脂肪源性干细胞向心肌细胞分化及其移植治疗心血管疾病(英文)

Differentiation of adipose tissue-derived stem cells into myocardial cells and their transplantation for treatment of cardiovascular diseases

背景:作为成体干细胞的一种,脂肪源性干细胞具有可塑性并且能在特定条件下分化为心肌细胞。将自体脂肪间充质干细胞移植到心肌梗死区域后,能够分化为心肌细胞及血管内皮细胞,构建新的血管故能改善心泵功能。目的:全面了解影响脂肪干细胞向心肌细胞分化及移植的各种因素,以及目前临床及实验室研究中,应用脂肪干细胞移植治疗心肌病的现状。方法:电子检索 MEDLINE (1981-01/2010- 04)、PubMed 数据库,中国生物医学文献数据库(CBM)(1990-01/2010-04)、中文学术期刊全文数据库(CNKI),筛查相关文章的参考文献,主要检索主题词包括"脂肪源性干细胞; 心肌细胞;细胞分化;细胞移植;心肌病治疗"。结果与结论:纳入综述文献 6 篇;试验研究报告 24 篇。目前脂肪源性干细胞的分离培养方法基本统一,已找到有效的体外扩增技术,但尚无直接方法进行干细胞鉴别;脂肪源性干细胞的诱导分化在体内、体外均可进行,并具有早期分化特性,比骨髓间充质干细胞更有利于向心肌细胞的分化;应针对不同类型心肌病选择不同移植方法;干细胞磁标记技术可以对已经植入体内的脂肪源性干细胞进行活体动态监测;自体移植脂肪干细胞是心肌病的一种新的治疗方法,但要将其成功用于临床实践还需找到可以抑制脂肪源性干细胞的促肿瘤细胞特性的方法以保证术后患者的长期安全性。

BACKGROUND：Adipose-derived stem cells（ADSCs）,a kind of adult stem cells,possess plasticity and can be induced into myocardial cells under certain conditions.Autologous ADSCs transplanted into the infarct area can differentiate into myocardial cells and vascular endothelial cells to construct new vessels and thereby improve cardiac pump function.OBJECTIVE：To study the factors that influence ADSCs differentiation and transplantation and the current clinical and laboratory research progress of ADSCs transplantation for treatment of cardiomyopathy.METHODS：A computer-based retrieval was performed in Medline（between January 1990 and April 2010）,PubMed database,the China Biological Medicine Database（CBM）（between January 1990 and April 2010）,and China National Knowledge Infrastructure（CNKI） with the keywords adipose-derived stem cells,myocardial cells,cell differentiation,cell transplantation,cardiomyopathy treatment.RESULTS AND CONCLUSION：A total of 30 articles,consisting of 6 reviews and 24 randomized controlled trials,were obtained.At present,there have been uniform methods of ADSCs isolation and culture,and ADSCs can be effectively proliferated in vitro,but there have been no direct methods to identify these stem cells.ADSCs differentiation can be induced both in vitro and in vivo,besides,with a characteristic of early differentiation.ADSCs transplantation is a more conductive therapy for myocardial disease compared with bone marrow stem cells（BMSCs） transplantation.Different ADSCs transplantation methods should be carried out in different types of cardiomyopathy.Stem cell labeling technique can help to dynamically monitor implanted in vivo.Transplantion of autologous ADSCs is a new way to treating cardiomyopathy.However,for successes in clinical practice,the method to inhibit tumor cells-promoting characteristics is needed to ensure long-term safety of the patients receiving ADSCs transplantation.