Multipotent Mesenchymal Stromal Cell Therapy and Risk of Malignancies
Multipotent Mesenchymal Stromal Cell Therapy and Risk of Malignancies
复制标题
DOI：
10.1007/s12015-011-9345-4
复制
发表时间：
2013-02-01
影响因子：
4.8
通讯作者：
Perico, Norberto
中科院分区：
文献类型：
--
作者：
Casiraghi, Federica;Remuzzi, Giuseppe;Perico, Norberto
多能间充质干细胞(MSC)的细胞治疗在治疗大量退行性疾病和免疫/炎症性疾病方面具有巨大的前景。它们的多向分化潜能、免疫特权和促进受损组织恢复的能力，以及抗炎和免疫抑制特性，是目前正在进行的大量临床研究的重点。目前公认的骨髓间充质干细胞修复/免疫调节作用的临床潜力包括移植物抗宿主疾病、血液系统恶性肿瘤、心血管疾病、神经和遗传性疾病、自身免疫性疾病、器官移植、难治性创伤和骨/软骨缺陷等。然而，有研究表明，临床需要广泛的体外培养，以及它们的促血管生成、抗凋亡和免疫调节特性可能共同起到肿瘤促进剂的作用，这引发了重大的安全性问题。本文将综述有关MSC体外分化不良和体内维持肿瘤生长能力的现有数据，以期阐明基于MSC的治疗方法是否具有实际的恶性肿瘤风险。
Cell therapy with Multipotent Mesenchymal Stromal Cells (MSC) holds enormous promise for the treatment of a large number of degenerative and immune/inflammatory diseases. Their multilineage differentiation potential, immunoprivilege and capacity of promoting recovery of damaged tissues coupled with anti-inflammatory and immunosuppressive properties are the focus of a multitude of clinical studies currently underway. The recognized clinical potential of MSC repairing/immunomodulatory effects now encompasses graft-versus-host disease, hematologic malignancies, cardiovascular diseases, neurologic and inherited diseases, autoimmune diseases, organ transplantation, refractory wounds, and bone/cartilage defects among others. However, it has been suggested that both the need of extensive ex vivo culture for MSC clinical use, and their proangiogenic, anti-apoptotic and immunomodulatory properties may act together as tumor promoters, raising significant safety concerns. This paper will review the available data on in vitro MSC maldifferentiation and the ability of MSC to sustain tumor growth in vivo, with the aim to clarify whether MSC-based therapeutic approaches may carry actual risk of malignancies.