干细胞治疗支气管肺发育不良的新启示:干细胞衍生物

Cell derivatives: Inspiration from stem cell therapy for bronchopulmonary dysplasia

随着围生医学的发展,极早产儿的生存率得到大大提升,但相应的,支气管肺发育不良(bronchopulmonary dysplasia,BPD)的防治现状愈加严峻。BPD与新生儿死亡率、神经系统发育障碍密切相关,早期预测及治疗BPD尤为重要。近年来,已有许多临床前证据表明干细胞可治疗BPD,这种治疗作用是通过旁分泌多种生物因子尤其是干细胞外泌体实现的,且干细胞分泌的某些分子可在早产儿气道分泌物中分离并与BPD的发生密切相关,干细胞衍生物或可成为预测及治疗BPD的方式。现就干细胞衍生物治疗BPD的研究进展、优势、挑战以及作为BPD早期预测标记物的作用做简要综述。

With the development of perinatal medicine,the survival of extreme preterm infants has been greatly improved.As a consequence,the incidence of bronchopulmonary dysplasia(BPD),one of the most common complications of preterm infants,keeps increasing.BPD may lead to great mortality and morbidity in neonatal period,and it is also closely related to poor long-term neurodevelopmental outcomes.What’s more,BPD costs a lot in and even out of the hospital.So it is important to predict and treat BPD early.In the last decade,a surge of preclinical studies have demonstrated that stem cells,especially the mesenchymal stem cells(MSCs),may be a reliable way of treating BPD,and this therapy has been proved to be safe and tolerable in a phase I clinical trial.Recent studies find that stem cells exert their therapeutic benefit through paracrine effects.And certain molecules secreted by stem cells can be separated from the airway of premature infants and those molecules are closely related to BPD.Stem cell derivatives may be next breakthrough therapy and reliable biomarkers for BPD.This review will summarize the progress,advantages and challenges of stem cell derivatives in the treatment of BPD and its use in predicting BPD.