间充质干细胞治疗重症急性胰腺炎

Therapeutic potential of mesenchymal stem cells for severe acute pancreatitis

急性胰腺炎通常是一种轻度的自限性疾病,10%～15%的病例会发展成重症急性胰腺炎,伴随系统性炎症反应及多器官衰竭。重症急性胰腺炎尚无有效的治疗手段,目前的治疗方案主要是提供对症支持治疗,耗费了巨大的卫生资源。间充质干细胞具有自我更新、增殖和多向分化潜能。研究发现间充质干细胞还具有免疫调节和促进组织修复功能,多项动物实验发现间充质干细胞治疗重症急性胰腺炎可以减轻胰腺组织炎症水平,缓解胰腺组织水肿,减少腺泡组织的凋亡。在中西医结合的基础上配合间充质干细胞治疗可以取得更加显著的治疗效果。间充质干细胞治疗重症急性胰腺炎的临床实验研究仅限与极少数病例,因此还需要进一步进行系统研究以确定间充质干细胞移植的最佳时机和有效剂量。虽然仍然存在着各种各样的问题,但是将间充质干细胞应用于重症急性胰腺炎的治疗已经展现出良好的应用前景。

Acute pancreatitis is a generally mild and self-limiting disease.However,about 10%-15%of patients with the condition can be severe,in whom a systemic inflammatory response and multiple organ failure occur.Despite huge improvements in intensive care treatment,no effective medical therapies are currently available to prevent this condition.Mesenchymal stem cells(MSCs)are capable of self-renewal,proliferation and differentiating into various cells,and they are being tested for their immunoregulatory activities and regenerative potential.Recently,MSCs have been reported as a stem cell-based therapy in experimental severe acute pancreatitis,which significantly reduced the inflammatory level,pancreatic edema and acinar cell degeneration.The combination of MSCs with Chinese herbal medicine has shown more potential for the treatment of severe acute pancreatitis.Thus,MSCs will be a promising tool for treatment of severe acute pancreatitis.However,in spite of these encouraging findings,the optimal dosage and detailed mechanisms need to be explored further.