Department of Pediatric Surgery, University of Texas Medical School at Houston, 6431 Fannin Street, MSB 5.234, Houston, TX, 77030, USA.
Transl Stroke Res. 2012 Sep;3(3):318-23. doi: 10.1007/s12975-012-0192-7. Epub 2012 May 22.
Traumatic brain injuries and their associated treatments carry high cost in both financial impact and morbidity to human life. Recent studies and trials present promising results in reducing secondary injury in the days and weeks following the primary insult. A number of studies, both pre-clinical and clinical, have found that different populations of stem/progenitor cells result in a reduction of inflammation, maintenance of the blood brain barrier, and an overall improved prognosis. The mechanism of action of these cellular therapies appears to rely upon the ability of the cells to influence microglia/macrophage phenotype and alter the state of the inflammatory response. The spleen has become an area of intense interest as an arena where therapeutic cells interact with reactive macrophages to cause system-level changes in immune activity. Additionally, the spleen enacts anti-inflammatory responses originating in the CNS, delivered through vagal activity with a recently described mechanism culminating in acetylcholine release. This review provides a summary of recent findings as to the mechanisms of action observed in current cellular therapies.
创伤性脑损伤及其相关治疗在经济影响和对人类生命发病率方面都代价高昂。最近的研究和试验在减少原发性损伤后几天和几周内的继发性损伤方面取得了有希望的结果。许多临床前和临床研究发现，不同群体的干细胞/祖细胞可减少炎症、维持血脑屏障，并整体改善预后。这些细胞疗法的作用机制似乎依赖于细胞影响小胶质细胞/巨噬细胞表型并改变炎症反应状态的能力。脾脏已成为一个备受关注的领域，因为治疗细胞在那里与反应性巨噬细胞相互作用，导致免疫系统活动的系统水平发生变化。此外，脾脏通过最近描述的机制执行源自中枢神经系统的抗炎反应，该机制最终导致乙酰胆碱释放。本综述总结了目前细胞疗法中观察到的作用机制的最新发现。
