嗅鞘细胞移植治疗脊髓损伤:问题与瞻望

Olfactory ensheathing cells transplantation for the treatment of spinal cord injury:Issues and looking forward

背景:嗅鞘细胞兼具有许旺细胞和星形胶质细胞的特性,能分泌多种神经生长因子和营养因子,改善脊髓损伤局部的微环境、诱导轴突的再生及髓鞘化、促进脊髓损伤后的功能恢复。目的:总结当前嗅鞘细胞移植治疗脊髓损伤的最新研究成果,将研究思路和最新研究进展相结合进行综述。方法:以"olfactory ensheathing cell,transplantation,spinal cord injury"为检索词,检索PubMed数据库(1990-01/2012-01),以"嗅鞘细胞,移植,脊髓损伤"为检索词,检索CNKI数据库(2000-01/2012-01),文献检索语种为英文和中文。纳入与嗅鞘细胞移植治疗脊髓损伤相关的文献,排除重复文献。结果与结论:计算机初检得到372篇文献,根据纳入排除标准,对其中23篇文献进行分析。大量动物及临床实验研究表明,嗅鞘细胞移植能有效促进脊髓损伤局部形态及功能的恢复,为临床治疗脊髓损伤患者提供了新途径。但是如何解决嗅鞘细胞的来源问题、如何避免异体移植免疫排斥反应的发生、以及异种移植中的生物安全问题是限制嗅鞘细胞移植治疗脊髓损伤临床应用的重要因素。因此,自体嗅鞘细胞移植治疗脊髓损伤能够较好地解决上述问题,将有可能成为后续研究的热点。

BACKGROUND： The treatment of spinal cord injury is always a stubborn problem for neurosurgeons because nerve cell cannot regenerate by itself and the gila scar can prevent the axonal regeneration. Olfactory ensheathing cells have characteristics of both Schwann cells and astrocytes. They can secrete a variety of nerve growth factors and neurotrophic factors, and can improve the local microenvironment, induce axonal regeneration and myelination, and promote the function recovery. OBJECTIVE： To review the advanced research results of olfactory ensheathing cells transplantation for the treatment of spinal cord injury, and to review the combination of advanced research and research thinking. METHODS： We searched the PubMed database for the articles published from January 1990 to January 2012 with the key words of ＂olfactory ensheathing cell, transplantation, spinal cord injury＂ in English. Meanwhile, we searched the CNKI database for articles published from January 2000 to January 2012 with the key words of ＂olfactory ensheathing cell, transplantation, spinal cord injury＂ in Chinese. Articles related with olfactory ensheathing cells transplantation for the treatment of spinal cord injury were included and the repetitive articles were eliminated. RESULTS AND CONCLUSION： A total of 372 articles were included after initial screening according to the exclusion criteria, and 23 articles were selected for the reciew. Experimental evidence from animal models and clinical studies suggest that olfactory ensheathing cells transplantation can improve the morphologic and functional recovery of spinal cord injury which provides a new way for the clinical treatment of spinal cord injury. The clinical application of olfactory ensheathing cells transplantation for spinal cord injury is limited by the source of olfactory ensheathing, avoiding immunological rejection during allotransplantation and the safety of heterotransplantation. Therefore, autotransplantation of olfactory ensheathing cells for the treatment of spinal cord injury is effective and it maybe a focus in the future.