骨髓干细胞移植治疗肝硬化的基础与临床研究现状

Basic and Clinical Research of Bone Marrow Stem Cells in Treatment of Hepatic Cirrhosis

肝硬化是一种临床常见的肝病良性终末期表现。目前临床上尚缺乏有效的治疗措施。肝脏移植是最理想的治疗方法,但受供体肝脏来源限制,且费用昂贵。近年来开展的自体骨髓干细胞(BMSCs)移植治疗,为肝硬化的治疗带来了新的希望。BMSCs主要包括造型血干细胞和间充质干细胞,其具有可塑性,体外通过生长因子,体内利用特定微环境均可诱导BMSCs分化为肝前体细胞和成熟肝细胞,并明显改善肝功能。从动物实验到临床研究亦表明,BMSCs具有来源丰富、费用低廉、损伤小、自体移植不栓塞、无排斥反应等优点,为治疗肝病带来了新思路,有望成为生物人工肝的细胞来源。本文就BMSCs移植治疗肝硬化的研究现状,尤其是移植途径以及在肝脏内定居、迁移和分化机制的示踪观察方法和存在的问题作一综述,以期为从事肝病研究的同仁提供参考依据。通过对BMSCs移植从基础研究及临床应用的最新进展的描述,展示BMSCs在肝硬化治疗方面良好的治疗前景。

Liver Diseases, General Hospital of Beijing Military Command; Liver cirrhosis is a common benign end-stage liver disease shorting clinical effective treatment measures. Liver transplantation is the optimal treatment method, but with the limitation of donor liver source and high-cost. In recent years, the development of auto-logous bone marrow stem cells（BMSCs） transplantation has brought new hope for the treatment of liver cirrhosis.BMSCs include mesenchymal stem cells and hemopeietic stem cells, which are characterized by plasticity. Growth factors in vitro and special microenvironment in vivocouuld induce the differentiation of bone marrow stem cells into the precursor of hepatocytes and mature hepatocytes. Moreover, hepatic function could be improved obviously. The superiorities of bone marrow stem cells included affluent source, low cost, little injury, without embolism and graft rejection in autologous transplantation, which offere a new style for curing hepatic diseases. bone marrow stem cells would be the cell resource of artificial liver. In this paper, the research status of BMSCs transplantation for the treatment of liver cirrhosis, especially the ways of liver transplantation and the tracing method of BMSCs settlement, migration and differentiation mechanism in liver and existing problems are reviewed, expecting to provide reference for colleagues engaged in the study of liver diseases. Basic and clinical research about bone marrow stem cells transplantation indicate that bone marrow stem cells transplantation has a broad prospect in the treatment of hepatic cirrhosis.