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关于间充质基质细胞移植治疗脓毒症的观点。

A perspective on mesenchymal stromal cell transplantation in the treatment of sepsis.

机构信息

*Department of Intensive Care, Erasmus Medical Center, Rotterdam; and †Department of Intensive Care, Vlietland Hospital, Schiedam, the Netherlands.

出版信息

Shock. 2013 Nov;40(5):352-7. doi: 10.1097/SHK.0000000000000039.

Abstract

Although a variety of disease-modifying agents have been studied as potential sepsis treatments, no beneficial effects on the course of sepsis, in terms of survival, have been observed until now. Because of their plasticity, mesenchymal stromal cells (MSCs) have been implicated as an effective novel therapy modality for various diseases and are widely used for cellular therapies and tissue engineering. The existing knowledge supports the idea that MSCs might be beneficial in sepsis treatment. Our objective was to selectively address the evidence, based on multistep processes, supporting the potential of MSC-based therapies in clinical sepsis trials. In this study, we performed a stepwise approach to defend the evaluation of MSC treatments for sepsis from the bench to the bedside. Altogether, the reviewed data postulate that the signals produced by inflamed tissues might determine the functional effects of MSCs. These effects include bacterial clearance, suppression of inflammation, antiapoptosis, or stimulation of regenerative responses. We conclude that the clinical application of MSCs is a feasible and well-tolerated approach and therefore may have benefits for patients with sepsis.

摘要

虽然已经研究了多种疾病修饰剂作为潜在的败血症治疗方法,但迄今为止,在生存方面,没有观察到它们对败血症病程有任何有益影响。由于间充质基质细胞 (MSCs) 的可塑性,它们被认为是治疗各种疾病的有效新型治疗方法,并广泛用于细胞治疗和组织工程。现有的知识支持这样一种观点,即 MSCs 可能有益于败血症的治疗。我们的目的是基于多步过程,有针对性地阐述支持基于 MSC 的疗法在临床败血症试验中应用的潜在证据。在这项研究中,我们采用逐步方法来评估 MSC 治疗败血症的方法,从实验室到临床。总的来说,审查的数据表明,炎症组织产生的信号可能决定 MSCs 的功能效应。这些作用包括清除细菌、抑制炎症、抗细胞凋亡或刺激再生反应。我们得出结论,MSC 的临床应用是一种可行且耐受良好的方法,因此可能对败血症患者有益。

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