Yamawaki-Ogata Aika, Mutsuga Masato, Narita Yuji
Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
Inflamm Regen. 2023 Aug 7;43(1):40. doi: 10.1186/s41232-023-00280-8.
An aortic aneurysm (AA) is defined as focal aortic dilation that occurs mainly with older age and with chronic inflammation associated with atherosclerosis. The aneurysmal wall is a complex inflammatory environment characterized by endothelial dysfunction, macrophage activation, vascular smooth muscle cell (VSMC) apoptosis, and the production of proinflammatory molecules and matrix metalloproteases (MMPs) secreted by infiltrated inflammatory cells such as macrophages, T and B cells, dendritic cells, neutrophils, mast cells, and natural killer cells. To date, a considerable number of studies have been conducted on stem cell research, and growing evidence indicates that inflammation and tissue repair can be controlled through the functions of stem/progenitor cells. This review summarizes current cell-based therapies for AA, involving mesenchymal stem cells, VSMCs, multilineage-differentiating stress-enduring cells, and anti-inflammatory M2 macrophages. These cells produce beneficial outcomes in AA treatment by modulating the inflammatory environment, including decreasing the activity of proinflammatory molecules and MMPs, increasing anti-inflammatory molecules, modulating VSMC phenotypes, and preserving elastin. This article also describes detailed studies on pathophysiological mechanisms and the current progress of clinical trials.
主动脉瘤(AA)被定义为主要发生于老年且与动脉粥样硬化相关的慢性炎症有关的局灶性主动脉扩张。动脉瘤壁是一个复杂的炎症环境,其特征为内皮功能障碍、巨噬细胞活化、血管平滑肌细胞(VSMC)凋亡以及由浸润的炎症细胞(如巨噬细胞、T细胞和B细胞、树突状细胞、中性粒细胞、肥大细胞和自然杀伤细胞)分泌的促炎分子和基质金属蛋白酶(MMPs)。迄今为止,已经开展了大量关于干细胞研究的工作,越来越多的证据表明炎症和组织修复可以通过干/祖细胞的功能来控制。本综述总结了目前用于AA的基于细胞的疗法,包括间充质干细胞、VSMC、多谱系分化应激耐受细胞和抗炎M2巨噬细胞。这些细胞通过调节炎症环境在AA治疗中产生有益效果,包括降低促炎分子和MMPs的活性、增加抗炎分子、调节VSMC表型以及保留弹性蛋白。本文还描述了病理生理机制的详细研究以及临床试验的当前进展。