缺血性心脏病干细胞治疗的争论热点与最新进展

The advent progress and the key barriers of stem cell therapy for ischemia heart disease

文章讨论了细胞修复治疗在缺血性心脏病中的应用。介绍了不同类型细胞的心脏修复效应。重点介绍了胚胎干细胞(ESCs)及诱导型多能干细胞(iPS)临床应用障碍,而ESC及iPS源心脏前体细胞,心肌源性干细胞等修复心肌的最新进展。尤其重点描述了来自于人胚外或胚胎中胚层的脐带华通胶源间充质干细胞的细胞生物学特性,如:兼有胚胎干细胞及间充质干细胞标志特征,无伦理道德问题,多向分化而无致肿瘤性,多代增殖保持干性特征,独特的免疫调节功能等,使之WJ-MSCs将成为心脏再生医学中最具希望的种子细胞。

In this review, we discuss cell therapy for cardiac repair. The effects of various cell therapies on cardiovascular disease are described. Particular attention is given, the pluripotent stem cells derived from the inner cell mass of early-stage embryos have provided a prototype for cardiac repair. However, ethical considerations and oncogenic risk along with practical limitations have precluded adoption of ESCs used ; Induced pluripotent stemeell （iPS） technology provides an emerging innovation that iPS reliably generates an embryonic-like ground state from autologous sources, but the oncogenesis remains largely risk. Therefore, ESC/iPS-derived cardiovascular progenitor may represent a source of stem cell useful for cellular therapy. Autologous cardiac progenitor/stem cells are also thought to be highly promising cells for future therapy. On the other hand, human Wharton＇s jelly-derived mesen- ehymal stem cells （WJ-MSCs） from the umbilical cord matrix which are of extraembryonic and/or embryonic mesoderm origin and containing both hESC and hMSCs markers appear to be less troublesome in not being an ethically controversial source, widely muhipotent, not tumorigenic, maintain ＂sternness＂ for several serial passages, and immunoregulatory features. So WJ-MSCs have extremely promising for cardiac regenerative medicine.