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脂肪来源干细胞治疗脊髓损伤:进展、挑战与未来方向。

Adipose-derived stem cell therapy for spinal cord injuries: Advances, challenges, and future directions.

作者信息

Shimizu Yusuke, Ntege Edward Hosea, Takahara Eisaku, Matsuura Naoki, Matsuura Rikako, Kamizato Kota, Inoue Yoshikazu, Sowa Yoshihiro, Sunami Hiroshi

机构信息

Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Nakagami, Okinawa, 903-0215, Japan.

Department of Anesthesiology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Nakagami, Okinawa, 903-0215, Japan.

出版信息

Regen Ther. 2024 Jul 26;26:508-519. doi: 10.1016/j.reth.2024.07.007. eCollection 2024 Jun.

Abstract

Spinal cord injury (SCI) has limited treatment options for regaining function. Adipose-derived stem cells (ADSCs) show promise owing to their ability to differentiate into multiple cell types, promote nerve cell survival, and modulate inflammation. This review explores ADSC therapy for SCI, focusing on its potential for improving function, preclinical and early clinical trial progress, challenges, and future directions. Preclinical studies have demonstrated ADSC transplantation's effectiveness in promoting functional recovery, reducing cavity formation, and enhancing nerve regrowth and myelin repair. To improve ADSC efficacy, strategies including genetic modification and combination with rehabilitation are being explored. Early clinical trials have shown safety and feasibility, with some suggesting motor and sensory function improvements. Challenges remain for clinical translation, including optimizing cell survival and delivery, determining dosing, addressing tumor formation risks, and establishing standardized protocols. Future research should focus on overcoming these challenges and exploring the potential for combining ADSC therapy with other treatments, including rehabilitation and medication.

摘要

脊髓损伤(SCI)恢复功能的治疗选择有限。脂肪来源干细胞(ADSCs)因其能够分化为多种细胞类型、促进神经细胞存活和调节炎症而展现出前景。本综述探讨了ADSCs治疗SCI的方法,重点关注其改善功能的潜力、临床前和早期临床试验进展、挑战及未来方向。临床前研究已证明ADSCs移植在促进功能恢复、减少空洞形成以及增强神经再生和髓鞘修复方面的有效性。为提高ADSCs疗效,正在探索包括基因改造和与康复相结合在内的策略。早期临床试验已显示出安全性和可行性,一些试验表明运动和感觉功能有所改善。临床转化仍面临挑战,包括优化细胞存活和递送、确定给药剂量、应对肿瘤形成风险以及建立标准化方案。未来研究应专注于克服这些挑战,并探索将ADSCs治疗与其他治疗方法(包括康复和药物治疗)相结合的潜力。

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