干细胞治疗梗阻性肾病:研究现状与存在问题

Stem cell therapy for obstructive nephropathy: current situation and problems

背景:梗阻性肾纤维化的治疗思路主要集中于解除肾结石、肾盂输尿管狭窄等危险因素以及针对上皮-间质转化、肾纤维化发生相关因子及改善肾间质微循环等肾纤维化发生机制进行,目前治疗效果并不理想。以干细胞为基础的再生医学研究有可能为梗阻性肾纤维化的治疗带来新的希望。目的:综合分析不同来源干细胞治疗梗阻性肾纤维化的机制及研究进展。方法:检索Pub Med、Ovid medline全文数据库、CNKI、维普数据库、万方数据库等并收集关于干细胞治疗梗阻性肾纤维化的文章,中文以"干细胞、梗阻性肾病、肾纤维化"为检索词,英文以"stem cells、obstructive nephropathy、renal fibrosis"为检索词进行检索,最终选择51篇文章进行总结。结果与结论:干细胞治疗梗阻性肾病尚处于实验阶段,大量研究表明干细胞移植对梗阻性肾病肾间质纤维化的治疗具有积极的作用,干细胞可移植定位于肾间质,向肾小管上皮细胞分化,促进肾纤维化的恢复,干细胞还能分泌、上调或下调一些细胞因子抗纤维化,在及时、早期解除梗阻的前提下,干细胞移植有可能为梗阻性肾纤维化恢复提供一种新型的治疗方案。

BACKGROUND： Thought of treatment of obstructive renal fibrosis is mainly concentrated at relieving the kidney stone, renal pelvis and ureter stenosis as well as at epithelial mesenchymal transition, renal fibrosis related factors and improving the renal interstitial microcirculation. At present, the therapeutic effect is not ideal. However regenerative medicine based on stem cells may bring a new hope for the treatment of obstructive renal fibrosis. OBJECTIVE： To summarize the mechanism and progress in different sources of stem cells in the treatment of obstructive renal fibrosis. METHODS： The database of PubMed, Ovid MEDLINE, CNKI full text database, VIP database, Wanfang database were retrieved to collect articles about stem cel were ＂stem cells, obstructive nephropathy, renal fibrosis＂ included in result analysis. therapy for obstructive renal fibrosis. The key words n Chinese and English. Finally, there were 51 articles RESULTS AND CONCLUSION： Stem cell therapy for obstructive nephropathy is still in the experimental stage. A large number of studies have shown that stem cell transplantation has positive effects on the treatment of obstructive renal interstitial fibrosis. Stem cells can be located in the renal interstitium after transplantation to differentiate into renal tubular epithelial cells, thereby promoting the recovery of renal fibrosis. Stem cells are able to secrete, up- or down-regulate some cytokines to treat fibrosis. If the obstruction is relieved timely and early, stem cell transplantation may become a novel treatment for obstructive renal fibrosis.