Adult stem cells for acute lung injury: remaining questions and concerns.
Adult stem cells for acute lung injury: remaining questions and concerns.
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DOI：
10.1111/resp.12093
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发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Lee JW
中科院分区：
文献类型：
--
作者：
Zhu YG;Hao Q;Monsel A;Feng XM;Lee JW
急性肺损伤（ALI）或急性呼吸窘迫综合征仍然是住院患者发病率和死亡率的主要原因。ALI的病理生理学涉及激发事件（如肺炎、脓毒症或吸入）与宿主免疫应答之间的复杂相互作用，导致肺蛋白渗透性、肺水肿消退受损、受损肺泡中的强烈炎症反应和低氧血症。在多项临床前研究中，成人干细胞已被证明具有治疗作用，因为它能够通过旁分泌机制减轻损伤和炎症，并且可能凭借其多能性再生组织。这些特征刺激了密集的研究努力，以探索使用干细胞或祖细胞治疗肺损伤的可能性。各种干细胞或祖细胞已被分离、表征，并在ALI的临床前动物模型中进行实验测试。然而，关于最佳剂量、途径和使用的成体干细胞或祖细胞的问题仍然存在。在这里，我们回顾了目前的机制，干细胞在ALI的治疗效果，以及将出现的问题，作为临床试验的ALI计划。
Acute lung injury (ALI) or acute respiratory distress syndrome remains a major cause of morbidity and mortality in hospitalized patients. The pathophysiology of ALI involves complex interactions between the inciting event, such as pneumonia, sepsis or aspiration, and the host immune response resulting in lung protein permeability, impaired resolution of pulmonary edema, an intense inflammatory response in the injured alveolus and hypoxemia. In multiple pre-clinical studies, adult stem cells have been shown to be therapeutic due to both the ability to mitigate injury and inflammation through paracrine mechanisms and perhaps to regenerate tissue by virtue of their multi-potency. These characteristics have stimulated intensive research efforts to explore the possibility of using stem or progenitor cells for the treatment of lung injury. A variety of stem or progenitor cells have been isolated, characterized, and tested experimentally in pre-clinical animal models of ALI. However, questions remain concerning the optimal dose, route and the adult stem or progenitor cell to use. Here, we review current mechanisms underlying the therapeutic effect of stem cells in ALI as well as the questions that will arise as clinical trials for ALI are planned.
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