotransplantation

Vascularized composite allograft transplantation is an important method in tissue repair and reconstruction. However, the side effects of immunosuppressive therapy remains the great burden of these patients and lacks an appropriate solution. There is a growing attention to the emerging cell therapy, like mesenchymal stem cell, especially adipose derived mesenchymal stem cell,in combine with immunosuppressive agents which may prolong the graft survival and reduce the side effects of immunosuppressor. The underlying mechanism of adipose derived mesenchymal stem cell therapy may include the paracrine of immunomodulatory molecules, the induction of regulatory T cells, mixed chimerism and the reduction of ischemia reperfusion injury. Moreover, the safety, timing and dosage of adipose derived stem cell should be tested and determined before clinical application.