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[用于难治性血管炎的血管再生疗法]

[Vascular regeneration therapy for intractable vasculitis].

作者信息

Kawamoto Atsuhiko, Asahara Takayuki

机构信息

Division of Vascular Regeneration Therapy, Department of Regeneration Medicine, Institute of Biomedical Research and Innovation.

出版信息

Nihon Rinsho. 2009 Mar;67(3):612-8.

Abstract

The field of cell-based transplantation has expanded considerably and is poised to become an established cardiovascular therapy in the near future. In this review, we will focus on endothelial progenitor cells (EPCs), which are immature cells capable of differentiating into mature endothelial cells (ECs). The major source of EPCs is the bone marrow (BM). BM-derived EPCs are mobilized into peripheral blood and recruited to the foci of pathophysiological neovascularization and reendothelialization, thereby contributing to vascular regeneration. Severe EPC dysfunction is an indicator of poor prognosis and severe endothelial dysfunction. Indeed, number of circulating EPCs and their migratory activity are reduced in patients with diabetes, coronary artery disease (CAD) or subjects with multiple coronary risk factors. Effective neovascularization induced by EPC transplantation for hindlimb, myocardial and cerebral ischemia has been demonstrated in many preclinical studies, and early clinical trials of EPC transplantation in chronic and acute CAD as well as Buerger disease indicate safety and feasibility of the cell-based therapies. Further development in cell processing technology for efficient isolation, expansion, mobilization, recruitment and transplantation of EPCs into target tissues are underway and expected to be tested in clinical trials in the near future.

摘要

基于细胞的移植领域已得到显著拓展,并有望在不久的将来成为一种成熟的心血管治疗方法。在本综述中,我们将聚焦于内皮祖细胞(EPCs),它们是能够分化为成熟内皮细胞(ECs)的未成熟细胞。EPCs的主要来源是骨髓(BM)。源自BM的EPCs被动员到外周血中,并被招募到病理生理性新生血管形成和再内皮化的部位,从而促进血管再生。严重的EPC功能障碍是预后不良和严重内皮功能障碍的一个指标。事实上,糖尿病患者、冠状动脉疾病(CAD)患者或具有多种冠状动脉危险因素的受试者,其循环EPCs数量及其迁移活性均会降低。许多临床前研究已证实,EPC移植可有效诱导后肢、心肌和脑缺血的新生血管形成,并且EPC移植治疗慢性和急性CAD以及血栓闭塞性脉管炎的早期临床试验表明了基于细胞的治疗方法的安全性和可行性。目前正在进行细胞处理技术的进一步研发,以实现EPCs的高效分离、扩增、动员、募集并移植到靶组织中,预计不久后将在临床试验中进行测试。

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