Muraro Paolo A, Uccelli Antonio
Division of Neuroscience and Mental Health, Faculty of Medicine, Imperial College Building 560/Burlington Danes, Room E415, Imperial College London, 160 Du Cane Road, London, UK.
Results Probl Cell Differ. 2010;51:237-57. doi: 10.1007/400_2008_14.
In the last few years there has been extraordinary progress in the field of stem cell research. Two types of stem cells populate the bone marrow: haematopoietic stem/progenitor cells (HSC) and mesenchymal stem cells (MSC). The capacity of HSC to repopulate the blood has been known and exploited therapeutically for at least four decades. Today, haematopoietic stem cell transplantation (HSCT) holds a firm place in the therapy of some haematological malignancies, and a potential role of HSCT for treatment of severe autoimmune diseases has been explored in small-scale clinical studies. Multiple sclerosis (MS) is the noncancerous immune mediated disease for which the greatest number of transplants has been performed to date. The results of clinical studies are double-faced: on the one hand, HSCT has demonstrated powerful effects on acute inflammation, arresting the development of focal CNS lesions and clinical relapses; on the other hand, the treatment did not arrest chronic worsening of disability in most patients with secondary progressive MS, suggesting limited or no beneficial effects on the chronic processes causing progressive disability. MSC are a more recent addition to the range of experimental therapies being developed to treat MS. While interest in MSC usage was originally raised by their potential capacity to differentiate into different cell lineages, recent work showing their interesting immunological properties has led to a revised concept, envisioning their utilization for immuno-modulatory purposes. In this review we will summarize the current clinical and experimental evidence on HSC and MSC and outline some key questions warranting further investigation in this exciting research area.
在过去几年中，干细胞研究领域取得了非凡进展。骨髓中有两种类型的干细胞：造血干/祖细胞（HSC）和间充质干细胞（MSC）。HSC 重新填充血液的能力至少在四十年前就已为人所知并用于治疗。如今，造血干细胞移植（HSCT）在某些血液系统恶性肿瘤的治疗中占据了稳固地位，并且在小规模临床研究中探索了 HSCT 治疗严重自身免疫性疾病的潜在作用。多发性硬化症（MS）是迄今为止进行移植数量最多的非癌性免疫介导疾病。临床研究结果有两面性：一方面，HSCT 已显示出对急性炎症有强大作用，可阻止中枢神经系统局灶性病变的发展和临床复发；另一方面，在大多数继发进展型 MS 患者中，该治疗并未阻止残疾的慢性恶化，这表明对导致进行性残疾的慢性过程的有益作用有限或没有作用。MSC 是正在开发的用于治疗 MS 的一系列实验性疗法中的新成员。虽然最初对 MSC 使用的兴趣源于它们分化为不同细胞谱系的潜在能力，但最近显示其有趣免疫特性的研究导致了一个修订概念，设想将其用于免疫调节目的。在本综述中，我们将总结关于 HSC 和 MSC 的当前临床和实验证据，并概述在这个令人兴奋的研究领域中值得进一步研究的一些关键问题。
