间充质干细胞在再生障碍性贫血治疗中的应用

Application of mesenchymal stem cells in the treatment of aplastic anemia

背景:造血干细胞移植现在仍然是儿童和青年重型再生障碍性贫血的一线治疗选择,但供者来源有限,费用高,且5%～15%的患者因为慢性移植物抗宿主病影响疗效和生活质量。因此尚需探索能提高疗效,减轻不良反应的治疗途径。间充质干细胞易于分离并且增殖力稳定,可以满足临床需求。目的:总结间充质干细胞的研究进展、免疫学特性以及在再生障碍性贫血治疗中的应用情况。方法:由第一作者在2010-06检索PubMed数据库(http://www.ncbi.nlm.nih.gov/PubMed)及中国期刊全文数据库(http://www.cnki.net)1995/2010有关间充质干细胞的研究进展、免疫学特性以及在再生障碍性贫血治疗中应用的文献。英文检索词为"mesenchymal stem cells,aplastic anemia,anemia",中文检索词为"间充质干细胞,再生障碍性贫血,贫血"。结果与结论:共收集119篇关于间充质干细胞及再生障碍性贫血的文献,中文85篇,英文34篇,排除因研究目的与课题无关、发表较早、重复及类似研究,纳入30篇符合标准的文献。目前普遍认为再生障碍性贫血是一种获得性骨髓造血功能衰竭症,再生障碍性贫血的发生、发展与T细胞功能亢进引起的造血组织损伤密切相关。间充质干细胞具有免疫负调节及支持造血双重作用,且具有可移植性和来源广泛的特点。再生障碍性贫血患者和正常人的间充质干细胞在生物学特性上具有差异性,间充质干细胞将会为研究再生障碍性贫血的发病机制和治疗提供新的思路和方法。

BACKGROUND：Hematopoietic stem cell transplantation remains a choice in children and youth with severe aplastic anemia,but the source of donor is limited,with high cost.Moreover,chronic graft versus host disease in 5%-15% patients affected their curative effects and quality of life.Therefore,we should explore the pathway of treatment to elevate curative effects and relieve adverse reactions.Mesenchymal stem cells can be easily isolated and with stable proliferative ability,can satisfy clinical requirements.OBJECTIVE：To summarize the progress and immune characteristics of mesenchymal stem cells and its application in the study of aplastic anemia.METHODS：A computer-based online search was conducted by the first author in PubMed Database（http：//www.ncbi.nlm.nih.gov/PubMed） in June 2010 and CNKI Database（http：//www.cnki.net） from 1995 to 2010 for articles concerning the progress and immune characteristics of mesenchymal stem cells and its application in the study of aplastic anemia.The key words were ＂mesenchymal stem cells,aplastic anemia,anemia＂. RESULTS AND CONCLUSION：We collected 119 literatures on mesenchymal stem cells and aplastic anemia,which included 85 Chinese articles and 34 English articles.Articles published earlier,repeated,and similar studies were excluded,and finally 30 literatures were included.At present,aplastic anemia is an acquired failure in blood-producing function of bone marrow.The occurrence and development of aplastic anemia closely related to the injuries of hematopoietic tissue caused by the functional accentuation of T cells.Mesenchymal stem cells have the capability of immune negative accommodation and supporting hematopoiesis,with the properties of transplantation and wide source.Mesenchymal stem cells of patients with aplastic anemia are different from that of normal person in aspects of biology.Mesenchymal stem cells can provide new ideas and methods for the study of pathogenesy and treatment of aplastic anaemia.