干细胞治疗现状、策略与前景展望

当代医学已从分子治疗向细胞治疗过渡。干细胞治疗对一些重大疾病（糖尿病、中风、心肌梗死、肿瘤等）具有明显疗效，但是现有干细胞治疗方法还存在一些问题。缺乏统一的干细胞分类和鉴定方法以及干细胞制剂质量标准；质量合格的干细胞制剂数量不足；干细胞制剂具有适应证和禁忌证；干细胞治疗需要筛选患者，进行长期随访；此外，近年来干细胞研究和应用还发现其他一些问题，如依赖现象、违规治疗现象等。针对这些问题，提出了一些解决方法和应对策略。未来，随着干细胞治疗管理模式的转变，细胞水平的治疗将向组织水平的治疗发展。通过干细胞技术和组织工程技术融合发展起来的原位治疗，将是干细胞治疗发展的重要方向。利用干细胞活性成分（细胞因子等）或亚单位（囊泡或外泌体）进行治疗，是今后干细胞治疗发展的另一个方向。

Statuses, strategies and prospects of stem cell therapy

Contemporary medicine has a transition from molecular therapy to cell therapy. Stem cell therapy has obvious curative effects on some serious diseases (diabetes, stroke, myocardial infarction, tumor, etc.), but there are still some problems in the existing stem cell therapy. There is a lack of uniform classification and identification methods of stem cells and the quality standards of stem cell agents, the quantity of qualified stem cell agents is insufficient. Stem cell agents have indications and contraindications, and stem cell therapy needs to screen patients for long-term follow-up. In addition, stem cell researches and applications in recent years have also found some other problems, such as feeling of dependency and illegal treatment. To solve these problems, some solutions and coping strategies are put forward. In the future, with the change of stem cell therapy management model, cell level treatment will be developed into tissue-level treatment. In situ therapy, which is developed by combining stem cell technology with tissue engineering technology, will be an important direction of stem cell therapy. The use of stem cell bioactive components (cytokines, etc.) or subunits (vesicles or exosomes) for treatment is henceforth another direction of stem cell therapy.