外泌体在阿尔兹海默病发生发展及其治疗中的作用

阿尔茨海默病(Alzheimer’s disease, AD)是一种记忆和认知功能进行性丧失的神经退行性疾病,目前仍缺乏对其发病机制的理解以及有效治疗手段。受损神经细胞衍生的外泌体可以将miRNA、β淀粉样蛋白(amyloid-β, Aβ)、淀粉样前体蛋白(amyloid precursor protein, APP)等转移到邻近神经元加速周边神经元的死亡;胶质细胞通过外泌体调节Aβ产生、寡聚化和Aβ降解;间充质干细胞(mesenchymal stem cell, MSCs)通过外泌体释放脑啡肽酶(neprilysin, NEP)、miRNA、鞘脂激活蛋白原,从而起到抑制神经炎症、促进Aβ降解、改善AD的作用。外泌体的研究是AD研究的热点之一,该文综述了外泌体的形成以及其在AD发生、发展和治疗中的作用。     

间充质干细胞来源的外泌体在自身免疫性疾病中的治疗作用（英文）

自身免疫性疾病往往累及多个器官,可以引起多种并发症。近年来,自身免疫性疾病的新疗法被广泛提出,而间充质干细胞(mesenchymal stem cells, MSCs)因其独特的免疫调节能力成为了研究热点。外泌体是MSCs等细胞分泌的一种小囊泡,通过携带蛋白质、mRNA、microRNA、脂质等细胞内容物,参与细胞间物质和信息的传递,调节受体细胞的生物学功能,这可能是MSCs免疫调节功能的潜在机制。越来越多的研究表明,MSCs分泌的外泌体具有与MSCs相似甚至更好的免疫调节功能,其在自身免疫性疾病治疗中的作用已在某些疾病的动物模型中得到证实。本综述总结了MSCs及其外泌体对免疫系统和免疫细胞的作用,以及近年来MSCs来源的外泌体在自身免疫性疾病中作用的研究进展。     

间充质干细胞旁分泌作用治疗阿尔茨海默病的临床前研究进展

阿尔茨海默病(Alzheimer’s disease,AD)是最常见的神经退行性疾病之一,严重损害患者的记忆和认知能力。研究者经过多年探索仍无法找到治愈AD的有效药物。源于间充质干细胞(mesenchymal stem cells,MSCs)旁分泌的生长因子、细胞因子、趋化因子等生物因子及外泌体具有抗炎、清除β-淀粉样蛋白(β-amyloid peptide,Aβ)、促进神经生长以及抑制细胞凋亡等作用,MSCs的旁分泌作用被认为是治疗AD最有前途的临床疗法之一。该文首先总结了AD的发病机制,然后根据MSCs所具有的特征和优势,综述了利用MSCs的旁分泌作用治疗AD的临床前研究,期望为将来临床上治疗AD提供有价值的信息。     

间充质干细胞来源外泌体促心肌梗死血管新生及其机制研究进展

血管新生(angiogenesis)是机体内一个复杂的生理学和病理学过程,是治疗缺血性疾病的重要措施。大量实验研究已表明间充质干细胞(mesenchymal stem cells, MSCs)等干细胞移植可促进心肌梗死后血管新生,近期研究证实这一作用可能主要通过分泌外泌体形式介导。外泌体(exosome)通过传递与血管新生相关微RNA(microRNA, mi RNA)或蛋白质等生物活性物质,调控靶器官中与血管新生相关通路的基因表达,提高内皮细胞在缺血缺氧环境下的存活、迁移、成管能力,促进心肌梗死区域血管新生。通过基因修饰手段增强外泌体介导的心脏修复作用,以及将外泌体与生物活性肽结合形成工程外泌体来靶向缺血心肌治疗,是目前外泌体在心血管领域的热点研究方向。本文结合近年外泌体研究的相关文献,就MSCs来源外泌体促进心肌梗死血管新生的具体机制及现状研究作一综述。     

水凝胶负载干细胞外泌体在组织再生领域的应用研究进展

近年来,间充质干细胞(mesenchymal stem cells,MSCs)衍生的外泌体在组织再生领域引发许多关注。MSCs衍生外泌体作为细胞间通讯的信号分子,具有天然靶向性强、免疫原性低等特点,其通过MSCs旁分泌途径被细胞吸收,参与调控发挥促进细胞或组织再生功能。水凝胶作为再生医学领域的支架材料,具有良好的生物相容性、降解性等特点。将二者制成复合物联合使用后不仅可以提高外泌体在病变位置的滞留时间,且可通过原位注射等方法提高外泌体到达病变位置的剂量,在病变区域治疗效果显著且持续性改善。文中总结了现阶段外泌体与水凝胶复合物材料共同作用促进组织修复、再生的研究结果,以期为未来组织再生领域中的相关研究工作提供借鉴。     

综述与专论：运动经外泌体防治肌少症的研究进展

肌少症（sarcopenia）是以骨骼肌质量和肌力进行性下降为特征的增龄性综合征,探究其发病机理对于肌少症的预防与治疗具有重要意义。研究表明,外泌体（exosomes）与肌少症关联密切,可能是一种有益的削弱/防治手段,但其机制尚未厘清。近期研究表明,外泌体富含运动因子/细胞因子,其不仅参与机体细胞与组织间的交互作用（cross talk）,亦介导了包括骨骼肌细胞增殖与分化在内的诸多病理生理过程。此外,运动可通过促进外泌体的释放并调节外泌体携带的miRNAs和/或蛋白质的表达,从而有效改善肌少症。本文就外泌体及其生物学特性以及外泌体与肌少症之间的关系进行归纳梳理,总结并分析运动对外泌体的影响及其可能机制,以期为肌少症的防治提供新的策略。     

外泌体对睾丸微环境调控机制研究及应用进展

外泌体（exsomes）是一类具有生物活性的双层脂质组成的小囊泡,可携带不同类型的信息物质与受体细胞结合,通过信息传递与物质交换,促发受体细胞的表型发生变化。本文总结了在睾丸微环境中,外泌体通过调节细胞因子促进睾丸微环境中细胞增殖、调节细胞免疫维持睾丸免疫环境、调节氧化应激修复受体细胞功能、调节细胞自噬改善生精能力、调节细胞凋亡改善精子发生、调节细胞因子影响睾酮分泌等机制维持睾丸微环境稳态,并对外泌体在男科相关疾病预防、诊断、治疗中的作用进行归纳,外泌体在男性不育、勃起功能障碍、精索静脉曲张、性腺功能减退、前列腺癌等疾病诊疗中具备明显优势。外泌体作为一种新兴的应用物质,随着外泌体工程和提取工艺的不断优化,以及相关机制研究的不断深入,外泌体在男科疾病中的临床运用成为可能,有望成为治疗男科疾病的新手段。     

间充质干细胞来源外泌体在膝骨关节炎微环境中的作用

骨关节炎是一种涉及所有关节成分（包括关节软骨、软骨下骨、滑膜、韧带、关节囊和关节周围肌肉）的关节退行性疾病，会导致严重的残疾，其中最常见的是膝骨关节炎（knee osteoarthritis，KOA）。外泌体是一种由不同细胞分泌的直径为40~100 nm的胞外囊泡，可以传递DNA、微小RNA、mRNA、蛋白质等多种物质，并通过多种方式进行细胞间的信息传递和功能调节。间充质干细胞（mesenchymal stem cells，MSCs）可以从骨髓、脂肪、滑膜及外周血等组织分离，是一类具有多向分化潜能的祖细胞，以干细胞为基础的疗法可以修复软骨损伤，对抗KOA的发展，间充质干细胞能够分泌多种营养因子来调节受损的微环境，其中间充质干细胞来源的外泌体被认为在KOA炎症反应及软骨细胞代谢中发挥着重要的作用，其能够调节膝骨关节微环境中B细胞、T细胞、滑膜细胞、软骨细胞代谢及其细胞外基质的分解与合成平衡，维持软骨稳态。近期有多项研究表明，不同组织来源的间充质干细胞外泌体对骨关节炎均有明确的治疗作用，本文就MSCs来源的外泌体治疗KOA的具体机制进行综述，以期对干细胞治疗KOA提供理论依据。     

外泌体的生物学功能及其在基因治疗中的应用

外泌体(exosomes)是由细胞分泌的、在细胞间信息交流起重要作用的一类膜性小体。研究表明,外泌体在人体生理及病理机制中均发挥着重要的作用。自外泌体发现已有三十余年,随着蛋白组学研究的不断推进,人们对外泌体及其表面分子以及外泌体功能的了解亦不断加深,人们开始关注于改构外泌体以将其应用于基因治疗领域并取得了一系列成果,外泌体的临床应用前景将非常广阔。本文将综述外泌体的形成机制和特征,外泌体的生理病理功能、及其作为载体在基因治疗中的应用和改构策略。     

神经系统中一种新型的潜在治疗工具——外泌体

外泌体(exosomes)是一种由细胞分泌到胞外空间的纳米囊泡(nanovesicles),在神经系统中参与许多生理病理过程。大量研究表明,在神经系统中,外泌体可以作为细胞通讯的信使,参与复杂的细胞间信息交流。同时,外泌体也可作为诊断疾病的生物标志物及小分子物质传递载体,在治疗神经系统疾病中发挥着至关重要的作用。因此,exosomes有望成为治疗神经系统疾病的重要工具。该综述首先阐述了外泌体的基本特性,包括合成、存储、分离等;其次,讨论了间充质干细胞(mesenchymal stem cells,MSCs)分泌的外泌体在神经退行性疾病的诊断和治疗中的作用;最后,讨论了外泌体作为治疗神经系统疾病的新型工具将面临的挑战。该综述阐明了外泌体这一快速进展领域及其在神经系统疾病中的作用,特别是其治疗应用的最新进展。     

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。     

Neuronal differentiation of human mesenchymal stem cells: changes in the expression of the Alzheimer's disease-related gene seladin-1

Seladin-1 (SELective Alzheimer's Disease INdicator-1) is an anti-apoptotic gene, which is down-regulated in brain regions affected by Alzheimer's disease (AD). In addition, seladin-1 catalyzes the conversion of desmosterol into cholesterol. Disruption of cholesterol homeostasis in neurons may increase cell susceptibility to toxic agents. Because the hippocampus and the subventricular zone, which are affected in AD, are the unique regions containing stem cells with neurogenic potential in the adult brain, it might be hypothesized that this multipotent cell compartment is the predominant source of seladin-1 in normal brain. In the present study, we isolated and characterized human mesenchymal stem cells (hMSC) as a model of cells with the ability to differentiate into neurons. hMSC were then differentiated toward a neuronal phenotype (hMSC-n). These cells were thoroughly characterized and proved to be neurons, as assessed by molecular and electrophysiological evaluation. Seladin-1 expression was determined and found to be significantly reduced in hMSC-n compared to undifferentiated cells. Accordingly, the total content of cholesterol was decreased after differentiation. These original results demonstrate for the first time that seladin-1 is abundantly expressed by stem cells and appear to suggest that reduced expression in AD might be due to an altered pool of multipotent cells.     

Stem cell therapy for Alzheimer's disease

Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by memory loss and cognitive impairment. It is caused by synaptic failure and excessive accumulation of misfolded proteins. To date, almost all advanced clinical trials on specific AD-related pathways have failed mostly due to a large number of neurons lost in the brain of patients with AD. Also, currently available drug candidates intervene too late. Stem cells have improved characteristics of self-renewal, proliferation, differentiation, and recombination with the advent of stem cell technology and the transformation of these cells into different types of central nervous system neurons and glial cells. Stem cell treatment has been successful in AD animal models. Recent preclinical studies on stem cell therapy for AD have proved to be promising. Cell replacement therapies, such as human embryonic stem cells or induced pluripotent stem cell–derived neural cells, have the potential to treat patients with AD, and human clinical trials are ongoing in this regard. However, many steps still need to be taken before stem cell therapy becomes a clinically feasible treatment for human AD and related diseases. This paper reviews the pathophysiology of AD and the application prospects of related stem cells based on cell type.     

人脐带间充质干细胞通过分泌IL-6介导冈田酸对SH-SY5Y细胞毒性的保护作用

阿尔茨海默病(Alzheimer’s disease,AD)是一种国际公认的难治性神经退行性疾病,是引起痴呆的最常见的病因.其主要的病理学变化是由Aβ过度沉积引起的老年斑(SP),以及Tau蛋白过度磷酸化引起的神经纤维缠结(NFTs).从人脐带华通胶中分离出的间充质干细胞(hUC-MSCs)由于其强大的旁分泌作用,已经被证实对神经系统疾病有治疗效果,其中包括AD,这种治疗机制尚不明确.本研究用冈田酸对SH-SY5Y细胞系进行损伤,建立AD体外模型,然后用种有hUC-MSCs的transwell小室或其条件培养基对模型进行治疗,并发现其分泌的IL-6可能是介导这种修复作用的关键因子.     

低功率激光照射缓解Aβ引起的神经细胞毒性

阿尔兹海默尔症(Alzheimer’s disease,AD)随着世界人口老龄化的形势严峻,目前成为一种严重威胁老年人身体健康的疾病之一,探究其发病机制以及如何治疗已经刻不容缓。低功率激光照射(low-power laser irradiation,LPLI)作为一种无损伤的新型物理疗法,能调节机体的多种生物学功能,为AD提供一种潜在的治疗方法。我们发现:低功率激光照射可以缓解β-淀粉样蛋白(β-amyloid peptide,Aβ)引起的神经元细胞毒性及细胞死亡,并且可以改善树突萎缩,缓解突触功能性紊乱,为神经元细胞提供保护作用。这一研究将为低功率激光照射治疗阿尔兹海默症在临床上的应用奠定基础。     

脐带间充质干细胞的生物学特性及旁分泌作用的研究进展

脐带是由胚胎外中胚层和/或胚胎中胚层发育而来的组织,脐带间充质干细胞是具有自我更新、多向分化以及高度增殖潜能的多功能干细胞。研究证明,脐带间充质干细胞具有以下功能：参与炎症反应,抑制炎症因子分泌并促进免疫调节;参与受损伤组织的治疗与修复使其再生并改善特定疾病症状;抑制肿瘤增殖和迁移以及促进其凋亡等。然而目前尚未明确以上功能是间充质干细胞本身发挥作用,还是其分泌的相关因子对机体修复产生作用。主要对脐带间充质干细胞的定义、来源、生物学特性、分泌功能等方面的研究进展进行了综述,旨在更好地利用间充质干细胞修复组织,以期为脐带间充质干细胞的后续研究提供参考依据。     

Aging and amyloid beta-induced oxidative DNA damage and mitochondrial dysfunction in Alzheimer's disease: implications for early intervention and therapeutics

Alzheimer's disease (AD) is an age-related progressive neurodegenerative disease affecting thousands of people in the world and effective treatment is still not available. Over two decades of intense research using AD postmortem brains, transgenic mouse and cell models of amyloid precursor protein and tau revealed that amyloid beta (Aβ) and hyperphosphorylated tau are synergistically involved in triggering disease progression. Accumulating evidence also revealed that aging and amyloid beta-induced oxidative DNA damage and mitochondrial dysfunction initiate and contributes to the development and progression of the disease. The purpose of this article is to summarize the latest progress in aging and AD, with a special emphasis on the mitochondria, oxidative DNA damage including methods of its measurement. It also discusses the therapeutic approaches against oxidative DNA damage and treatment strategies in AD.     

Dementia: Alzheimer pathology and vascular factors: From mutually exclusive to interaction

Alzheimer's disease (AD) is the most common type of dementia. Both its incidence and prevalence are expected to increase exponentially as populations' age worldwide. Despite impressive efforts of research worldwide, neither cure nor effective preventive strategy is available for this devastating disease. Currently there are several hypotheses on what causes AD, with the amyloid hypothesis being the most investigated and accepted hypothesis over the past 20 years. However the exact role of amyloid-β in the onset and progression of AD is not yet fully understood, and even the validity of the amyloid hypothesis itself is still being discussed. This debate is fuelled by the vascular hypothesis, as increasing epidemiological, neuroimaging, pathological, pharmacotherapeutic and clinical studies suggest that vascular pathology plays a key role in the onset and progression of AD. We here will discuss arguments in favor and limitations of both hypotheses within the framework of available literature, but also provide arguments for convergence of both hypotheses.Finally we propose approaches that may aid in unraveling the etiology and treatment of AD. This article is part of a Special Issue entitled: Imaging Brain Aging and Neurodegenerative disease.     

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。     

Effects of estrogen treatment on glutamate uptake in cultured human astrocytes derived from cortex of Alzheimer's disease patients

Estrogen is thought to play a protective role against neurodegeneration through a variety of mechanisms including the activation of growth factors, the control of synaptic plasticity, and the reduction of response to various insults, such as iron and glutamate. Increasing evidence indicates an increased level of extracellular glutamate and a down-regulation of glutamate transporters in Alzheimer's disease (AD). In this study, we show that glutamate uptake in astrocytes derived from Alzheimer's patients is significantly lower than that from non-demented controls. Estrogen treatment increases glutamate uptake in a dose-dependent pattern. Two glutamate transporters, GLT-1 and GLAST, are expressed in the astrocytes. Up-regulation of the glutamate transporters is induced by estrogen treatment in AD astrocytes only. Our data suggest that the action of estrogen on glutamate uptake by astrocytes might contribute to its potential neuroprotective role in AD.