Mollura Daniel J, Hare Joshua M, Rabb Hamid
Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, MD 21205, USA.
Am J Kidney Dis. 2003 Nov;42(5):891-905. doi: 10.1016/j.ajkd.2003.07.018.
Significant attention is currently directed to the biological and therapeutic capabilities of stem cells for developing novel treatments for acute and chronic kidney diseases. To date, viable sources of stem cells for renal therapies include adult bone marrow and embryonic tissues, including the metanephric mesenchyme and mesonephros. Native adult kidney stem cells have yet to be identified. Systemically introduced stem cells can engraft in sites of renal disease and injury to show donor phenotypes. Stem cells can differentiate into cells similar to glomeruli, mesangium, and tubules in the kidneys. The impact of stem-cell engraftment and differentiation on renal function presently is unknown. Identification of renal diseases treatable with stem-cell therapies is expected to evolve as stem-cell technologies advance. Methods of modifying stem cells to improve homing, differentiation, and integration into host tissues need further characterization. Ethical and legal controversies about embryonic research and cloning are shaping the regulation and funding of stem-cell research for kidney diseases. Scientific and clinical understanding of stem cells and their potential for renal treatments are in the early stage of development. This field offers great promise, and there are significant opportunities for future investigation in clinical, biological, and ethical aspects of stem-cell therapy for kidney diseases.
目前,人们高度关注干细胞的生物学特性和治疗能力,以开发针对急性和慢性肾脏疾病的新型治疗方法。迄今为止,用于肾脏治疗的可行干细胞来源包括成人骨髓和胚胎组织,如后肾间充质和中肾。尚未鉴定出天然的成人肾脏干细胞。全身引入的干细胞可以植入肾脏疾病和损伤部位,显示出供体表型。干细胞可以分化为类似于肾脏中的肾小球、系膜和肾小管的细胞。目前尚不清楚干细胞植入和分化对肾功能的影响。随着干细胞技术的进步,预计可通过干细胞疗法治疗的肾脏疾病的鉴定将会不断发展。改善干细胞归巢、分化以及整合到宿主组织中的方法需要进一步研究。关于胚胎研究和克隆的伦理和法律争议正在影响肾脏疾病干细胞研究的监管和资金投入。对干细胞及其肾脏治疗潜力的科学和临床理解尚处于发展的早期阶段。该领域前景广阔,在肾脏疾病干细胞治疗的临床、生物学和伦理方面,未来有大量的研究机会。