不同胚层来源成体干细胞修复周围神经损伤  

Adult stem cells from different germ layers applied in peripheral nerve injury repair

作　　者：郑家晨 杨恩同 朱弈舟 刘芳 Zheng Jiachen;Yang Entong;Zhu Yizhou;Liu Fang(Basic Medical College of Naval Medical University,Shanghai 200433,China;Department of Human Anatomy,Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学基础医学院,上海市200433 [2]海军军医大学人体解剖学教研室,上海市200433

出　　处：《中国组织工程研究》2025年第19期4102-4110,共9页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金项目(81571211),项目负责人:刘芳。

摘　　要：背景:成体干细胞疗法是周围神经损伤修复与再生领域的研究热点之一。中胚层被视为成体干细胞的理想来源,间充质干细胞具有获得率高、来源广、增殖快等优异性能。而外胚层来源成体干细胞,尤其是神经嵴干细胞,具有神经源性,越来越受到研究人员的关注。目的:对来自外胚层和中胚层的多功能成体干细胞在周围神经损伤修复与再生中的作用及机制进行简要综述,探究不同来源成体干细胞的研究进展与应用前景,并结合临床研究,探讨成体干细胞疗法潜在的应用价值以及亟待解决的问题。方法:第一作者于2024年2月应用计算机在PubMed和SinoMed数据库检索2001年12月至2024年2月相关文献,以“ectodermal stem cells,mesenchymal stem cells,peripheral nerve injury,repair,regeneration”为英文检索词,以“外胚层干细胞、间充质干细胞、周围神经损伤、修复、再生”为中文检索词,最终纳入69篇文献进行分析论述。结果与结论:①外胚层来源成体干细胞具有优异的分化和再生潜能,尤其是毛囊神经嵴干细胞、嗅干细胞、牙外胚层干细胞等,具有神经源性,可在体外表达神经特异性标志物,但目前缺少临床试验研究。②中胚层来源成体干细胞种类多、易获得及纯化,其中骨髓间充质干细胞和脐带间充质干细胞在周围神经损伤修复的应用疗效及安全性方面有相关临床试验支持,能改善感觉及运动神经传导,且在随访中未出现并发症和明显不良反应。骨髓间充质干细胞的获取需行侵入性外科手术且要求患者与捐赠者骨髓配型吻合,应用受到一定限制;而脐带间充质干细胞虽无需侵入性获取,但分离较困难且表型不稳定。③内胚层来源成体干细胞常难以在体外生长,应用受限,目前应用于临床的可能性低。④综合来看,骨髓间充质干细胞仍为周围神经损伤干细胞治疗的首选细胞,适用于无外科手术�BACKGROUND:Adult stem cell therapy is one of the research hotspots in the field of peripheral nerve injury repair and regeneration.With excellent properties of mesenchymal stem cells such as high acquisition rate,wide source,and rapid proliferation,mesoderm have been regarded as the ideal source of adult stem cells,while ectoderm-derived adult stem cells,especially neural crest stem cells,have certain neurogenic properties and attract more and more attention from researchers.OBJECTIVE:To mainly review the role and mechanism of multifunctional adult stem cells from ectoderm and mesoderm in peripheral nerve injury repair and regeneration,so as to explore the research progress and application prospect of adult stem cells from different sources and discuss the potential application value of adult stem cell therapy and the problems to be solved in connection with clinical studies.METHODS:The first author searched the relevant articles published from December 2001 to February 2024 in PubMed and SinoMed by computer in February 2024.The Chinese and English search terms were“ectodermal stem cells,mesenchymal stem cells,peripheral nerve injury,repair,regeneration.”Finally,69 articles were included and analyzed.RESULTS AND CONCLUSION:(1)Ectodermal adult stem cells have excellent differentiation and regeneration potential,especially epidermal neural crest stems cells,olfactory stem cells,and dental ectomesenchymal stem cells,which have certain neurogenic properties and can express neural specific markers in vitro.However,relevant clinical research needs to be accumulated.(2)There are many types of adult stem cells derived from mesoderm,which are easy to obtain and purify.Among them,the efficacy and safety of bone marrow mesenchymal stem cells and umbilical cord mesenchymal stem cells in the repair of peripheral nerve injury are supported by clinical trials;that is,they can improve sensory and motor nerve conduction and there are no complications and obvious adverse reactions in follow-up.The acquisition of bone marrow me

关 键 词：成体干细胞 周围神经损伤 毛囊神经嵴干细胞 嗅干细胞 牙外胚层干细胞 骨髓间充质干细胞 脐带间充质干细胞 羊水间充质干细胞 皮肤干细胞 肌肉间充质干细胞 

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