干细胞在周围神经再生中的应用研究进展  

Advances in the application of stem cells in peripheral nerve regeneration

作　　者：叶钢[1] 李玉红[1,2] YE Gang;LI Yu-hong(Department of Pain Management and Anesthesiology,Shaoxing People’s Hospital (Shaoxing Hospital of Zhejiang University),Shaoxing, Zhejiang 312000, China)

机构地区：[1]绍兴市人民医院浙江大学绍兴医院疼痛科,浙江绍兴312000 [2]绍兴市人民医院浙江大学绍兴医院医学研究中心

出　　处：《中华全科医学》2019年第10期1736-1741,1772,共7页Chinese Journal of General Practice

基　　金：浙江省科技厅项目(2017C37160);浙江省卫计委项目(2018KY173);绍兴市科技局项目(2017B70038)

摘　　要：周围神经损伤是一种非常常见的疾病,临床严重程度不一,但对患者的工作效率和生活质量影响很大。目前治疗方法有限,作为首选的外科治疗在许多情况下不能提供令人满意的功能恢复。因此,如何更好地对周围神经损伤进行治疗一直是医学界的难题。在神经修复机制的研究中发现,周围神经损伤后伴随着复杂的再生过程,包括沃勒变性、轴突出芽以及髓鞘再生。施万细胞(Schwann cell,SCs)是外周神经系统的支持细胞,在神经损伤的生理反应和再生中起着不可或缺的作用。自体SCs的局限性包括获取困难、往往伴随着一定的侵袭性以及供体并发症、有限的扩增能力以及来源有限等限制其临床应用。随着生物医学的发展,人们把目光投向干细胞,实验发现干细胞是具有自我更新能力的多能细胞,有望改善神经损伤后功能恢复。干细胞可以分化为SCs样细胞,增强神经营养作用以及促进髓鞘形成,而不存在自体SCs的缺点,为改进现有治疗提供了途径。目前,很多学者研究各种类型的干细胞用于周围神经再生,根据干细胞来源有骨髓间充质干细胞、脂肪间充质干细胞、牙髓间充质干细胞、神经干细胞、胚胎干细胞、诱导多能干细胞、皮肤来源前体细胞以及肌源性干细胞等。本文就近年来上述干细胞在周围神经再生中的研究进展作一综述。Peripheral nerve injury is a very common disease with varying degrees of clinical severity, but it has a great impact on patients’ work efficiency and quality of life. As the first choice of surgical treatment in many cases does not provide satisfactory functional recovery, how to treat peripheral nerve injury has always been a difficult subject in the medical profession at present. In the study of nerve repairing mechanism, it was found that peripheral nerve injury was accompanied by complex regeneration process, including Waller degeneration, axonal sprouting and myelin regeneration. Schwann cells(SCs) are supporting cells of the peripheral nervous system and play an indispensable role in physiological response and regeneration of nerve injury. Limitations of autologous SCs include difficulty in acquisition, often accompanied by certain invasiveness and donor complication, limited proliferative ability and limited sources, which limit their clinical application. With the development of biomedicine, people turn their attention to stem cells. Experiments have found that stem cells are pluripotent cells with self-renewal ability, which is expected to improve the functional recovery after nerve injury. Stem cells can differentiate into SCs-like cells, enhance the neurotrophic effect and promote myelin sheath formation, but do not have the disadvantages of self-SCs, providing a way to improve the existing treatment. According to the source of stem cells, there are bone marrow mesenchyma stem cells, fat mesenchymal stem cells, dental pulp mesenchymal stem cells, nerve stem cells, embryonic stem cells, induced pluripotent stem cells, skin derived cells precursor cells and myogenic stem cells. This review summarizes the recent advances in above mentioned stem cells in peripheral nerve regeneration.

关 键 词：干细胞 施万细胞 周围神经再生 

分 类 号：R322.85[医药卫生—人体解剖和组织胚胎学] R745[医药卫生—基础医学]