间充质干细胞移植修复梗死心肌的策略及效果

背景：很多研究表明间充质干细胞治疗心肌梗死具有极大的潜力。目的：综述目前增强间充质干细胞治疗心肌梗死的移植策略及其移植后疗效评估方法。方法：应用计算机检索PubMed、知网、维普及康健数据库中1995年1月至2012年3月关于增强间充质干细胞移植疗效的文章,在标题和摘要中以“间充质干细胞;心功、血管新生或存活”或“Mesenchymal stem cell;Fuction、Angiogenesis or Survival”为检索词进行检索。选择文章内容与运用不同的移植策略来提高间充质干细胞移植后心功恢复、心肌血管新生及移植细胞存活率这几方面有关,同一领域文献则选择近期发表在权威杂志文章。初检得到220篇文献,根据纳入标准选择20篇文章进行综述。结果与结论：通过间充质干细胞体外扩增后诱导分化并移植是心肌梗死后重建做功心肌的具有潜力的新途径,但因其移植后心肌归巢、分化率及存活率低而应用受限。此外,采取合理方法精确评估移植疗效对后期移植策略选择也至关重要,且心脏结构功能重建、心肌纤维化减轻和毛细血管新生程度3个方面成为主要的评价标准。从心脏整体功能考虑到局部功能评估和由选择合适单成像方式成像到采取“非侵入性融合显像”是目前间充质干细胞移植疗效评价的新进步。通过采用合适的移植策略及疗效评价方法以增强间充质干细胞治疗心肌梗死疗效,值得并需要更进一步研究探讨。

Mesenchymal stem cell transplantation for treatment of myocardial infarction:Transplantation strategy and efficacy evaluation

BACKGROUND:Numerous studies have demonstrated that mesenchymal stem cells exhibit great potential in treatment of myocardial infarction.OBJECTIVE:To review the strategies of mesenchymal stem cell transplantation for treatment of myocardial infarction and evaluate the therapeutic effects after cell transplantation.METHODS:A computer-based online retrieval of PubMed, CNKI, CQVIP and FMJS databases was performed to search papers regarding therapeutic effects of mesenchymal stem cell transplantation with key words “mesenchymal stem cell; function, angiogenesis or survival” in Chinese and English. Papers describing different transplantation methods to enhance heart function recovery, angiogenesis and survivalrate after mesenchymal stem cell transplantation were searched. In the same research field, papers published recently or in high-impact journals were selected. A total of 220 papers were acquired in the initial retrieval. According to inclusion criteria, 20 papers were suitable for final analysis.RESULTS AND CONCLUSION:Stem cell in vitro expansion and differentiation followed by transplantation have emerged as a promising alternative therapeutic approach for cardiovascular disease, but existing strategies are restricted by low cell engraftment, differentiation and survival. In addition, it is also important that reasonable methods should be adopted to accurately assess transplantation efficacy for determining later transplantation strategies. Heart function reconstruction, myocardial fibrosis inhibition and angiogenesis are mainly used as evaluation criteria. From the global to the local function and from the right single imaging to “multimodality noninvasive imaging” are two new developments. How to choose appropriate transplantation strategies and efficacy evaluation method to enhance the efficacy of mesenchymal stem cell therapy needs further studies.