干细胞及其来源外泌体对心脏衰老干预作用的研究进展

Progress in intervention of cardiac aging with stem cells and their derived exosomes

衰老是心血管疾病的主要危险因素,心脏衰老参与了多种心血管疾病的病理进程。近年来,随着心脏衰老过程中结构和功能的变化及其细胞和分子机制研究的逐渐深入,作为未来新型生物药的干细胞及其来源外泌体以其独有的生物学特性和功能成为心脏衰老及相关心血管疾病的研究热点,多种干细胞被用于干预心脏衰老。造血干细胞(HSC)可通过减缓心脏内皮细胞衰老,促进衰老心脏的功能修复。胚胎干细胞(ESC)可分化成心肌细胞,从而改善心室功能和左室重塑。诱导多能干细胞(iPSC)可用于治疗衰老相关心肌梗死。间充质干细胞(MSC)来源广泛且具有低免疫源性,对心肌纤维化、心肌肥大等衰老相关心血管疾病展现出显著的治疗优势。干细胞来源外泌体是干细胞旁分泌作用的一种媒介,介导干细胞与受体细胞间的信息传递,可将各种遗传物质靶向递送至心肌细胞、内皮细胞、巨噬细胞等受体细胞,促进新生血管形成,抑制心肌细胞凋亡和炎症反应的发生,从而减轻心肌损伤,改善衰老心脏的功能,更具有靶向性和生物相容性。

Aging is considered a primary risk factor for cardiovascular disease,and cardiac aging plays a role in the pathogenesis of various cardiovascular diseases.Over the years,research into the structural and functional changes associated with cardiac aging,as well as the mechanisms underlying this process,has become increasingly extensive.Stem cells and their derived exosomes,with their unique biological features and functions,have emerged as a hot topic of research for cardiac aging and related cardiovascular diseases.As such,various types of stem cells are being explored as potential interventions for cardiac aging.Hematopoietic stem cells(HSCs)can decelerate the aging process of endothelial cells in the heart and facilitate the functional restoration of the aging heart.Embryonic stem cells(ESCs)can differentiate into cardiomyocytes,thereby ameliorating ventricular function and left ventricular remodeling.Induced pluripotent stem cells(iPSCs)can be utilized in the treatment of age-related myocardial infarction.Mesenchymal stem cells(MSCs),which have a wide range of sources and low immunogenicity,exhibit significant therapeutic advantages in age-related cardiovascular diseases such as myocardial fibrosis and cardiac hypertrophy.Stem cell-derived exosomes act as a mediator of their paracrine effects,facilitating the transfer of genetic material between stem cells and receptor cells.These exosomes can deliver various genetic materials to target cells,such as cardiomyocytes,endothelial cells,and macrophages,promoting neovascularization,inhibiting apoptosis of cardiomyocytes,and suppressing inflammatory responses.This approach can effectively reduce myocardial damage,improve the function of the aging heart,and has the advantages of targeting and biocompatibility.