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间充质干细胞在急性呼吸窘迫综合征中的基础研究与临床应用现状及前景

Current status and prospects of basic research and clinical application of mesenchymal stem cells in acute respiratory distress syndrome.

作者信息

Liang Tian-Yu, Lu Li-Hai, Tang Si-Yu, Zheng Zi-Hao, Shi Kai, Liu Jing-Quan

机构信息

Emergency and Critical Care Center, Intensive Care Unit, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou 310014, Zhejiang Province, China.

Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China.

出版信息

World J Stem Cells. 2023 Apr 26;15(4):150-164. doi: 10.4252/wjsc.v15.i4.150.

Abstract

Acute respiratory distress syndrome (ARDS) is a common and clinically devastating disease that causes respiratory failure. Morbidity and mortality of patients in intensive care units are stubbornly high, and various complications severely affect the quality of life of survivors. The pathophysiology of ARDS includes increased alveolar-capillary membrane permeability, an influx of protein-rich pulmonary edema fluid, and surfactant dysfunction leading to severe hypoxemia. At present, the main treatment for ARDS is mechanical treatment combined with diuretics to reduce pulmonary edema, which primarily improves symptoms, but the prognosis of patients with ARDS is still very poor. Mesenchymal stem cells (MSCs) are stromal cells that possess the capacity to self-renew and also exhibit multilineage differentiation. MSCs can be isolated from a variety of tissues, such as the umbilical cord, endometrial polyps, menstrual blood, bone marrow, and adipose tissues. Studies have confirmed the critical healing and immunomodulatory properties of MSCs in the treatment of a variety of diseases. Recently, the potential of stem cells in treating ARDS has been explored basic research and clinical trials. The efficacy of MSCs has been shown in a variety of models of ARDS, reducing bacterial pneumonia and ischemia-reperfusion injury while promoting the repair of ventilator-induced lung injury. This article reviews the current basic research findings and clinical applications of MSCs in the treatment of ARDS in order to emphasize the clinical prospects of MSCs.

摘要

急性呼吸窘迫综合征(ARDS)是一种常见且临床上具有毁灭性的导致呼吸衰竭的疾病。重症监护病房患者的发病率和死亡率居高不下,各种并发症严重影响幸存者的生活质量。ARDS的病理生理学包括肺泡-毛细血管膜通透性增加、富含蛋白质的肺水肿液流入以及表面活性物质功能障碍,导致严重低氧血症。目前,ARDS的主要治疗方法是机械通气联合利尿剂以减轻肺水肿,这主要是改善症状,但ARDS患者的预后仍然很差。间充质干细胞(MSCs)是具有自我更新能力且能表现出多向分化的基质细胞。MSCs可以从多种组织中分离出来,如脐带、子宫内膜息肉、月经血、骨髓和脂肪组织。研究已证实MSCs在治疗多种疾病中具有关键的愈合和免疫调节特性。最近,干细胞治疗ARDS的潜力已在基础研究和临床试验中得到探索。MSCs的疗效已在多种ARDS模型中得到证实,可减轻细菌性肺炎和缺血-再灌注损伤,同时促进呼吸机诱导的肺损伤的修复。本文综述了MSCs治疗ARDS的当前基础研究结果和临床应用,以强调MSCs的临床前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7acd/10173811/dddac7d75f8d/WJSC-15-150-g001.jpg

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