Department of Medicine, Division of Cardiology, Stanford University School of Medicine, Stanford, CA 94305-5454, USA.
Circ Res. 2013 Feb 1;112(3):549-61. doi: 10.1161/CIRCRESAHA.111.249243.
The ability of pluripotent stem cells to self-renew and differentiate into all somatic cell types brings great prospects to regenerative medicine and human health. However, before clinical applications, much translational research is necessary to ensure that their therapeutic progenies are functional and nontumorigenic, that they are stable and do not dedifferentiate, and that they do not elicit immune responses that could threaten their survival in vivo. For this, an in-depth understanding of their biology, genetic, and epigenetic make-up and of their antigenic repertoire is critical for predicting their immunogenicity and for developing strategies needed to assure successful long-term engraftment. Recently, the expectation that reprogrammed somatic cells would provide an autologous cell therapy for personalized medicine has been questioned. Induced pluripotent stem cells display several genetic and epigenetic abnormalities that could promote tumorigenicity and immunogenicity in vivo. Understanding the persistence and effects of these abnormalities in induced pluripotent stem cell derivatives is critical to allow clinicians to predict graft fate after transplantation, and to take requisite measures to prevent immune rejection. With clinical trials of pluripotent stem cell therapy on the horizon, the importance of understanding immunologic barriers and devising safe, effective strategies to bypass them is further underscored. This approach to overcome immunologic barriers to stem cell therapy can take advantage of the validated knowledge acquired from decades of hematopoietic stem cell transplantation.
多能干细胞自我更新并分化为所有体细胞类型的能力为再生医学和人类健康带来了广阔的前景。然而,在临床应用之前,需要进行大量的转化研究,以确保其治疗后代具有功能性和非致瘤性,具有稳定性且不会去分化,并且不会引发可能威胁其在体内存活的免疫反应。为此,深入了解其生物学、遗传和表观遗传构成以及抗原库对于预测其免疫原性以及开发确保成功的长期植入所需的策略至关重要。最近,人们对重编程体细胞将为个性化医学提供自体细胞治疗的期望提出了质疑。诱导多能干细胞显示出几种遗传和表观遗传异常,这些异常可能会促进体内的致瘤性和免疫原性。了解这些异常在诱导多能干细胞衍生物中的持续存在和影响对于允许临床医生在移植后预测移植物命运,并采取必要措施预防免疫排斥至关重要。随着多能干细胞治疗的临床试验即将到来,理解免疫障碍并设计安全、有效的策略来克服它们变得更加重要。这种克服干细胞治疗免疫障碍的方法可以利用从几十年的造血干细胞移植中获得的经过验证的知识。