Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China.
Department of Neonatology, Changzhou Maternity and Child Health Care Hospital of Nanjing Medical University, Changzhou 213000, China.
Biosci Rep. 2020 May 29;40(5). doi: 10.1042/BSR20200241.
Preterm birth is a complex syndrome and remains a substantial public health problem globally. Its common complications include periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP). Despite great advances in the comprehension of the pathogenesis and improvements in neonatal intensive care and associated medicine, preterm birth-related diseases remain essentially without adequate treatment and can lead to high morbidity and mortality. The therapeutic potential of mesenchymal stem/stromal cells (MSCs) appears promising as evidenced by their efficacy in preclinical models of pathologies relevant to premature infant complications. MSC-based therapeutic efficacy is closely associated with MSC secretomes and a subsequent paracrine action response to tissue injuries, which are complex and abundant in response to the local microenvironment. In the current review, we summarize the paracrine mechanisms of MSC secretomes underlying diverse preterm birth-related diseases, including PVL, BPD, NEC and ROP, are summarized, and focus is placed on MSC-conditioned media (CM) and MSC-derived extracellular vesicles (EVs) as key mediators of modulatory action, thereby providing new insights for future therapies in newborn medicine.
早产是一种复杂的综合征,仍然是全球一个重大的公共卫生问题。其常见并发症包括脑室周围白质软化症(PVL)、支气管肺发育不良(BPD)、坏死性小肠结肠炎(NEC)和早产儿视网膜病变(ROP)。尽管人们对发病机制的认识有了很大的提高,新生儿重症监护和相关医学也有所改善,但与早产相关的疾病基本上仍然没有有效的治疗方法,可能导致高发病率和死亡率。间充质干细胞(MSCs)的治疗潜力似乎很有前景,这一点可以从它们在与早产儿并发症相关的病理学的临床前模型中的疗效中得到证明。基于 MSC 的治疗效果与 MSC 分泌组及其对组织损伤的旁分泌反应密切相关,这些反应是复杂和丰富的,以响应局部微环境。在本综述中,我们总结了 MSC 分泌组在包括 PVL、BPD、NEC 和 ROP 等多种与早产相关的疾病中的旁分泌机制,并重点关注 MSC 条件培养基(CM)和 MSC 衍生的细胞外囊泡(EVs)作为调节作用的关键介质,从而为新生儿医学的未来治疗提供新的见解。