招募内源性干细胞-组织再生之梦

组织干细胞是成体组织中存在的一类尚未分化、能自我更新和增殖的特殊细胞群,具有分化为多种组织细胞的潜能.一般处于休眠状态,在组织损伤修复和维持组织的动态平衡中发挥重要的作用.体育运动、激素、生长因子和药物能激活内源性的组织干细胞,促进组织再生或伤口修复.利用内源性修复机制刺激组织再生,一直是生物医学领域的梦想.最新的研究表明,这个梦想现在可能成为现实.本文简要介绍了组织干细胞的内源性修复、内源性修复的生理学机制、招募内源性干细胞的主要方法及目前采用招募内源性干细胞修复和再生组织这一策略尚需克服的困难和临床应用前景.     

周围神经再生早期过程中内源性和外源性巨噬细胞数量变化的实验研究

目的：周围神经再生过程中巨噬细胞发挥了重要的作用,然而目前对于神经内内源性和外源性巨噬细胞的具体作用了解的却很少,因此本实验研究了小鼠坐骨神经损伤后早期再生过程中内源性和外源性巨噬细胞数量比例变化的情况,探索周围神经再生的规律。方法：移植CAG-EGFP转基因小鼠的全骨髓有核细胞到骨髓灭活野生型C5781／6小鼠体内建立嵌合体小鼠模型。待移植成功3个月后夹伤小鼠一侧坐骨神经,并在损伤后第2、7、14和28天取材、切片,使用巨噬细胞特异性抗体cD68进行免疫荧光染色,分析损伤神经段中内源性巨噬细胞（CD68＋／EGFP-）、外源性巨噬细胞（CD68＋／EGFP＋）的数量及其比例变化情况。结果：①夹伤骨髓移植模型小鼠坐骨神经后,参与坐骨神经损伤修复的巨噬细胞可分为两类,即内源性巨噬细胞（CD68＋／EGFP-）和外源性巨噬细胞（CD68＋／EGFP＋）;②夹伤坐骨神经后,浸润的总巨噬细胞数量从第2天开始逐渐增加,到第14天达到高峰,约为正常情况下的60倍,随后逐渐减少;③起初外、内源性巨噬细胞间的比例是1：1,差值最大出现在损伤后第14天为4：l。结论：小鼠坐骨神经夹伤后,内外源性巨噬细胞共同参与了受损神经组织远心段的修复和再生过程,损伤初期发挥作用的主要是内源性巨噬细胞,随后大量浸润的外源性巨噬细胞占主导作用。本实验首次连续观察并定量分析了神经损伤后早期内源性和外源性巨噬细胞的数量改变,证实了瓦勒氏变性过程中内源性和外源性巨噬细胞在不同阶段对巨噬细胞总量的贡献作用。     

诱导多能干细胞在组织工程修复关节软骨损伤的研究进展

关节软骨位于骨骼末端,主要起承重、减震和润滑关节的作用。由于缺乏血运,关节软骨损伤后难以自行修复。关节软骨损伤为临床常见疾病,目前尚无理想的方法促进其修复和再生,而以种子细胞、支架材料和细胞生长因子为基础的组织工程技术为关节软骨修复开辟了新道路。诱导多能干细胞(i PSC)作为软骨组织工程全新的种子细胞,与其他种子细胞相比,在软骨细胞移植及体外软骨组织和器官再造方面具有更广阔的应用前景。随着对i PSC的重编程机制、诱导方法、定向软骨分化条件以及临床应用安全性等研究的不断深入,其应用于临床的脚步将越来越近。     

促进老年退行性骨关节炎软骨内源性修复的化合物研究进展

老年退行性骨关节炎(OA)是由关节损伤、肥胖和衰老等因素引起的一种退行性疾病,最终引起关节软骨损伤,导致运动功能障碍。软骨细胞及细胞外基质是软骨组织的主要成分,它们的损伤是引起OA的根本原因。目前OA的治疗仅限于缓解症状,而随着干细胞的发现及对软骨细胞的深入认识,开发增强软骨内源性修复的药物是OA治疗的重要方向。目前研究发现,kartogenin等化合物可以促进间充质干细胞选择性的分化为软骨细胞而起到修复作用,此外,一些化合物还可以调控软骨细胞的信号通路,起到促进软骨细胞增殖、抑制软骨细胞凋亡、抑制基质金属蛋白酶活性、增加细胞外基质合成等作用,从而维持软骨细胞的数量、促进软骨基质的合成而抑制其降解。这些方法比常规通过微创刺激内源性干细胞或移植自体细胞更加安全、有效。本文就化合物对促进老年退行性骨炎软骨内源性修复的研究进行综述,为发现更多的有效化合物提供基础。     

骨和软骨干细胞的分化调控与细胞治疗

干细胞分化调控和细胞治疗为相关的骨关节疾病提供了新颖且有效的治疗策略。张晓玲课题组研究发现,地塞米松(Dexamethasone,Dex)可以使C/EBPα启动子甲基化,从而将骨髓间充质干细胞(bone marrow mesenchymal stem cells,BMMSCs)由成骨分化转向成脂分化。Li Cl激活的Wnt/β-catenin通路可以救援Dex对C/EBPα启动子的甲基化和成骨细胞/脂肪细胞的分化平衡,从而为地塞米松诱导的骨质疏松症提供了一个有效的治疗靶点。此外,张晓玲课题组发现了一个有趣的现象,关节软骨干细胞(articular cartilage stem cells,ACSCs)在骨关节炎(osteoarthritis,OA)早期阶段被激活,表现出短暂的增殖反应和尝试自我修复。而IL-1β能有效激活NF-κB通路,削弱ACSCs的损伤响应。NF-κB通路抑制剂可以援救ACSCs的软骨形成,诱导软骨再生,保护关节软骨损伤。同时,戴尅戎院士研究团队开发了一种基于富集骨髓间充质干细胞复合多孔β-磷酸三钙(β-tricalcium phosphate,β-TCP)的新的安全、有效的微创临床细胞治疗法,该细胞疗法能促进骨骼和软骨的修复和再生,避免了一些与细胞扩增有关的伦理问题,使得临床应用变得更便宜和更方便。     

哺乳动物Toll样受体与组织再生修复

机体损伤后通过诱导组织细胞产生复杂而又相互调控的系列反应,来促进损伤组织的再生.不同细胞因子、生长因子及细胞之间的协调平衡对于组织再生的调节非常重要,免疫系统在此过程中起着极其重要的作用.Toll样受体(Toll-like receptors,TLRs)可识别微生物病原体,在触发机体防御性抗病原微生物免疫反应中发挥着重要作用,是先天免疫系统中必不可少的重要成分,TLRs内源性配体的存在提示TLRs不仅可诱导机体防御性的抗微生物免疫反应,同时还是机体损伤后启动组织再生修复的敏感监测系统.本文概述了TLRs及其内源性配体,以及TLRs在诱导损伤后组织再生中的作用.TLR内源性配体及其在组织再生过程中的作用为促进机体损伤组织的再生修复提供了新的思路策略.     

神经干细胞激活的研究进展

神经干细胞是一类具有自我更新和多向分化潜能的细胞。在特定的条件下能够分化成神经元、星形胶质细胞和少突胶质细胞,从而参与神经发生和损伤修复。通常情况下,成体神经干细胞大多数处于静息状态。最新研究表明,在病理状况下,静息态的神经干细胞可以被激活,经增殖、迁移和分化,从而在损伤的部位进行神经元的再生和环路重建。该文主要对静息态和激活态神经干细胞的特征以及静息态神经干细胞激活的细胞和分子机制等方面进行了综述。     

骨碎补结合组织工程软骨促进软骨再生的实验研究

目的:评估骨碎补结合组织工程软骨治疗对实验兔软骨缺陷模型软骨再生的疗效。方法:将h IGF-1基因转染MSCs,并与脱细胞真皮基质(ADM)构建组织工程软骨。24只新西兰白兔随机分为A、B、C、D四组,A、C组进行自体软骨移植,B、D组进行改建的细胞-ADM移植。C、D组用40%骨碎补汤喂养4周,150 m L/d。第12周处死实验动物,分离缺损关节软骨部位,蜡块包埋染色,通过总体形态评价软骨再生组织。采用组织学评分评估再生软骨质量。采用甲苯胺蓝染色评价缺损部位产生软骨糖胺聚糖的情况。结果:与B组比较,C组和D组的新生软骨覆盖度、新骨髓的颜色、缺损边缘和表面粗糙度均显著提高(P0.05);再生软骨的组织学评分软骨表面评分显著改善(P0.05)。C组与D组具有比其他组更好的基质、细胞分布和表面指数。并且有较厚的透明样软骨组织,具有正常的糖胺聚糖产生。表明该治疗方法可以通过再生透明样软骨且没有不良事件来减少软骨缺陷。结论:工程软骨结合骨碎补治疗可显著改善兔膝关节软骨缺损修复的质量,为临床治疗软骨病变提供重要理论依据。     

3D生物打印在软骨修复中的应用*

关节软骨损伤后的自我修复是医学界一直在研究和探讨的难题。3D生物打印技术可以精准的分配载细胞生物材料,构建复杂的三维活体组织,在优化软骨缺损修复组织的内部结构、机械性能以及生物相容性上有很大优势,因此近年来成为软骨修复组织工程领域的研究热点。重点介绍了软骨生物3D生物打印的最新进展,包括软骨生物打印“墨水”材料的选择、种子细胞的来源以及3D生物打印技术的发展。此外,还阐述了3D生物打印技术在组织工程学应用上的部分局限性,并对其在软骨修复领域的发展与应用进行了预测。     

肝细胞生长因子在骨骼肌再生中的作用研究进展

骨骼肌损伤后的修复包括炎症反应期、修复期、组织重塑期三个阶段。而骨骼肌卫星细胞的激活、增殖与分化和骨骼肌伤后的修复有着密切的关系。骨骼肌损伤后,肝细胞生长因子(HGF)可以自分泌、旁分泌或内分泌的形式,调控肌卫星细胞功能,从而影响损伤骨骼肌的再生。其机制研究表明,HGF可能通过与其受体c-met结合,启动相关信号途径,参与骨骼肌卫星细胞激活、增殖、分化和迁移,从而影响骨骼肌再生进程。     

Cardiac stem cells: Current knowledge and future prospects

Regenerative medicine is the field concerned with the repair and restoration of the integrity of damaged human tissues as well as whole organs.Since the inception of the field several decades ago,regenerative medicine therapies,namely stem cells,have received significant attention in preclinical studies and clinical trials.Apart from their known potential for differentiation into the various body cells,stem cells enhance the organ's intrinsic regenerative capacity by altering its environment,whether by exogenous injection or introducing their products that modulate endogenous stem cell function and fate for the sake of regeneration.Recently,research in cardiology has highlighted the evidence for the existence of cardiac stem and progenitor cells(CSCs/CPCs).The global burden of cardiovascular diseases’morbidity and mortality has demanded an in-depth understanding of the biology of CSCs/CPCs aiming at improving the outcome for an innovative therapeutic strategy.This review will discuss the nature of each of the CSCs/CPCs,their environment,their interplay with other cells,and their metabolism.In addition,important issues are tackled concerning the potency of CSCs/CPCs in relation to their secretome for mediating the ability to influence other cells.Moreover,the review will throw the light on the clinical trials and the preclinical studies using CSCs/CPCs and combined therapy for cardiac regeneration.Finally,the novel role of nanotechnology in cardiac regeneration will be explored.     

Local activation of cardiac stem cells for post‐myocardial infarction cardiac repair

The prognosis of patients with myocardial infarction (MI) and resultant chronic heart failure remains extremely poor despite continuous advancements in optimal medical therapy and interventional procedures. Animal experiments and clinical trials using adult stem cell therapy following MI have shown a global improvement of myocardial function. The emergence of stem cell transplantation approaches has recently represented promising alternatives to stimulate myocardial regeneration. Regarding their tissue‐specific properties, cardiac stem cells (CSCs) residing within the heart have advantages over other stem cell types to be the best cell source for cell transplantation. However, time‐consuming and costly procedures to expanse cells prior to cell transplantation and the reliability of cell culture and expansion may both be major obstacles in the clinical application of CSC‐based transplantation therapy after MI. The recognition that the adult heart possesses endogenous CSCs that can regenerate cardiomyocytes and vascular cells has raised the unique therapeutic strategy to reconstitute dead myocardium via activating these cells post‐MI. Several strategies, such as growth factors, mircoRNAs and drugs, may be implemented to potentiate endogenous CSCs to repair infarcted heart without cell transplantation. Most molecular and cellular mechanism involved in the process of CSC‐based endogenous regeneration after MI is far from understanding. This article reviews current knowledge opening up the possibilities of cardiac repair through CSCs activation in situ in the setting of MI.     

Mesenchymal stem cells as a potent cell source for articular cartilage regeneration

Since articular cartilage possesses only a weak capac-ity for repair, its regeneration potential is considered one of the most important challenges for orthopedic surgeons. The treatment options, such as marrow stimulation techniques, fail to induce a repair tissue with the same functional and mechanical properties of native hyaline cartilage. Osteochondral transplantation is considered an effective treatment option but is as-sociated with some disadvantages, including donor-site morbidity, tissue supply limitation, unsuitable mechani-cal properties and thickness of the obtained tissue. Although autologous chondrocyte implantation results in reasonable repair, it requires a two-step surgical pro-cedure. Moreover, chondrocytes expanded in culture gradually undergo dedifferentiation, so lose morpho-logical features and specialized functions. In the search for alternative cells, scientists have found mesenchymal stem cells(MSCs) to be an appropriate cellular mate-rial for articular cartilage repair. These cells were origi-nally isolated from bone marrow samples and further investigations have revealed the presence of the cells in many other tissues. Furthermore, chondrogenic dif-ferentiation is an inherent property of MSCs noticedat the time of the cell discovery. MSCs are known to exhibit homing potential to the damaged site at which they differentiate into the tissue cells or secrete a wide spectrum of bioactive factors with regenerative proper-ties. Moreover, these cells possess a considerable im-munomodulatory potential that make them the general donor for therapeutic applications. All of these topics will be discussed in this review.     

Papain-induced changes in the guinea pig knee joint with special reference to cartilage healing

The repair of articular cartilage following papain injection into the knee joint of the guinea pig was studied by light and electron microscopy, as well as by autoradiography using tritiated thymidine. Papain injection rapidly produced complete degradation of cartilage proteoglycan. Although a number of chondrocytes were also destroyed, the remaining chondrocytes showed mitotic cell division with resultant formation of cell clusters. Such chondrocytic regeneration, however, did not contribute significantly to the repair of cartilage tissue. On the other hand, mesenchymal cells proliferated from the transition zone and extended over the surface of the damaged cartilage. At the peripheral portion of the articular surface, they migrated and differentiated into chondrocytes with the formation of abundant intercellular matrix to produce hyaline cartilage. From these findings, it was apparent that mesenchymal cells in the transition zone were actively engaged in the repair of articular cartilage.     

Regeneration of the central nervous system using endogenous repair mechanisms

Recent advances in developmental and stem cell biology have made regeneration-based therapies feasible as therapeutic strategies for patients with damaged central nervous systems (CNSs), including those with spinal cord injuries, Parkinson disease, or stroke. These strategies can be classified into two approaches: (i) the replenishment of lost neural cells and (ii) the induction of axonal regeneration. The first approach includes the activation of endogenous neural stem cells (NSCs) in the adult CNS and cell transplantation therapy. Endogenous NSCs have been shown to give rise to new neurons after insults, including ischemia, have been sustained; this form of neurogenesis followed by the migration and functional maturation of neuronal cells, as well as the responses of glial cells and the vascular system play crucial roles in endogenous repair mechanisms in damaged CNS tissue. In this review, we will summarize the recent advances in regeneration-based therapeutic approaches using endogenous NSCs, including the results of our own collaborative groups.     

Stem cells and growth factor delivery systems for cardiovascular disease

Coronary (CAD) and peripheral (PAD) artery diseases are major causes of morbidity and mortality, and millions of CAD and PAD patients are treated by various medications, bypass surgery or angioplasty around the world. Such patients might benefit from novel stem cells and tissue engineering strategies aimed at accelerating natural processes of postnatal collateral vessel formation and repairing damaged tissues. By combining three fundamental “tools”, namely stem cells, biomaterials and growth factors (GFs), such strategies may enhance the efficacy of cell therapy in several ways: (a) by supplying exogenous stem cells or GFs that stimulate resident cardiac stem cell (CSC) migration, engraftment and commitment to cardiomyocytes, and that induce and modulate arterial response to ischemia; (b) by supporting the maintenance of GFs and transplanted stem cells in the damaged tissues through the use of biocompatible and biodegradable polymers for a period of time sufficient to allow histological and anatomical restoration of the damaged tissue. This review will discuss the potential of combining stem cells and new delivery systems for growth factors, such as vehicle-based delivery strategies or cell-based gene therapy, to facilitate regeneration of ischemic tissues. These approaches would promote the ability of resident CSCs or of exogenous multipotent stem cells such as adipose tissue-derived mesenchymal stem cells (AT-MSCs) to induce the healing of damaged tissue, by recruiting and directing these cells into the damage area and by improving angiogenesis and reperfusion of ischemic tissues.     

Endogenous musculoskeletal tissue engineering - a focused perspective

Two major difficulties facing widespread clinical implementation of existing Tissue Engineering (TE) strategies for the treatment of musculoskeletal disorders are (1) the cost, space and time required for ex vivo culture of a patient’s autologous cells prior to re-implantation as part of a TE construct, and (2) the potential risks and availability constraints associated with transplanting exogenous (foreign) cells. These hurdles have led to recent interest in endogenous TE strategies, in which the regenerative potential of a patient’s own cells is harnessed to promote tissue regrowth without ex vivo cell culture. This article provides a focused perspective on key issues in the development of endogenous TE strategies, progress to date, and suggested future research directions toward endogenous repair and regeneration of musculoskeletal tissues and organs.     

The Role of the Biochemical and Biophysical Environment in Chondrogenic Stem Cell Differentiation Assays and Cartilage Tissue Engineering

The field of regenerative medicine offers hope for the development of a cell-based therapy for the repair of articular cartilage (AC). Yet, the greatest challenge in the use of stem cells for tissue repair, is understanding how the cells respond to stimuli and using that knowledge to direct cell fate. Novel methods that utilize stem cells in cartilage regeneration will require specific spatio-temporal controls of the biochemical and biophysical signaling environments. Current chondrogenic differentiation research focuses on the roles of biochemical stimuli like growth factors, hormones, and small molecules, and the role of the physical environment and mechanical stimuli, such as compression and shear stress, which likely act through mechanical receptors. Numerous signals are associated with chondrogenic-like activity of cells in different systems, however many variables for a controlled method still need to be optimized; e.g., spatial and temporal application of the stimuli, and time of transplantation of an engineered construct. Understanding the necessary microenvironmental signals for cell differentiation will advance cell therapy for cartilage repair.     

Compound screening platform using human induced pluripotent stem cells to identify small molecules that promote chondrogenesis

Articular cartilage, which is mainly composed of collagen II, enables smooth skeletal movement. Degeneration of collagen II can be caused by various events, such as injury, but degeneration especially increases over the course of normal aging. Unfortunately, the body does not fully repair itself from this type of degeneration, resulting in impaired movement. Microfracture, an articular cartilage repair surgical technique, has been commonly used in the clinic to induce the repair of tissue at damage sites. Mesenchymal stem cells (MSC) have also been used as cell therapy to repair degenerated cartilage. However, the therapeutic outcomes of all these techniques vary in different patients depending on their age, health, lesion size and the extent of damage to the cartilage. The repairing tissues either form fibrocartilage or go into a hypertrophic stage, both of which do not reproduce the equivalent functionality of endogenous hyaline cartilage. One of the reasons for this is inefficient chondrogenesis by endogenous and exogenous MSC. Drugs that promote chondrogenesis could be used to induce self-repair of damaged cartilage as a non-invasive approach alone, or combined with other techniques to greatly assist the therapeutic outcomes. The recent development of human induced pluripotent stem cell (iPSCs), which are able to self-renew and differentiate into multiple cell types, provides a potentially valuable cell resource for drug screening in a “more relevant” cell type. Here we report a screening platform using human iPSCs in a multi-well plate format to identify compounds that could promote chondrogenesis.