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多发性硬化症中的干细胞移植:现状与未来展望。

Stem cell transplantation in multiple sclerosis: current status and future prospects.

机构信息

Institute of Experimental Neurology-DIBIT 2, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy.

出版信息

Nat Rev Neurol. 2010 May;6(5):247-55. doi: 10.1038/nrneurol.2010.35. Epub 2010 Apr 20.

Abstract

This article provides an overview of the current knowledge relating to the potential use of transplanted stem cells in the treatment of patients with multiple sclerosis (MS). Two types of stem cells, CNS-derived neural stem/precursor cells (NPCs) and bone marrow-derived mesenchymal stem cells (MSCs) are considered to provide reproducible and robust therapeutic effects when intravenously or intrathecally injected into both rodents and primates with experimental autoimmune encephalomyelitis. Furthermore, preliminary safety data concerning the use of intrathecally injected autologous MSCs in patients with progressive MS are available. We discuss how the data gathered to date challenge the narrow view that the therapeutic effects of NPCs and MSCs observed in the treatment of MS are accomplished solely by cell replacement. Both types of stem cell, when transplanted systemically, might instead influence disease outcome by releasing a plethora of factors that are immunomodulatory or neuroprotective, thereby directly or indirectly influencing the regenerative properties of intrinsic CNS stem/precursor cells.

摘要

本文概述了当前关于移植干细胞在多发性硬化症(MS)患者治疗中应用的相关知识。两种类型的干细胞,中枢神经系统来源的神经干细胞/前体细胞(NPCs)和骨髓来源的间充质干细胞(MSCs),当静脉内或鞘内注射到实验性自身免疫性脑脊髓炎的啮齿动物和灵长类动物中时,被认为具有可重复和强大的治疗效果。此外,关于鞘内注射自体 MSC 在进展性 MS 患者中应用的初步安全性数据是可用的。我们讨论了迄今为止收集的数据如何挑战 NPCs 和 MSCs 治疗 MS 中观察到的治疗效果仅通过细胞替代来实现的狭隘观点。当系统性移植时,这两种类型的干细胞可能通过释放大量具有免疫调节或神经保护作用的因子来影响疾病结局,从而直接或间接地影响内在中枢神经系统干细胞/前体细胞的再生特性。

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