内皮祖细胞与间充质干细胞治疗血管支架相关疾病  

Endothelial progenitor cell and mesenchymal stem cell therapy for vascular stent-associated diseases

作　　者：李清音 李林华 张春乐[1] 付平[1] Li Qingyin;Li Linhua;Zhang Chunle;Fu Ping(Kidney Research Institute,Department of Nephrology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China;Frontier Science Center for Disease-related Molecular Network,Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川大学华西医院肾脏内科,肾脏病研究所,四川省成都市610041 [2]四川大学疾病分子网络前沿科学中心,四川省成都市610041

出　　处：《中国组织工程研究》2025年第19期4091-4101,共11页Chinese Journal of Tissue Engineering Research

摘　　要：背景:随着干细胞研究的发展,成体干细胞如内皮祖细胞和间充质干细胞在动脉粥样硬化、血管支架植入损伤并发症中的治疗效能逐渐被发现,由于静脉输注成体干细胞治疗疾病存在靶向性差、治疗效率低等问题,近年来对血管支架表面改性以实现内皮祖细胞或间充质干细胞的局部聚集与功能调节一直是研究的焦点。目的:论述内皮祖细胞、间充质干细胞在血管支架相关疾病中的治疗进展,以及基于内皮祖细胞、间充质干细胞的血管支架设计方面的研究现状。方法:在CNKI、万方、PubMed、Web of Science数据库检索建库以来发表的相关文献。中文检索词“内皮损伤,支架植入术,血栓,内膜增生,动脉粥样硬化,内皮修复,内皮祖细胞,间充质干细胞,血管支架”;英文检索词“endothelial injury,stenting,thrombosis,intimal hyperplasia,atherosclerosis,endothelial repair,endothelial regeneration,endothelial progenitor cell,mesenchymal stem cell,vascular stent,vascular scaffold”。根据纳入和排除标准,最终对127篇文献进行综述。结果与结论:内皮祖细胞、间充质干细胞能够通过分化以及旁分泌作用治疗动脉粥样硬化及支架植入损伤并发症,其作用机制主要包括保护内皮细胞、调节炎症细胞与炎症因子表达、调节平滑肌细胞增殖和表型等。间充质干细胞在治疗应用中可能伴有血栓、血管钙化等不良反应,使用细胞外囊泡、联合使用肝素进行表面设计是解决这一问题的可行方案。目前基于内皮祖细胞的支架研究较多,主要从内皮祖细胞的募集、捕获、增殖、分化与活性等方面进行支架表面改性;血管领域基于间充质干细胞捕获的支架研究较少,但间充质干细胞来源外泌体洗脱支架被发现具有极高的治疗效能。此外一些基础疾病如糖尿病可能会对成体干细胞活性造成影响,导致基于干细胞设计的支架失去效能,因而未来�BACKGROUND:With advancements in stem cell research,the therapeutic efficacy of adult stem cells such as endothelial progenitor cells and mesenchymal stem cells in atherosclerosis and complications arising from atherosclerosis and vascular stent implantation is gradually being recognized.Due to the limitations of intravenous infusion of adult stem cells,including poor targeting and low treatment efficiency,recent research has focused on surface modification of vascular stents to achieve localized aggregation and functional modulation of endothelial progenitor cells or mesenchymal stem cells.OBJECTIVE:To discuss the therapeutic progress of endothelial progenitor cells and mesenchymal stem cells in vascular stent-related diseases,summarize the research status of the design of vascular stents based on endothelial progenitor cells and mesenchymal stem cells.METHODS:Relevant literature was retrieved on CNKI,WanFang,PubMed,and Web of Science databases since their inception.The Chinese search terms were“endothelial injury,stenting,thrombosis,intimal hyperplasia,atherosclerosis,endothelial repair,endothelial progenitor cell,mesenchymal stem cell,vascular stent.”English search terms were“endothelial injury,stenting,thrombosis,intimal hyperplasia,atherosclerosis,endothelial repair,endothelial regeneration,endothelial progenitor cell,mesenchymal stem cell,vascular stent,vascular scaffold.”According to inclusion and exclusion criteria,127 articles were finally reviewed.RESULTS AND CONCLUSION:Endothelial progenitor cells and mesenchymal stem cells can treat atherosclerosis and complications of stent implantation through differentiation and paracrine effects,mainly by protecting endothelial cells,regulating the expression of inflammatory cells and cytokines,and modulating smooth muscle cell proliferation and phenotype.Mesenchymal stem cells may have adverse reactions such as thrombosis and vascular calcification in therapeutic applications,and using extracellular vesicles and co-administration with heparin for surface m

关 键 词：内皮祖细胞 间充质干细胞 动脉粥样硬化 球囊损伤 支架植入损伤 内膜增生 表面改性 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] Q819[生物学—生物工程]