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干细胞作为再生心肌细胞的来源。

Stem cells as a source of regenerative cardiomyocytes.

作者信息

Fukuda Keiichi, Yuasa Shinsuke

机构信息

Department of Regenerative Medicine and Advanced Cardiac Therapeutics, Keio University School of Medicine, Tokyo, Japan.

出版信息

Circ Res. 2006 Apr 28;98(8):1002-13. doi: 10.1161/01.RES.0000218272.18669.6e.

Abstract

The realization of regenerative cardiac medicine depends on the availability of cardiomyocytes in sufficient numbers for transplantation of cardiac tissue and the accompanying blood vessels. Embryonic stem (ES) cells, bone marrow (BM) stem cells, and tissue-derived stem cells are all potential cell sources. Although ES cells are highly proliferative and suitable for mass production, an efficient protocol is yet to be established to ensure selective cardiomyocyte induction using these cells. Recent advances in developmental biology have clarified the involvement of critical factors in cardiomyocyte differentiation, including bone morphogenic protein and Wnt signaling proteins, and such factors have the potential to improve the efficiency of stem cell induction. Initial studies of the intracoronary administration of BM mononuclear cells after myocardial infarction has yielded promising results; however, intensive investigation of the underlying molecular mechanisms at play as well as double-blinded clinical trials will be necessary to establish the extent of both migration of the BM stem cells into the damaged cardiac tissue and their differentiation into cardiomyocytes. Several types of cardiac tissue stem cells have also been reported, but an accurate and extensive comparison of these cells with regard to their characteristics and multipotency remains to be done. An integrative study involving developmental biology, stem cell biology, and tissue engineering is required to achieve the full potential of cardiac regeneration.

摘要

再生心脏医学的实现取决于能否获得足够数量的心肌细胞用于心脏组织及伴随血管的移植。胚胎干细胞、骨髓干细胞和组织来源的干细胞都是潜在的细胞来源。尽管胚胎干细胞具有高度增殖性且适合大规模生产,但尚未建立有效的方案来确保利用这些细胞选择性诱导心肌细胞。发育生物学的最新进展已阐明关键因子参与心肌细胞分化,包括骨形态发生蛋白和Wnt信号蛋白,这些因子有可能提高干细胞诱导效率。心肌梗死后冠状动脉内注射骨髓单个核细胞的初步研究已取得了有前景的结果;然而,要确定骨髓干细胞向受损心脏组织的迁移程度及其分化为心肌细胞的程度,有必要深入研究其潜在分子机制并开展双盲临床试验。也已报道了几种类型的心脏组织干细胞,但就其特征和多能性对这些细胞进行准确而广泛的比较仍有待开展。需要开展一项涉及发育生物学、干细胞生物学和组织工程的综合研究,以充分发挥心脏再生的潜力。

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