Therapeutic use of mesenchymal stem cell-derived extracellular vesicles in acute lung injury.
Therapeutic use of mesenchymal stem cell-derived extracellular vesicles in acute lung injury.
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作者：
Lee JH;Park J;Lee JW
急性呼吸窘迫综合征是危重病人呼吸衰竭的主要原因。尽管对其病理生理学进行了广泛的研究，但死亡率仍然很高。没有有效的药物治疗方法。基于大量的临床前动物研究，间充质干细胞或基质细胞（MSC）作为急性肺损伤的治疗方法具有很大的前景，目前国际上正在进行I/II期临床试验。然而，对干细胞使用的担忧，特别是医源性肿瘤形成的风险，以及在骨髓移植设施中生产、储存和分配细胞的高昂成本，可能会限制这种挽救生命的疗法的使用。越来越多的证据表明，包括MSC条件培养基和MSCs释放的细胞外囊泡在内的新型干细胞衍生疗法可能构成令人信服的替代方案。本文综述了MSC细胞外囊泡治疗急性肺损伤和其他炎性肺疾病的临床前研究。虽然某些后勤障碍限制了间充质干细胞条件培养基的临床应用，如治疗所需的体积和条件培养基成分缺乏标准化，但间充质干细胞细胞外囊泡的治疗应用仍然有希望，主要是因为细胞外囊泡能够维持母细胞的功能表型。然而，间充质干细胞细胞外囊泡的利用将需要大规模生产，并在鉴定、表征和定量方面标准化。
Acute respiratory distress syndrome is a major cause of respiratory failure in critically ill patients. Despite extensive research into its pathophysiology, mortality remains high. No effective pharmacotherapy exists. Based largely on numerous preclinical animal studies, administration of mesenchymal stem or stromal cell (MSC) as a therapeutic for acute lung injury holds great promise, and phase I/II clinical trials are currently underway internationally. However, concern for the use of stem cells, specifically the risk of iatrogenic tumor formation, as well as the prohibitive cost of production, storage, and distribution of cells in bone marrow transplant facilities may limit access to this life saving therapy. Accumulating evidence now suggest that novel stem cell derived therapies including MSC conditioned medium and extracellular vesicles released from MSCs, might constitute compelling alternatives. The current review summarizes the preclinical studies testing MSC extracellular vesicles as treatment for acute lung injury and other inflammatory lung diseases. While certain logistical obstacles limit the clinical applications of MSC conditioned medium such as the volume required for treatment and lack of standardization of what constitutes the components of conditioned medium, the therapeutic application of MSC extracellular vesicles remains promising, primarily due to ability of extracellular vesicles to maintain the functional phenotype of the parent cell. However, utilization of MSC extracellular vesicles will require large-scale production and standardization concerning identification, characterization and quantification.
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DOI：
10.1186/cc13896
发表时间：
2014-05-28
期刊：
Critical care (London, England)
影响因子：
--
作者：
Hu SL;He HL;Pan C;Liu AR;Liu SQ;Liu L;Huang YZ;Guo FM;Yang Y;Qiu HB
通讯作者：
Qiu HB
影响因子：
3.4
作者：
Dubyak GR
通讯作者：
Dubyak GR
影响因子：
33.6
作者：
Jiang D;Liang J;Noble PW
通讯作者：
Noble PW
影响因子：
3.7
作者：
Bruno S;Grange C;Collino F;Deregibus MC;Cantaluppi V;Biancone L;Tetta C;Camussi G
通讯作者：
Camussi G
影响因子：
6.1
作者：
Biancone, Luigi;Bruno, Stefania;Camussi, Giovanni
通讯作者：
Camussi, Giovanni