Stem cells as therapeutic vehicles for the treatment of high-grade gliomas
Stem cells as therapeutic vehicles for the treatment of high-grade gliomas
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DOI：
10.1093/neuonc/nor204
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发表时间：
2012-03-01
期刊：
影响因子：
15.9
通讯作者：
Germano, Isabelle M.
中科院分区：
文献类型：
--
作者：
Binello, Emanuela;Germano, Isabelle M.
在过去的十年中，干细胞作为基于细胞治疗人类高级别胶质瘤的潜在工具引起了极大的兴趣。到目前为止，已经测试了3种类型的干细胞作为各种治疗剂的载体：胚胎，神经和间充质。在基于干细胞的递送的背景下检查的治疗方法和/或药剂的类型包括细胞因子、酶/前药自杀组合、病毒颗粒、基质金属蛋白酶和抗体。每种策略都有其特定的优点和缺点。无论干细胞的来源和/或类型如何，将其转化为临床环境都有几个值得关注的领域，例如成人大脑中的迁移，潜在的致畸作用，免疫排斥以及监管和伦理问题。尽管如此，一项临床试验正在进行中，使用基于神经干细胞的酶/前药自杀组合递送治疗复发性高级别胶质瘤。一个拟议的未来方向可能包括使用干细胞作为载体，用于递送靶向胶质瘤干细胞的药物，这与高级别胶质瘤对治疗的抗性有关。总的来说，干细胞为基于细胞的方法治疗高级别胶质瘤提供了前所未有的机会，高级别胶质瘤的预后一直很差，需要继续寻找治疗方案。
Stem cells have generated great interest in the past decade as potential tools for cell-based treatment of human high-grade gliomas. Thus far, 3 types of stem cells have been tested as vehicles for various therapeutic agents: embryonic, neural, and mesenchymal. The types of therapeutic approaches and/or agents examined in the context of stem cell based delivery include cytokines, enzyme/prodrug suicide combinations, viral particles, matrix metalloproteinases, and antibodies. Each strategy has specific advantages and disadvantages. Irrespective of the source and/or type of stem cell, there are several areas of concern for their translation to the clinical setting, such as migration in the adult human brain, potential teratogenesis, immune rejection, and regulatory and ethical issues. Nonetheless, a clinical trial is under way using neural stem cell based delivery of an enzymc/prodrug suicide combination for recurrent high-grade glioma. A proposed future direction could encompass the use of stem cells as vehicles for delivery of agents targeting glioma stem cells, which have been implicated in the resistance of high-grade glioma to treatment. Overall, stem cells are providing an unprecedented opportunity for cell-based approaches in the treatment of high-grade gliomas, which have a persistently dismal prognosis and mandate a continued search for therapeutic options.