脐血干细胞移植治疗脑卒中的作用与机制

背景:多项研究表明脐血干细胞移植可以改善脑缺血后的神经功能缺损。目的:总结脐血干细胞移植治疗脑卒中的研究进展及其作用机制。方法:由第一作者应用计算机检索2001-01/2011-08 PubMed数据库及万方数据库有关脐血干细胞移植治疗缺血性脑卒中基础研究方面的文献。检索词"umbilical cord blood stem cells,focal cerebral ischemic,transplantation,脐血干细胞,局灶性脑缺血,移植",共检索到文献50篇,最终纳入符合标准的文献30篇。结果与结论:脐血干细胞具有自我更新和多向分化潜能,在适当的诱导下可分化为神经细胞。相关研究表明脐血干细胞能缩减脑卒中大鼠的脑梗死体积并改善行为学预后,其机制包括减轻炎症反应,增加营养因子的分泌,促进血管发生和神经纤维重塑等。虽然脐血干细胞在实验研究上取得了较大进展,但仍有许多问题有待解决,如何提高脐血的利用率,如何限制干细胞的过度增殖,整合到损伤部位的移植细胞是否能发挥功能等,待进一步探讨。

Effect and mechanism of umbilical cord blood stem cells transplantation in the treatment of stroke

BACKGROUND: Many basic and clinical studies have shown that umbilical cord blood stem cells (UCBSCs) transplantation can improve neurological function after focal cerebral ischemia. OBJECTIVE: To summarize the related research and the underlying mechanism of UCBSCs transplantation in the treatment of stroke. METHODS: The first author retrieved PubMed database and Wanfang database for articles of basic research on UCBSCs transplantation for cerebral ischemia published from January 2001 to August 2011. The key words were "umbilical cord blood stem cells, focal cerebral ischemic, transplantation" in English and Chinese. A total of 50 relevant literatures were retrieved, and finally, 30 articles were included according to the inclusion criteria. RESULTS AND CONCLUSION: UCBSCs could be differentiated into nerve cells in appropriate induced conditions with the characters of self-renewal, proliferation, and multi-directional differentiation potential. Related studies had indicated that UCBSCs transplantation could improve neurological disorder and decrease damaged infarct volume. The mechanisms include reducing inflammation, increasing trophic factor secretion, and promoting angiogenesis and nerve fiber reorganization. Greater achievements have been made in the treatment of stroke, but many problems still existed. Some problems need further investigation, for example, how to improve the utilization rate of UCBSCs, prevent excessive cell proliferation and whether these cells can be integrated into the injury site to preserve normal function.