骨髓和脐带间充质干细胞联合移植治疗杜氏型肌营养不良1例并文献复习

目的:研究自体骨髓和脐带间充质干细胞联合移植治疗杜氏型肌营养不良(DMD)的疗效和安全性方法对经临床表现、血清酶学、肌电图、基因分析、肌肉活检、肌肉核磁共振成像(MRI)确诊的1例DMD患者采用自体骨髓和脐带间充质干细胞联合移植的方案进行治疗.术后第3、6、9、12个月定期观察患者临床症状及各项疗效指标的变化并结合国内外文献进行综合分析.结果随访12个月,该患者肌力提高,动作灵活.血清肌酸激酶和乳酸脱氢酶较前明显下降,活动能力评分和徒手肌力较前增加,肌电图运动单位电位波幅减低及时限缩短较前改善,肌肉MRI复查显示肌肉病变程度较前减轻、肌肉轮廓较前清晰.结论自体骨髓和脐带间充质干细胞联合移植是一种治疗DMD的有效治疗方法.     

DDR2基因缺失小鼠的繁育及子代基因型的鉴定

目的：探讨盘状结构域受体2（DDR2）基因缺失小鼠的优化繁殖方法与子代小鼠DDR2基因型的鉴定方法,建立DDR2基因缺失小鼠模型,为进一步研究DDR2分子在肿瘤、肺纤维化、类风湿性关节炎等复杂疾病中的功能以及作用机制奠定基础。方法：将从美国JAX实验室引进的三对杂合子小鼠进行饲养并交配繁殖,繁殖成功后其子代中将会出现野生型、杂合子以及纯合子3种基因型。用基因组提取试剂盒试剂盒提取子鼠鼠尾的基因组DNA,经紫外分光光度计定量后,采用Taqman qPCR的方法准确鉴定出小鼠的基因型,同时观察子代小鼠各基因型的比例,并通过小鼠体态观察,进一步证实Taqman qPCR鉴定方法的可靠性。结果：DDR2基因杂合子小鼠互交繁殖可得到DDR2野生型小鼠、DDR2纯合子小鼠以及DDR2杂合子小鼠三种基因型小鼠,所得子代基本符合孟德尔遗传规律,且雌性和雄性DDR2纯合子小鼠体长均较DDR2野生型小鼠和DDR2杂合子小鼠小,鼻子也较其它基因型小鼠明显变短,无繁殖能力。依据Taqman qPCR的结果所得出的纯合子小鼠体貌特征与文献报道一致,证实了Taqman qPCR结果的可靠性。结论：雌、雄性DDR2杂合子小鼠交配可有效获得DDR2基因缺失小鼠;实验所用Taqman qPCR方法能够准确鉴定子代小鼠的基因型,DDR2纯合子小鼠的获得为后续实验的提供了较理想的动物模型。     

Smad3基因剔除小鼠的繁殖与基因型鉴定

目的为进一步深入研究Smad3基因在脊椎动物发育中的重要作用,对Smad3基因剔除小鼠进行保种和繁育研究.方法采用基因剔除杂合子小鼠进行保种,通过PCR和Southern杂交对杂合子小鼠交配所产生的后代进行基因型鉴定,纯合子小鼠和野生型小鼠用于表型分析,杂合子小鼠用于留种和繁殖生产.结果采用PCR方法对278只子代小鼠进行了基因型鉴定,83只为野生型,133只为杂合子,62只为纯合子.结论Smad3基因剔除突变能稳定遗传.采用杂合子小鼠保种,子代小鼠三种基因型比例符合孟德尔遗传定律.     

Caveolin-1基因敲除小鼠子代基因型的鉴定及繁育方法

目的探讨小凹蛋白-1(caveolin-1)基因敲除小鼠的鉴定方法与最优繁育方式,为深入研究caveolin-1在脑缺血损伤修复中的作用提供理想的动物模型。方法将引进的caveolin-1基因敲除小鼠饲养于SPF级实验室,煮沸裂解法提取鼠尾组织基因组DNA,根据美国杰克逊实验室(Jackson Laboratory)提供的引物序列进行PCR反应检测其基因型,采用caveolin-1~(+/-)杂合子互交、杂合子与caveolin-1~(-/-)纯合子杂交(正交及反交)、纯合子互交4种不同的交配方式,观察亲代小鼠的受孕率、子代小鼠的外形特征及纯合率。结果琼脂糖凝胶电泳显示PCR产物分子量大小约200 bp和661 bp,与预期的目的基因片段分子量大小一致,成功鉴定了caveolin-1基因敲除小鼠的不同基因型;不同交配方式的繁殖结果基本符合孟德尔遗传规律,且雌性、雄性caveolin-1~(-/-)纯合鼠具有一定的繁殖能力,三种不同基因型小鼠的外形特征无明显差异。结论煮沸裂解法提取基因组DNA、PCR法能够快速可靠鉴定caveolin-1基因敲除小鼠的基因型;caveolin-1杂合子小鼠互交与纯合子互交相结合的繁育方法可能是短期内获得足量纯合子子鼠与同源野生子鼠的较好方式。     

Tbx18-Cre基因敲入小鼠的繁殖、鉴定及其应用

为了探讨Tbx18-Cre基因敲入小鼠(Tbx18:Cre knock-in Mus musculus)的繁殖、鉴定及Tbx18基因敲除小鼠和遗传示踪小鼠模型的应用,将Tbx18-Cre基因敲入杂合子小鼠进行繁殖,应用PCR法鉴定其子代基因型。将子代雌雄杂合子小鼠互交,应用H.E染色观察Tbx18基因敲除胚鼠心的形态学变化。将杂合子小鼠与RosaEYFP报告小鼠交配,应用心冰冻切片技术观察Tbx18:Cre/Rosa26REYFP双转基因遗传示踪胚鼠心内Tbx18阳性心外膜祖细胞发育命运。结果表明,用于繁殖、基因敲除研究及基因遗传示踪的子代基因型均符合孟德尔遗传规律。同时心H.E染色和心冰冻切片发现,Tbx18敲除小鼠心窦房结发育存在缺陷,而Tbx18阳性心外膜祖细胞是心发育重要的祖细胞来源。研究结果揭示,Tbx18-Cre基因敲除小鼠是研究先天性心脏病发病机制的理想模式动物,Tbx18阳性心外膜祖细胞可能是心脏病患者心脏修复和再生潜在的种子细胞。     

Microdystrophin基因重组腺病毒的构建及转染mdx骨髓间充质干细胞的表达

构建含有人microdystrophin基因的重组腺病毒,来感染dystrophin基因敲除小鼠mdx的骨髓间充质干细胞(MSC)进行基因修饰,为同种异体基因修饰的干细胞移植治疗DMD疾病奠定基础。用NotⅠ酶切含microdystrophin基因的pBSK-MICRO质粒,获得microdystrophin基因。片段回收后定向插入腺病毒穿梭质粒pShuttle-CMV,获得重组质粒pShuttle-CMV-MICRO。PmeⅠ线性化重组质粒pShuttle-CMV-MICRO,去磷酸化后回收后与腺病毒骨架质粒pAdeasy-1共电转化BJ5183感受态细胞。同源重组后用选择性培养基筛选阳性克隆,提取质粒,用脂质体介导转染293细胞,通过观察293细胞病变及PCR扩增目的基因等方法鉴定重组的腺病毒。然后将病毒上清转染DMD模型鼠mdx小鼠的骨髓间充质干细胞,通过RT-PCR以及间接免疫荧光检测microdystrophin的转录及蛋白表达。成功构建了含有microdystrophin基因的重组腺病毒,病毒滴度为5·58×1012vp/mL。间接免疫荧光检测可见microdystrophin蛋白在mdx小鼠MSCs中高效表达。该重组腺病毒载体的构建及成功转染到mdxMSCs内表达为下一步用microdystrophin基因修饰的mdxMSCs进行同种异体移植治疗DMD疾病奠定了基础。     

Duchenne肌营养不良基因缺陷及基因治疗

Duchenne肌营养不良(DMD)是常见的神经肌肉遗传病之一,由于骨胳肌肌膜上的抗肌萎缩蛋白(dys—trophin)完全或部分缺失引起。本文介绍了dystrophin的结构和功能,对DMD基因治疗的目的基因。基因治疗方式(包括病毒载体和非病毒载体)。基因转染途径作了较为全面的介绍,指出腺相关病毒载体介导的基因治疗及干细胞移植是有希望的治疗方向。经全身途径使目的基因广泛转染骨胳肌并实现心肌和膈肌的转染,是基因治疗研究的难点。     

假肥大型肌营养不良肌细胞抗肌萎缩蛋白的免疫组化研究

目的研究假肥大型肌营养不良患者肌细胞中抗肌萎缩蛋白(dystrophin)的表达及其诊断意义。方法应用针吸型活检术取121例假肥大型肌营养不良症患者(108例DMD患者,13例BMD患者)的肌组织,采用HE染色观察被检肌肉病理改变,免疫组织化学染色技术检测抗肌营养不良蛋白表达,以正常人肌细胞作为对照。结果正常人肌细胞膜上抗肌营养不良蛋白染色阳性,呈完整环形条带沿肌细胞膜分布;DMD患者肌膜完全无显色;BMD患者染色弱阳性,可见沿肌细胞膜分布的间断表达。结果 应用针吸型活检技术和免疫组化染色法检测抗肌营养不良蛋白,有助于DMD和BMD确诊及鉴别诊断。     

SPARC基因敲除小鼠的繁育及子代基因型的鉴定

目的:探讨富含半胱氨酸的分泌型酸性蛋白(SPARC)基因敲除小鼠的繁殖和鉴定方法,为进一步研究SPARC蛋白的功能奠定基础。方法:将所引进的杂合子小鼠进行饲养并繁殖,繁殖成功后其子代中将会出现野生型、杂合子以及纯合子3种基因型。提取子鼠鼠尾基因组DNA,用PCR法扩增SPARC和Neo基因片段,通过限制性内切酶酶切反应,证实PCR扩增产物的正确性;应用Westernblot检测SPARC蛋白质的表达,进一步证实PCR鉴定方法的可靠性。结果:SPARC基因杂合子小鼠互交繁殖结果基本符合孟德尔遗传规律,SPARC基因缺失纯合子小鼠有繁殖能力。琼脂糖凝胶电泳结果显示PCR产物分子量大小与预期的目的基因片段相对分子质量大小一致,酶切和Westernblot结果证实PCR结果可靠。结论:PCR方法能够准确鉴定SPARC基因突变小鼠基因型。     

Grx-1基因敲除鼠的繁殖及子代基因型鉴定

目的探讨glutaredoxin-1(Grx-1)基因敲除小鼠的优化繁殖及子代鼠的鉴定方法,为进一步研究Grx-1在支气管肺发育不良(BPD)中的作用奠定基础。方法将从美国哈佛医学院引进的纯合子Grx-1基因敲除小鼠与野生型小鼠进行交配后得到的子一代小鼠同代间相互交配,繁殖出的子二代中将出现纯合子、杂合子以及野生型3种基因型。从出生起观察其生长发育情况,2周龄时剪尾提取基因组DNA,用PCR方法扩增目的基因片段,琼脂糖凝胶电泳结果判定基因型。结果 Grx-1纯合子小鼠的饲养繁殖取得成功,获得了一批Grx-1基因敲除纯合子小鼠。结论正确的饲养繁殖以及鉴定方法是获得Grx-1基因敲除纯合子小鼠的有效途径,为相关研究提供动物实验模型奠定了基础。     

Duchenne型肌营养不良症发病机制

Duchenne型肌营养不良症是我国常见的X连锁隐性遗传性肌病。目前广泛应用的动物模型是mdx小鼠,但其没有很好地模拟人类疾病特点。最近,Sacco等报导了一个新的小鼠模型mdx/mTRG2,它不仅有抗肌萎缩蛋白的缺陷,还有端粒酶的缺失,较好地模拟了人类疾病的症状。通过该模型,人们认识到抗肌萎缩蛋白的缺陷引起肌细胞退化,肌肉干细胞被激活对抗其退化,但干细胞的过度增殖又导致端粒长度下降,引起肌肉干细胞增殖能力的衰竭,最终产生了肌营养不良的表型。该模型使人们对Duchenne型肌营养不良症的发病机制有了进一步的理解,为其治疗提供了新的研究平台。     

Muscular Dystrophy in mdx Mice Despite Lack of Neuronal Nitric Oxide Synthase

Abstract: Neuronal nitric oxide synthase (nNOS) is a component of the dystrophin complex in skeletal muscle. The absence of dystrophin protein in Duchenne muscular dystrophy and in mdx mouse causes a redistribution of nNOS from the plasma membrane to the cytosol in muscle cells. Aberrant nNOS activity in the cytosol can induce free radical oxidation, which is toxic to myofibers. To test the hypothesis that derangements in nNOS disposition mediate muscle damage in Duchenne dystrophy, we bred dystrophin-deficient mdx male mice and female mdx heterozygote mice that lack nNOS. We found that genetic deletion of nNOS does not itself cause detectable pathology and that removal of nNOS does not influence the extent of increased sarcolemmal permeability in dystrophin-deficient mice. Thus, histological analyses of nNOS-dystrophin double mutants show pathological changes similar to the dystrophin mutation alone. Taken together, nNOS defects alone do not produce muscular dystrophy in the mdx model.     

Genomic integration of the full‐length dystrophin coding sequence in Duchenne muscular dystrophy induced pluripotent stem cells

Plasmid vectors that express the full‐length human dystrophin coding sequence in human cells were developed. Dystrophin, the protein mutated in Duchenne muscular dystrophy, is extraordinarily large, providing challenges for cloning and plasmid production in Escherichia coli. The authors expressed dystrophin from the strong, widely expressed CAG promoter, along with co‐transcribed luciferase and mCherry marker genes useful for tracking plasmid expression. Introns were added at the 3' and 5' ends of the dystrophin sequence to prevent translation in E. coli, resulting in improved plasmid yield. Stability and yield were further improved by employing a lower‐copy number plasmid origin of replication. The dystrophin plasmids also carried an attB site recognized by phage phiC31 integrase, enabling the plasmids to be integrated into the human genome at preferred locations by phiC31 integrase. The authors demonstrated single‐copy integration of plasmid DNA into the genome and production of human dystrophin in the human 293 cell line, as well as in induced pluripotent stem cells derived from a patient with Duchenne muscular dystrophy. Plasmid‐mediated dystrophin expression was also demonstrated in mouse muscle. The dystrophin expression plasmids described here will be useful in cell and gene therapy studies aimed at ameliorating Duchenne muscular dystrophy.     

Expression of dystrophin on the cell surface membrane of intrafusal fibers of human skeletal muscle

Summary We examined the morphological expression of dystrophin in the intrafusal muscle fibers in skeletal muscle from normal human and Duchenne muscular dystrophy (DMD) patients, using antisera against the N-terminal and C-terminal regions of dystrophin. The intrafusal fibers of normal muscle express dystrophin on their cell surface membrane, but those of DMD muscle do not.Abbreviation DMD Duchenne muscular dystrophy     

Skeletal muscle repair by adult human mesenchymal stem cells from synovial membrane

We have demonstrated previously that adult human synovial membrane-derived mesenchymal stem cells (hSM-MSCs) have myogenic potential in vitro (De Bari, C., F. Dell'Accio, P. Tylzanowski, and F.P. Luyten. 2001. Arthritis Rheum. 44:1928-1942). In the present study, we have characterized their myogenic differentiation in a nude mouse model of skeletal muscle regeneration and provide proof of principle of their potential use for muscle repair in the mdx mouse model of Duchenne muscular dystrophy. When implanted into regenerating nude mouse muscle, hSM-MSCs contributed to myofibers and to long term persisting functional satellite cells. No nuclear fusion hybrids were observed between donor human cells and host mouse muscle cells. Myogenic differentiation proceeded through a molecular cascade resembling embryonic muscle development. Differentiation was sensitive to environmental cues, since hSM-MSCs injected into the bloodstream engrafted in several tissues, but acquired the muscle phenotype only within skeletal muscle. When administered into dystrophic muscles of immunosuppressed mdx mice, hSM-MSCs restored sarcolemmal expression of dystrophin, reduced central nucleation, and rescued the expression of mouse mechano growth factor.     

Metabolic profiles of dystrophin and utrophin expression in mouse models of Duchenne muscular dystrophy

Metabolic profiles from ¹H nuclear magnetic resonance spectroscopy have been used to describe both one and two protein systems in four mouse models related to Duchenne muscular dystrophy using the pattern recognition technique partial least squares. Robust statistical models were built for extracts and intact cardiac tissue, distinguishing mice according to expression of dystrophin. Using metabolic profiles of diaphragm, models were built describing dystrophin and utrophin, a dystrophin related protein, expression. Increased utrophin expression counteracted some of the deficits associated with dystrophic tissue. This suggests the method may be ideal for following treatment regimes such as gene therapy.     

Human multipotent adipose-derived stem cells restore dystrophin expression of Duchenne skeletal-muscle cells in vitro

Background information. DMD (Duchenne muscular dystrophy) is a devastating X‐linked disorder characterized by progressive muscle degeneration and weakness. The use of cell therapy for the repair of defective muscle is being pursued as a possible treatment for DMD. Mesenchymal stem cells have the potential to differentiate and display a myogenic phenotype in vitro. Since liposuctioned human fat is available in large quantities, it may be an ideal source of stem cells for therapeutic applications. ASCs (adipose‐derived stem cells) are able to restore dystrophin expression in the muscles of mdx (X‐linked muscular dystrophy) mice. However, the outcome when these cells interact with human dystrophic muscle is still unknown. Results. We show here that ASCs participate in myotube formation when cultured together with differentiating human DMD myoblasts, resulting in the restoration of dystrophin expression. Similarly, dystrophin was induced when ASCs were co‐cultivated with DMD myotubes. Experiments with GFP (green fluorescent protein)‐positive ASCs and DAPI (4′,6‐diamidino‐2‐phenylindole)‐stained DMD myoblasts indicated that ASCs participate in human myogenesis through cellular fusion. Conclusions. These results show that ASCs have the potential to interact with dystrophic muscle cells, restoring dystrophin expression of DMD cells in vitro. The possibility of using adipose tissue as a source of stem cell therapies for muscular diseases is extremely exciting.     

Stem cells from umbilical cord blood differentiate into myotubes and express dystrophin in vitro only after exposure to in vivo muscle environment

BACKGROUND INFORMATION: Duchenne muscular dystrophy is a disease characterized by progressive and irreversible muscle degeneration for which there is no therapy. HUCB (human umbilical cord blood) has been considered as an important source of haematopoietic and mesenchymal stem cells, each having been shown to differentiate into distinct cell types. However, it remains unclear if these cells are able to differentiate into muscle cells. RESULTS: We have showed that stem cells from HUCB did not differentiate into myotubes or express dystrophin when cultured in muscle-conditioned medium or with human muscle cells. However, delivery of GFP (green fluorescent protein)-transduced mononucleated cells from HUCB, which comprises both haematopoietic and mesenchymal populations, into quadriceps muscle of mdx (mouse dystrophy X-chromosome linked) mice resulted in the expression of human myogenic markers. After recovery of these cells from mdx muscle and in vitro cultivation, they were able to fuse and form GFP-positive myotubes that expressed dystrophin. CONCLUSIONS: These results indicate that chemical factors and cell-to-cell contact provided by in vitro conditions were not enough to trigger the differentiation of stem cells into muscle cells. Nevertheless, we showed that the HUCB-derived stem cells were capable of acquiring a muscle phenotype after exposure to an in vivo muscle environment, which was required to activate the differentiation programme.     

Essential role of TRPV2 ion channel in the sensitivity of dystrophic muscle to eccentric contractions

Duchenne myopathy is a lethal disease due to the absence of dystrophin, a cytoskeletal protein. Muscles from dystrophin-deficient mice (mdx) typically present an exaggerated susceptibility to eccentric work characterized by an important force drop and an increased membrane permeability consecutive to repeated lengthening contractions. The present study shows that mdx muscles are largely protected from eccentric work-induced damage by overexpressing a dominant negative mutant of TRPV2 ion channel. This observation points out the role of TRPV2 channel in the physiopathology of Duchenne muscular dystrophy.