胚胎干细胞及诱导多能干细胞向心肌细胞分化和调控的研究进展

胚胎干细胞（embryonic stem cells,ESCs）具有自我更新、无限增殖和多向分化的特性,包括分化成心脏组织的多种类型细胞。经体细胞重编程产生的诱导多能干细胞（induced pluripotent stem cells,iPS）也被证明有类似胚胎干细胞的特性。但这些多能干细胞向心肌细胞自发分化的效率非常低,因此,如何有效地诱导这些多能干细胞向心肌细胞的定向分化对深入认识心肌发生发育的关键调控机制和实现其在药物发现和再生医学,如心肌梗塞、心力衰竭的细胞治疗以及心肌组织工程中的应用均具有非常重要的意义。该文重点综述了近年来胚胎干细胞及诱导多能干细胞向心肌细胞分化和调控的研究进展,并探讨了这一研究领域亟待解决的关键问题和这些多能干细胞的应用前景。     

诱导多能干细胞在医学方面的应用

2006年,首次报道在体外简单的转录因子就可以使体细胞重编程为多能性细胞。自从这项技术诞生以来,人们为改善诱导多能干细胞(iPSCs)技术做出了巨大努力,发展各种方法用于将重编程因子导入体细胞制备诱导多能干细胞(iPSCs)。诱导多能干细胞(iPSCs)技术彻底改变了人类对疾病发病机制的探索和药物开发的进程。本文简述了诱导多能干细胞的来源及诱导策略、近年来iPSCs在疾病建模、药物研发、再生医学等方面的应用,同时探讨了该技术当前存在的问题,并对未来进行了展望。     

有氧运动与干细胞动员的心肌细胞增殖研究进展

适宜运动是防治心脏疾病的有效方式,其作用机制尚未完全阐明,安全有效的运动处方需要系统研究。运动可使正常心肌细胞发生生理性肥大与增殖以及多种细胞因子的分泌和干细胞的有效动员,促进心肌细胞增殖分化。成体心肌细胞增殖的来源包括存活的心肌细胞、心肌干/祖细胞以及外周的骨髓间充质干细胞等。干细胞的动员、趋化归巢并分化为心肌细胞是心肌损伤修复的细胞基础。本文从心肌细胞增殖潜力、心肌梗死(MI)的干细胞治疗和运动促进MI心肌细胞增殖等三个方面综述运动促进干细胞动员,诱导内源性心肌细胞再生对MI心肌修复和心功能改善的可能机制、存在问题及相关研究进展。     

间充质干细胞定向心肌细胞分化的研究进展

心肌梗死是由心脏缺血引发心肌细胞不可逆的坏死造成的疾病。目前,用干细胞来治疗心肌梗死越来越具有吸引力。间充质干细胞(mesenchymal stem cells,MSCs)是一种多能干细胞,普遍存在于动物体的一些间质组织(如骨髓、脂肪)中。由于其良好的体外扩增能力、多向分化的潜能且不受伦理学制约等优点,学者们对如何让MSCs高效、定向地分化为心肌细胞,从而补充心脏病人缺血心肌的坏死细胞做了大量的研究。目前已经发现,使MSCs向心肌方向分化的体外诱导方法主要包括化学药物诱导、生物因子诱导、物理诱导、共培养诱导以及分子改造诱导(转移miRNA和转录因子)。该文旨在通过对以上五类方法进行综述,以此了解体外诱导MSCs心肌向分化的研究现状。     

生精干细胞的研究进展

生精干细胞（spermatogonial stem cells,Sscs）是动物出生后保持分裂能力的生殖细胞,其通过自身复制从而终生存在,并不停地进行减数分裂而分化成精子。然而,最近的研究发现生精干细胞具有一定的多能性,在体外可被培养和诱导成多能性细胞,显示生精干细胞是再生医学和细胞治疗疾病的另一理想祖细胞来源。该综述将着重讨论生精干细胞的多能性研究情况和相关问题。     

胚胎干细胞向心肌细胞分化过程中能量代谢变化的研究

目的：定向诱导人胚胎干细胞分化为心肌细胞，对分化过程中胚胎干细胞、心肌祖细胞和心肌细胞糖酵解能力和线粒体氧化磷酸化能力进行实时定量检测，探索分化过程中细胞能量代谢表型的转换机制.方法：用GSK3抑制剂CHIR99021和Wnt信号通路小分子抑制剂IWP2的方法定向分化人胚胎干细胞为心肌祖细胞和心肌细胞；细胞免疫荧光检测人胚胎干细胞标志物，流式细胞术检测人心肌祖细胞和心肌细胞标志物；应用细胞外流量分析（Extracellular Flux Analysis）方法检测人胚胎干细胞、心肌祖细胞和心肌细胞能量代谢情况.结果：人胚胎干细胞干性保持稳定，均表达Nanog、OCT4、SOX2细胞标志物；在向心肌分化过程中，第7d心肌祖细胞标志物Isl1表达99%以上，分化第15d心肌细胞标志物cTnT表达83%以上；人胚胎干细胞糖酵解代谢能力最强，心肌细胞线粒体功能最强，心肌祖细胞处于两种代谢方式的过度阶段.结论：在人胚胎干细胞向心肌细胞分化的过程中，细胞糖酵解能力逐渐减弱，线粒体氧化磷酸化能力逐渐增强，细胞的能量代谢类型发生转变.     

人多能干细胞来源的肾定向分化平台的构建

肾是一种重要的人体器官,具有多种生理功能。然而,全球范围内约有10%的人口患有肾疾病。因此,建立一种接近人体肾的结构与功能的模型进行肾疾病的研究是十分必要的。多能干细胞体外定向诱导分化技术的兴起,为再生医学和精准医学领域注入了新的动力。本研究通过在体外条件下模拟体内肾发育的过程,将人多能干细胞包括胚胎干细胞和诱导多能干细胞,通过体外定向诱导分化形成肾的祖细胞,进而建立肾的结构与功能单位:肾元。该研究通过激活WNT信号通路,同时抑制TGF-β信号通路,将人多能干细胞从多能态定向诱导至原条阶段。之后通过细胞自分化的能力使其发育至中间中胚层,再通过激活FGF信号通路,将其分化至肾祖细胞阶段。流式细胞检测结果显示,肾祖细胞占总细胞数的51.5%~61.9%。通过免疫荧光检测发现:分化得到的结构中包含肾小球足细胞、近端小管、远端小管等肾组织结构。该研究建立的肾体外分化方法,具有稳定性好、分化效率高、重复性好的特点。为研究人类肾的早期发育机制,肾疾病模型构建,以及药物筛选提供了一种新的方法。     

体细胞重编程为多能干细胞的研究进展

胚胎干细胞不仅是研究哺乳动物早期胚胎发育、细胞分化、基因表达调控等发育生物学问题的有力工具,还可用于新药评价、细胞治疗等方面的研究.然而,为科学研究而捐献的人类卵子并不能够轻易获得,限制了人类胚胎干细胞相关研究的进展,解决这个问题的理想办法就是找到能够替代胚胎干细胞的其他成体多能细胞.综述了将哺乳动物体细胞诱导为多能干细胞的方法,重点介绍了利用特定的转录因子将体细胞诱导为诱导多能干细胞(induced pluripotent stem cells,iPS细胞)的最新进展,详细阐述了转录因子在诱导细胞重编程过程中发挥的作用,以及iPS细胞筛选与鉴定的方法,并展望了iPS细胞的应用前景.     

心脏干/祖细胞与心肌损伤修复

细胞移植是一种有希望的组织再生的治疗手段.多种类型的细胞已经用于动物心 肌损伤的修复中,包括胚胎干细胞、胚胎和新生动物的心肌细胞、骨骼肌成肌细胞、 骨髓干细胞、脂肪来源的干细胞、可诱导的多能干细胞等.但是,这些用于移植的细胞 存在成活率低、在心脏局部存留少、与宿主心肌细胞不能整合和免疫排斥等问题,这 些问题限制了它们的应用.心脏自身存在的干细胞因为没有其他来源细胞存在的种种 问题,因而成为备受关注的治疗心肌梗死的种子细胞.但是,心脏干/祖细胞也有自身 弊端,包括干细胞群的细胞生物学或遗传学标志没有统一,在心肌中数量极少,体外 扩增能力有限等,因而限制了心脏干/祖细胞的有效应用.如何能有效动员和促进心脏 干/祖细胞增殖,依赖于人们对心脏干/祖细胞增殖、分化、归巢的调控机制,包括心 脏干/祖细胞修复损伤心肌的分子机制的深入了解.本文将就近年来在心脏再生领域中 ,心脏干/祖细胞的研究新进展进行综述.     

编者按

正随着我国老龄化的加剧,心血管疾病的发病率逐年攀升,心血管疾病已占据我国居民疾病死亡原因的首位。近年来,饮食不健康、生活不规律、缺乏运动和心理压力大等导致心血管疾病的发病呈现持续上升和年轻化现象。心血管疾病因发病率和死亡率高、治愈率低,严重危害我国国民健康和公共卫生安全。干细胞及相关技术(如基因编辑技术、类器官和单细胞测序技术)的快速发展,为人类心血管疾病研究和治疗带来了新的希望和推动力。人体干细胞包括多能干细胞和成体干细胞等。其中,人多能干细胞,如胚胎干细胞和诱导多能干细胞,可在体外培养过程中维持无限自我更新能力,可定向诱导分化为人体几乎所有细胞类型,为研究和治疗人类疾病(特别是心血管疾病和神经退行性病变等重大疾病)提供了一个取之不尽、     

Prospects for pluripotent stem cell‐derived cardiomyocytes in cardiac cell therapy and as disease models

The derivation of embryonic stem cells (hESC) from human embryos a decade ago started a new era in perspectives for cell therapy as well as understanding human development and disease. More recently, reprogramming of somatic cells to an embryonic stem cell‐like state (induced pluripotent stem cells, iPS) presented a new milestone in this area, making it possible to derive all cells types from any patients bearing specific genetic mutations. With the development of efficient differentiation protocols we are now able to use the derivatives of pluripotent stem cells to study mechanisms of disease and as human models for drug and toxicology testing. In addition derivatives of pluripotent stem cells are now close to be used in clinical practice although for the heart, specific additional challenges have been identified that preclude short‐term application in cell therapy. Here we review techniques presently used to induce differentiation of pluripotent stem cells into cardiomyocytes and the potential these cells have as disease models and for therapy. J. Cell. Biochem. 107: 592–599, 2009. © 2009 Wiley‐Liss, Inc.     

Induction and enhancement of cardiac cell differentiation from mouse and human induced pluripotent stem cells with cyclosporin-A

Induced pluripotent stem cells (iPSCs) are novel stem cells derived from adult mouse and human tissues by reprogramming. Elucidation of mechanisms and exploration of efficient methods for their differentiation to functional cardiomyocytes are essential for developing cardiac cell models and future regenerative therapies. We previously established a novel mouse embryonic stem cell (ESC) and iPSC differentiation system in which cardiovascular cells can be systematically induced from Flk1(+) common progenitor cells, and identified highly cardiogenic progenitors as Flk1(+)/CXCR4(+)/VE-cadherin(-) (FCV) cells. We have also reported that cyclosporin-A (CSA) drastically increases FCV progenitor and cardiomyocyte induction from mouse ESCs. Here, we combined these technologies and extended them to mouse and human iPSCs. Co-culture of purified mouse iPSC-derived Flk1(+) cells with OP9 stroma cells induced cardiomyocyte differentiation whilst addition of CSA to Flk1(+) cells dramatically increased both cardiomyocyte and FCV progenitor cell differentiation. Spontaneously beating colonies were obtained from human iPSCs by co-culture with END-2 visceral endoderm-like cells. Appearance of beating colonies from human iPSCs was increased approximately 4.3 times by addition of CSA at mesoderm stage. CSA-expanded human iPSC-derived cardiomyocytes showed various cardiac marker expressions, synchronized calcium transients, cardiomyocyte-like action potentials, pharmacological reactions, and ultra-structural features as cardiomyocytes. These results provide a technological basis to obtain functional cardiomyocytes from iPSCs.     

Somatic cell reprogramming for regenerative medicine: SCNT vs. iPS cells

Reprogramming of somatic cells to a pluripotent state holds huge potentials for regenerative medicine. However, a debate over which method is better, somatic cell nuclear transfer (SCNT) or induced pluripotent stem (iPS) cells, still persists. Both approaches have the potential to generate patient-specific pluripotent stem cells for replacement therapy. Yet, although SCNT has been successfully applied in various vertebrates, no human pluripotent stem cells have been generated by SCNT due to technical, legal and ethical difficulties. On the other hand, human iPS cell lines have been reported from both healthy and diseased individuals. A recent study reported the generation of triploid human pluripotent stem cells by transferring somatic nuclei into oocytes, a variant form of SCNT. In this essay, we discuss this progress and the potentials of these two reprogramming approaches for regenerative medicine.     

Cellular reprogramming of somatic cells

The process of 'cell reprogramming' can be achieved by somatic cell nuclear transfer, cell fusion with embryonic stem cells, exposure to stem cell extracts, or by inducing pluripotentcy mediated by defined factors giving rise to what are termed induced pluripotent stem cells. More recently, the fate of a somatic cell can be directly induced to uptake other cell fates, termed lineage-specific reprogramming, without the need to de-differentiate the cells to a pluripotent state. In this review we will describe the different methods of reprogramming somatic cells.     

核移植与诱导多能干细胞技术在体细胞重编程研究中的应用

体细胞重编程是指分化的体细胞在特定的条件下被逆转后恢复到多能性或全能性状态,或者形成多能干细胞系,或者形成早期胚胎然后发育成一个新的个体的过程。诱导体细胞重编程的方法有许多,如核移植（nuclear transfer,NT）、细胞融合、细胞培养和通过导入特定因子获得诱导多能干（induced pluripotent stem,iPS）细胞的方法等。其中核移植和iPS技术是到目前为止诱导体细胞为多能干细胞最为完全、最具有运用于临床再生医学潜能的方法。然而,它们的效率都很低,机制也不清楚,如何将两个方法结合在一起,提高重编程的效率,揭示重编程的机制,进而促进其在患者特异性治疗中的运用将是下阶段的努力方向。     

诱导多能干细胞及其在神经退行性疾病研究中的应用

用干细胞转录因子OCT4、SOX2、c-MYC和KLF4进行体细胞重编程产生具有胚胎干细胞特性的诱导多能干细胞(iPS细胞)是干细胞研究领域的突破性进展。近年来,iPS细胞的研究从产生方法、重编程机理及实际应用方面不断取得进展。由于iPS细胞的产生可取自体细胞,因而克服了胚胎干细胞应用的伦理学和免疫排斥等缺陷,为iPS细胞的临床应用开辟了广阔的前景。该文将对iPS细胞的产生方法、重编程机理及其在神经性退行性疾病的研究与应用进行文献综述,反映近几年iPS细胞最新研究成果,并阐述了用病人iPS细胞模型探讨帕金森氏病、老年性痴呆症、脊髓侧索硬化症、脊髓肌肉萎缩症及舞蹈症等5种常见神经性退行性疾病发病机理的研究现状。     

Pluripotent stem cell‐based heart regeneration: From the developmental and immunological perspectives

Heart diseases such as myocardial infarction cause massive loss of cardiomyocytes, but the human heart lacks the innate ability to regenerate. In the adult mammalian heart, a resident progenitor cell population, termed epicardial progenitors, has been identified and reported to stay quiescent under uninjured conditions; however, myocardial infarction induces their proliferation and de novo differentiation into cardiac cells. It is conceivable to develop novel therapeutic approaches for myocardial repair by targeting such expandable sources of cardiac progenitors, thereby giving rise to new muscle and vasculatures. Human pluripotent stem cells such as embryonic stem cells and induced pluripotent stem cells can self‐renew and differentiate into the three major cell types of the heart, namely cardiomyocytes, smooth muscle, and endothelial cells. In this review, we describe our current knowledge of the therapeutic potential and challenges associated with the use of pluripotent stem cell and progenitor biology in cell therapy. An emphasis is placed on the contribution of paracrine factors in the growth of myocardium and neovascularization as well as the role of immunogenicity in cell survival and engraftment. (Part C) 96:98–107, 2012. © 2012 Wiley Periodicals, Inc.     

Human parthenogenetic embryonic stem cells: one potential resource for cell therapy

Pluripotent stem cells derived from somatic cells through such processes as nuclear transfer or induced pluripotent stem (iPS) cells present an important model for biomedical research and provide potential resources for cell replacement therapies. However, the overall efficiency of the conversional nuclear transfer is very low and the safety issue remains a major concern for iPS cells. Embryonic stem cells (ESCs) generated from parthenogenetic embryos are one attractive alternative as a source of histocompatible cells and tissues for cell therapy. Recent studies on human parthenogenetic embryonic stem cells (hPG ESCs) have revealed that these ESCs are very similar to the hESCs derived from IVF or in vivo produced blastocysts in gene expression and other characteristics, but full differentiation and development potential of these hPG ESCs have to be further investigated before clinical research and therapeutic interventions. To generate various pluripotent stem cells, diverse reprogramming techniques and approaches will be developed and integrated. This may help elucidate the fundamental mechanisms underlying reprogramming and stem cell biology, and ultimately benefit cell therapy and regenerative medicine. Supported by the National High Technology Research and Development Program of China (Grant No. 2006AA02A101).