表皮干细胞特性及其应用 走向临床的路程还有多长?

Characteristics and application of epidermal stem cells:How far is it from basic research to clinical application?

背景:表皮干细胞作为皮肤组织的特异性干细胞,不仅是维持皮肤新陈代谢的主要功能细胞,而且与创面修复紧密相关,是皮肤及其附属器发生、修复的基础。目的:对近年来表皮干细胞的特性及临床应用研究现状做一综述。方法:应用计算机以Epidermal stem cell,Basic study,Gene therapy为检索词,检索PubMed数据库(2009/06-08);以表皮干细胞、基础研究、基因治疗为检索词,检索CNKI数据库(2009/06-08)。结果与结论:计算机初检得到532篇文献,中文283篇,英文249篇。阅读标题和摘要进行初筛,排除因研究目的与此文无关的127篇,内容重复性的研究158篇,Meta分析25篇,共保留31篇文献进行综述。表皮干细胞具有体内慢周期性、自我更新能力、对皮肤基底膜的黏附等典型特征,在组织结构中位置相对固定,位于表皮内血供丰富的基底层及毛囊隆突部。表皮干细胞的增殖分化受到外在因素和内在因素的影响,前者指干细胞所处的微环境,即干细胞"壁龛",后者则包括整合素-丝裂原激活蛋白激酶通路、Wnt信号通路、c-Myc原癌基因、Notch信号传导通路。目前常用的表皮干细胞标记物包括整合素、角蛋白以及p63,p75、表皮细胞表面转铁蛋白受体CD71等。在临床应用方面,表皮干细胞可用于组织工程与创伤修复、基因治疗及表皮肿瘤等领域。

BACKGROUND： Epidermal stem cell as a specific stem cell in skin tissue, not only plays an important role in maintaining the metabolism of skin, but also closely related to wound repair, is the basis of occurrence of skin and its appendages. OBJECTIVE： To summarize the research status on features and application of epidermal stem cells in recent years. METHODS： A computer-based online search was conducted in PubMed Database and CNKI Database with the key words of ＂epidermal stem cell, basic study, gene therapy＂ from June to August, 2009. RESULTS AND CONCLUSION： 532 articles were received in the first round, including 283 in Chinese and 249 in English. Articles which were unrelated articles （n=127）, repeated research （n=158）, and Meta analysis （n=25） were excluded. A total of 31 articles were reserved for review. Epidermal stem cell had the typical characteristics of long periodicity in vivo, self-renew capacity and easy to adherent to skin basement membrane. They had constant position in tissues which were located in basal layer and hair follicle bulge with rich blood supply in epidermis. The proliferation and differentiation of epidermal stem cells were affected by external and internal factors. The former meant microenvironment which stem cell existed in, that was called ＂Niche＂ of stem cell; the latter included integrin-mitogen-activated protein kinase pathway, Wnt signaling pathway, c-Myc proto-oncogene, and Notch signaling pathway. Currently, common marker of epidermal stem cells includes integrin, keratin, p63, p75, and epidermal cell-surface transferrin receptor CD71, etc. Epidermal stem cells can be explored in tissue engineering and wound repair, gene therapy, epidermal tumors, etc.