Schroeder Gregory D, Kepler Christopher K, Vaccaro Alexander R
From the Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
J Am Acad Orthop Surg. 2016 Apr;24(4):266-75. doi: 10.5435/JAAOS-D-14-00375.
Acute spinal cord injuries are life-changing events that lead to substantial morbidity and mortality, but the role of cell-based treatment for these injuries is unclear. Cell therapy is a rapidly evolving treatment methodology, with basic science and early phase I/II human trials showing promise. Multiple cell lines can be used in cell therapy, including adult or embryonic stem cells, Schwann cells, olfactory ensheathing cells, and induced pluripotent stem cells. Adult stem cells, Schwann cells, and olfactory ensheathing cells are readily available but lack the ability to differentiate into cells of the central nervous system. Mesenchymal stem cells can decrease cell death by modifying the local environment into which they are introduced. Peripheral nerve cells, such as Schwann cells and olfactory ensheathing cells, can myelinate existing axons and foster axonal growth in the central nervous system, and embryonic stem cells can differentiate into neural progenitor stem cells of the central nervous system. Induced pluripotent stem cells are the basis of an emerging technology that has yet to be implemented in human trials but may offer a means of cell therapy without the ethical dilemmas associated with embryonic cells.
急性脊髓损伤是改变人生的事件，会导致严重的发病率和死亡率，但基于细胞的治疗对这些损伤的作用尚不清楚。细胞疗法是一种迅速发展的治疗方法，基础科学和早期I/II期人体试验显示出了前景。多种细胞系可用于细胞疗法，包括成体或胚胎干细胞、雪旺细胞、嗅鞘细胞和诱导多能干细胞。成体干细胞、雪旺细胞和嗅鞘细胞容易获得，但缺乏分化为中枢神经系统细胞的能力。间充质干细胞可通过改变其被引入的局部环境来减少细胞死亡。周围神经细胞，如雪旺细胞和嗅鞘细胞，可使现有轴突髓鞘化并促进中枢神经系统中的轴突生长，而胚胎干细胞可分化为中枢神经系统的神经祖干细胞。诱导多能干细胞是一项新兴技术的基础，该技术尚未在人体试验中实施，但可能提供一种细胞疗法，而不存在与胚胎细胞相关的伦理困境。
