细胞移植治疗脊髓损伤研究进展

Research Progress of Cell Transplantation in the Treatment of Spinal Cord Injury

脊髓损伤(spinal cord injury,SCI)属于中医学理论“体惰”“痿证”的范畴;目前临床上仅能通过手术减压或者使用药物对症干预,无法从根本上改善受损神经的功能,并易导致“脊髓脊膜腔综合征”。近年来国内外对神经脊髓损伤的病理机制研究不断深入,加之组织工程学和细胞移植技术的发展,发现细胞移植后具有免疫调节、分化、神经保护等功能,通过改善损伤区局部微环境,诱导神经干细胞定向分化为神经元对SCI后多因素导致的兴奋毒性、自由基损伤神经元以及胶质瘢痕组织的形成等问题进行修复,从而达到重建神经环路、恢复神经功能的效果。文章以当前治疗的进展为背景对干细胞移植、嗅鞘细胞移植、雪旺细胞移植及细胞移植途径等方面治疗脊髓损伤后神经环路重建进行综合阐述,为临床上有效地治疗脊髓损伤提供参考。

Spinal cord injury(SCI)belongs to the category of“body laziness”and“impotence”in Chinese medicine;currently,only surgical decompression or symptomatic intervention with drugs can be used,which cannot fundamentally improve the function of damaged nerves.It cannot fundamentally improve the function of the damaged nerve,and is prone to“spinal cord cavity syndrome”.In recent years,research on the pathological mechanism of neurospinal cord injury has been intensified,and the development of tissue engineering and cell transplantation technology.The immunomodulatory function,differentiation function and neuroprotection function of cells after cell transplantation have been discovered,and by improving the local microenvironment of the injured area,neural stem cells can be induced to differentiate into neurons to repair the excitotoxicity,free radical damage to neurons and the formation of glial scar tissue caused by multiple factors after SCI.This results in the reconstruction of neural circuits and restoration of neural function.This article provides a comprehensive description of stem cell transplantation,olfactory sheath cell transplantation,Schwann cell transplantation and cell transplantation pathways for neural circuit reconstruction after spinal cord injury in the context of current therapeutic advances to provide a reference for effective clinical treatment of spinal cord injury.