骨髓间充质干细胞移植治疗糖尿病神经源性膀胱的研究与进展

Bone marrow mesenchymal stem cells transplantation in the treatment of diabetic cystopathy

背景:干细胞移植治疗近年来吸引了相当多的关注,为治疗糖尿病神经源性膀胱提供了新思路。目的:综述骨髓间充质干细胞移植治疗糖尿病神经源性膀胱的研究与应用进展。方法:由第一作者以"bone marrow mesenchymal stem cells,diabetic neurogenic bladder,differentiation,transplantation;骨髓间充质干细胞,糖尿病神经源性膀胱,分化,移植"为检索词,检索2000至2016年Sciencedirect、Pub Med、Embase、万方及知网数据库应用骨髓间充质干细胞对糖尿病神经源性膀胱治疗及机制相关文献。结果与结论:在糖尿病神经源性膀胱出现膀胱功能障碍时移植骨髓间充质干细胞,通过增殖和分化为平滑肌细胞修复膀胱及尿道功能,同时可合成多种生长因子,对膀胱内局部微环境产生营养性旁分泌作用,包括抗炎、促进增殖和存活等,有效治疗糖尿病神经源性膀胱。一方面,骨髓间充质干细胞凭借向损伤部位趋化的能力,通过血液循环迁移到受损部位参与修复;另一方面,骨髓间充质干细胞合成多种生长因子,以及具有可抑制炎性应答的细胞因子。但目前临床研究尚少,其有效性及安全性有待进一步验证。

BACKGROUND： Stem cell transplantation has gained considerable support recently. It provides new opportunities for treating diabetic neurogenic bladder.OBJECTIVE： To summarize the research progress in bone marrow mesenchymal stem cells（BMSCs）transplantation in the treatment of diabetic neurogenic bladder. METHODS： The first author retrieved Sciencedirect, Pub Med, Embase, Wangfang and CNKI databases, for relevant articles of BMSCs transplantation in the treatment of diabetic neurogenic bladder, published from 2000 to 2016. The key words were ＂bone marrow mesenchymal stem cells, diabetic neurogenic bladder, differentiation, transplantation＂ in Chinese and English, respectively. RESULTS AND CONCLUSION： In patients with diabetic neurogenic bladder, the transplantation of BMSCs may provide safer and longer-lasting outcomes by repairing the damaged bladder and urethra. And it can produce various bioactive substances, which will have nutritional paracrine effects on the bladder microenvironment, including anti-inflammation, promoting cell proliferation and improving cell survival. On the one hand, the BMSCs have the ability to migrate to the injury site via the blood circulation. On the other hand, BMSCs can produce various growth factors, as well as the cytokines that can inhibit the inflammatory response. While the current clinical studies are lacking, its efficacy and safety needs further verification.