干细胞移植治疗脊髓损伤的研究进展

Advances of stem cells transplantation for spinal cord injury

背景:干细胞移植作为治疗脊髓损伤最具前景的方法,已经在大量的动物实验和临床试验中得到证实。目的:综述干细胞移植治疗脊髓损伤的相关研究进展。方法:应用计算机检索2006-01/2010-12中国知网、Medline数据库相关文章,中文检索词"干细胞,脊髓损伤,细胞移植",英文检索词"stem cells,spinal cord injury,cell stransplantation",共检索到文献494篇,最终纳入符合标准的文献24篇。结果与结论:研究发现,移植的干细胞可以在脊髓内迁移、分化为神经元并分泌神经营养物质,促进神经组织的修复,改善神经功能。胚胎干细胞最早用于治疗脊髓损伤,但潜在的致瘤性等成为其临床应用的障碍;神经干细胞理论上是治疗脊髓损伤的首选干细胞,由于分离纯化技术要求严格,费用昂贵等使其在研究中进展缓慢;骨髓间充质干细胞来源丰富、取材方便,可行自体移植,避开了伦理学和移植后排斥等问题,目前被认为是一种理想的自体干细胞移植来源。随着细胞联合移植、基因修饰及组织工程支架移植治疗脊髓损伤的研究不断取得进展,许旺细胞、嗅鞘细胞的应用范围和治疗效果也得到提升。

BACKGROUND： Stem cell transplantation as the most promising treatment for spinal cord injury, has been confirmed in a large number of animal experiments and clinical trials. OBJECTIVE： To review the related research progress of stem cell transplantation for spinal cord injury. METHORDS： A computer-based online search of related articles were performed in CNKI and Medline database published from January 2006 to December 2010, with the of ＂Stem cells; Spinal cord injury; Cells transplantation＂ in Chinese and English, respectively. 494 articles were collected, and 24 were included. RESULTS AND CONCLUSION： Studies show that transplanted cells can migrate, differentiate into neurons and secrete neural nutrients to promote nerve tissue repair and improve neural function. Embryonic stem cells have been used in the treatment of spinal cord injury, but the potential tumorigenicity limits its clinical application. Neural stem cells are theoretically preferred treatment of spinal cord injury, but this technique develops slowly because of strict separation and purification technology and expensive cost. Mesenchymal stem cell has rich sources, and simple sampling, with feasible autologous transplantation, which avoids the ethical problems and graft rejection. Currently mesenchymal stem cell has been identified as an ideal autologous stem cell transplantation source. With advancing cell transplantation, gene modification and tissue engineered scaffold transplantation for treatment of spinal cord injury, the application range and treatment effect of Schwann cells and olfactory ensheathing cells are also improved.