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类固醇介导的肝移植中血液间充质干细胞减少可能影响长期恢复。

Steroid-Mediated Decrease in Blood Mesenchymal Stem Cells in Liver Transplant could Impact Long-Term Recovery.

机构信息

Department of Medicine, Division of Hematology/Oncology, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA.

Rutgers Graduate School of Biomedical Sciences, Newark, NJ, USA.

出版信息

Stem Cell Rev Rep. 2017 Oct;13(5):644-658. doi: 10.1007/s12015-017-9751-3.

Abstract

Orthotopic liver transplant (OLT) remains the standard of care for end stage liver disease. To circumvent allo-rejection, OLT subjects receive gluococorticoids (GC). We investigated the effects of GC on endogenous mesenchymal stem (stromal) cells (MSCs) in OLT. This question is relevant because MSCs have regenerative potential and immune suppressor function. Phenotypic analyses of blood samples from 12 OLT recipients, at pre-anhepatic, anhepatic and post-transplant (2 h, Days 1 and 5) indicated a significant decrease in MSCs after GC injection. The MSCs showed better recovery in the blood from subjects who started with relatively low MSCs as compared to those with high levels at the prehepatic phase. This drop in MSCs appeared to be linked to GC since similar change was not observed in liver resection subjects. In order to understand the effects of GC on decrease MSC migration, in vitro studies were performed in transwell cultures. Untreated MSCs could not migrate towards the GC-exposed liver tissue, despite CXCR4 expression and the production of inflammatory cytokines from the liver cells. GC-treated MSCs were inefficient with respect to migration towards CXCL12, and this correlated with retracted cytoskeleton and motility. These dysfunctions were partly explained by decreases in the CXCL12/receptor axis. GC-associated decrease in MSCs in OLT recipients recovered post-transplant, despite poor migratory ability towards GC-exposed liver. In total, the study indicated that GC usage in transplant needs to be examined to determine if this could be reduced or avoided with adjuvant cell therapy.

摘要

原位肝移植(OLT)仍然是治疗终末期肝病的标准方法。为了避免同种异体排斥反应,OLT 受者接受糖皮质激素(GC)。我们研究了 GC 对 OLT 中内源性间充质干细胞(基质)细胞(MSCs)的影响。这个问题很重要,因为 MSCs 具有再生潜力和免疫抑制功能。对 12 名 OLT 受者在术前、无肝期和移植后(2 小时、第 1 天和第 5 天)的血液样本进行表型分析表明,GC 注射后 MSCs 数量显著减少。与术前阶段 MSC 水平较高的患者相比,GC 注射前 MSC 水平相对较低的患者的血液中 MSC 恢复更好。这种 MSC 下降似乎与 GC 有关,因为在肝切除术患者中没有观察到类似的变化。为了了解 GC 对 MSC 迁移减少的影响,在 Transwell 培养物中进行了体外研究。尽管 CXCR4 表达和肝细胞产生炎性细胞因子,但未经处理的 MSC 不能向 GC 暴露的肝组织迁移。GC 处理的 MSC 向 CXCL12 的迁移效率较低,这与收缩的细胞骨架和运动性相关。这些功能障碍部分可以通过 CXCL12/受体轴的减少来解释。尽管 GC 暴露的肝脏对 MSC 的迁移能力较差,但 OLT 受者中的 GC 相关 MSC 在移植后会恢复。总的来说,该研究表明,需要检查移植中 GC 的使用情况,以确定是否可以通过辅助细胞治疗来减少或避免。

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