我们能修复它吗?评估胎盘干细胞治疗妊娠疾病的潜力。

Can we fix it? Evaluating the potential of placental stem cells for the treatment of pregnancy disorders.

机构信息

Department of Obstetrics and Gynaecology, University of Auckland, New Zealand.

Department of Obstetrics and Gynaecology, University of Auckland, New Zealand.

出版信息

Placenta. 2014 Feb;35(2):77-84. doi: 10.1016/j.placenta.2013.12.010. Epub 2013 Dec 30.

Abstract

In pregnancy disorders such as pre-eclampsia, intrauterine growth restriction (IUGR) and recurrent miscarriage a poorly functioning placenta is thought to be a major component of the disease process. However, despite their prevalence, we currently have no way to fix dysfunctional placentae or directly treat these disorders. Over the past two decades our understanding of the role that stem cells play in organ development and regeneration has expanded rapidly, and over the past 5 years the therapeutic use of stem cells to both regenerate damaged tissues, and act as potent modulators of diseased microenvironments, has become a reality in many organs including the heart, kidney, liver, skin and eye. Over its short lifespan the placenta undergoes rapid and continuous growth and differentiation, meaning that placental 'organogenesis' only truly ends at delivery, and thus stem cells are likely to play important roles in placental function for the duration of pregnancy. Two populations of stem cells exist in the placenta that contribute to this on-going growth and differentiation: trophoblast stem cells and mesenchymal stem cells. This review will address our current understanding of how each of these stem cell populations contributes to successful placental function, how epithelial and mesenchymal stem cell populations are being translated to the clinic in other fields, and whether these advances can teach us anything about how placental stem cells could be used to fix faulty placentae in the future.

摘要

在妊娠疾病如子痫前期、宫内生长受限(IUGR)和复发性流产中,功能失调的胎盘被认为是疾病过程的主要组成部分。然而,尽管它们很常见,但我们目前还没有办法修复功能失调的胎盘或直接治疗这些疾病。在过去的二十年中,我们对干细胞在器官发育和再生中的作用的理解迅速扩展,在过去的 5 年中,干细胞在治疗中既可以用于再生受损组织,又可以作为疾病微环境的有效调节剂,在许多器官中已经成为现实,包括心脏、肾脏、肝脏、皮肤和眼睛。在其短暂的寿命中,胎盘经历了快速和连续的生长和分化,这意味着胎盘的“器官发生”直到分娩才真正结束,因此干细胞在妊娠期间很可能在胎盘功能中发挥重要作用。胎盘中有两种干细胞群对这种持续的生长和分化做出贡献:滋养层干细胞和间充质干细胞。这篇综述将讨论我们目前对这两种干细胞群如何促进胎盘功能的理解,以及这些上皮和间充质干细胞群如何在其他领域转化为临床应用,以及这些进展是否可以让我们了解未来如何利用胎盘干细胞来修复有缺陷的胎盘。

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