脂肪干细胞在泌尿系统疾病中的研究进展

脂肪干细胞(adipose-derived stem cells,ADSCs)是一类从脂肪分离出来的具有自我更新及多向分化潜能的成体干细胞,ADSCs具有高度的可塑性,可分化成多种类型的细胞。与其他干细胞相比,ADSCs具有来源充足,取材方便,供体易接受等独特优势,已成为基础医学及临床治疗的研究热点。ADSCs诱导分化和移植可有效治疗多种组织损伤性疾病,改善或修复器官功能,近年来ADSCs作为细胞疗法及组织工程的新型种子细胞在泌尿系统疾病治疗中取得了重大进展。本文重点讨论ADSCs的生物学特性及其在泌尿系统疾病中的应用前景。     

干细胞移植治疗心力衰竭的研究进展

由于心肌梗死发作等原因可造成心肌受损、心力衰竭。干细胞可以向心肌细胞定向分化,这使得通过细胞移植治疗心力衰竭成为可能。简要综述了有望用于移植的干细胞,以及目前实验与临床研究进展和面临的问题。     

骨髓单个核细胞移植治疗心肌梗死的机制及临床研究现状

心肌梗死(myocardial infarction,MI)是心血管疾病中导致患者死亡的主要病因。自体骨髓单个核细胞(bone marrow mononuclear cells,BMMNCs)因其具有易分离获得和无免疫排斥等优点,成为治疗心肌梗死的候选种子细胞之一。前期动物实验已经证明,BMMNCs修复受损心肌的主要机制是通过促进梗死部位血管新生、调节免疫系统平衡以及分化为心肌细胞等,从而改善缺血心肌的血液循环和收缩功能,但在临床试验中的结论不尽一致。因此,该文就BMMNCs在治疗心肌梗死的主要机制、临床研究现状以及影响BMMNCs治疗心肌梗死疗效的因素分别予以综述。     

干细胞在肝脏疾病治疗中的临床应用及分子机制

干细胞是指一群具有自我更新和多向分化潜能的细胞,是最有治疗潜力的细胞资源,已成为再生医学领域的研究热点。目前,已有多种干细胞用于肝脏疾病的治疗,能有效改善患者血清指标,减少并发症发生,并提高生活质量。这些干细胞在细胞来源、移植途径及治疗效果等多个方面各有特点,但其治疗肝脏疾病的机制尚不清楚。本文将对目前已用于肝病治疗的各种干细胞的临床应用以及可能的分子机制进展进行阐述。     

电刺激提高分化心肌细胞成熟度并改善心肌梗死大鼠心脏功能

该研究探讨了电刺激对诱导多能干细胞的心脏分化影响,并评估了分化心肌细胞对心肌梗死的治疗效果。电刺激和非电刺激促进诱导多能干细胞分化出功能性心肌细胞;qRT-PCR和细胞免疫荧光检测分化心肌细胞中心源性基因和功能成熟基因表达情况;建立心肌梗死模型SD大鼠并将其随机分为心肌梗死组、电刺激组和对照组,每组10只。心肌梗死组只结扎冠状动脉,电刺激组和对照组分别在心肌梗死边界注射电刺激和无电刺激预处理的分化心肌细胞。超声心动图和有创血流动力学检测心功能;Masson染色评估梗死面积,免疫组化检测梗死边缘区毛细血管密度。结果表明,电刺激可提高分化心肌细胞的自发搏动,并上调分化心肌细胞中心源性基因(Nkx2-5、GATA4、α-MHC和CX-43)和功能成熟基因(α-actinin和RYR2)的表达(P0.05)。电刺激明显改善心肌梗死大鼠心功能,减小梗死面积和增加梗死边缘区毛细血管密度(P0.05)。以上结果表明,电刺激可提高诱导多能干细胞的心脏分化效率并促进分化心肌细胞的成熟;经电刺激预处理的分化心肌细胞可明显改善心肌梗死大鼠心功能。     

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。     

胚胎干细胞体外分化为造血干细胞

造血干细胞移植已成为治疗白血病、再生障碍性贫血、重症免疫缺陷征、地中海贫血、急性放射病、某些恶性实体瘤和淋巴瘤等造血及免疫系统功能障碍性疾病的成熟技术和重要手段,另外这一技术还被尝试用于治疗艾滋病,已取得积极的效果。但是由于移植需要配型相同的供体,并且过程复杂,使得造血干细胞移植因缺少配型相同的供体来源以及费用昂贵而不能被广泛应用。胚胎干细胞是一种能够在体外保持未分化状态并且能进行无限增殖的细胞,在适合条件下能够分化为体内各种类型的细胞,研究胚胎干细胞分化为造血干细胞,不仅可作为研究动物的早期造血发生的模型,而且可以增加造血干细胞的来源,还可以通过基因剔除、治疗性克隆等方法来解决移植排斥的问题,从而为造血干细胞移植的发展扫除了障碍,因此有着重要的研究价值和应用前景。现对胚胎干细胞体外分化为造血干细胞的诱导方法,诱导过程中的调控机制,并对胚胎干细胞分化为造血干细胞的存在问题和发展前景进行讨论。     

胚胎干细胞的心脏应用

心肌梗死期间死亡的心肌细胞将由没有收缩功能的疤痕组织替代,因而极可能引起心力衰竭。对治疗心衰来说,修复死亡或损伤的心肌以及改善心功能仍面临着极大挑战。干细胞移植已在近年来的实验中用于修复损失的心肌。本文总结了近期在心肌损伤动物中实施胚胎干细胞移植的实验结果,并着重介绍对这类特定细胞的研究进展。胚胎干细胞取源于早期哺乳类胚胎的胚芽细胞,属于多功能干细胞。这类细胞具有长期增殖而不分化的能力,或台色够在培养过程中分化成包括心肌细胞在内的所有特殊体细胞。由于胚胎干细胞具有极大的增殖和分化为成熟组织的能力,它们可能成为一种潜在的很有实用价值的细胞来源,可用于对病态心脏的功能心肌再生的细胞治疗。新近的研究表明,在心肌梗死动物模型中,心肌内移植胚胎干细胞或由其分化成的心肌样细胞,能导致已损伤心肌的再生,并改善心脏功能。另外,在病毒性心肌炎小鼠中,静脉输入胚胎干细胞可明显提高生存率和减轻心肌损伤。有关人类胚胎干细胞在体外分化成心肌细胞以及这些细胞的特性,近来已有报道。然而,要在临床能应用人类胚胎干细胞或由其分化成的心肌细胞来治疗晚期心脏疾病,还必须越过大量的伦理、法律和科学上的障碍。     

人源胚胎神经干细胞移植可对抗大鼠的脑缺血/再灌注损伤

本文旨在研究人源胚胎神经干细胞(human embryonic neural stem cells,h NSCs)移植到脑缺血/再灌注损伤大鼠脑内后的迁移、分化,以及对大鼠脑卒中的疗效。我们在大脑中动脉栓塞(middle cerebral artery occlusion,MCAO)1 h的大鼠模型上,于血流再灌注后第7天注射h NSCs到缺血侧侧脑室,通过焦油紫染色测量大鼠的脑梗死体积,通过检测大鼠的感觉运动行为评估其神经功能的恢复水平,通过免疫荧光共标观察移植后的h NSCs在脑内的迁移与分化。结果显示,h NSCs移植后能够显著减小脑卒中大鼠脑梗死体积,并改善脑卒中大鼠的转棒、错步和转角等运动行为能力;侧脑室注射的h NSCs优先向胼胝体以及梗死区周边迁移,迁移到胼胝体的h NSCs可以分化成少突胶质细胞和星形胶质细胞,迁移到梗死区周边的细胞能够分化成神经元。以上这些结果提示,侧脑室移植的h NSCs可能通过向特定脑区的迁移和分化发挥对脑缺血/再灌注损伤大鼠的保护作用。     

脂肪组织源性干细胞研究进展

增加具有完整功能的种子细胞数目是细胞移植的首要环节。近来研究发现,成体动物脂肪组织中含有大量的具有多向分化潜能的间充质干细胞,在特定条件下可分化为多种组织细胞,如脂肪细胞、成骨细胞、软骨细胞、肌细胞及神经星状细胞等,且具有极强的自我复制能力,有望成为组织工程理想的种子细胞。本文综述了脂肪组织源性干细胞（ADSCs）的发现、生物学特性、多向分化潜能、应用前景及存在的问题。     

Melatonin protects ADSCs from ROS and enhances their therapeutic potency in a rat model of myocardial infarction

Myocardial infarction (MI) is a major cause of death and disability worldwide. In the last decade, mesenchymal stem cells (MSCs) based cell therapy has emerged as a promising therapeutic strategy. Although great advance have been made using MSCs to treat MI, the low viability of transplanted MSCs severely limits the efficiency of MSCs therapy. Here, we show evidence that ex vivo pre‐treatment with melatonin, an endogenous hormone with newly found anti‐oxidative activity, could improve survival and function of adipose tissue derived MSCs (ADSCs) in vitro as well as in vivo. ADSCs with 5 μM melatonin pre‐treatment for 24 hrs showed increased expression of the antioxidant enzyme catalase and Cu/Zn superoxide dismutase (SOD‐1), as well as pro‐angiogenic and mitogenic factors like insulin‐like growth factor 1, basic fibroblast growth factor, hepatocyte growth factor (HGF), epidermal growth factor. Furthermore, melatonin pre‐treatment protected MSCs from reactive oxygen species (ROS) induced apoptosis both directly by promoting anti‐apoptosis kinases like p‐Akt as well as blocking caspase cascade, and indirectly by restoring the ROS impaired cell adhesion. Using a rat model of MI, we found that melatonin pre‐treatment enhanced the viability of engrafted ADSCs, and promoted their therapeutic potency. Hopefully, our results may shed light on the design of more effective therapeutic strategies treating MI by MSCs in clinic.     

Transplantation of adipose-derived stem cells overexpressing hHGF into cardiac tissue

The delivery of adipose-derived stem cells (ADSCs) for promoting tissue repair has become a potential new therapy, while hepatocyte growth factor (HGF) is an important growth factor with angiogenic, antifibrotic, and anti-inflammatory benefits. Therefore, transplantation of ADSCs into acute myocardial infarction (AMI) may improve cardiac function through angiogenesis and anti-fibrosis, and that hHGF may enhance these effects. ADSCs were isolated from human subcutaneous adipose tissue. Lentivirus vector encoding human HGF (lenti-hHGF) was constructed and infected into ADSCs. Results indicated that transplantation of ADSCs led to improvement of left ventricular function, explained partly through their ability to differentiate into endothelial cells, resulting in increased blood flow and decreased fibrosis. Furthermore, hHGF enhanced these effects. This suggests that ADSCs combined with HGF gene transfer may be a useful strategy for the treatment of patients with ischemic heart disease.     

Effects of pre-, peri-, and postmyocardial infarction treatment with omapatrilat in rats: survival,arrhythmias, ventricular function,and remodeling

We showed previously that the vasopeptidase inhibitor (VPI) omapatrilat improves peri-myocardial infarction (MI) survival, but the mechanisms involved and whether these effects are sustained remained to be determined, and are the subject of this study. Rats (n = 272) received omapatrilat (20 mg x kg-1x day-1) starting 7 days before MI and continued peri- and post-MI, or no treatment (control). One group of rats had continuous ambulatory ECG and blood pressure recordings started 6 h before MI and continued until 24 h after MI, when survival was evaluated, and the rats were killed, and MI size was evaluated. A second group had left ventricular (LV) remodeling evaluated by echocardiography at 30 days and, at 38 days, had cardiac hemodynamics and morphology done and survival evaluated. Survival 24 h after MI (n = 255) improved with omapatrilat (60% vs. 46% for control; P = 0.0378). Over the next 37 days, there was no further improvement with omapatrilat but the early benefit was sustained. Omapatrilat reduced MI size 24 h after MI (36 +/- 2 vs. 42 +/- 2 mm2 for controls; P = 0.034). Omapatrilat reduced ventricular arrhythmia score 1-12 h after MI. Omapatrilat decreased blood pressure, but not during the first 24 h after MI. Omapatrilat reduced LV diastolic and systolic dimensions and LV and right ventricular weights compared with control large MI, indicating a decrease in reactive hypertrophy. Improvement in cardiac remodeling was accompanied by improved cardiac hemodynamics. Thus this study indicates that pre-, peri-, and post-MI treatment with the VPI omapatrilat is beneficial in survival, ventricular arrhythmias, LV remodeling, and cardiac function.     

Hyperlipidemia inhibits the protective effect of lisinopril after myocardial infarction via activation of dendritic cells

To investigate the prevention of cardiac remodelling and inflammatory immune response after myocardial infarction (MI) via ACEI regulating dendritic cells (DCs), we explored whether the protective effect of ACEI was repressed under hyperlipidemic environment. In vivo, the survival rate and left ventricular function of the mice were recorded on day 7 after MI. Tissue samples of the myocardium, spleen, bone marrow and peripheral blood were assessed for Ang II concentration, inflammatory cytokines and DCs expression. In vitro, DCs were treated with ox-LDL + Ang II, simulating the internal environment of MI in ApoE^−/− mice to explore the mechanism involved in the DCs maturation and inflammation. Under hyperlipidemic circumstances, we found that the cardioprotective effect of ACEI was attenuated through regulating DCs maturation and inflammation after MI, affecting survival rate and left ventricular function. Effects of lisinopril on the release of spleen-derived DCs and myocardial infiltration were also reduced under hyperlipidemic conditions. In vitro, immune maturation and inflammation of DCs were further induced by ox-LDL on the basis of Ang II treatment, as indicated by the upregulation of CD83, CD86, and the expressions of cytokines and chemokines. Furthermore, ox-LDL could activate TLR4-MyD88 signalling pathway, promoting IRAK-4 and NF-κB. The present study demonstrated that ACEI reduced the recruitment of DCs to the infarct site, leading to a higher survival rate and improved function. However, this effect was inhibited under hyperlipidemic environment. TLR4-MyD88 signalling pathway may be responsible for the molecular mechanism involved in the immune maturation and inflammation of DCs induced by ox-LDL.     

Application of the fourth universal definition of myocardial infarction in clinical practice

Abstract

Purpose: The Fourth Universal Definition of Myocardial Infarction (MI) has highlighted the different pathophysiological mechanisms that may lead to ischaemic and non-ischaemic myocardial injury and has emphasised that the diagnosis of myocardial infarction requires the presence of acute myocardial ischaemia in the setting of acute myocardial injury. This case based review intends to illustrate basic principles on how to apply this new, revised definition in clinical practice.

Methods and Results: The distinction between different types of MIs (type 1 or type 2) and the delineation of MI from acute non-ischaemic myocardial injury may be challenging in individual patients, which is illustrated by presenting and discussing real-life routine cases.

Conclusions: Type 1?MI is a consequence of coronary plaque rupture or erosion with intracoronary thrombus formation that is usually apparent on coronary angiography. Plausible triggering mechanisms causing myocardial oxygen supply/demand mismatch must be identified for the diagnosis of type 2?MI and its treatment should focus initially on management of the underlying disease attributable to acute myocardial ischaemia.     

Intramyocardial injection of hypoxia-preconditioned adipose-derived stromal cells treats acute myocardial infarction: an in vivo study in swine

Hypoxic preconditioning is a promising method for improving the anti-apoptotic and paracrine signaling capabilities of adipose-derived stromal cells (ADSCs). The purpose of this study was to analyze the influence of different hypoxic conditions on ADSCs and the therapeutic effects of hypoxia-preconditioned ADSCs (HPADSCs) on an animal model of myocardial infarction (MI). For the in vitro studies, ADSCs were divided into five groups and cultured in different oxygen concentrations (1, 3, 5, 10, and 21 %). After 24 h, RT-PCR and western blots showed that 3 % oxygen preconditioning could improve the viability and cytokine secretion of the ADSCs. A Matrigel assay indicated that the HPADSC-conditioned medium could stimulate endothelial cells to form capillary-like tubes. For the in vivo studies, MI was induced by coronary occlusion in 24 mature Chinese minipigs. The animals were divided into three groups and treated by intramyocardial injection with vehicle alone (saline group), with 1?×?10⁸ ADSCs cultured in normoxic conditions (ADSCs group) or with 1?×?10⁸ ADSCs precultured in 3 % oxygen (HPADSCs group). SPECT and echocardiography demonstrated that cardiac function was improved significantly in the HPADSC transplant group compared with the vehicle control group (P?P?相似文献   

Mitochondrial ROS in myocardial ischemia reperfusion and remodeling

Despite major progress in interventional and medical treatments, myocardial infarction (MI) and subsequent development of heart failure (HF) are still associated with high mortality. Both during ischemia reperfusion (IR) in the acute setting of MI, as well as in the chronic remodeling process following MI, oxidative stress substantially contributes to cardiac damage. Reactive oxygen species (ROS) generated within mitochondria are particular drivers of mechanisms contributing to IR injury, including induction of mitochondrial permeability transition or oxidative damage of intramitochondrial structures and molecules. But even beyond the acute setting, mechanisms like inflammatory signaling, extracellular remodeling, or pro-apoptotic signaling that contribute to post-infarction remodeling are regulated by mitochondrial ROS. In the current review, we discuss both sources and consequences of mitochondrial ROS during IR and in the chronic setting following MI, thereby emphasizing the potential therapeutic value of attenuating mitochondrial ROS to improve outcome and prognosis for patients suffering MI.     

Migration of bone marrow-derived cells and improved perfusion after treatment with erythropoietin in a murine model of myocardial infarction

Erythropoietin (EPO) was shown to have protective effects after myocardial infarction (MI) by neovascularization and antiapoptotic mechanisms. Beside direct receptor-dependent mechanisms, mobilization and homing of bone marrow-derived cells (BMCs) may play a pivotal role in this regard. In this study, we intended to track different subpopulations of BMCs and to assess serially myocardial perfusion changes in EPO-treated mice after MI. To allow tracking of BMCs, we used a chimeric mouse model. Therefore, mice (C57BL/6J) were sublethally irradiated, and bone marrow (BM) from green fluorescent protein transgenic mice was transplanted. Ten weeks later coronary artery ligation was performed to induce MI. EPO was injected for 3 days with a total dose of 5000 IU/kg. Subpopulations (CD31, c-kit, CXCR-4 and Sca-1) of EGFP(+) cells were studied in peripheral blood, bone marrow and hearts by flow cytometry. Myocardial perfusion was serially investigated in vivo by pinhole single-photon emission computed tomography (SPECT) at days 6 and 30 after MI. EPO-treated animals revealed an enhanced mobilization of BMCs into peripheral blood. The numbers of these cells in BM remained unchanged. Homing of all BMCs subpopulations to the ischaemic myocardium was significantly increased in EPO-treated mice. Among the investigated subpopulations, EPO predominantly affected migration of CXCR-4(+) (4.3-fold increase). Repetitively SPECT analyses revealed a reduction of perfusion defects after EPO treatment over time. Our study shows that EPO treatment after MI enhances the migration capacity of BMCs into ischaemic tissue, which may attribute to an improved perfusion and reduced size of infarction, respectively.