骨髓间充质干细胞改善心肌梗死后心功能的机制和诱导因素

Mechanism and induction factor of bone marrow mesenchymal stem cells for improving cardiac function after myocardial infarction

目的:分析骨髓间充质干细胞移植对心肌梗死后心脏功能的影响及其作用机制,探讨骨髓间充质干细胞向心肌样细胞分化过程中的诱导因素。方法:由本文第一作者检索Pubmed数据库和中国期刊全文数据库有关骨髓间充质干细胞移植治疗心肌梗死的相关文献,共检索到60篇文献,对资料进行初审,纳入标准:①骨髓间充质干细胞移植对心肌梗死后心功能的影响。②骨髓间充质干细胞移植改善心肌梗死后心功能的作用机制。③骨髓间充质干细胞向心肌样细胞分化的诱导因素。排除标准:重复研究和Meta分析类文章。最终纳入23篇文献进行分析讨论。结果:①骨髓间充质干细胞具有很强的自我更新能力及多项分化潜能,在一定条件下能分化为肌细胞、骨细胞、软骨细胞和脂肪细胞等。②骨髓间充质干细胞可以改变心肌梗死后的心脏功能。其可能的作用机制为能够分化为心肌样细胞,并促进了新血管生成,减少心室重构,即移植后的干细胞在缺血受损伤的心脏微环境中与宿主细胞和细胞外基质之间的相互作用下,分化为有效的心肌组织,同时还可分泌促进血管生成的血管生成素配体和细胞因子,进一步促进新生血管的形成。③体内外环境诱导因素在骨髓间充质干细胞诱导分化为心肌样细胞的过程中起着非常重要的作用,对各种微量因素及微环境中各种细胞因子的调节可以提高干细胞定向分化的效率。结论:骨髓间充质干细胞在心脏疾病治疗中已表现出独特的优越性,然而其作为心血管疾病治疗的一种全新策略目前还处于初步研究阶段,为了使骨髓间充质干细胞移植更安全有效地应用于临床,仍有很多方面的问题需要进一步探索。

AIM： To analyze the action mechanism and effect of bone marrow mesenchymal stem cell （BMSC） transplantation on cardiac function after myocardial infarction and to investigate the induction factors of the differentiation of BMSCs into cardiomyocytes. METHODS： Pubmed Database and China Journal Full-text Database （CJFD） were undertaken to identify relevant articles on BMSC transplantation in the treatment of myocardial infarction. Totally 60 articles were searched and primarily checked. Inclusive criteria： articles on①ffects of BMSC transplantation on cardiac function after myocardial infarction, ②improvement of action mechanism of cardiac function after myocardial infarction by BMSC transplantation, and ③induction factors of the differentiation of BMSCs into cardiomyocytes. Exclusive criteria： articles on repetitive studies and Meta analysis. A total of 23 articles were included for analysis. RESULTS： ①BMSCs possess strong capacities of self-renewal and multiple directional differentiation. BMSCs can differentiate into myocytes, osteocytes, chondrocytes and adipocytes under a certain condition. ②BMSCs can regulate cardiac function after myocardial infarction. Its action mechanism refers to BMSCs can differentiate into cardiomyocytes, promote the production of neovascularity and reduce ventricle reconstitution. Similarly, transplanted stem cells interacted with host cells and extracellular matrix can differentiate into myocardial tissues, secrete angiogenin ligand and cytokine, resulting in production of new vessels in ischemic injured heart. ③in vitro and vivo condition plays an important role in the differentiation of BMSCs into cardiomyocytes, and enhances the efficiency of oriental differentiation of stem cells by modulating various trace elements and cytokines in microenvironment. CONCLUSION： BMSCs have distinct superiority in treating heart disease. BMSCs for treating cardiovascular disease were in primary research. Thus, many problems require further study to obtain a safe effective usage of BMSCs in clinical transplantation.