Challenges and Strategies for Improving the Regenerative Effects of Mesenchymal Stromal Cell-Based Therapies.
Challenges and Strategies for Improving the Regenerative Effects of Mesenchymal Stromal Cell-Based Therapies.
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DOI：
10.3390/ijms18102087
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发表时间：
2017-10-02
影响因子：
5.6
通讯作者：
Toietta G
中科院分区：
文献类型：
--
作者：
Baldari S;Di Rocco G;Piccoli M;Pozzobon M;Muraca M;Toietta G
基于细胞的疗法有可能彻底改变当前对高患病率和相关经济和社会负担疾病的治疗方法。不幸的是，临床试验在恢复退化组织的正常功能方面仅取得了有限的进展。这种限制至少部分是由于机械、细胞和宿主因素的共同作用导致移植细胞在移植后几小时内死亡。特别是，植入期间的机械应力、递送时的细胞外基质损失、受体部位的营养和氧气缺乏以及宿主炎症反应是限制移植细胞长期存活的有害因素。细胞疗法对再生医学的有益效果最终取决于到达靶组织的施用细胞的数量、它们的活力以及它们对组织再生的促进。因此，旨在改善活细胞植入的策略对于再生医学至关重要。在这里，我们回顾了阻碍细胞成功植入的主要因素以及已研究的增强细胞治疗有益效果的策略。此外，我们还提供了关于间充质基质细胞衍生的细胞外囊泡递送作为一种无细胞再生方法是否可以规避当前细胞治疗局限性的观点。
Cell-based therapies have the potential to revolutionize current treatments for diseases with high prevalence and related economic and social burden. Unfortunately, clinical trials have made only modest improvements in restoring normal function to degenerating tissues. This limitation is due, at least in part, to the death of transplanted cells within a few hours after transplant due to a combination of mechanical, cellular, and host factors. In particular, mechanical stress during implantation, extracellular matrix loss upon delivery, nutrient and oxygen deprivation at the recipient site, and host inflammatory response are detrimental factors limiting long-term transplanted cell survival. The beneficial effect of cell therapy for regenerative medicine ultimately depends on the number of administered cells reaching the target tissue, their viability, and their promotion of tissue regeneration. Therefore, strategies aiming at improving viable cell engraftment are crucial for regenerative medicine. Here we review the major factors that hamper successful cell engraftment and the strategies that have been studied to enhance the beneficial effects of cell therapy. Moreover, we provide a perspective on whether mesenchymal stromal cell-derived extracellular vesicle delivery, as a cell-free regenerative approach, may circumvent current cell therapy limitations.
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