间充质干细胞治疗脊髓损伤:细胞治疗及联合新药和生物材料

Mesenchymal stem cells in the treatment of spinal cord injury:cell therapy and combination of new drugs and biomaterials

背景:脊髓损伤治疗主要为改善损伤部位炎症微环境以及神经功能的再生和修复。间充质干细胞具有体外易扩增、可多向分化及抑制继发性炎症、免疫调节等特性,使得对包括脊髓损伤在内的各种难治性组织损伤性疾病进行间充质干细胞移植治疗成为一种极有潜力的细胞治疗方式。目的:简述近年来间充质干细胞治疗脊髓损伤的临床前和临床研究,并提出间充质干细胞在试验研究中面临的问题和发展方向。方法:以“间充质干细胞,脊髓损伤,细胞移植,免疫调节,联合治疗,生物材料”和“mesenchymal stem cells,spinal cord injury,cell transplantation,immunomodulation,combination therapy,biomaterial”作为检索词,检索万方数据库、中国期刊全文数据库(CNKI)及PubMed数据库2000至2020年发表的相关文献。结果与结论:①不同来源的间充质干细胞在动物模型及临床试验中可发挥抗炎、诱导轴突及神经元再生的作用,有效改善受损部位的神经功能;②间充质干细胞来源外泌体在脊髓损伤动物模型中表现出免疫调节、促血管新生等作用;③为更大程度发挥间充质干细胞的潜能,进行细胞预处理、联合新药或联合生物材料等是间充质干细胞治疗脊髓损伤的研究方向。

BACKGROUND:The treatment of spinal cord injury is mainly to improve the inflammation microenvironment of the injury site,as well as the regeneration and repair of neural function.Mesenchymal stem cells have the characteristics of easy proliferation in vitro,multi-directional differentiation,and suppression of secondary inflammation and immunomodulation,which makes the transplantation of mesenchymal stem cells for various refractory tissue injury diseases including spinal cord injury become a potential cell therapy.OBJECTIVE:To summarize the preclinical and clinical research of mesenchymal stem cells in the treatment of spinal cord injury in recent years,and put forward the problems and development directions of mesenchymal stem cells in experimental research.METHODS:We searched the articles published in Wanfang databases,CNKI and PubMed databases from 2000 to 2020.The key words were“mesenchymal stem cells,spinal cord injury,cell transplantation,immunomodulation,combination therapy,biomaterials”in Chinese and English,respectively.RESULTS AND CONCLUSION:(1)Mesenchymal stem cells from different sources play the role of anti-inflammatory,inducing axon and neuron regeneration in animal models and clinical experiments,and effectively improve the neural function of the damaged area.(2)The exosomes derived from mesenchymal stem cells show the effects of immunomodulation and angiogenesis in the disease model of spinal cord injury.(3)In order to maximize the potential of mesenchymal stem cells,exploring cell pretreatment,combined with new drugs or biological materials is the research direction of mesenchymal stem cells in the treatment of spinal cord injury.