间充质干细胞源性外泌体治疗继发性淋巴水肿  

Mesenchymal stem cells-derived exosomes in treatment of secondary lymphedema

作　　者：王欣欣 王景信[2] Wang Xinxin;Wang Jingxin(Xinxiang Medical University,Xinxiang 453000,Henan Province,China;Zhengzhou Central Hospital,Zhengzhou 450007,Henan Province,China)

机构地区：[1]新乡医学院,河南省新乡市453000 [2]郑州市中心医院,河南省郑州市450007

出　　处：《中国组织工程研究》2023年第10期1603-1609,共7页Chinese Journal of Tissue Engineering Research

基　　金：河南省医学科技攻关计划项目(2018020778),项目负责人:王景信;河南省重点研发与推广专项(科技攻关)项目(222102310657),项目负责人:王景信;新乡医学院研究生科技创新支持计划项目(YJSCX202146Y),项目负责人:王欣欣。

摘　　要：背景:多种细胞通过旁分泌形式可分泌微囊泡,其中体积最小的被称为外泌体。起初外泌体被认做细胞的“代谢废物”,后发现其通过转运独立的蛋白质、脂质、mi RNA或以配体形式参与调控许多重要的信号通路。间充质干细胞源性外泌体作为极具研究潜力的非细胞疗法之一,广泛应用于多种疾病,对继发性淋巴水肿具有重要治疗作用。目的:综述间充质干细胞源性外泌体对继发性淋巴水肿的作用及其研究进展,展望未来研究仍需蓄力的方向。方法:通过关键词及“滚雪球”式在PubMed、Google Scholar、Embase、Scopus、Wiley数据库和中国知网、万方数据库检索间充质干细胞源性外泌体对继发性淋巴水肿的相关文献,检索时间为2005-2022年,最终共纳入58篇文献进行综述分析。结果与结论:(1)间充质干细胞源性外泌体因低免疫原性的优势广泛应用于组织再生和内脏纤维化等多种研究领域,其来源丰富,脂肪、骨髓、脐血源性外泌体应用最为成熟。(2)间充质干细胞源性外泌体对于继发性淋巴水肿的缓解作用已经被证实,通过在动物水肿局部皮下注射间充质干细胞源性外泌体,淋巴管内皮细胞显著增生分化形成新生旁系淋巴管,有效减少水肿体积。(3)外泌体调控慢性炎症反应中巨噬细胞、转化生长因子β及其他炎性细胞或因子的数量,改善间质微环境,影响后续纤维化、脂肪沉积进程,但具体调控机制有待探讨。(4)目前间充质干细胞源性外泌体对继发性淋巴水肿的康复作用研究仅限于动物实验,并未涉及临床,且在研究过程中外泌体最佳浓度、最佳干预时间及干预频率等方面均无清晰界定,未来需要更多机制研究并补充临床相关试验。BACKGROUND:A variety kinds of cells can secrete microvesicles because of their paracrine effect,and the smallest microvesicles are called exosomes.Initially,exosomes were recognized as the “metabolic waste” of normal cells.However,they can engage in the regulation of several signaling pathways by transporting special substances such as proteins,lipids,mi RNA and ligands or just act as ligands.As one of the most promising therapies,mesenchymal stem cells-derived exosomes are widely used in the study of various diseases and have a significant role in secondary lymphedema.OBJECTIVE:To review the development and effect of mesenchymal stem cells derived exosomes on secondary lymphedma systematically,and summarize the deficiency of researches.METHODS:With the key words and “snowballing ways”,articles about rehabilitation of mesenchymal stem cells-derived exosomes on secondary lymphedma were searched in Pub Med,Google Scholar,Embase,Scopus,Wiley,CNKI and Wanfang databases from 2005 to 2022.A total of 58 articles were included finally.RESULTS AND CONCLUSION:(1) Due to the low immunogenicity of mesenchymal stem cells-derived exosomes,they are widely used in tissue regeneration,visceral fibrosis and many other kinds of diseases.There are rich sources of them,the application of adipose,bone marrow,umbilical cord blood-derived exosomes are most frequent.(2) Mesenchymal stem cells-derived exosomes benefit secondary lymphedema in animal experiments.They can reduce the volume of edema by promoting lymphatic endothelial cell differentiation and reconstructing new lymphatic values.(3) Meanwhile,the exosomes can interact with macrophages and transforming growth factor β and other important factors to regulate the local inflammation as well as the process of fibrosis and fat deposition.However,the specific intervention machanisms are still incomplete.(4) Current researches focus on the animal experiments not touch upon clinical experiments.Besides,there are no clear conclusions about the optimal concentration,proper time a

关 键 词：间充质干细胞源性外泌体 继发性淋巴水肿 淋巴管内皮细胞 炎症因子 纤维化 水凝胶 组织工程 综述 

分 类 号：R459.9[医药卫生—治疗学] R363[医药卫生—临床医学] R364