Department of Urology, Shanghai General Hospital (Shanghai Peoples Hosp 1), Shanghai JiaoTong University School of Medicine, 100 Haining Rd, Shanghai, 200080, China.
Department of Urology, The Affiliated Hospital of School of Medicine of NingBo University, Ningbo, China.
Neurochem Res. 2017 Dec;42(12):3537-3547. doi: 10.1007/s11064-017-2401-y. Epub 2017 Sep 26.
Diabetic cystopathy is a common complication of voiding disorders in diabetes mellitus. Neuropathy and bladder remodeling underlie the lack of efficacy of pharmacological and surgical treatments. Previous studies have shown that decreased levels of nerve growth factor (NGF) are closely associated with disease progression. Besides, application of human umbilical cord mesenchymal stem cells (hUC-MSCs) is also considered a promising therapeutic strategy for treatment of diabetic neuropathy. In our study, we determine the therapeutic efficacy and mechanisms of hUC-MSCs which transfected with NGF geen in ameliorating diabetic cystopathy for the first time. We transducted hUC-MSCs with NGF-expressing lentivirus so that the hUC-MSCs can express NGF efficiently, then the NGF-expressing hUC-MSCs were intrathecally administrated in L6-S1 spinal cord of diabetic rats 3 days after induced by streptozotocin. Nine weeks later, the level of neurotrophins and voiding function of bladder were detected. Results show that improvements in voiding function were related to the neurotrophins and cytokines released by the intrathecally transplanted hUC-MSCs. In addition, the hUC-MSCs also differentiated into neurons and astrocytes within the spinal cord in rats. These two mechanisms play a combined role in neural regeneration and the amelioration of the symptoms of diabetic cystopathy.
糖尿病性膀胱病是糖尿病排尿障碍的常见并发症。神经病变和膀胱重塑是导致药物和手术治疗效果不佳的基础。先前的研究表明,神经生长因子 (NGF) 水平降低与疾病进展密切相关。此外,人脐带间充质干细胞 (hUC-MSCs) 的应用也被认为是治疗糖尿病性神经病变的一种有前途的治疗策略。在我们的研究中,我们首次确定了转染 NGF 基因的 hUC-MSCs 改善糖尿病性膀胱病的治疗效果和机制。我们用表达 NGF 的慢病毒转导 hUC-MSCs,使 hUC-MSCs 能够有效地表达 NGF,然后在链脲佐菌素诱导后 3 天将表达 NGF 的 hUC-MSCs 鞘内注射到糖尿病大鼠的 L6-S1 脊髓中。9 周后,检测神经生长因子和膀胱的排尿功能。结果表明,排尿功能的改善与鞘内移植的 hUC-MSCs 释放的神经营养因子和细胞因子有关。此外,hUC-MSCs 还在大鼠脊髓内分化为神经元和星形胶质细胞。这两种机制共同作用于神经再生和改善糖尿病性膀胱病的症状。