干细胞治疗阿尔茨海默病的研究进展及挑战

Advance and challenges in stem cell therapy for Alzheimer's disease

阿尔茨海默病(Alzheimer’s disease,AD)是中枢神经系统常见的慢性进行性神经退行性疾病,病理特征主要是细胞外淀粉样蛋白沉积,细胞内神经元纤维缠结以及神经元丢失等,其中神经元丢失是造成AD患者功能损伤的根本原因之一。目前对AD的治疗多以缓解症状为主,而不能从根本上解决AD的病理特征。近年来,神经再生理论的发展和干细胞体外培养的成功为AD的治疗提供了一个崭新的视野。目前,干细胞来源主要包括神经干细胞、胚胎干细胞、骨髓间充质干细胞、诱导性多功能干细胞等。干细胞主要通过修复和替代受损神经细胞、重建细胞环路和功能、神经保护和营养支持、抑制淀粉样蛋白的形成和调解免疫功能等发挥治疗AD的作用。该综述主要介绍外源性移植干细胞治疗AD的研究进展及挑战,以及小分子化合物促进内源性神经再生的研究现状。

Alzheimer’ s disease ( AD) , the most prevalent type of neurodegenerative disease, characterized by extracellular β-amyloid ( Aβ) plaque deposition, intracellular neurofibrillary tangles, and the loss of diverse neurons. Neuron loss might be the main cause that induces irreversible decline of cognitive function in AD patients. At present, AD therapy only relieves symptoms instead of fundamentally affecting the major pathologi-cal characteristics of the disease. Recently, rapid advances in neurogenesis and stem-cell biology have provided a new and pro-spective potential for AD treatment. Stem-cell types in the treat-ment of neurodegenerative diseases include neural stem cells ( NSCs ) , embryonic stem cells ( ESCs ) , mesenchymal stem cells ( MSCs ) , and induced pluripotent stem cells ( iPSCs ) . Stem cell therapy shows anti-AD function by replacing the dam-aged and lost neurons, rebuilding the cellular loop, inhibiting amyloidogenesis, promoting neurotrophic factor release, and reg-ulating immune reaction. This review highlights the recent pro-gress, mechanisms, and preclinical evidence of exogenous trans-planted stem cell, and addresses the current major challenges of stem cell transplantation in clinic. In addition, this review also summarizes the research status of compound promoting endoge-nous neurogenesis in brief.