Farin Azadeh, Liu Charles Y, Elder James B, Langmoen Iver A, Apuzzo Michael L J
Department of Neurological Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Neurosurgery. 2009 Jan;64(1):15-39; discussion 34. doi: 10.1227/01.NEU.0000337580.02706.DC.
Since their discovery, stem cells have fascinated scientists with their ultimate potential: the ability to cure disease, repair altered physiology, and reverse neurological deficit. Stem cell science unquestionably promises to eliminate many of the tragic limitations contemporary medicine must acknowledge, and cloning may provide young cells for an aging population. Although it is widely believed that stem cells will transform the way medicine is practiced, therapeutic interventions using stem cell technology are still in their infancy. The 3 most common stem cell sources studied today are umbilical cord blood, bone marrow, and human embryos. Although cord blood is currently used to treat dozens of disorders and bone marrow stem cells have been used clinically since the 1960s, human embryonic stem cells have yet to be successfully applied to any disease. Undeniably, stem cell therapy has the potential to be one of the most powerful therapeutic options available. In this introductory article of a 5-part series on stem cells, we narrate the evolution of modern stem cell science, delineating major landmarks that will prove responsible for taking stem cell technology from the laboratory into revolutionary clinical applications: from the first milestone of identifying the mouse hematopoietic stem cell to the latest feats of producing pluripotent stem cells without embryos at all. In Part 2, we present the evidence demonstrating the certainty of adult mammalian neurogenesis; in Parts 3 and 4, we describe neurosurgical applications of stem cell technology; and in Part 5, we discuss the philosophical and ethical issues surrounding stem cell therapy, as well as future areas of exploration.
自干细胞被发现以来,其巨大的潜力一直吸引着科学家们:治愈疾病、修复生理机能改变以及逆转神经功能缺损的能力。干细胞科学无疑有望消除当代医学必须承认的许多悲惨局限,而克隆可能为老龄化人口提供年轻细胞。尽管人们普遍认为干细胞将改变医学实践方式,但使用干细胞技术的治疗干预仍处于起步阶段。如今研究的3种最常见的干细胞来源是脐带血、骨髓和人类胚胎。虽然脐带血目前已用于治疗数十种疾病,骨髓干细胞自20世纪60年代以来就已应用于临床,但人类胚胎干细胞尚未成功应用于任何疾病。不可否认,干细胞疗法有可能成为最强大的治疗选择之一。在这个关于干细胞的5部分系列文章的介绍性文章中,我们讲述现代干细胞科学的发展历程,勾勒出将干细胞技术从实验室带入革命性临床应用的主要里程碑:从识别小鼠造血干细胞的第一个里程碑到完全不使用胚胎产生多能干细胞的最新成果。在第2部分中,我们展示证明成年哺乳动物神经发生确定性的证据;在第3部分和第4部分中,我们描述干细胞技术的神经外科应用;在第5部分中,我们讨论围绕干细胞疗法的哲学和伦理问题以及未来的探索领域。