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人类干细胞疗法的进展:临床前研究及中枢神经系统再生的前景。

Advances in human stem cell therapies: pre-clinical studies and the outlook for central nervous system regeneration.

作者信息

Forbes Lindsey H, Andrews Melissa R

机构信息

Medical Research Council Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.

School of Biological Sciences, University of Southampton, Southampton, UK.

出版信息

Neural Regen Res. 2021 Apr;16(4):614-617. doi: 10.4103/1673-5374.295287.

Abstract

Cell transplantation has come to the forefront of regenerative medicine alongside the discovery and application of stem cells in both research and clinical settings. There are several types of stem cells currently being used for pre-clinical regenerative therapies, each with unique characteristics, benefits and limitations. This brief review will focus on recent basic science advancements made with embryonic stem cells and induced pluripotent stem cells. Both embryonic stem cells and induced pluripotent stem cells provide platforms for new neurons to replace dead and/or dying cells following injury. Due to their capacity for reprogramming and differentiation into any neuronal type, research in preclinical rodent models has shown that embryonic stem cells and induced pluripotent stem cells can integrate, survive and form connections in the nervous system similar to de novo cells. Going forward however, there are some limitations to consider with the use of either stem cell type. Ethically, embryonic stem cells are not an ideal source of cells, genetically, induced pluripotent stem cells are not ideal in terms of personalized treatment for those with certain genetic diseases the latter of which may guide regenerative medicine away from personalized stem cell based therapies and into optimized stem cell banks. Nonetheless, the potential of these stem cells in central nervous system regenerative therapy is only beginning to be appreciated. For example, through genetic modification, stem cells serve as ideal platforms to reintroduce missing or downregulated molecules into the nervous system to further induce regenerative growth. In this review, we highlight the limitations of stem cell based therapies whilst discussing some of the means of overcoming these limitations.

摘要

随着干细胞在研究和临床环境中的发现与应用,细胞移植已成为再生医学的前沿领域。目前有几种类型的干细胞正被用于临床前的再生治疗,每种干细胞都有其独特的特征、优势和局限性。本简要综述将聚焦于胚胎干细胞和诱导多能干细胞在基础科学方面的最新进展。胚胎干细胞和诱导多能干细胞都为新神经元替代损伤后死亡和/或濒死的细胞提供了平台。由于它们具有重编程和分化为任何神经元类型的能力,临床前啮齿动物模型的研究表明,胚胎干细胞和诱导多能干细胞能够在神经系统中整合、存活并形成类似于新生细胞的连接。然而,在使用这两种干细胞类型时,都有一些局限性需要考虑。从伦理角度来看,胚胎干细胞并非理想的细胞来源;从基因角度而言,对于某些患有特定遗传疾病的人来说,诱导多能干细胞在个性化治疗方面并不理想,这可能会使再生医学从基于个性化干细胞的疗法转向优化的干细胞库。尽管如此,这些干细胞在中枢神经系统再生治疗中的潜力才刚刚开始被认识到。例如,通过基因改造,干细胞可作为理想的平台,将缺失或下调的分子重新引入神经系统,以进一步诱导再生生长。在本综述中,我们在讨论克服这些局限性的一些方法的同时,强调了基于干细胞疗法的局限性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da8d/8067917/1b6f19f2ef10/NRR-16-614-g001.jpg

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