干细胞移植修复椎间盘退变的研究现状

RESEARCH SITUATION OF STEM CELLS TRANSPLANTATION FOR INTERVERTEBRAL DISC DEGENERATION

目的总结干细胞对椎间盘退变的修复机制,综述干细胞移植修复椎间盘退变的研究现状。方法查阅近年干细胞移植修复椎间盘退变的相关文献,分析总结干细胞移植修复椎间盘退变的临床疗效、修复机制、影响修复效果的相关因素,以及面临的主要问题。结果临床自体干细胞移植可修复椎间盘退变并有效缓解腰腿痛症状。干细胞在退变椎间盘内可向椎间盘软骨细胞分化,促进细胞外基质以及营养因子合成,延缓椎间盘细胞凋亡,维持椎间盘免疫豁免状态。干细胞的种类与数量、细胞移植的载体支架、干细胞移植前的预处理方法,以及移植椎间盘的退变程度等因素皆可影响干细胞移植的修复效果。减少移植干细胞的回漏、调控干细胞在椎间盘中的迁移分布、探明干细胞在退变椎间盘微环境下维持其干细胞特性的能力和规律是面临的全新挑战。结论基于干细胞移植的生物学修复策略是早期扭转椎间盘退变的可行方案。

Objective To summarize the research situation of stem cells transplantation for intervertebral disc （IVD） degeneration. Methods The original articles about stem ceils transplantation for repair of IVD degeneration were extensively reviewed; the clinical applications, the mechanisms, and related factors to influence repair effect were analyzed; and obstacles in stem cells transplantation for repair of IVD degeneration. Results Autogenic stem cells transplantation can repair IVD degeneration and effectively relieve the symptoms of low back and leg pain. Stem cells can differentiate into disc chondrocytes in the disc microenvironment, increase the production of various growth factors, and exert a trophic effect on disc cells. It is also evident that the transplanted stem cells can potentially protect disc cells from apoptosis and maintain an immune-privileged state in the IVD. Multiple factors such as tissue origin of stem cells, methods to pre-modulate the seeds, choice of injectable scaffolds, and even the severity of degeneration are closely related to the repair effects. To get a more efficient stem cell therapy, future researches are challenged to modulate the migration and distribution of stem cells in the IVD, avoid flow back, and better understand their ability to restore stemness properties within the degenerative disc niche. Conclusion Stem cells transplantation is proven to be a promising biological aporoach for repair of IVD deueneratinn.