细胞移植在白癜风治疗中的应用

Cell transplantation in the treatment of vitiligo

目的:介绍细胞移植治疗白癜风的各种方法及效果。资料来源:应用计算机检索Medline 1996-01/2006-12与细胞移植治疗白癜风相关的文章,检索词为“vitili,gotransplantatio,nMelanocyte-keratinocyte cell,epidermal cell”,限定文献语种为“English”;同时检索万方数据库2000-01/2006-12相关文章,检索词为“白癜风,移植,黑素细胞,表皮细胞”,限定文献语种为中文。资料选择:共检索到相关文献180余条,选择细胞移植治疗白癜风临床应用,以及相关的表皮细胞或黑素细胞培养文章,无论是否随机、有无对照组均纳入,排除综述类及重复文献。资料提炼:对筛选的文章进一步查找全文,纳入31篇作为参考文献进行综述。31篇中介绍表皮细胞培养移植的8篇,介绍自体培养的黑素细胞移植的13篇,5篇论述表皮细胞悬液移植情况,报道同种异体黑素细胞移植的5篇。资料综合:文章介绍了4种移植治疗白癜风的不同方法,包括自体表皮细胞培养移植、自体培养的和非培养的黑素细胞移植、以及同种异体黑素细胞移植。治疗方法的选择因人而异,主要根据白斑的部位和大小。自体培养和非培养的黑素细胞移植治疗白癜风比传统的表皮移植效果好,用少量供皮区可以治疗大面积皮损,很有前景,但还有诸如细胞繁殖方法、移植技术、费用以及安全性等问题需要解决。结论:细胞移植是治疗白癜风的一个重要手段,但目前关于细胞移植的临床经验并不多,有的还在研究和探索阶段,所以应该小心谨慎。

OBJECTIVE： To introduce the methods and outcomes of cell transplantation therapy for vitiligo. DATA SOURCES： An online search on Medline was undertaken to identify the articles related to the cell transplantation in treatment of vitiligo published between January 1996 and December 2006, with the keywords of ＂vitiligo, transplantation, melanocyte-keratinocyte cell, epidermal cell＂, and language was limited to English; meanwhile, the related Chinese articles were retrieved in Wanfang database from January 2000 to December 2006 by inputting the words of ＂vitiligo, transplantation, melanocyte-keratinocyte cell, epidermal cell＂. STUDY SELECTION： Over 180 literatures were screened out, and those referring to the clinical application of cell transplantation in treatment of vitiligo and the culture of epidermal cell or melanocyte-keratinocyte cell were selected, no matter randomized or controlled group involvement. Reviews and repeated articles were deleted. DATA EXTRACTION： All the included articles were looked up for full-texts, and 31 of them were reviewed as references, comprising 8 papers of introducing cultured transplantation of epidermal cell, 13 papers of introducing the transplantation of melanocyte-keratinocyte cell after autoallergic culture, 5 discussions of the suspension transplantation of epidermal cell, and 5 reports of the transplantation of homologous melanocyte-keratinocyte cell. DATA SYNTHESIS： This study introduces four kinds of transplantation therapy for vitiligo, including the cultured transplanation of epidermal cell, the transplantation of cultured or uncultured melanocyte-keratinocyte cell, and the transplantation of homologous melanocyte-keratinocyte cell. The therapy choice mainly depends on the locus and size of vitiligo. Compared with conventional epidermal cell transplantation, the transplantation therapy of cultured or uncultured melanocyte-keratinocyte cell can obtain better curative effect on vitiligo, a large area of skin defect can be healed by a small quantity of donor skin, however, there are many unsolved problems, such as cell proliferation, transplantation, cost and safety. CONCLUSION： Cell transplantation plays a crucial role on treating vitiligo, but still need exploration for lack of clinical experience, and it is scrupulous to apply cell transplantation.