干细胞移植修复脊髓损伤的策略与进展  

Strategies and advance on stem cell transplantation for repair of spinal cord injury

作　　者：何宛俞 程乐平 He Wanyu;Cheng Leping(Institute of Neuroscience and Guangxi Key Laboratory of Brain Science,Guangxi Health Commission Key Laboratory of Basic Research on Brain Function and Disease,School of Basic Medical Sciences,Guangxi Medical University,Nanning 530021,Guangxi Zhuang Autonomous Region,China;Key Laboratory of Longevity and Aging-Related Diseases of Chinese Ministry of Education,Nanning 530021,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西医科大学基础医学院,神经科学研究所,广西脑科学研究重点实验室,广西壮族自治区卫生健康委员会脑功能与脑疾病基础研究重点实验室(广西医科大学),广西壮族自治区南宁市530021 [2]长寿与老年相关疾病教育部重点实验室,广西壮族自治区南宁市530021

出　　处：《中国组织工程研究》2024年第19期3090-3096,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金资助项目(32070976),项目负责人:程乐平;广西科技基地和人才专项(AD21075052),项目负责人:程乐平。

摘　　要：背景:脊髓损伤不仅给患者的身体和心理造成严重的伤害,而且给社会带来沉重的经济负担。脊髓损伤最初由机械性创伤造成,随后引起继发性损伤,并且随着病情的发展,逐渐形成胶质瘢痕。目的:归纳总结脊髓损伤的病理进程和干细胞移植修复脊髓损伤的策略,以期为脊髓损伤的治疗提供最佳方案。方法:应用计算机检索PubMed和中国知网数据库,中文检索词为“干细胞移植,脊髓损伤”,英文检索词为“stem cell,spinal cord injury,spinal cord,mesenchymal stem cells,neural stem cells,pathophysiology,clinical trial,primary injury,secondary injury”,按照纳入和排除标准对文献进行筛选,最终纳入91篇文献进行综述分析。结果与结论:①干细胞移植修复脊髓损伤的策略分为外源性干细胞移植和内源性干细胞移植,将治疗脊髓损伤的外源性干细胞移植策略分为4种,分别是将干细胞注射到损伤部位、负载干细胞的生物材料移植、胚胎组织移植、工程神经网络组织或脊髓样组织的移植;②与单一的治疗方式相比,联合治疗可更有效促进神经再生和脊髓功能恢复;③调控损伤部位的微环境、磁刺激、电刺激、振荡电场刺激、过表达转录因子、康复治疗等可与干细胞移植进行联合治疗,从而促进脊髓功能的恢复。BACKGROUND:Spinal cord injury not only causes serious physical and psychological injuries to patients but also brings a heavy economic burden to society.Spinal cord injury is initially triggered by mechanical trauma,followed by secondary injuries,and as the disease progresses,a glial scar develops.OBJECTIVE:To summarize the pathological process of spinal cord injury and strategies for stem cell transplantation to repair spinal cord injury,aiming to provide the best protocol for treating spinal cord injury.METHODS:Computer search was used to search PubMed and CNKI databases.Chinese search terms were“stem cell transplantation,spinal cord injury”.English search terms were“stem cell,spinal cord injury,spinal cord,mesenchymal stem cells,neural stem cells,pathophysiology,clinical trial,primary injury,secondary injury”.The literature was screened according to the inclusion and exclusion criteria.Finally,91 articles were included for review analysis.RESULTS AND CONCLUSION:(1)The strategies for repairing spinal cord injury through stem cell transplantation can be divided into exogenous stem cell transplantation and endogenous stem cell transplantation.The exogenous stem cell transplantation strategy for the treatment of spinal cord injury is divided into four kinds:injecting stem cells into the site of injury;transplantation of biomaterials loaded with stem cells;fetal tissue transplantation;transplantation of engineered neural network tissue or spinal cord-like tissue.(2)Compared with a single treatment method,combination therapy can more effectively promote nerve regeneration and spinal cord function recovery.(3)Microenvironment regulating the injury site,magnetic stimulation,electrical stimulation,epidural oscillating electric field stimulation,transcription factor overexpression and rehabilitation therapy can be combined with stem cell transplantation for combination therapy,thereby promoting the recovery of spinal cord function.

关 键 词：脊髓损伤 原发性损伤 继发性损伤 胶质瘢痕 干细胞移植 生物材料 间充质干细胞 联合治疗 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R622.3