Angelos Mathew G, Kaufman Dan S
aDepartment of Medicine bStem Cell Institute, University of Minnesota, Minneapolis, Minnesota, USA.
Curr Opin Organ Transplant. 2015 Dec;20(6):663-70. doi: 10.1097/MOT.0000000000000244.
In this review, we summarize the current status of clinical trials using therapeutic cells produced from human embryonic stem cells (hESCs) and human induced pluripotent stem cells (hiPSCs). We also discuss combined cell and gene therapy via correction of defined mutations in human pluripotent stem cells and provide commentary on key obstacles facing widescale clinical adoption of pluripotent stem cell-based therapy.
Initial data suggest that hESC/hiPSC-derived cell products used for retinal repair and spinal cord injury are safe for human use. Early-stage studies for treatment of cardiac injury and diabetes are also in progress. However, there remain key concerns regarding the safety and efficacy of these cells that need to be addressed in additional well designed clinical trials. Advances using the clustered regulatory interspaced short palindromic repeats (CRISPR)/Cas9 gene-editing system offer an improved tool for more rapid and on-target gene correction of genetic diseases. Combined gene and cell therapy using human pluripotent stem cells may provide an additional curative approach for disabling or lethal genetic and degenerative diseases wherein there are currently limited therapeutic opportunities.
Human pluripotent stem cells are emerging as a promising tool to produce cells and tissues suitable for regenerative therapy for a variety of genetic and degenerative diseases.
在本综述中,我们总结了使用源自人类胚胎干细胞(hESC)和人类诱导多能干细胞(hiPSC)的治疗性细胞进行临床试验的现状。我们还讨论了通过纠正人类多能干细胞中特定突变的细胞与基因联合疗法,并对基于多能干细胞的疗法在临床广泛应用所面临的关键障碍进行评论。
初步数据表明,用于视网膜修复和脊髓损伤的hESC/hiPSC衍生细胞产品对人类使用是安全的。治疗心脏损伤和糖尿病的早期研究也在进行中。然而,这些细胞的安全性和有效性仍存在关键问题,需要在更多精心设计的临床试验中加以解决。使用成簇规律间隔短回文重复序列(CRISPR)/Cas9基因编辑系统取得的进展为更快速且精准地对遗传疾病进行基因校正提供了一种改进工具。使用人类多能干细胞的基因与细胞联合疗法可能为目前治疗机会有限的致残或致命性遗传和退行性疾病提供另一种治愈方法。
人类多能干细胞正成为一种有前景的工具,可用于生产适合多种遗传和退行性疾病再生治疗的细胞和组织。