间充质干细胞防治慢性移植物抗宿主病：进展与挑战

慢性移植物抗宿主病(cGVHD)是异基因造血干细胞移植后的主要并发症，也是导致非复发死亡的主要原因，因其病理生理过程复杂，常规糖皮质激素联合免疫抑制药的防治有效率不足50%。对于糖皮质激素抵抗的cGVHD患者需启动二线治疗，然而目前的二线治疗方法尚未形成共识，且治疗效果不佳。间充质干细胞(MSC)是最常见的成体干细胞之一，因其具有多维度、多靶点的免疫调控功能，已被广泛应用于cGVHD的预防及治疗，且大量研究证实了MSC治疗cGVHD的安全性和有效性，有望成为cGVHD防治的新策略。本文主要围绕MSC防治cGVHD的研究进展、作用机制及存在的问题等方面进行综述，以期为今后优化MSC治疗方案、提高cGVHD防治效果提供新思路。

Prevention and treatment of chronic graft-versus-host disease by mesenchymal stem cells: advances and challenges

Chronic graft-versus-host disease (cGVHD) is the main complication after allogeneic hematopoietic stem cell transplantation, which is also the major cause of non-relapse -related death. Due to its complex pathophysiological process, the response rate of conventional glucocorticoids combined with immunosuppressants is less than 50%. Second-line therapy should be given for patients with glucocorticoid-resistant cGVHD. Nevertheless, no consensus has been reached on current second-line therapy and the therapeutic effect is relatively poor. Mesenchymal stem cell (MSC) is one of the most common adult stem cells. Due to multi-dimensional and multi-target immune regulating function, MSC has been widely applied in the prevention and treatment of cGVHD. In addition, accumulated studies have confirmed the safety and efficacy of MSC in the treatment of cGVHD, which is expected to become a novel strategy for the prevention and management of cGVHD. In this article, research progress, mechanism and existing problems of prevention and treatment of cGVHD by MSC were reviewed, aiming to provide novel ideas for optimizing therapeutic regimens of MSC and enhancing the prevention and treatment effect of cGVHD in subsequent research.