骨髓间质干细胞向心肌细胞分化的可塑性及应用研究进展

减少心肌缺血后损伤,促进心肌细胞和血管再生是治疗心肌缺血损伤、心力衰竭的重要思路,而干细胞移植为该思路带来了新的曙光。骨髓间质干细胞（-mesenchymal stem cells,MSCs）,也称为骨髓基质细胞,能分化为骨、软骨和脂肪细胞表型。研究表明,MSCs还能分化为内皮细胞、神经细胞、平滑肌细胞、骨骼肌细胞和心肌细胞表型。MSCs具有多向分化的潜能,且自体移植可以避免免疫排斥反应,同时也易于在体外大量扩增。研究显示,MSCs移植能抑制损伤心肌的重塑和改善心肌功能。因此,骨髓间质干细胞移植给人们展示了一个诱入的前景。本文综述了近年来有关MSCs特性的新认识,尤其是MSCs向心肌细胞方向分化的可塑性、影响因素和信号转导机制,以及MSCs治疗心肌梗死的动物实验和临床研究进展。

Plasticity of bone marrow mesenchymal stem cells differentiating into cardiomyocytes and the potential of cardiac therapeutics

Current treatments for ischemic cardiomyopathy aim at minimizing the deteriorated consequences of damaged myocardium.Recent stem cell researches have provided major impetus for the possibility of treating heart failure by generating new myocardium and vascular structures. Bone marrow mesenchymal stem cells(MSCs),also referred to as marrow stromal cells,differentiate readily into chondrocytes,adipocytes,and osteocytes.Recent provocative data suggest that they can also express phenotypic characteristics of endothelial,neural,smooth muscle,skeletal myoblasts,and cardiac myocytes.The multilineage potential,no immune reaction if self-transplantation,and the relative easiness of expansion in culture make MSCs a promising source of cells for medical therapies.Recent researches demonstrate that implantation of intramyocardial MSCs can prevent deteriorated remodeling and improve cardiac function,although the underling mechanisms need to be further clarified.This review summarized recent studies in the recognization of MSCs,particularly the MSC plasticity into cardiomyocytes,factors and signal pathways that mediate MSC differentiation,and animal studies as well as clinic trials of the implantation of MSCs in postinfarct myocardium.