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脐带血干细胞移植治疗脊髓损伤。

Transplantation of umbilical cord blood stem cells for treating spinal cord injury.

机构信息

Department of Neurosurgery, Korea University Medical Center, Anam Hospital, Korea University College of Medicine, #126, 5-GA, Anam-Dong, Sungbuk-Ku, Seoul 136-705, Korea.

出版信息

Stem Cell Rev Rep. 2011 Mar;7(1):181-94. doi: 10.1007/s12015-010-9163-0.

Abstract

Spinal cord injury (SCI) develops primary and secondary damage to neural tissue and this often results in permanent disability of the motor and sensory functions. However, there is currently no effective treatment except methylprednisolone, and the use of methylprednisolone has also been questioned due to its moderate efficacy and the drug's downside. Regenerative medicine has remarkably developed since the discovery of stem cells, and many studies have suggested the potential of cell-based therapies for neural injury. Especially, the therapeutic potential of human umbilical cord blood cells (hUCB cells) for intractable neurological disorders has been demonstrated using in vitro and vivo models. The hUCB cells are immune naïve and they are able to differentiate into other phenotypes, including the neural lineage. Their ability to produce several neurotropic factors and to modulate immune and inflammatory reactions has also been noted. Recent evidence has emerged suggesting alternative pathways of graft-mediated neural repair that involve neurotrophic effects. These effects are caused by the release of various growth factors that promote cell survival, angiogenesis and anti-inflammation, and this is all aside from a cell replacement mechanism. In this review, we present the recent findings on the stemness properties and the therapeutic potential of hUCB as a safe, feasible and effective cellular source for transplantation in SCI. These multifaceted protective and restorative effects from hUCB grafts may be interdependent and they act in harmony to promote therapeutic benefits for SCI. Nevertheless, clinical studies with hUCB are still rare because of the concerns about safety and efficiency. Among these concerns, the major histocompatibility in allogeneic transplantation is an important issue to be addressed in future clinical trials for treating SCI.

摘要

脊髓损伤(SCI)会导致神经组织的原发性和继发性损伤,这通常会导致运动和感觉功能的永久性丧失。然而,目前除了甲基强的松龙外,没有有效的治疗方法,而且由于其疗效中等,以及药物的副作用,甲基强的松龙的使用也受到了质疑。自从干细胞被发现以来,再生医学已经有了显著的发展,许多研究表明,细胞疗法对神经损伤具有潜在的治疗作用。特别是,人脐带血细胞(hUCB 细胞)对难治性神经疾病的治疗潜力已经在体外和体内模型中得到了证明。hUCB 细胞具有免疫幼稚性,能够分化为其他表型,包括神经谱系。它们能够产生多种神经营养因子,并调节免疫和炎症反应的能力也得到了证实。最近的证据表明,移植物介导的神经修复的替代途径涉及神经营养作用。这些作用是由各种生长因子的释放引起的,这些生长因子促进细胞存活、血管生成和抗炎,而这些都不包括细胞替代机制。在这篇综述中,我们介绍了 hUCB 的干性特性和治疗潜力的最新发现,hUCB 是一种安全、可行和有效的细胞来源,可用于 SCI 的移植。hUCB 移植物的这些多方面的保护和修复作用可能是相互依存的,它们协同作用,促进 SCI 的治疗益处。然而,由于对安全性和效率的担忧,hUCB 的临床研究仍然很少。在这些担忧中,同种异体移植中的主要组织相容性是未来治疗 SCI 的临床试验中需要解决的一个重要问题。

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