经羊膜干细胞疗法:产前治疗多种先天性疾病的新策略  

Transamniotic stem cell therapy:a novel strategy for prenatal treatment of multiple congenital diseases

作　　者：成曦 孙宝兰[2] 谢园园 张玉泉[1] Cheng Xi;Sun Baolan;Xie Yuanyuan;Zhang Yuquan(Department of Gynecology and Obstetrics,Affiliated Hospital of Nantong University,Medical School of Nantong University,Nantong 226001,Jiangsu Province,China;Department of Laboratory,Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu Province,China)

机构地区：[1]南通大学附属医院妇产科,南通大学医学院,江苏省南通市226001 [2]南通大学附属医院检验科,江苏省南通市226001

出　　处：《中国组织工程研究》2023年第24期3892-3900,共9页Chinese Journal of Tissue Engineering Research

基　　金：江苏省研究生科研与实践创新计划项目(KYCX21_3118),项目负责人:谢园园;江苏省研究生科研与实践创新计划项目(KYCX20_2799),项目负责人:成曦。

摘　　要：背景:产前诊断的进步使得多种先天性疾病的产前管理和治疗成为可能,经羊膜干细胞疗法作为一种产前治疗先天性异常的新策略应运而生。目的:文章对应用经羊膜干细胞疗法产前治疗多种先天性疾病的研究结果进行综述。方法:通过计算机检索中国知网、维普、万方和PubMed数据库发表的文献,检索时间从各数据库建库至2022-08-01,中文检索词为“经羊膜干细胞疗法”“经羊膜”“羊膜腔内”“干细胞”或“经羊膜干细胞疗法”,英文检索词为“Transamniotic stem cell therapy”“Transamniotic”“intra-amniotic”“stem cells”或“TRASCET”。最终共纳入61篇经羊膜干细胞疗法相关的文献进行综述。结果与结论:(1)经羊膜干细胞疗法通过充分放大生理或病理条件下存在于羊水中干细胞的生物学功能用于产前胎儿异常治疗。(2)羊膜腔内输注的特定干细胞不仅可以直接播散至暴露于羊水的缺陷,而且还可以血行转运至胎盘、羊膜、绒毛膜、脐带、胎儿骨髓、脾脏、髋骨和脑等部位。(3)羊膜腔内输注间充质干细胞可明显促进组织修复和/或显著改善与主要先天性异常相关的不良影响,例如经羊膜干细胞疗法可以通过形成新生皮肤诱导部分或完全覆盖实验性脊柱裂;经羊膜干细胞疗法还可以缓解与腹裂相关的肠道损伤;同时,经羊膜干细胞疗法还能影响实验性先天性膈疝肺发育,显著降低肺小动脉壁厚度;经羊膜干细胞疗法可以逆转大鼠宫内生长受限的不良影响,包括显著改善胎盘效率以及提高胎儿体质量。(4)经羊膜干细胞疗法在先天性脊柱裂、腹裂、先天性膈疝和宫内生长受限这些先天性疾病模型中展现出良好的治疗潜能,但迄今为止尚无经羊膜干细胞疗法的临床报道,临床转化前需要在大型动物中进一步验证经羊膜干细胞疗法的有效性和安全性。(5)尽管经羊膜干细胞疗法目�BACKGROUND:Advances in prenatal diagnosis have made it possible to prenatal management and treatment of various congenital diseases.Transamniotic stem cell therapy has emerged as a new strategy for prenatal treatment of congenital anomalies.OBJECTIVE:To review the results of studies using transamniotic stem cell therapy in the prenatal treatment of various congenital diseases.METHODS:Databases of CNKI,VIP,WanFang and PubMed were searched from the inception to August 1,2022.The keywords were“transamniotic stem cell therapy”,“transamniotic”,“intra-amniotic”,“stem cells”or“TRASCET”in English and Chinese.Finally,a total of 61 articles on transamniotic stem cell therapy were included for review.RESULTS AND CONCLUSION:(1)Transamniotic stem cell therapy can be used to treat fetal abnormalities by fully magnifying the biological function of stem cells in amniotic fluid under physiological or pathological conditions.(2)Specific stem cells infused into amniotic cavity can not only be directly disseminated to defects exposed to amniotic fluid,but also be transported to placenta,amnion,chorion,umbilical cord,fetal bone marrow,spleen,hip bone and brain.(3)Intra-amniotic infusion of mesenchymal stem cells remarkably promoted tissue repair and/or significantly ameliorated adverse effects associated with major congenital abnormalities.For example,transamniotic stem cell therapy can induce partial or complete coverage of experimental spina bifida by forming new skin.Transamniotic stem cell therapy can also alleviate the bowel damage associated with gastroschisis;at the same time,transamniotic stem cell therapy can also affect lung development in experimental congenital diaphragmatic hernia and significantly diminish the thickness of pulmonary arteriole wall.Transamniotic stem cell therapy can reverse the adverse effects of intrauterine growth restriction in rats,including significantly improving placental efficiency and increasing fetal weight.(4)Transamniotic stem cell therapy has shown good therapeutic poten

关 键 词：经羊膜干细胞疗法 产前治疗 先天性疾病 出生缺陷 羊水干细胞 胎盘干细胞 综述 

分 类 号：R459.9[医药卫生—治疗学] R363[医药卫生—临床医学] R714