干细胞诱导心肌细胞增殖与运动促进心肌细胞再生的研究进展

Stem cell-induced proliferation of myocardial cells and exercise-induced regeneration of myocardial cells

背景:干细胞移植治疗心血管疾病表现出传统方法无可比拟的优越性,但干细胞向心肌细胞自发分化的效率非常低,而且影响干细胞分化的因素很多。目的:阐明不同来源干细胞治疗心肌梗死的优缺点,探讨提高心肌细胞分化效率的方法,最佳诱导分化条件及运动促进干细胞动员、诱导内源性心肌细胞再生的机制。方法:由第一作者检索1985至2015年Pub Med数据库和中国知网收录的与干细胞治疗心肌梗死、干细胞向心肌细胞分化运动影响干细胞增殖及心肌细胞再生的相关文献。英文检索词为"stem cells,myocardial infarction,myocardial regeneration,cardiac cell,exercise",中文检索词为"干细胞,心肌梗死,心肌再生,心肌细胞,运动",共纳入54篇文章进行综述。结果与结论:为了提高心肌细胞分化率,近年来多种化学诱导剂和生物成分先后应用于干细胞向心肌细胞分化的研究,模拟心肌微环境和血管细胞生长因子的作用也是诱导心肌细胞分化的主要方法。通过有氧运动促进干细胞动员来诱导缺血心脏血管新生和上调各种血管生长因子表达,可促进心肌细胞增殖和修复。有关干细胞的获取、移植排斥反应、向心肌细胞定向分化的调控机制还需进行深入探讨。

BACKGROUND： Stem cell transplantation has incomparable superiorities in the treatment of cardiovascular diseases. But stem cells have a very low efficiency to differentiate into myocardial cells spontaneously, and thereare many factors influencing stem cell differentiation. OBJECTIVE： To clarify the pros and cons of different sources of stem cells in the treatment of myocardial infarction, to investigate the methods for improving the differentiation efficiency of myocardial cells, optimal differentiation conditions and mechanism underlying exercise-induced stem cell mobilization and endogenous myocardial cell regeneration. METHODS： A computer-based search of CNKI and Pub Med databases was performed by the first author forarticles related to stem cell therapy for myocardial infarction and stem cell differentiation into myocardial cells, exercise effect on stem cell proliferation and myocardial cell regeneration published from 1985 to 2015. The key words were ＂stem cells, myocardial infarction, myocardial regeneration, cardiac cell, exercise＂ in Chinese and English, respectively. Finally, 54 articles were included in result analysis. RESULTS AND CONCLUSION： In recent years, a variety of chemical inducers and biological components have been used in the myocardial differentiation of stem cells. Simulation of myocardial microenvironment and vascular cell growth factors are the main methods of inducing myocardial differentiation. Aerobic exercise-induced stem cell mobilization can induce ischemic cardiac angiogenesis and upregulate a variety of vascular endothelial growth factors so as to promote myocardial proliferation and repair. However, in-depth exploration is still needed in the harvesting of stem cells, transplant rejection, and regulatory mechanisms underlying the directed differentiation of stem cells into cardiomyocytes.