极小胚胎样干细胞靶向治疗缺血性心脏病

Very Small Embryonic-like Stem Cell Targeting Therapy of Ischemic Heart Disease

缺血性心脏病及其终末期所致的心力衰竭是一类全球致死病因。缺血性心脏病是一类由于冠状动脉粥样硬化性痉挛、狭窄、闭塞和毛细血管网病变,所引起的心肌细胞供氧与需氧之间不平衡,从而导致心肌细胞减少、坏死进而心肌纤维化、心肌瘢痕组织形成并最终表现为心功能不全、心力衰竭的一类疾病。目前,治疗缺血性心脏病的主要治疗方法为药物和介入治疗,此类疗法虽能开通狭窄血管,挽救缺血心肌,但都无法逆转已坏死心肌和促进心肌细胞再生。心脏移植虽能较为彻底地改善心脏状态,但临床中碍于供体数目较少以及移植后排斥反应,难于大规模开展。近年来研究发现骨髓中非造血干细胞主要包括骨髓基质干细胞内皮祖细胞、极小胚胎样干细胞等,在促进细胞再生研究中显示出巨大潜力。而其中的极小胚胎样干细胞较其他非造血干细胞有较多优势:体积小、分化力更强、冠状动脉移植后栓塞率低等,可以改善心功能和延缓心肌重构。现就极小胚胎样干细胞在缺血性心脏病的治疗应用中的研究进展进行综述。

Ischemic heart disease and end-stage heart failure is a leading cause of death in the world. Coronary spasm, stenosis, occlu- sion and capillary network lesions can lead to ischemic heart disease, which is caused by the imbalance between myocardial oxygen supply and oxygen, resulting in a reduction in myocardial cells, necrosis and myocardial fibrosis, myocardial scarring and ultimately manifests as heart failure. At present,the main treatment methods of ischemic heart disease are drug therapy and interventional therapy. These therapies can open blocked blood vessels, save the ischemic myocardium, but cannot reverse necrosis cardiac muscle or promote cardiac muscle cells regen- eration. Although heart transplants are able to improve the function of heart, it is difficult to carry out due to organ-donor problems and trans- plant immune rejection. In recent years, studies have found non-hematopoietic stem cells in bone marrow （non-hematopoietic stem cells） include bone marrow stem cells （mesenchymal stem cells） and very small embryonic-like stem ceils of endothelial progenitor ceils shows great potential in promoting cell regeneration. Very small embryonic-like stem cell have substantial advantages ： small size, better differentiation ability and low rate of coronary artery thrombosis. This review focuses on the very small embryonic-like stem cell research progress in ischemic heart disease.