Monsel Antoine, Zhu Ying-Gang, Gennai Stephane, Hao Qi, Liu Jia, Lee Jae W
From the Multidisciplinary Intensive Care Unit (Jean-Jacques Rouby, M.D., Ph.D., Director), Department of Anesthesiology and Critical Care (Pierre Coriat, M.D., Ph.D., Chairman), La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, France (A.M.); UPMC Université Paris, Paris, France (A.M.); Department of Anesthesiology, University of California San Francisco, San Francisco, California (A.M., Y.-g.Z., S.G., Q.H., J.L., J.W.L.).
Anesthesiology. 2014 Nov;121(5):1099-121. doi: 10.1097/ALN.0000000000000446.
Critically ill patients often suffer from multiple organ failures involving lung, kidney, liver, or brain. Genomic, proteomic, and metabolomic approaches highlight common injury mechanisms leading to acute organ failure. This underlines the need to focus on therapeutic strategies affecting multiple injury pathways. The use of adult stem cells such as mesenchymal stem or stromal cells (MSC) may represent a promising new therapeutic approach as increasing evidence shows that MSC can exert protective effects following injury through the release of promitotic, antiapoptotic, antiinflammatory, and immunomodulatory soluble factors. Furthermore, they can mitigate metabolomic and oxidative stress imbalance. In this work, the authors review the biological capabilities of MSC and the results of clinical trials using MSC as therapy in acute organ injuries. Although preliminary results are encouraging, more studies concerning safety and efficacy of MSC therapy are needed to determine their optimal clinical use. (ANESTHESIOLOGY 2014; 121:1099-121).
重症患者常伴有多器官功能衰竭，累及肺、肾、肝或脑。基因组学、蛋白质组学和代谢组学方法揭示了导致急性器官衰竭的常见损伤机制。这凸显了关注影响多种损伤途径的治疗策略的必要性。使用成体干细胞，如间充质干细胞或基质细胞（MSC），可能代表一种有前景的新治疗方法，因为越来越多的证据表明，MSC可通过释放促有丝分裂、抗凋亡、抗炎和免疫调节可溶性因子，在损伤后发挥保护作用。此外，它们还可减轻代谢组学和氧化应激失衡。在这项工作中，作者回顾了MSC的生物学特性以及使用MSC治疗急性器官损伤的临床试验结果。尽管初步结果令人鼓舞，但仍需要更多关于MSC治疗安全性和有效性的研究，以确定其最佳临床应用。（《麻醉学》2014年；121:1099 - 121）
