Newborn Research Centre, Royal Women's Hospital, Parkville, Victoria, Australia
Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia.
Arch Dis Child Fetal Neonatal Ed. 2020 Sep;105(5):563-568. doi: 10.1136/archdischild-2019-317896. Epub 2020 Apr 6.
Recent decades have seen the rapid progress of neonatal intensive care, and the survival rates of the most preterm infants are improving. This improvement is associated with changing patterns of morbidity and new phenotypes of bronchopulmonary dysplasia and preterm brain injury are recognised. Inflammation and immaturity are known contributors to their pathogenesis. However, a new phenomenon, the exhaustion of progenitor cells is emerging as an important factor. Current therapeutic approaches do not adequately address these new mechanisms of injury. Cell therapy, that is the use of stem and stem-like cells, with its potential to both repair and prevent injury, offers a new approach to these challenging conditions. This review will examine the rationale for cell therapy in the extremely preterm infant, the preclinical and early clinical evidence to support its use in bronchopulmonary dysplasia and preterm brain injury. Finally, it will address the challenges in translating cell therapy from the laboratory to early clinical trials.
近几十年来，新生儿重症监护取得了飞速发展，最早产婴儿的存活率也在不断提高。这种改善与发病率模式的变化有关，同时也认识到了支气管肺发育不良和早产儿脑损伤的新表型。炎症和不成熟被认为是其发病机制的已知因素。然而，一种新的现象，祖细胞的衰竭，正在成为一个重要因素。目前的治疗方法并不能充分解决这些新的损伤机制。细胞疗法，即使用干细胞和类干细胞，具有修复和预防损伤的潜力，为这些具有挑战性的疾病提供了一种新的治疗方法。本文将探讨细胞疗法在极早产儿中的应用原理，以及支持其在支气管肺发育不良和早产儿脑损伤中应用的临床前和早期临床证据。最后，它将讨论将细胞疗法从实验室转化为早期临床试验所面临的挑战。
