Techung Lee, Department of Biochemistry and Center for Research in Cardiovascular Medicine, University at Buffalo, Buffalo, NY 14214, United States.
World J Stem Cells. 2010 Aug 26;2(4):61-6. doi: 10.4252/wjsc.v2.i4.61.
Preclinical and clinical trials of stem cell therapy have been carried out for treating a broad spectrum of diseases using several types of adult stem cells. While encouraging therapeutic results have been obtained, much remains to be investigated regarding the best cell type to use, cell dosage, delivery route, long-term safety, clinical feasibility, and ultimately treatment cost. Logistic aspects of stem cell therapeutics remain an area that requires urgent attention from the medical community. Recent cardiovascular trial studies have demonstrated that growth factors and cytokines derived from the injected stem cells and host tissue appear to contribute largely to the observed therapeutic benefits, indicating that trophic actions rather than the multilineage potential (or stemness) of the administered stem cells may provide the underlying tissue healing power. However, the capacity for trophic factor production can be aberrantly downregulated as seen in human heart disease. Skeletal muscle is a dynamic tissue with an impressive ability to continuously respond to environmental stimuli. Indeed, a relation exists between active skeletal muscle and low cardiovascular risk, highlighting the critical link between the skeletal muscle and cardiovascular systems. Adding to this notion are recent studies showing that stem cells injected into skeletal muscle can rescue the failing rodent heart through activation of the muscle trophic factor network and mobilization of bone marrow multilineage progenitor cells. However, aging and disease can adversely affect the host tissue into which stem cells are injected. A better understanding of the host tissue response in stem cell therapy is necessary to advance the field and bridge the gap between preclinical and clinical findings.
已经进行了使用多种类型成体干细胞治疗广泛疾病的干细胞治疗的临床前和临床试验。虽然已经获得了令人鼓舞的治疗效果，但关于最佳细胞类型、细胞剂量、输送途径、长期安全性、临床可行性以及最终治疗成本，仍有许多问题需要研究。干细胞治疗的后勤方面仍然是医学界需要紧急关注的领域。最近的心血管试验研究表明，注射的干细胞和宿主组织中衍生的生长因子和细胞因子似乎在很大程度上促成了观察到的治疗益处，这表明营养作用而不是给予的干细胞的多能性（或干性）可能提供了潜在的组织愈合能力。然而，正如在人类心脏病中所见，营养因子产生的能力可能会异常下调。骨骼肌是一种具有令人印象深刻的连续响应环境刺激能力的动态组织。事实上，活跃的骨骼肌与低心血管风险之间存在关联，突出了骨骼肌和心血管系统之间的关键联系。最近的研究进一步证明，注入骨骼肌的干细胞可以通过激活肌肉营养因子网络和动员骨髓多能祖细胞来挽救衰竭的啮齿动物心脏，从而增加了这一概念。然而，衰老和疾病会对注入干细胞的宿主组织产生不利影响。为了推进该领域并弥合临床前和临床研究之间的差距，有必要更好地了解干细胞治疗中的宿主组织反应。
