胃肠道干细胞及胃肠疾病的干细胞移植治疗

Gastrointestinal stem cells and stem cell transplantation for gastrointestinal diseases

目的:对胃肠道干细胞的特性、分布及其调控机制等进行总结归纳,分析胃肠道干细胞、造血干细胞、骨髓干细胞移植在胃肠疾病临床治疗中的应用情况及其存在的问题。资料来源:应用计算机检索CNKI2004/2006有关胃肠道干细胞及干细胞移植在胃肠道疾病治疗中应用的相关文章,检索词“胃肠道干细胞,胃干细胞,肠道干细胞,胃肠疾病”,限定文章语言种类为中文。应用计算机检索PUBMED1999/2004相关文章,检索词:gastrointestinal stem cell,gastric stem cells,intestinal stem cell,限定文章语言种类为English。资料选择:对资料进行初审,纳入标准:①有关胃肠道干细胞、胃干细胞、肠道干细胞增殖分化特性及其调控机制方面的相关文章;②有关胃肠疾病的干细胞移植治疗方面的相关文章。排除标准:①重复性研究;②陈旧性文献。资料提炼:共搜集到上述文章41篇,按上述标准纳入30篇,其中有关胃肠道干细胞及其在胃肠道损伤修复中应用的相关研究文章8篇,胃干细胞及其在胃肠疾病治疗中应用的相关研究文章3篇,肠干细胞及其在胃肠疾病治疗中应用的相关研究文章7篇,造血干细胞、骨髓干细胞移植在胃肠疾病及其他相关疾病治疗中应用的相关文章12篇。资料综合:胃肠道干细胞具有自我更新与增殖能力,一般认为,胃的干细胞定位于腺体峡部区域,肠道干细胞位于肠黏膜隐窝的基底部,胃肠道干细胞能根据组织需要调解细胞增生分化的速度,对维持胃肠黏膜更新及保持组织内环境稳定起着重要作用。肿瘤干细胞理论认为胃肠道肿瘤的发生与干细胞的突变有关,胃肠道干细胞可能是基因突变和积累的靶细胞。造血干细胞、骨髓干细胞移植在胃癌、炎症性肠病、胃肠道上皮损伤等胃肠道疾病治疗中得到广泛应用,并取得较好疗效,但胃肠干细胞的特异性标志及干细胞移植治疗胃肠道疾病的作用机制有待于深入研究。结论:胃肠道干细胞在胃肠道组织及细胞损伤修复中发挥着关键作用,胃肠干细胞突变以及生长调控机制异常可能导致胃肠肿瘤,在胃肠疾病治疗中造血干细胞、骨髓干细胞移植具有广阔的应用前景。

OBJECTIVE： To＇summarize the characteristic, distdbution and regulatory mechanism of gastrointestinal stem cells and analyze the application and existing problems of gastrointestinal stem cell, haemopoietic stem cell and bone marrow stem cell transplantation in clinical gastrointestinal diseases. DATA SOURCES： China National Knowledge Infrastructure （CNKI） was undertaken to identify the relevant articles on the application of gastrointestinal stem cells and stem cell transplantation in gastrointestinal diseases published from 2004 to 2006 with the key words of ＂gastrointestinal stem cells, gastric stem cells, intestinal stem cells, gastrointestinal diseases＂ in Chinese. Relevant articles were retrieved in Pubmed database published from 1999 to 2004 with the key words of ＂gastrointestinal stem cells, gastric stem cells, intestinal stem cells＂ in English. STUDY SELECTION： The data were checked primarily. Inclusive criteria included （1）relevant articles on proliferation, differentiation and regulatory mechanisms of gastrointestinal stem cells, gastric stem cells, intestinal stem cells, and （2） relevant articles on stem cell transplantation for gastrointestinal diseases. Exclusive cdteria included （3）repetitive research, and （4）literatures with old content. DATA EXTRACTION： A total of 41 articles were selected, and 30 met the inclusive criteria. Of them, 8 articles were on gastrointestinal stem cells and the application in repair of gastrointestinal injury, 3 articles were on gastric stem ceils and the application in therapy of gastrointestinal diseases, 7 articles were on intestinal stem cells and the application in therapy of gastrointestinal diseases and 12 articles were on the application of haemopoietic stem cell and bone marrow stem cell transplantations in gastrointestinal diseases and other relevant diseases. DATA SYNTHESIS： Gastrointestinal stem cells have the capacity of self-renewal and proliferation. It is thought that gastric stem cells locate at glandular organ isthmic portion and intestinal stem cells locate at intestinal mucosa recessus. Gastrointestinal stem cells can regulate the speed of cell proliferation and differentiation according to the requirement of human tissues, and play an important role in maintaining gastrointestinal mucosa renewal and keeping stable tissue environment. The theory of cancer stem cells indicates that the occurrence of gastroenteric tumor is associated with the mutation of stem cells and gastrointestinal stem cells can be the target cells of gene mutation and accumulation. Haemopoietic stem cell and bone marrow stem cell transplantations are widely applied in therapy of gastrointestinal diseases such as gastric cancer, inflammatory bowel disease, gastrointestinal epithelium injury and so on and get perfect curative effect. Specific markers of gastrointestinal stem cells and action mechanism of stem cell transplantation for gastrointestinal diseases deserve further study. CONCLUSION： Gastrointestinal stem cells play a major role in gastrointestinal tissues and cell injury repair. Gastrointestinal tumor can be caused by mutation and abnormal mechanism of growth regulation of gastrointestinal stem cells. Haemopoietic stem cell and bone marrow stem cell transplantations have widely application in therapy of gastrointestinal diseases.