Department of Cardiology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China (X.P., L.D., Y.H., Q.X.).
Department of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing, China (Y.F.).
Arterioscler Thromb Vasc Biol. 2021 Jan;41(1):167-178. doi: 10.1161/ATVBAHA.120.315052. Epub 2020 Oct 8.
Pulmonary arterial hypertension (PAH) is a progressive disease characterized by endothelial dysfunction and vascular remodeling. Despite significant advancement in our understanding of the pathogenesis of PAH in recent years, treatment options for PAH are limited and their prognosis remains poor. PAH is now seen as a severe pulmonary arterial vasculopathy with structural changes driven by excessive vascular proliferation and inflammation. Perturbations of a number of cellular and molecular mechanisms have been described, including pathways involving growth factors, cytokines, metabolic signaling, elastases, and proteases, underscoring the complexity of the disease pathogenesis. Interestingly, emerging evidence suggests that stem/progenitor cells may have an impact on disease development and therapy. In preclinical studies, stem/progenitor cells displayed an ability to promote endothelial repair of dysfunctional arteries and induce neovascularization. The stem cell-based therapy for PAH are now under active investigation. This review article will briefly summarize the updates in the research field, with a special focus on the contribution of stem/progenitor cells to lesion formation via influencing vascular cell functions and highlight the potential clinical application of stem/progenitor cell therapy to PAH.
肺动脉高压(PAH)是一种进行性疾病,其特征为内皮功能障碍和血管重构。尽管近年来我们对 PAH 的发病机制有了显著的了解,但 PAH 的治疗选择仍然有限,其预后仍然较差。PAH 现在被视为一种严重的肺动脉血管病变,其结构变化由过度的血管增殖和炎症驱动。已经描述了许多细胞和分子机制的紊乱,包括涉及生长因子、细胞因子、代谢信号、弹性蛋白酶和蛋白酶的途径,突出了疾病发病机制的复杂性。有趣的是,新出现的证据表明,干细胞/祖细胞可能对疾病的发展和治疗有影响。在临床前研究中,干细胞/祖细胞显示出促进功能失调的动脉内皮修复和诱导新生血管形成的能力。基于干细胞的 PAH 治疗正在积极研究中。本文综述简要总结了该研究领域的最新进展,特别关注干细胞/祖细胞通过影响血管细胞功能对病变形成的贡献,并强调了干细胞/祖细胞治疗 PAH 的潜在临床应用。