Emerging therapeutic approaches for multipotent mesenchymal stromal cells.
Emerging therapeutic approaches for multipotent mesenchymal stromal cells.
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多能间充质基质细胞的新兴治疗方法。
DOI：
10.1097/moh.0b013e32833e5b18
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发表时间：
2010-11
影响因子：
3.2
通讯作者：
Lazarus HM
中科院分区：
文献类型：
--
作者：
Caimi PF;Reese J;Lee Z;Lazarus HM
多能间充质间质细胞（MSCs）是一种罕见的细胞，存在于骨髓和其他器官中，能够分化为中胚层谱系组织。间充质干细胞具有免疫调节特性，并具有广泛的体外扩增能力。早期临床研究证明了输注自体间充质干细胞的安全性和可行性，并提示其在造血细胞移植（HCT）后促进移植的作用。随后使用同种异体间充质干细胞进行的初步研究显示其安全性，但在治疗移植物抗宿主病（GVHD）的有效性方面结果相互矛盾。更大规模的II期同种异体间充质干细胞输注研究，包括从单倍体和第三方供体获得的细胞，显示出GVHD治疗的有效性；然而，最近的随机、安慰剂对照研究未能证实这些结果。新的研究包括脐带血移植中的MSC输注，组织再生/修复中的MSC治疗，从脂肪组织中获取和使用MSC，以及使用放射性核素、基因和荧光染料标记的MSC进行细胞跟踪/成像研究。由于间充质干细胞的分化潜力和免疫调节特性，它们仍然是HCT研究的重点。虽然自体、异体和第三方供体间充质干细胞的输注是安全的，但需要进一步的研究来阐明在HCT情况下收获和扩增的最佳方法、最佳给药时间和疗效。
Multipotent mesenchymal stromal cells (MSCs) are rare cells resident in bone marrow and other organs capable of differentiating into mesodermal lineage tissues. MSCs possess immunomodulatory properties and have extensive capacity for ex vivo expansion. Early clinical studies demonstrated safety and feasibility of infusing autologous MSCs and suggested a role in enhancing engraftment after hematopoietic cell transplant (HCT). Subsequent pilot studies using allogeneic MSCs showed safety but contradictory results regarding efficacy in treating graft-versus-host disease (GVHD). Larger, phase II allogeneic MSC infusion studies, including cells obtained from haploidentical and third-party donors, showed efficacy in GVHD treatment; however, recent randomized, placebo-controlled studies failed to corroborate these results. New investigations include MSC infusions in umbilical cord blood transplantation, MSC therapy for tissue regeneration/repair, harvest and use of MSCs from adipose tissue and cell-tracking/imaging studies using radionuclides, gene-and fluorescent dye labeled-MSCs. MSCs remain the subject of intense investigation in HCT because of their differentiation potential and immunomodulatory properties. While infusions of autologous, allogeneic and third-party donor MSCs are safe, further research is needed to clarify the optimal methods for harvesting and expansion, optimal timing of administration and efficacy in the setting of HCT.