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间质干细胞(MSCs)及 MSC-外泌体与药物干预联合治疗肝纤维化的研究进展。

Progress of mesenchymal stem cells (MSCs) & MSC-Exosomes combined with drugs intervention in liver fibrosis.

机构信息

Subcenter for Stem Cell Clinical Translation, First Affiliated Hospital of Gannan Medical University, Jiangxi, China; School of Rehabilitation Medicine, Gannan Medical University, Jiangxi, China.

School of Rehabilitation Medicine, Gannan Medical University, Jiangxi, China.

出版信息

Biomed Pharmacother. 2024 Jul;176:116848. doi: 10.1016/j.biopha.2024.116848. Epub 2024 Jun 3.

Abstract

Liver fibrosis is an intrahepatic chronic damage repair response caused by various reasons such as alcoholic liver, fatty liver, viral hepatitis, autoimmune diseases, etc., and is closely related to the progression of liver disease. Currently, the mechanisms of liver fibrosis and its treatment are hot research topics in the field of liver disease remedy. Mesenchymal stem cells (MSCs) are a class of adult stem cells with self-renewal and multidirectional differentiation potential, which can ameliorate fibrosis through hepatic-directed differentiation, paracrine effects, and immunomodulation. However, the low inner-liver colonization rate, low survival rate, and short duration of intervention after stem cell transplantation have limited their wide clinical application. With the intensive research on liver fibrosis worldwide, it has been found that MSCs and MSCs-derived exosomes combined with drugs have shown better intervention efficiency than utilization of MSCs alone in many animal models of liver fibrosis. In this paper, we review the interventional effects and mechanisms of mesenchymal stem cells and their exosomes combined with drugs to alleviate hepatic fibrosis in vivo in animal models in recent years, which will provide new ideas to improve the efficacy of mesenchymal stem cells and their exosomes in treating hepatic fibrosis in the clinic.

摘要

肝纤维化是由酒精性肝病、脂肪肝、病毒性肝炎、自身免疫性疾病等多种原因引起的肝内慢性损伤修复反应,与肝病的进展密切相关。目前,肝纤维化的机制及其治疗是肝病治疗领域的热点研究课题。间充质干细胞(MSCs)是一类具有自我更新和多向分化潜能的成体干细胞,可通过肝向分化、旁分泌作用和免疫调节来改善纤维化。然而,干细胞移植后干细胞的内肝定植率低、存活率低、干预持续时间短,限制了其广泛的临床应用。随着全球对肝纤维化的深入研究,发现在许多肝纤维化动物模型中,MSCs 及其衍生的外泌体与药物联合使用比单独使用 MSCs 具有更好的干预效果。本文综述了近年来间充质干细胞及其外泌体与药物联合减轻动物模型肝纤维化的干预作用及其机制,为提高间充质干细胞及其外泌体治疗肝纤维化的疗效提供新的思路。

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