干细胞治疗缺血性脑卒中的研究进展

背景：干细胞是一类种类多样,具有自我复制更新能力、多向分化潜能和高度增殖潜能的细胞,其治疗缺血性脑损伤将具有良好的前景。干细胞疗法为缺血性脑卒中的治疗提供了一种新的途径,但其机制尚不能完全明确。目的：综述干细胞的类型及其治疗缺血性脑卒中机制的研究进展。方法：第一作者应用计算机检索1992年1月至2012年9月PubMed数据库、中国期刊全文数据库有关干细胞分类及其移植治疗缺血性脑卒中疗效、安全性、机制方面的文章,英文检索词“stem cells,brain ischemic stroke,transplantation,treatment”;中文检索词“干细胞,缺血性脑卒中,移植,治疗”。共检索到168篇相关文献,61篇文献符合纳入标准。结果与结论：虽然干细胞移植治疗脑卒中尚处于动物模型研究阶段,但已初步显示出其广阔的发展前景。多项干细胞移植治疗脑卒中促进功能恢复的临床Ⅰ期或Ⅱ期试验已经完成。干细胞移植治疗缺血性脑卒中的实验病例没有出现不良反应并显示出功能促进效果。干细胞移植治疗缺血性脑卒中存在的主要问题包括干细胞的来源、移植途径、干细胞在宿主体内存活及与宿主脑的整合问题、治疗的有效性以及安全性等。面对已经取得的一些机制研究和临床试验结果,如何安全而迅速地将治疗缺血性脑卒中的干细胞疗法从实验推向临床,仍然是需要努力的方向。

Stem cell therapy for ischemic stroke

BACKGROUND: Stem cells are a kind of cells characterized as species diversity, self-replication and renewal ability, multiple differentiation potential and high proliferation potential. Then, the stem cell treatment for ischemic brain injury would be of great benefit. Stem cell therapy provides a new way for the treatment of ischemic stroke, but the mechanism is still unclear.OBJECTIVE:To describe the types of stem cells and review the mechanism underlying stem cell treatment for ischemic stroke.METHODS: The first author retrieved PubMed database, Chinese Journal Full-text Database for articles related to stem cell classification and effectiveness, safety and mechanism of stem cell therapy for ischemic stroke published from January 1992 to September 2012. The key words were “stem cells, brain ischemic stroke, transplantation, treatment” in English and Chinese, respectively. A total of 168 literatures were retrieved, and 61 articles met the inclusion criteria.RESULTS AND CONCLUSION:Stem cell therapy for ischemic stroke has shown a promising prospect though it is staged in the period of animal models. Stem cell transplantation for promoting functional recovery in the treatment of stroke has been completed in the clinical phase I or phase II trials. Stem cell transplantation for ischemic stroke appears to have no adverse reactions and to promote functional recovery. Main difficulties in stem cell transplantation for treatment of ischemic stroke include sources of stem cells, transplantation approach, stem cell survival in the host body, stem cell integration with the host brain, therapeutic effectiveness and security. Based on the acquired results from the mechanism research and clinical trials, how to safely and quickly apply the stem cell therapy from the experiments to the clinic still needs to work.