人工耳蜗植入与骨髓间充质干细胞移植联合治疗感音神经性耳聋研究进展

Research Advances on Convergence of Cochlear Implantation with Bone Mesenchymal Stem Cell Transplantation in Therapy of Sensorineural Hearing Loss

感音神经性聋(sensorineural hearing loss,SNHL)是耳科学领域难点及热点问题,内耳毛细胞和螺旋神经元(spiral ganglion neurons,SGNs)的损伤是导致SNHL的主要因素之一,目前治疗SNHL的方法主要有助听器或人工耳蜗植入(cochlear implant,CI),但都无法恢复正常的听觉结构,治疗效果不佳。近年来,有学者提出是否能将干细胞移植与人工耳蜗植入相结合,以实现SGNs损伤修复从而提高人工耳蜗植入的效能,而骨髓间充质干细胞(bone mesenchymal stem cells,BMSCs)由于其高扩增潜能,遗传稳定,易于分离培养,低免疫源性和免疫调节功能,近几年成为现代生物学和医学的研究热点,且已被多个临床试验证实具有很大的临床应用潜能,可被应用于组织损伤修复,如心肌梗死、脊柱及脑损伤、软骨及骨损伤。本文将从SGNs数量与人工耳蜗植入效果的关系、BMSCs移植实现SGNs再生或修复几方面进行综述,包括探讨人工耳蜗植入联合干细胞移植面临的治疗难点。

Sensorineural hearing loss(SNHL)is a difficult and hot issue in the field of otology.The damage of inner ear hair cells and spiral ganglion neurons(SGNs)is one of the major factors leading to SNHL.Treatment or rehabilitation for sensorineural hearing loss can be achieved with hearing aids or cochlear implants,but none of them can restore the normal auditory structures and the outcomes are often unsatisfactory.In recent years,some scholars have questioned whether cochlear implants can be combined with stem cell transplantation to improve the efficacy of cochlear implants.Bone mesenchymal stem cells(BMSCs)have become a research hotspot in modern biology and medicine in recent years due to their high amplification potentials,ease to isolate and culture,low immunogenicity and immunomodulatory functions.BMSCs have been confirmed by a number of clinical trials to have great potentials for clinical applications in tissue damage repair,such as for myocardial infarction,brain injury,and cartilage and bone damage.In this review,we will review the relationship between the number of SGNs and efficacy of cochlear implants and transplantation of BMSCs for SGN regeneration/repair,covering challenges in combining cochlear implantation and stem cell transplantation.