干细胞移植治疗脊髓损伤的临床应用现状

神经干细胞不牵涉伦理学纠纷,但体外分离纯化技术要求严格,费用昂贵,使得神经干细胞在脊髓损伤修复中的应用研究进展缓慢。胚胎干细胞最早用于治疗脊髓损伤,移植后胚胎干细胞能够存活并且向脊髓损伤部位迁移分化成神经元,但由于取材来源的限制以及难以回避的伦理学问题成为其临床应用的障碍,此外未分化的胚胎干细胞具有潜在的致瘤性。骨髓干细胞除具备干细胞的基本特点外,还具有可塑性,表现为骨髓干细胞在某些信号的影响下,锚靠一类组织并分化成该组织细胞,同时骨髓干细胞能够分泌一些营养物质促进内源性细胞的增殖和生长。与其他移植细胞相比,骨髓干细胞易于提取分离,可行自体移植且组织相容性好,因此便于临床应用。对于干细胞治疗脊髓损伤的移植方式,目前大体有3种：局部种植、经腰穿途径、经静脉途径,但尚不清楚何种方式更合适。

Clinical application of stem cell transplantation in treating spinal cord injury

Research progress regarding the nerve stem cell in repairing spinal cord injury was slow due to the strict and expensive separation and purification techniques of the nerve stem cells, even though nerve stem cells therapy did not involved in ethics dispute. The embryo stem cell are used for treating the spinal cord injury at the early time, which could survive, migrated to the spinal cord damage spot, differentiate into the neuron after transplant, but its clinical practice is blocked by ethics questions and limited resource, as well as the latent oncogenicity of the undifferentiating embryo stem cells. The marrow stem cell has the stem cell essential feature and plasticity, which could anchor a kind of organization and differentiate into this organ cell under certain signal influence, meanwhile, the marrow stem cell, can secrete some nutrients that promoted endogene cell multiplication and growth. Compared with other transplant cell, the marrow stem cell is characterized by easy to separate and good organization compatibility, therefore, it is suitable for the clinical practice. Tough the transplant way of stem cell treatment the spinal cord injury had 3 kinds at present roughly: by partial plant way, by lumber puncture and by vein way, it was still not clear which way was the most appropriate one.