Popp Felix C, Renner Philipp, Eggenhofer Elke, Slowik Przemyslaw, Geissler Edward K, Piso Pompiliu, Schlitt Hans J, Dahlke Marc H
Department of Surgery, University of Regensburg, Regensburg, Germany.
Liver Transpl. 2009 Oct;15(10):1192-8. doi: 10.1002/lt.21862.
Mesenchymal stem cells (MSCs) are promising candidate cells for immunomodulation therapy that are currently being tested in the preclinical and clinical setting. MSCs suppress the immune response in a variety of in vitro and disease models and may thus be of benefit for patients suffering from autoimmune disorders or transplant rejection. The mechanism by which MSCs modulate the immune response is still under thorough investigation, but it most likely involves expression of local factors such as indoleamine 2,3-dioxygenase, inducible nitric oxide synthase, and others as well as interactions with dendritic or antigen-presenting cells. Although MSCs have been evaluated in clinical phase I and II studies for graft-versus-host disease and heart, kidney, and bone disease, their introduction into solid organ transplantation is still eagerly awaited. In this short review, we summarize the current understanding of immunomodulation achieved by MSC therapies and introduce a possible outline for a clinical study that will use MSCs in the context of a calcineurin inhibitor-free induction protocol after liver transplantation.
间充质干细胞（MSCs）是免疫调节治疗中很有前景的候选细胞，目前正在临床前和临床环境中进行测试。MSCs在多种体外和疾病模型中抑制免疫反应，因此可能对患有自身免疫性疾病或移植排斥反应的患者有益。MSCs调节免疫反应的机制仍在深入研究中，但很可能涉及局部因子如吲哚胺2,3-双加氧酶、诱导型一氧化氮合酶等的表达以及与树突状细胞或抗原呈递细胞的相互作用。尽管MSCs已在移植物抗宿主病以及心脏、肾脏和骨骼疾病的临床I期和II期研究中进行了评估，但它们在实体器官移植中的应用仍备受期待。在这篇简短的综述中，我们总结了目前对MSCs疗法实现免疫调节的理解，并介绍了一项临床研究的可能方案，该研究将在肝移植后使用MSCs进行无钙调神经磷酸酶抑制剂诱导方案。
