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。     

骨髓间充质干细胞抗肝纤维化的研究进展

肝纤维化及其终末病变肝硬化已严重危害全球人类健康,虽然慢性肝病的治疗手段和抗肝纤维化药物的研究已取得了很大进展,肝移植依然是最有效的治疗方案,但器官的紧缺却是一个现实问题。目前寻找有效的干预手段进行抗肝纤维化治疗已越来越受到大家的关注。近些年,大量基础及临床研究均证实在一定条件下利用骨髓间充质干细胞(MSCs)可以抑制肝星状细胞活化诱导其凋亡,实现肝纤维化逆转。随着干细胞技术的快速发展,基于骨髓间充质干细胞(MSCs)的细胞疗法在肝纤维化治疗领域的研究与应用已成为一个充满生命力的新方向。本文将对肝纤维化及基于MSCs的治疗机制进展及其应用进行综述。     

骨桥蛋白与肝脏发育、肝再生及肝脏疾病

骨桥蛋白(osteopontin,OPN)是一种分泌型磷酸化糖蛋白,结构上与多种胞外基质蛋白相似,功能上具有细胞因子的特点,在多种生理、病理过程中发挥重要作用。在肝中,它可能参与肝脏发育和肝再生,并与急性肝炎、脂肪性肝炎、肝纤维化及肝癌等疾病的发生、发展密切相关。本文综述了OPN在肝脏发育、肝再生和肝脏疾病等中的作用研究进展,为开展OPN在促进肝再生及肝脏疾病诊断、治疗方面的应用提供重要理论基础。     

自体骨髓间充质干细胞对二甲基甲酰胺中毒肝衰竭患者肝功能恢复的促进作用

目的探讨自体骨髓间充质干细胞（BM-MSCs）对二甲基甲酰胺（DMF）中毒致急性肝衰竭后肝功能延迟恢复患者的疗效和安全性。 方法1例DMF中毒性急性肝衰竭患者,在人工肝为主的内科综合治疗后肝功能持续得不到恢复时,采取患者骨髓,分离、培养制备BM-MSCs,经肝动脉介入输注到患者肝内,观察其临床表现、肝功生化、凝血、肝脏影像学、肝组织病理学等改变及BM-MSCs近期不良反应和远期的安全性。 结果BM-MSCs治疗后,患者持续不见好转的肝功生化指标开始改善,凝血功能恢复速度加快,凝血酶原活动度（PTA）逐渐恢复到40%以上,上腹部CT见肝脏再生结节较前增大,Child-Pugh分级由C级转为A级,终末期肝病模型（MELD）评分由21分降到7分;干细胞输注早期未出现相关的不良反应,8周后再生结节穿刺活检其病理特征为：肝细胞变性、坏死、纤维化、胆汁淤积与再生并存。随访3年患者肝功生化正常、肝硬化结节影像学观察无明显变化,未发生癌变。 结论BM-MSCs肝动脉介入治疗对DMF中毒致急性肝衰竭肝功能延迟恢复患者的肝功能改善具有一定促进作用,近期无明显不良反应,中远期安全性好。     

肝干细胞的来源与作用

卵圆细胞(oval cells)是肝脏内体积小、细胞质清澈、核卵圆形、不易定性的细胞。它们可能来源于骨髓或与骨髓有关的细胞群,是活化形式的肝干细胞。肝干细胞的形态特征与卵圆细胞相似,生化标记为c-kit／CD^45／TER19。本文总结了人们对肝干细胞的认识和肝干细胞在肝脏发育、肝再生、肝癌发生中的作用及与其它细胞来源的联系。     

新分离的脂肪来源基质细胞与培养的脂肪干细胞用于肝纤维化治疗的效能比较

目的:比较新分离的脂肪来源基质细胞(f ASC)与脂肪干细胞(ASC)在抗大鼠肝纤维化方面的治疗潜能。方法:利用胶原酶解法获得新鲜分离的f ASC,体外扩增培养获得不同代数的ASC,用流式细胞仪分析不同代数细胞的表型;建立大鼠肝纤维化模型,并将f ASC或ASC用于干细胞移植治疗,通过血液肝功能指标检测、RT-PCR、HE染色和天狼星红染色评价2类细胞的治疗效果。结果:f ASC和ASC均可显著改善肝纤维化的大鼠肝脏功能,二者用于治疗肝脏疾病的疗效相似。结论:在肝脏疾病的脂肪干细胞移植治疗中,应当综合考虑移植的干细胞体外传代次数和治疗效果间的关系。     

肝干细胞的来源与作用

卵圆细胞(oval cells)是肝脏内体积小、细胞质清澈、核卵圆形、不易定性的细胞。它们可能来源于骨髓或与骨髓有关的细胞群,是活化形式的肝干细胞。肝干细胞的形态特征与卵圆细胞相似,生化标记为c-kit/CD~(45)/TER19。本文总结了人们对肝干细胞的认识和肝干细胞在肝脏发育、肝再生、肝癌发生中的作用及与其它细胞来源的联系。     

肝细胞生长因子基因修饰的间充质干细胞治疗肝损伤的研究进展

减轻肝脏损伤、促进肝脏修复和再生始终是肝脏疾病研究中的重点。间充质干细胞(MSCs)是众多具有组织修复和再生能力细胞中的明星细胞,合成的多种细胞因子经旁分泌途径发挥调控细胞生存,调节炎症反应,促进血管再生和减轻纤维化等多种生物学效应,肝细胞生长因子(HGF)便是重点细胞因子之一。基于HGF的信号调控作用,再结合MSCs的干细胞优势,HGF基因修饰间充质干细胞(HGF-MSCs)作为一种干细胞治疗新策略能够发挥“1+1>2”的效果。本文就HGF-MSCs在减轻和修复肝损伤中的研究进展作综述。     

骨髓干细胞移植治疗肝硬化的基础与临床研究现状

肝硬化是一种临床常见的肝病良性终末期表现。目前临床上尚缺乏有效的治疗措施。肝脏移植是最理想的治疗方法,但受供体肝脏来源限制,且费用昂贵。近年来开展的自体骨髓干细胞(BMSCs)移植治疗,为肝硬化的治疗带来了新的希望。BMSCs主要包括造型血干细胞和间充质干细胞,其具有可塑性,体外通过生长因子,体内利用特定微环境均可诱导BMSCs分化为肝前体细胞和成熟肝细胞,并明显改善肝功能。从动物实验到临床研究亦表明,BMSCs具有来源丰富、费用低廉、损伤小、自体移植不栓塞、无排斥反应等优点,为治疗肝病带来了新思路,有望成为生物人工肝的细胞来源。本文就BMSCs移植治疗肝硬化的研究现状,尤其是移植途径以及在肝脏内定居、迁移和分化机制的示踪观察方法和存在的问题作一综述,以期为从事肝病研究的同仁提供参考依据。通过对BMSCs移植从基础研究及临床应用的最新进展的描述,展示BMSCs在肝硬化治疗方面良好的治疗前景。     

铁和铁调素在肝纤维化中的作用

多种慢性肝纤维化疾病均伴有肝脏过多的铁沉积,铁在肝纤维化发病中起重要作用。其机制包括:铁通过催化自由基生成和脂质过氧化反应破坏细胞生物大分子,引起细胞凋亡和坏死,激活肝星状细胞转化为肌成纤维细胞等。近来研究证实,由肝脏产生的铁调素(Hepc)表达的降低在慢性肝纤维化疾病肝脏铁沉积中起重要作用,补充外源性Hepc可以降低肝纤维化患者肝脏铁含量。因此,铁调素用于治疗铁过载疾病及肝纤维化具有重要价值。     

Adult stem cells: seing is not being

Recent unexpected observations in adult rodents that stem/progenitor cells located in the bone marrow, but also in other tissues, could, after their transplantation to an irradiated host contribute to the regeneration of damaged organs such as brain, liver, pancreas or muscle, have raised much hope for future therapeutic applications. These data have also initially been interpreted as a proof of a possible transdifferentiation or plasticity of adult stem cells located in these tissues. Additional experiments rigorously analyzed have tempered initial enthusiasm, by showing that if marrow cells do migrate in damaged muscles and liver, their contribution to organ repair is low, and in some cases, explained by cell fusion. Nevertheless, among bone marrow cells, two categories of stem cells now emerge that have a potentially tremendous interest in cell therapy, if we succeed in understanding how to purify, amplify and differentiate these more efficiently and reproducibly.     

M-CSF诱导人骨髓间充质干细胞分化为肝样细胞的分子机制

本研究主要目的是明确M-CSF诱导骨髓间充质干细胞分化为肝样细胞的分子机制,为临床中的肝移植和治疗肝病提供新思路。对取自于本院骨科治疗的患者的股骨骨髓间充质干细胞进行提取、分离、传代培养及鉴定。流式细胞仪检测BMSCs的表面表型。为了诱导BMSCs的肝分化,本研究将BMSCs加入到培养基中。骨髓间充质干细胞诱导21 d后,BMSCs表达了肝细胞特异性标志物a-蛋白(AFP)和细胞角蛋白18(CK18),通过免疫荧光染色证实了分化与为分化的BMSCs表达的差异性。分化的BMSCs还显示了肝细胞的体外功能特征,包括白蛋白产生、尿素分泌和糖原储存。本研究结果表明,BMSCs在M-CSF诱导下可分化为功能性肝细胞样细胞,可作为肝病治疗的细胞来源。     

绿色荧光转基因大鼠模型的建立

目的随着干细胞研究的推进,大鼠干细胞的研究日趋迫切。本研究旨在为活体荧光影像系统、干细胞归巢、细胞移植体内示踪研究,提供绿色荧光蛋白EGFP转基因大鼠模型。方法通过显微注射方式获得EGFP转基因大鼠,采用活体荧光影像系统、激光共聚焦显微镜,对EGFP转基因大鼠各个组织的荧光表达水平进行比较;采用流式细胞术检测转基因大鼠血液和骨髓细胞、骨髓干细胞的荧光标记率,筛选骨髓干细胞高效标记绿色荧光的转基因大鼠。结果建立了心脏、肝脏、肌肉、肺、胰腺、脑、膀胱、胃、肾脏、肠和脾脏组织中,系统性表达EGFP的SD-TgN（ACT-EGFP-1）ZLFILAS转基因大鼠;流式细胞术检测表明,该品系血液细胞绿色荧光标记率为94.4%,骨髓干细胞绿色荧光标记率为97.8%。结论建立了多组织系统性高表达绿色荧光,骨髓干细胞荧光标记率高达95%以上的转基因大鼠,为影像分析,造血干细胞的归巢等研究提供了大鼠模型。     

Purified hematopoietic stem cells can differentiate into hepatocytes in vivo

The characterization of hepatic progenitor cells is of great scientific and clinical interest. Here we report that intravenous injection of adult bone marrow cells in the FAH(-/-) mouse, an animal model of tyrosinemia type I, rescued the mouse and restored the biochemical function of its liver. Moreover, within bone marrow, only rigorously purified hematopoietic stem cells gave rise to donor-derived hematopoietic and hepatic regeneration. This result seems to contradict the conventional assumptions of the germ layer origins of tissues such as the liver, and raises the question of whether the cells of the hematopoietic stem cell phenotype are pluripotent hematopoietic cells that retain the ability to transdifferentiate, or whether they are more primitive multipotent cells.     

Stabilins are expressed in bone marrow sinusoidal endothelial cells and mediate scavenging and cell adhesive functions

Bone marrow sinusoidal endothelial cells have a specific function as a site of transmigration of hematopoietic stem and progenitor cells and mature blood cells between bone marrow and blood stream. However, the specific characteristics of bone marrow sinusoidal endothelial cells are still largely unclear. We here report that these cells express stabilin-1 and stabilin-2, which in liver sinusoidal endothelial cells have been identified as endocytic scavenger receptors for several ligands, including SPARC and hyaluronan. We show here that intravenously injected formaldehyde-treated serum albumin, advanced glycation end-products, and collagen I α-chains were taken up by bone marrow sinusoidal endothelial cells, showing that these cells have a scavenging function and thereby may modulate bone marrow vascular stem cell niches. Importantly, we show hyaluronan mediated adhesion of hematopoietic stem and progenitor cells to stabilin-2-transfected cells, suggesting that stabilin-2 contributes to adhesion and homing of circulating stem and progenitor cells to bone marrow.     

Studies of the cellular cure for osteopetrosis by transplanted cells: specificity of the cell type in ia rats.

Spleen cells from normal rats are known to cure osteopetrosis in ia littermates within 3 weeks. In this study cell suspensions from liver, thymus, bone marrow, salivary gland, skeletal muscle and brain from normal rats were tested for their ability to cure osteopetrosis in ia littermates whose ability to reject these cells had been suppressed by whole-body irradiation. Cells from liver, thymus and bone marrow cured the disease as effectively as spleen cells from normal littermates. Mutants that received cells from salivary gland, muscle and brain remained osteopetrotic. These data suggest that some cell found in spleen, liver, thymus and bone marrow of 10-day-old normal rats, such as a lymphoid cell or stem cell, can restore hemopoiesis and bone resorption in osteopetrotic (ia) rats.     

Comparison of direct and indirect radiation effects on osteoclast formation from progenitor cells derived from different hemopoietic sources

Hemopoietic stem and progenitor cells from different sources differ in radiosensitivity. Recently, we have demonstrated that the multinucleated cell responsible for bone resorption and marrow cavity formation, the osteoclast, is in fact of hemopoietic lineage. In this investigation we have studied the radiosensitivity of osteoclast formation from two different hemopoietic tissues: fetal liver and adult bone marrow. Development of osteoclasts from hemopoietic progenitors was induced by coculture of hemopoietic cell populations with fetal mouse long bones depleted of their own osteoclast precursor pool. During culture, osteoclasts developed from the exogenous cell population and invaded the calcified hypertrophic cartilage of the long bone model, thereby giving rise to the formation of a primitive marrow cavity. To analyze the radiosensitivity of osteoclast formation, either the hemopoietic cells or the bone rudiments were irradiated before coculture. Fetal liver cells were found to be less radiosensitive than bone marrow cells. The D0, Dq values and extrapolation numbers were 1.69 Gy, 5.30 Gy, and 24.40 for fetal liver cells and 1.01 Gy, 1.85 Gy, and 6.02 for bone marrow cells. Irradiation of the (pre)osteoclast-free long bone rudiments instead of the hemopoietic sources resulted in a significant inhibition of osteoclast formation at doses of 4 Gy or more. This indirect effect appeared to be more prominent in the cocultures with fetal than with adult hemopoietic cells. Furthermore, radiation doses of 8.0-10.0 Gy indirectly affected the appearance of other cell types (e.g., granulocytes) in the newly formed but underdeveloped marrow cavity. The results indicate that osteoclast progenitors from different hemopoietic sources exhibit a distinct sensitivity to ionizing irradiation. Radiation injury to long bone rudiments disturbs the osteoclast-forming capacity as well as the hemopoietic microenvironment.