间充质干细胞在类风湿性关节炎治疗中的免疫调节作用

Immunomodulatory effects of mesenchymal stem cells in the treatment of rheumatoid arthritis

背景:间充质干细胞拥有强大的抗炎和免疫调节功能,有关其治疗类风湿性关节炎的实验研究已经深入开展,其可能成为临床治疗类风湿性关节炎的新方法,但具体的分子机制有待阐明。目的:为更好地理解间充质干细胞治疗类风湿性关节炎的分子机制,进一步补充间充质干细胞对炎症性关节炎保护作用方面的最新进展,探讨间充质干细胞移植治疗类风湿性关节炎效果的差异,期待这些成果能为开发精准化靶点治疗类风湿性关节炎的药物提供新思路。方法:检索PubMed、Elsevier、CNKI和万方数据库,查阅2008至2019年期间国内外有关类风湿性关节炎与间充质干细胞的文献。检索词分别为“类风湿性关节炎,间充质干细胞”和“mesenchymal stem cells,rheumatoid arthritis”。最后选择55篇文献纳入结果分析。结果与结论:类风湿性关节炎发病机制涉及多种免疫细胞的增殖、分化及多种炎症因子的失衡。间充质干细胞具有免疫调节功能,且对类风湿性关节炎具有明显治疗效果,在抑制T细胞增殖、上调Treg细胞比例、抑制B细胞功能和减少B细胞数量、影响树突状细胞成熟、诱导M2型巨噬细胞产生、抑制M1型巨噬细胞活化方面有重要作用。

BACKGROUND:Mesenchymal stem cells possess powerful anti-inflammatory and immunoregulatory functions.Intensive studies on mesenchymal stem cells for the treatment of rheumatoid arthritis have been conducted.Mesenchymal stem cells may become a new method for the treatment of clinical rheumatoid arthritis;however,the specific molecular mechanism remains to be elucidated.OBJECTIVE:To explore the therapeutic efficacy of mesenchymal stem cell transplantation on rheumatoid arthritis in a bid to better understand its molecular mechanism and further clarify the recent advances in its protective role in inflammatory arthritis,providing new ideas for the development of targeted drugs for the treatment of rheumatoid arthritis.METHODS:PubMed database,Elsevier,CNKI and WanFang databases were searched to review literatures on rheumatoid arthritis and mesenchymal stem cells published from 2008 to 2019.The search terms were “rheumatoid arthritis,mesenchymal stem cells” in English and Chinese.Finally,55 articles were selected for inclusion in the results analysis.RESULTS AND CONCLUSION:The pathogenesis of rheumatoid arthritis involves the proliferation and differentiation of various immune cells and the imbalance of various inflammatory factors.Mesenchymal stem cells have immunoregulatory functions and exert considerable therapeutic effects on rheumatoid arthritis.These cells have important roles in inhibiting T cell proliferation,up-regulating Treg cell ratio,suppressing B cell function,reducing B cell number,affecting dendritic cell maturation,inducing M2 type macrophage production,and hindering M1 type macrophage activation.