Stem cell rescue for carbon monoxide poisoning?
Stem cell rescue for carbon monoxide poisoning?
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干细胞拯救一氧化碳中毒？
DOI：
10.1097/ccm.0b013e318196fd6e
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发表时间：
2009
影响因子：
8.8
通讯作者：
Thom,Stephen
中科院分区：
文献类型：
--
作者：
Thom,Stephen
在这一期的《重症监护医学》中，Jiang等人（1）提供了第一份报告，描述了一种基于干细胞的策略，用于改善一氧化碳（CO）中毒后的脑损伤。通过使用大鼠模型，作者证明了在中毒后24小时注入骨髓源性干细胞可以减少中毒后5周通过Morris水迷宫测试评估的CO诱导的学习障碍，并且他们还表明治疗改善了脑组织学。将骨髓来源的干细胞输注到颈动脉中之后的益处，并且使用已经离体培养一段时间以诱导它们向神经元干细胞表型（MS-NSC）分化的骨髓细胞发现了稍微更好的结果。注入的干细胞弥散分布，可以在已知被CO损伤的脑区发现，包括大脑皮层、海马、基底神经节和脑室下白色物质。文章的主要结论是，注入的干细胞被隔离在受伤的大脑中，这些细胞似乎介导了神经功能的改善。作者认为，与骨髓源性干细胞相比，MS-NSCs移植表现出更高的存活率和终末神经细胞分化。由于移植细胞的数量相对较少，他们认为发生了旁分泌效应，其中干细胞释放出改善内源性脑细胞功能的试剂或生长因子。这些想法在文献中得到了很好的支持，也有替代的可能性。
In this issue of Critical Care Medicine, Jiang et al (1) provide the first report describing a stem cell-based strategy for ameliorating brain injury after carbon monoxide (CO) poisoning. By using a rat model, the authors demonstrated that infusing bone marrow-derived stem cells 24 hours after poisoning could diminish CO-induced learning impairment assessed by Morris Water maze tests at 5 weeks postpoisoning, and they also showed that treatments improved brain histology. Benefits followed infusion of bone marrow-derived stem cells into the carotid artery, and somewhat better results were found using bone marrow cells that had been cultured for a period of time ex vivo to induce them to differentiate toward a neuronal stem cell phenotype (MS-NSCs). Infused stem cells were diffusely distributed and could be found in brain areas know to be injured by CO, including the cerebral cortex, hippocampus, basal ganglia, and subventricular white matter.This is an exciting and provocative investigation on many levels. The major conclusion in the article is that infused stem cells are sequestered in the injured brain and these cells seem to mediate improvements of neurologic function. The authors suggest that MS-NSCs transplants exhibit higher survival rates and terminal neurocyte differentiation vs. bone marrow-derived stem cells. Because the number of transplanted cells is relatively small, they believe that paracrine effects occur wherein the stem cells liberate agents or growth factors that improve function of endogenous brain cells. These ideas are well supported in the literature and there are also alternative possibilities.