应用骨髓干细胞治疗肝硬化研究进展

随着干细胞研究的深入和技术的发展,再生医学的干细胞疗法治疗肝脏疾病已成为研究热点。骨髓来源造血干细胞和间充质干细胞等在肝脏疾病治疗方面有巨大潜力。骨髓干细胞参与肝纤维化与肝硬化修复主要包括迁移、归巢与转化等过程,并需要多种细胞因子和趋化因子的协同作用促进肝细胞再生与减轻肝纤维化。本文拟对骨髓干细胞治疗肝硬化的最新研究进展进行综述。     

间充质干细胞对肝纤维化进展的调控机制

肝纤维化是各种病因引起肝损伤后细胞外基质沉积或瘢痕形成的过程,可持续进展为肝硬化,甚至肝癌等终末期肝脏疾病,严重危害人类健康。间充质干细胞(mesenchymal stem cells, MSCs)是一类具有多向分化潜能的多能干细胞,近年来被广泛应用于多种疾病治疗。现今,MSCs移植已被运用于肝纤维化治疗研究,治疗结局众说纷纭,其作用机制莫衷一是。现就MSCs通过免疫、炎症、归巢等途径对肝纤维化进展的调控机制做一综述。     

脐静脉和骨髓来源的间充质干细胞的比较研究

间充质干细胞(MSCs)的来源有限,成人骨髓是MSCs的主要来源,这极大地限制了其在实验和临床中的应用。为拓宽MSCs来源,从细胞形态、生长特性、免疫表型和多向分化能力等四个方面对人脐静脉来源和成人骨髓来源的间充质干细胞进行了比较研究。结果表明,人脐静脉来源和成人骨髓来源的 MSCs具有相似的生物学特征,成纤维细胞样形态生长,并具有强大的体外扩增和多向分化能力。人脐静脉来源的MSCs可替代成人骨髓MSCs,作为满足实验和临床需要的重要来源。     

骨髓间充质干细胞移植对VCD 所致卵巢损伤的修复研究

目的:探讨小鼠骨髓间充质干细胞(MSCs)移植对去氧乙烯基环己烯(VCD)所致卵巢早衰治疗的可行性。方法:采用VCD(160mg kg-1,day-1)连续腹腔注射来诱导小鼠卵巢早衰。每侧卵巢注射转染了绿色荧光基因小鼠骨髓来源的MSCs,于移植后14、28天及45天,取各组血液标本及卵巢组织,同时观察小鼠动情周期的变化;酶联免疫法检测血清FSH、LH水平,显微镜下观察MSC在卵巢的分布。结果:MSCs移植后各组均可见绿色荧光,并且主要分布于卵巢间质区,卵巢泡膜细胞区也可见绿色荧光细胞。MSCs组动情周期较实验对照组缩短,FSH与LH水平较实验对照组低,差异具有显著性。结论:骨髓间充质干细胞可改善卵巢早衰小鼠的卵巢内分泌功能,并且长时间存在于卵巢组织。骨髓间充质干细胞可能成为卵巢早衰治疗的新方法。     

Snail基因修饰对骨髓间充质干细胞CXCR4表达水平及向SDF-1趋化能力的影响

为研究Snail基因修饰对骨髓间充质干细胞(MSCs)CXCR4表达水平及向SDF-1趋化能力影响, 将重组真核表达载体(pCAGGSneo-snail-HA)及对照空质粒(pCAGGSneo)转染MSCs, 采用免疫荧光细胞化学染色、荧光标记流式细胞仪技术及RT-PCR检测细胞CXCR4表达水平; 体外跨膜趋化实验评价MSCs向SDF-1趋化能力, 观察抗CXCR4中和抗体的干预作用。MSCs-Sna的CXCR4表达水平明显高于MSCs-neo。MSCs-Sna在SDF-1诱导下细胞迁移量较MSCs-neo显著增加(P<0.05)。抗CXCR4中和抗体可显著减少SDF-1a诱导的MSCs-Sna趋化运动。研究提示通过上调Snail表达而提高MSCs向正调节表达SDF-1的受损组织迁移效率的可行性, 为优化MSCs迁移力的研究提供了实验基础。     

骨髓间充质干细胞成肌和成脂分化的调控

骨髓间充质干细胞(mesenchymal stem cells,MSCs)是来源于骨髓基质的一类具有高度自我更新能力和多向分化潜能的成体干细胞.因其具有容易获取、体外扩增方便迅速、移植排斥反应较弱等优点而成为临床应用的理想细胞模型.骨髓间充质干细胞向成肌和成脂的分化对动物机体内肌肉和脂肪的组成具有直接影响,因而与肉品质及人类健康息息相关.本文综述了骨髓间充质干细胞定向分化为骨骼肌细胞和脂肪细胞的过程及其调控机制,并重点分析了关键调控因子PRDM16(PR domain-containing16)和骨形态发生蛋白(bone morphogenetic proteins,BMPs)在骨髓间充质干细胞成肌和成脂分化中的作用.     

超顺磁性氧化铁纳米粒子标记骨髓间充质干细胞实验研究

目的:研究不加转染剂,超顺磁性氧化铁纳米粒子(superparamagnetic iron oxide,SPIO)对骨髓间充质干细胞(bonemarrow-derived mesenchymal stem cells,MSCs)的标记效果.方法:全骨髓法培养猪骨髓间充质干细胞,用50 ug/ml铁浓度的SPIO标记MSCs,普鲁士蓝染色鉴定标记效果,流式细胞仪测定标记MSCs的增殖及凋亡,台盼蓝染色检测标记细胞的活力.结果:不加转染剂,SPIO标记MSCs达100%,50 ug/ml铁浓度标记对MSCs活力、增殖及凋亡无影响.结论:不加转染剂,50 ug/ml铁浓度SPIO可安全、有效的标记MSCs.     

牛骨髓间充质干细胞的分离培养和初步鉴定

本试验采用全骨髓法和密度梯度离心法来分离纯化和体外培养牛骨髓间充质干细胞,并研究了不同培养基和血清对BMSCs的生长的影响以及对牛骨髓间充质干细胞的初步鉴定。结果表明,全骨髓法和密度梯度离心法均可获得纯化度较高的牛骨髓间充质干细胞,并且能够分化为脂肪样细胞,为利用MSCs作为种子细胞治疗多种疾病提供试验基础,同时可以利用骨髓间充质干细胞作为核供体进行核移植的研究和动物遗传资源的保存。     

影响骨髓间充质干细胞分离效率的若干因素的研究

骨髓间充质干细胞来源有限,数量稀少,极大地限制了其在组织修复、细胞治疗等方面的应用。为了解决细胞数量限制的问题,从提高分离效率的角度对骨髓间充质干细胞的分离过程进行了研究,考察了培养基种类、初次换液时间、起始接种密度对兔骨髓间充质干细胞分离效率的影响。结果表明,α-MEM培养基较DMEM、DMEM-LG培养基更适于兔MSCs的分离;从骨髓中分离得到的单个核细胞以1×106cells／ml的密度接种,接种24h后换液在短时间内得到的MSCs数目最多。采用以上分离条件,能够获得形态均一、可稳定传代10代以上仍保持旺盛增殖能力的MSCs,并具有向骨、脂肪分化能力。     

阿司匹林对骨髓间充质干细胞移植治疗缺血性脑卒中的影响研究进展

阿司匹林是缺血性脑卒中患者急性期治疗药物及卒中再发的二级预防常用药物,骨髓间充质干细胞(BMSCs)移植是治疗缺血性脑血管疾病的新的新兴技术。已证实阿司匹林可抑制骨髓间充质干细胞的增殖及影响骨髓间充质干细胞的分化。本文就阿司匹林对骨髓间充质干细胞移植治疗缺血性脑卒中的影响等进行综述。     

Direct intercellular communications dominate the interaction between adipose-derived MSCs and myofibroblasts against cardiac fibrosis

The onset of cardiac fibrosis post myocardial infarction greatly impairs the function of heart. Recent advances of cell transplantation showed great benefits to restore myocardial function, among which the mesenchymal stem cells (MSCs) has gained much attention. However, the underlying cellular mechanisms of MSC therapy are still not fully understood. Although paracrine effects of MSCs on residual cardiomyocytes have been discussed, the amelioration of fibrosis was rarely studied as the hostile environment cannot support the survival of most cell populations and impairs the diffusion of soluble factors. Here in order to decipher the potential mechanism of MSC therapy for cardiac fibrosis, we investigated the interplay between MSCs and cardiac myofibroblasts (mFBs) using interactive co-culture method, with comparison to paracrine approaches, namely treatment by MSC conditioned medium and gap co-culture method. Various fibrotic features of mFBs were analyzed and the most prominent anti-fibrosis effects were always obtained using direct co-culture that allowed cell-to-cell contacts. Hepatocyte growth factor (HGF), a well-known anti-fibrosis factor, was demonstrated to be a major contributor for MSCs’ anti-fibrosis function. Moreover, physical contacts and tube-like structures between MSCs and mFBs were observed by live cell imaging and TEM which demonstrate the direct cellular interactions.     

Immunomodulation of activated hepatic stellate cells by mesenchymal stem cells

Bone marrow-derived mesenchymal stem cells (MSCs) have been reported to prevent the development of liver fibrosis in a number of pre-clinical studies. Marked changes in liver histopathology and serological markers of liver function have been observed without a clear understanding of the therapeutic mechanism by which stem cells act. We sought to determine if MSCs could modulate the activity of resident liver cells, specifically hepatic stellate cells (SCs) by paracrine mechanisms using indirect cocultures. Indirect coculture of MSCs and activated SCs led to a significant decrease in collagen deposition and proliferation, while inducing apoptosis of activated SCs. The molecular mechanisms underlying the modulation of SC activity by MSCs were examined. IL-6 secretion from activated SCs induced IL-10 secretion from MSCs, suggesting a dynamic response of MSCs to the SCs in the microenvironment. Blockade of MSC-derived IL-10 and TNF-alpha abolished the inhibitory effects of MSCs on SC proliferation and collagen synthesis. In addition, release of HGF by MSCs was responsible for the marked induction of apoptosis in SCs as determined by antibody-neutralization studies. These findings demonstrate that MSCs can modulate the function of activated SCs via paracrine mechanisms provide a plausible explanation for the protective role of MSCs in liver inflammation and fibrosis, which may also be relevant to other models of tissue fibrosis.     

In Vivo Tracking and Comparison of the Therapeutic Effects of MSCs and HSCs for Liver Injury

Background

Mesenchymal stem cells (MSCs) and hematopoietic stem cells (HSCs) have been studied for damaged liver repair; however, the conclusions drawn regarding their homing capacity to the injured liver are conflicting. Besides, the relative utility and synergistic effects of these two cell types on the injured liver remain unclear.

Methodology/Principal Findings

MSCs, HSCs and the combination of both cells were obtained from the bone marrow of male mice expressing enhanced green fluorescent protein(EGFP)and injected into the female mice with or without liver fibrosis. The distribution of the stem cells, survival rates, liver function, hepatocyte regeneration, growth factors and cytokines of the recipient mice were analyzed. We found that the liver content of the EGFP-donor cells was significantly higher in the MSCs group than in the HSCs or MSCs+HSCs group. The survival rate for the MSCs group was significantly higher than that of the HSCs or MSCs+HSCs group; all surpassed the control group. After MSC-transplantation, the injured livers were maximally restored, with less collagen than the controls. The fibrotic areas had decreased to a lesser extent in the mice transplanted with HSCs or MSCs+HSCs. Compared with mice in the HSCs group, the mice that received MSCs had better improved liver function. MSCs exhibited more remarkable paracrine effects and immunomodulatory properties on hepatic stellate cells and native hepatocytes in the treatment of the liver pathology. Synergistic actions of MSCs and HSCs were most likely not observed because the stem cells in liver were detected mostly as single cells, and single MSCs are insufficient to provide a beneficial niche for HSCs.

Conclusions/Significance

MSCs exhibited a greater homing capability for the injured liver and modulated fibrosis and inflammation more effectively than did HSCs. Synergistic effects of MSCs and HSCs were not observed in liver injury.     

Strategies to improve the efficiency of mesenchymal stem cell transplantation for reversal of liver fibrosis

End‐stage liver fibrosis frequently progresses to portal vein thrombosis, formation of oesophageal varices, hepatic encephalopathy, ascites, hepatocellular carcinoma and liver failure. Mesenchymal stem cells (MSCs), when transplanted in vivo, migrate into fibrogenic livers and then differentiate into hepatocyte‐like cells or fuse with hepatocytes to protect liver function. Moreover, they can produce various growth factors and cytokines with anti‐inflammatory effects to reverse the fibrotic state of the liver. In addition, only a small number of MSCs migrate to the injured tissue after cell transplantation; consequently, multiple studies have investigated effective strategies to improve the survival rate and activity of MSCs for the treatment of liver fibrosis. In this review, we intend to arrange and analyse the current evidence related to MSC transplantation in liver fibrosis, to summarize the detailed mechanisms of MSC transplantation for the reversal of liver fibrosis and to discuss new strategies for this treatment. Finally, and most importantly, we will identify the current problems with MSC‐based therapies to repair liver fibrosis that must be addressed in order to develop safer and more effective routes for MSC transplantation. In this way, it will soon be possible to significantly improve the therapeutic effects of MSC transplantation for liver regeneration, as well as enhance the quality of life and prolong the survival time of patients with liver fibrosis.     

Effects of FGF21‐secreting adipose‐derived stem cells in thioacetamide‐induced hepatic fibrosis

Mesenchymal stem cells (MSCs) have been investigated to treat liver diseases, but the efficiency of MSCs to treat chronic liver diseases is conflicting. FGF21 can reduce inflammation and fibrosis. We established FGF21‐secreting adipose derived stem cells (FGF21_ADSCs) to enhance the effects of ADSCs and transplanted them into thioacetamide (TAA)‐induced liver fibrosis mice via the tail vein. Transplantation of FGF21_ADSCs significantly improved liver fibrosis by decreasing serum hyaluronic acid and reducing the expression of fibrosis‐related factors such as α‐smooth muscle actin (α‐SMA), collagen and tissue inhibitor of metalloproteinase‐1 (TIMP‐1) compared with the Empty_ADSCs by inhibition of p‐JNK, NF‐κB and p‐Smad2/3 signalling. α‐lactoalbumin (LA) and lactotransferrin (LTF), secretory factors produced from FGF21_ADSCs inhibited TGF‐β1‐induced expression of α‐SMA and collagen in LX‐2 cells. These results suggest that transplantation of FGF21_ADSCs inhibited liver fibrosis more effectively than Empty_ADSCs, possibly via secretion of α‐LA and LTF.     

Hedgehog-mediated paracrine interaction between hepatic stellate cells and marrow-derived mesenchymal stem cells

During liver injury, bone marrow-derived mesenchymal stem cells (MSCs) can migrate and differentiate into hepatocytes. Hepatic stellate cell (SC) activation is a pivotal event in the development of liver fibrosis. Therefore, we hypothesized that SCs may play an important role in regulating MSC proliferation and differentiation through the paracrine signaling pathway. We demonstrate that MSCs and SCs both express hedgehog (Hh) pathway components, including its ligands, receptors, and target genes. Transwell co-cultures of SCs and MSCs showed that the SCs produced sonic hedgehog (Shh), which enhanced the proliferation and differentiation of MSCs. These findings demonstrate that SCs indirectly modulate the activity of MSCs in vitro via the Hh pathway, and provide a plausible explanation for the mechanisms of transplanted MSCs in the treatment of liver fibrosis.     

The comparison of multipotential for differentiation of progenitor mesenchymal-like stem cells obtained from livers of young and old rats

The presence of stem cells differentiating to hepatocytes and cholangiocytes has been previously reported in livers of young rats. Here, we have isolated, cultured, and characterized mesenchymal stem cells (MSCs) from livers of young and old rats and tested their multipotential for differentiation. The mesenchymal stem cells in liver sections were identified by the presence of markers, respectively for primary stem cells Thy-1 and CD34, for differentiation to early cholangiocytes GST and CK19, and for differentiation to hepatocytes GSTalpha and CK18. Ki67 was detected as the cell proliferation marker. Cells isolated from livers of either age group were tested in a culture for their viability following storage and were characterized for the presence of most of the markers detected in cells in situ. The results revealed age-dependent changes in the number of recovered primary MSCs. In both age groups we have observed cells changing under differentiating conditions to liver cell lineages, such as cholangiocytes and hepatocytes, as well as to non-liver cells such as adipocytes, astrocytes, neuroblasts, and osteoblasts. Our data revealed that from the livers of rats 20 months and older the primary MSCs could be isolated and expanded; however, they were significantly fewer, even though their differentiation multipotential was preserved. The mechanism involved in the differentiation of liver MSCs seemed to depend on a constellation of signals in Notch signalling pathways. Thus, our results support the idea of potential use of liver as a source of MSCs, not only for liver reconstruction but also for cell therapy in general.     

The Therapeutic Effects of Bone Marrow-Derived Mesenchymal Stem Cells and Simvastatin in a Rat Model of Liver Fibrosis

Liver fibrosis is the excessive accumulation of extracellular matrix (ECM) proteins including collagen that occurs in most types of chronic liver diseases. Studies concerning the capacity of mesenchymal stem cells (MSCs) and simvasatain (SIMV) to repair fibrotic tissues through reducing inflammation, collagen deposition, are still controversial. This study aimed to investigate the therapeutic efficacy of bone marrow (BM)-derived MSCs and SIMV on carbon tetrachloride (CCl₄)-induced liver fibrosis in rats. Rats were divided into: normal, CCl₄, CCl₄/MSCs, CCl₄/SIMV, CCl₄/MSCs/SIMV, and SIMV groups. BM-derived MSCs were detected by RT-PCR of CD29 and were then infused into the tail vein of female rats that received CCl₄ injection to induce liver fibrosis. Sex-determining region Y (SRY) gene on Y-chromosome gene was assessed by PCR to confirm homing of the male stem cells in liver tissue of the female recipients. Serum liver function tests, liver procollagens I and III, tissue inhibitors of metalloproteinase-1 (TIMP-1), endoglin, matrix metalloproteinase-1 (MMP-1) gene expressions, transforming growth factor-beta (TGF-β1) immunostaining, and histopathologicl examination were performed. MSCs and SIMV decreased liver procollagens I and III, TIMP-1 and endoglin gene expressions, TGF-β1 immunostaining, and serum liver function tests compared with the CCl₄ group. MMP-1 expression was increased in the CCl₄/MSCs group. Histopathological examination as well as fibrosis score supports the biochemical and molecular findings. It can be concluded that MSCs and SIMV were effective in the treatment of hepatic CCl₄-induced fibrosis-rat model. Treatment with MSCs was superior to SIMV. This antifibrotic effect can be attributed to their effect on the MMPs/TIMPs balance which is central in fibrogenesis.