Platelet Biology Laboratory, New York Blood Center, Lindsley F. Kimball Research Institute, New York, NY, USA.
Br J Haematol. 2014 Apr;165(2):237-47. doi: 10.1111/bjh.12764. Epub 2014 Feb 13.
Stem cell technology holds great promise for transfusion medicine, and generation of platelets from stem cells would be transformative. Platelet transfusions are life saving for millions of people and the clinical demand for platelets continues to increase: there is a real need to increase the supply of platelets. Accordingly, there is great interest in the potential of producing platelets from stem cells for clinical use. There has been initial success in ex vivo generation of platelets from stem cells using cord blood stem cells, embryonic stem cells and induced pluripotent stem cells. However, the platelet yields achieved by these strategies have not been sufficient for clinical purposes. This review provides updated information about the current strategies of ex vivo generation of platelets. Megakaryocytopoiesis and platelet generation, along with the importance of genetic determinants of these processes, are reviewed in the context of efforts to generate these products from stem cells. Current challenges and rate-limiting steps in ex vivo platelet generation are discussed, together with strategies to overcome them. While much work remains, great progress has been made, moving ex vivo generation of platelets ever closer to the clinic.
干细胞技术在输血医学中具有巨大的应用前景，而从干细胞中生成血小板将具有变革性意义。血小板输注对数百万人的生命至关重要，对血小板的临床需求持续增加：确实需要增加血小板的供应。因此，人们对利用干细胞为临床应用生成血小板的潜力产生了浓厚的兴趣。已经初步成功地使用脐带血干细胞、胚胎干细胞和诱导多能干细胞从干细胞中体外生成血小板。然而，这些策略所获得的血小板产量还不足以满足临床需求。本文综述了目前从干细胞体外生成血小板的策略。本文综述了巨核细胞生成和血小板生成的最新信息，以及这些过程的遗传决定因素的重要性，同时还讨论了从干细胞生成这些产品的努力。本文讨论了体外血小板生成中的当前挑战和限速步骤，以及克服这些挑战的策略。虽然还有很多工作要做，但已经取得了很大的进展，使体外血小板生成离临床应用越来越近。
