外伤性视神经损伤及间充质干细胞治疗作用研究进展  

Mesenchymal stem cell therapies for traumatic optic nerve injury

作　　者：袁湘玲 姚瑶(综述) 伍子建(审校) Yuan Xiangling;Yao Yao;Ng Tsz Kin(Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong,Shantou 515041,China)

机构地区：[1]汕头大学•香港中文大学联合汕头国际眼科中心,汕头515041

出　　处：《中华实验眼科杂志》2025年第1期69-79,共11页Chinese Journal Of Experimental Ophthalmology

基　　金：广东省基础与应用基础研究基金区域联合基金—青年基金(2019A1515110685);广东省中医药建设专项资金面上项目(20202089)。

摘　　要：外伤性视神经损伤引起的视网膜神经节细胞(RGC)继发性死亡和轴突丢失是导致不可逆性视功能损害的主要原因。视神经受损后RGC的快速死亡及复杂的死亡途径致使临床治疗效果收效甚微。近年来,干细胞的潜能成为神经退行性病变组织修复再生的新治疗手段。成体干细胞,尤其是间充质干细胞(MSC),因其免疫调控特性和神经保护作用,在外伤性视神经损伤修复治疗上被广泛研究。MSC以旁分泌神经营养因子、释放外泌体及细胞移植直接接触受损组织等方式发挥神经保护作用促进RGC存活及轴突再生,并经处理后可增强其干细胞特性;此外,MSC可被诱导转分化为RGC,发挥细胞替代治疗的修复作用。本文将总结MSC在外伤性视神经损伤治疗方面的动物实验和临床研究进展,以及其作用机制,同时归纳了增强MSC神经保护作用的方法,还探讨未来MSC在外伤性视神经损伤上的发展方向,这有利于今后制定更完善可靠的MSC应用于外伤性视神经损伤的治疗策略。Optic nerve injury by trauma would lead to secondary retinal ganglion cell(RGC)death and axonal loss,which are the causes of irreversible visual impairment and even blindness.Currently,there is still no effective clinical treatment to cure optic nerve injury owing to limited regeneration or recovery and complex death mechanism in RGCs.Recently,stem cell therapy has been proposed as a viable treatment strategy for optic nerve injury.Adult stem cells,especially mesenchymal stem cells(MSCs)have been widely studied in animal models and tested in clinical trials for optic neuropathies.MSCs could promote RGC survival and axonal regeneration by their neuroprotective effects,including neurotrophic factor and exosome secretion,cell-cell contact and immunomodulation.The neuroprotective properties of MSCs could further be enhanced by preconditioning.In addition,MSCs are also able to be induced and transdifferentiate into RGC for potential cell replacement therapy.This article reviews the applications of MSCs in optic nerve injury treatment and their related mechanisms,summarizes the strategies to enhance the neuroprotective effects of human MSCs and discusses the future prospects of MSCs for optic nerve injury treatment to present the diversified function of MSCs,which will help formulate a more complete and reliable treatment strategy for MSC application in traumatic optic nerve injury in the future.

关 键 词：外伤性视神经损伤 间充质干细胞 视网膜神经节细胞 神经保护作用 细胞替代治疗 

分 类 号：R774.6[医药卫生—眼科]