脂肪干细胞治疗复杂性肛瘘:作用与机制  

Treatment of complex anal fistula with adipose-derived stem cells: roles and mechanisms

作　　者：刘艳妮 倪敏[2] 张睿[1] 黄小波[1] 周春根 江滨[2] Liu Yan-ni;Ni Min;Zhang Rui;Huang Xiao-bo;Zhou Chun-gen;Jiang Bin(Nanjing University of Chinese Medicine,Nanjing 210000,Jiangsu Province,China;Nanjing Traditional Chinese Medicine Hospital,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]南京中医药大学,江苏省南京市210000 [2]南京市中医院,江苏省南京市210000

出　　处：《中国组织工程研究》2018年第33期5399-5407,共9页Chinese Journal of Tissue Engineering Research

基　　金：南京市卫生局重点资助项目(ZKX17034;ZKX15040)~~

摘　　要：背景:随着干细胞移植和组织工程技术的发展,脂肪干细胞移植在复杂性肛瘘中的治疗越来越受到重视。脂肪干细胞通过分泌各种生长因子和细胞因子,调节机体免疫系统,抑制局部和全身炎性反应,促进局部血管生成,激活成纤维细胞等机制,加速创面愈合。目的:对脂肪干细胞治疗复杂性肛瘘的效果、存在问题及对创面愈合的作用机制作一综述。方法:由第一作者以"adipose-derived stem cells,perianal fistulas,complex perianal fistulas,wound healing"为英文关键词,以"脂肪干细胞,肛瘘,复杂性肛瘘,创面愈合"为中文关键词,检索2003至2018年期间收录在PubMed、Medline、中国知网、万方等数据库中有关脂肪干细胞治疗复杂性肛瘘的文献,排除与文章研究目的无关及重复性的文章,纳入符合标准的95篇文献进行归纳总结。结果与结论:脂肪干细胞通过诱导分化、调节炎症免疫、促进血管新生、激活成纤维细胞等作用加速术后的创面愈合。国外脂肪干细胞治疗肛瘘临床研究结果显示:无论是自体还是异体脂肪干细胞治疗肛瘘,均具有创伤小、无括约肌损伤、疼痛轻、修复快、复发率低、住院时间短等特殊优势,安全性与有效性得到了初步认证,为临床治疗复杂性肛瘘提供了一种新的治疗手段。BACKGROUND:With the development of stem cell transplantation and tissue engineering technology,adipose-derived stem cell transplantation for complex anal fistula has received increasing attentions.By secreting various growth factors and cytokines,adipose-derived,stem cells regulate the body’s immune system,inhibit local and systemic inflammatory reactions,promote local angiogenesis,and activate fibroblasts,thereby accelerating wound healing.OBJECTIVE:To review the effects and existing problems of adipose-derived stem cells in the treatment of complex anal fistula as well as the mechanisms underlying wound healing.METHODS:The keywords of“adipose-derived stem cells,perianal fistulas,complex perianal fistulas,wound healing”in English and Chinese were to search relevant articles addressing adipose-derived stem cells for complex anal fistula treatment published from 2003 to 2018 in PubMed,Medline,CNKI,and WanFang.After removal of repetitive or irrelevant articles,95 eligible articles were finally reviewed.RESULTS AND CONCLUSION:Adipose-derived stem cells accelerate postoperative wound healing by inducing differentiation,regulating inflammatory immunity,promoting angiogenesis,and activating fibroblasts.Clinical evidence from foreign literatures reveal that either autologous or allogeneic adipose-derived stem cells have special advantages in the treatment of anal fistula,including small trauma,no sphincter injury,little pain,rapid repair,low recurrence rate,and short hospital stay.Safety and effectiveness of adipose-derived stem cells for anal fistula has been initially confirmed,providing a new strategy for the clinical treatment of complex anal fistula.

关 键 词：脂肪干细胞 复杂性肛瘘 创面修复 干细胞 脂肪组织 干细胞 直肠瘘 组织工程 

分 类 号：R394.2[医药卫生—医学遗传学]