心肌球源性细胞在心力衰竭中的应用

Application of cardiosphere-derived cells in ischemic heart failure

冠状动脉或其分支阻塞而引起心肌缺血可导致急性心肌梗死,梗死区域周围形成瘢痕组织后心脏收缩功能下降,心室发生病理性重塑,最终出现充血性心力衰竭。心肌球源性细胞(CDC)是来自心肌的干细胞,在体外可以分化为心肌细胞和血管内皮细胞。在体内可以触发自身心肌细胞增殖和通过旁分泌募集祖细胞。旁分泌介质不但拥有干细胞的作用,且没有细胞移植相关的并发症。临床实验证明了CDC可以促进心肌梗死后的心脏功能的恢复。长期疗效还有待大规模临床试验的验证。

Acute cardiac infarction is caused by acute cardiac ischemia due to stensis of coronary artery and its branches. Serious cardiac ischemia may cause necrosis of heart cells and scar around the infarction area may cause heart dysfunction and remolding, leading to heart faiure. Stem cells derived from cardiac tissue itself, referred to as cardiosphere-derived cells (CDCs), may give rise to muscular cells and vascular endothelial cells in vitro and trigger native cardiomyocyte proliferation and recruitment of endogenous progenitor cells via paracrine effects. Mediators involved in paracrine signaling can be used as a stem cell-free therapy, with all the benefits and none of the associated complications of stem cells. Large-scale clinical trials are needed to confirm the long-term efficacy of CDC.