摘要
支气管肺发育不良(bronchopulmonary dysplasia,BPD)是早产儿的慢性肺部疾病,尤其是极早产儿(出生胎龄小于32周)最常见的并发症。尽管围产期救治及护理取得了进步,但现代临床管理仍然缺乏专门促进肺修复和肺生长的疗法。间充质干细胞(mesenchymal stem cells,MSCs)是一类具有多向分化潜能的干细胞,其最新进展揭示了干细胞/祖细胞修复受损器官的前景。但MSCs本身存在的临床风险导致其无法实现更加广泛的应用。研究表明,在BPD动物模型中,MSCs来源的细胞外囊泡(MSCs-derived extracellular vesicles,MSC-EVs)可以通过下调纤维化因子、减轻炎症反应、促进血管生成、抗细胞凋亡、抗氧化应激等途径促进肺血管生成和肺泡的发育,减少肺动脉高压和炎症,在BPD肺损伤修复中发挥重要作用。本文主要综述了MSC-EVs治疗早产儿BPD的有潜力的临床前证据及可能机制,为今后其在BPD的临床应用提供新的治疗思路。
Bronchopulmonary dysplasia(BPD)is a chronic lung disease of preterm infants,particularly being the most common complication among extremely preterm infants(those born with a gestational age of less than 32 weeks).Despite advances in perinatal treatment and care,modern clinical management still lacks therapies specifically designed to promote lung repair and growth.Mesenchymal stem cells(MSCs)are a type of stem cells with multi-differentiation potential,and recent advances have revealed their potential to repair damaged organs through stem/progenitor cell-mediated regeneration.However,clinical risks associated with MSCs have hindered their broader applications.Research indicates that in BPD animal models,MSC-derived extracellular vesicles(MSC-EVs)manage to promote pulmonary angiogenesis,facilitate alveolar development,reduce pulmonary arterial hypertension,and alleviate pulmonary inflammation by downregulating fibrotic factors,alleviating inflammatory responses,and promoting angiogenesis,anti-apoptosis,and resistance to oxidative stress.Therefore,they play critical roles in the repair of lung injuries associated with BPD.This article reviews the potential preclinical evidence and possible mechanisms of MSC-EV-associated therapy in the treatment of neonatal BPD,providing new therapeutic insights for its future clinical application in neonatal BPD.
作者
刘怡波
蔡成
LIU Yi-Bo;CAI Cheng(Department of Neonatology,Shanghai Children’s Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200062,China)
出处
《生理科学进展》
CAS
北大核心
2024年第1期5-12,共8页
Progress in Physiological Sciences
基金
国家自然科学基金面上项目(2021YGZQ08)资助课题。
关键词
胞外囊泡
支气管肺发育不良
新生儿
免疫调节
氧化应激
extracellular vesicle
bronchopulmonary dysplasia
neonatus
immunomodulation
oxidative stress