心肌梗死细胞治疗的临床试验进展

干细胞移植治疗心肌梗死已有10余年历史,目的在于增加支架介入或冠脉搭桥治疗基础上的获益。细胞种类的选择是决定疗效的关键,大致可分为"第一代"和"第二代"干细胞。"第一代"是谱系非选择性干细胞,分自体和异体,早期阳性结果居多,近年多为中性结果。"第二代"是纯化干细胞,通过细胞表面标记分选出特定细胞谱系,即心脏干细胞,进行定向分化,在II期临床试验中展现获益。另外,近来诱导多能干细胞i PSC成为研究热点。目前干细胞直接心肌再生的证据很少,越来越多的研究肯定其旁分泌作用。

Clinical Trial Progress of Cell therapy for Myocardial Infarction

Cell therapy for myocardial infarction had a history of ten years, aimed at additional benefit of traditional treatment such as coronary artery intervention or coronary artery bypass graft. It was the cell type that determined curative effect, which was roughly divided into two categories, the first and second generation of stemcells. The first generation was non-selective cell lineage, including autograft and allograft, the early positive results in the majority but more than to neutral results in recent years. The second generation was purified stem cell, sorting specific cell lineage, cardiac stem cell, for directional differentiation through cell surface markers and showed benefit in phase II clinical trials. Besides, induced pluripotent stemcell had become the research hotspot. Currently, the evidence of myocardial direct regeneration was very little, more and more research affirmed its paracrine function.