中药联合骨髓间充质干细胞治疗缺血性脑卒中作用及机制研究进展

Effect and Mechanism of Chinese Medicine Combined with Bone Marrow Mesenchymal Stem Cells in Treatment of Ischemic Stroke:A Review

脑卒中是威胁人类健康的主要疾病之一,其中缺血性脑卒中约占70%。缺血性脑卒中具有病理机制复杂、发病率高、致残率高和死亡率高的特点。目前,对缺血性卒中有效的临床治疗措施非常有限,迫切需要开发新的有效的治疗措施以改善患者预后。近年来,骨髓间充质干细胞(BMSCs)移植对包括缺血性脑卒中在内的多种疾病展现出巨大的治疗潜力,成为一个新的研究热点,但由于BMSCs移植后在人体中的归巢率和存活率低等问题,其对缺血性卒中的临床疗效有待进一步提升。中药具有多成分、多途径、多靶点等特点,其对缺血性脑卒中的良好疗效受到广泛关注。中药与BMSCs移植均具有良好的整体脑保护作用,二者联合对缺血性卒中的疗效明显优于单独应用,作用机制包括提高BMSCs移植效率、促进血管新生、增强神经可塑性、改善神经炎症、增强神经保护、调控血脑屏障及外泌体。这种中药与现代前沿细胞疗法相结合的治疗方法体现了中西医结合的优势所在,为缺血性脑卒中的防治和提高BMSCs移植疗效提供了新的模式和思路。

Stroke is one of the major diseases threatening human health,with ischemic stroke accounting for about 70%.Ischemic stroke is characterized by complex pathological mechanism and high incidence,mobility and mortality.At present,the effective clinical treatment measures for ischemic stroke are limited,and it is urgent to develop new and effective treatment measures to improve the prognosis of patients.In recent years,bone marrow mesenchymal stem cells(BMSCs)transplantation has shown great therapeutic potential for a variety of diseases,including ischemic stroke,and has become a new research hotspot.However,due to the low homing and survival rate of BMSCs in human body after transplantation,their clinical effect on ischemic stroke needs to be further improved.With the characteristics of multi-components,multi-channels and multi-targets,Chinese medicine displays desirable curative effect on ischemic stroke,which has been widely concerned.Both Chinese medicine and BMSCs transplantation have good overall brain protection,and their combined effect on ischemic stroke is significantly better than that of single application.The mechanisms include improving the transplantation efficiency of BMSCs,promoting angiogenesis,enhancing neuroplasticity,ameliorating neuroinflammation,enhancing neuroprotection,and regulating the blood-brain barrier and exosomes.The combination of Chinese medicine and modern cutting-edge cell therapy reflects the advantages of integrative medicine,providing a new model and idea for preventing and treating ischemic stroke and improving the efficacy of BMSCs transplantation.