Simonson Oscar E, Domogatskaya Anna, Volchkov Pavel, Rodin Sergey
a Division of Cardiothoracic Surgery and Anesthesiology, Department of Molecular Medicine and Surgery , Karolinska Institutet, Karolinska University Hospital , 171 77 Stockholm , Sweden.
Ann Med. 2015;47(5):370-80. doi: 10.3109/07853890.2015.1051579. Epub 2015 Jul 6.
Human pluripotent stem cells (hPSCs) have practically unlimited proliferation potential and a capability to differentiate into any cell type in the human body. Since the first derivation in 1998, they have been an attractive source of cells for regenerative medicine. Numerous ethical, technological, and regulatory complications have been hampering hPSC use in clinical applications. Human embryonic stem cells (ESCs), parthenogenetic human ESCs, human nuclear transfer ESCs, and induced pluripotent stem cells are four types of hPSCs that are different in many clinically relevant features such as propensity to epigenetic abnormalities, generation methods, and ability for development of autologous cell lines. Propensity to genetic mutations and tumorigenicity are common features of all pluripotent cells that complicate hPSC-based therapies. Several recent advances in methods of derivation, culturing, and monitoring of hPSCs have addressed many ethical concerns and technological challenges in development of clinical-grade hPSC lines. Generation of banks of such lines may be useful to minimize immune rejection of hPSC-derived allografts. In this review, we discuss different sources of hPSCs available at the moment, various safety risks associated with them, and possible solutions for successful use of hPSCs in the clinic. We also discuss ongoing clinical trials of hPSC-based treatments.
人类多能干细胞(hPSCs)具有几乎无限的增殖潜力,并有能力分化为人体中的任何细胞类型。自1998年首次获得以来,它们一直是再生医学中具有吸引力的细胞来源。众多伦理、技术和监管方面的复杂问题一直阻碍着hPSCs在临床应用中的使用。人类胚胎干细胞(ESCs)、孤雌生殖人类ESCs、人类核移植ESCs和诱导多能干细胞是四种类型的hPSCs,它们在许多临床相关特征上存在差异,如表观遗传异常倾向、产生方法以及自体细胞系的发育能力。基因突变倾向和致瘤性是所有多能细胞的共同特征,这使得基于hPSCs的治疗变得复杂。hPSCs衍生、培养和监测方法的一些最新进展解决了临床级hPSC系开发中的许多伦理问题和技术挑战。建立此类细胞系库可能有助于将hPSC衍生的同种异体移植物免疫排斥降至最低。在本综述中,我们讨论了目前可用的hPSCs的不同来源、与之相关的各种安全风险以及在临床上成功使用hPSCs的可能解决方案。我们还讨论了基于hPSCs治疗的正在进行的临床试验。