间充质干细胞治疗急性放射性损伤的研究

doi:10.3877/cma.j.issn.2095-1221.2018.02.009

急性放射性损伤是组织损伤的一种重要类型，目前未有较理想的治疗方案。间充质干细胞（MSCs）能够多向分化、自我更新，且具有分泌多种细胞因子、抗炎、免疫调节等生物活性。其在促进组织修复的优势显而易见，而移植的时机、剂量长期以来莫衷一是。致瘤性等安全问题制约其临床研究的进一步开展。近年来，MSCs趋向于无细胞化移植取得了明显成效。这一研究新进展势必迎来急性放射性损伤治疗的新格局，本文对此研究现状及进展进行综述。

关键词: 间充质干细胞, 放射损伤, 细胞治疗

Acute radiation injury is one of serious complication of exposure to irradiation, but there is still no effective means to prevent and treat it. However, mesenchymal stem cells (MSCs) are self-renewal and differentiating into various cell lineages. These cells possess attributes such as secreting a variety of cytokines, anti-inflammatory and immunosuppressive properties. The advantages of MSCs in tissue-repaired is conspicuous, but the timing and doses of transplants have been controversial. The safety problems such as tumorigenicity restrict clinical trials. Recently, the result of cell-free transplantation is fruitful, and the new situation definitely comes soon. This review summarizes and discusses recent advances on MSCs treating severe acute radiation.

Key words: Mesenchymal stem cells MSCs, Radiation injury, Cell therapy

表1 MSCs治疗放射性损伤的临床应用

时间	研究者	例数	损伤类型	移植细胞类型	治疗时间	治疗剂量	效果
2007	艾辉胜等^[40]	2	肠型放射病、极重度骨髓放射病	异基因造血干细胞联合BM-MSCs	照射后		恢复造血，未发生GVHD
					5 ~ 6 d	3.60×10⁶/kg
					CD34移植后14 d	5.80×10⁶/kg
2009	Kursova LV等^[41]	11	放射性肺损伤	BM-MSCs	—	6.25×10⁶/kg	症状好转
2009	Kursova LV等^[41]	11	放射性肺损伤	BM-MSCs	—	（1 ~ 2）×10⁸ cells	症状好转
2013	M Guo等^[42]	1	重度骨髓放射病、肠型放射病	BM-MSCs联合异基因外周血造血干细胞	受照后		造血恢复、肠道功能未恢复
					3 d	1.10×10⁷ cells/2ml
					8 d	1.55×10⁶ cells/2ml
					14 d	11.00×10⁷ cells/2ml
					23 d	6.30×10⁷ cells/2ml
					32 d	5.60×10⁷ cells/2ml
					37 d	5.10×10⁷ cells/2ml
					40 d	5.00×10⁷ cells/2ml
2016	刘玉龙等^[43]	1	轻度骨髓损伤、四度急性皮肤损伤	UC-MSCs	受照后		VEGF升高血象恢复；皮肤损伤愈合
					271 d	10.10×10⁷/U
					278 d	10.10×10⁷/U
2017	谯智慧等^[44]	8	放射性肺纤维化	UC-MSCs	受照后		呼吸道症状减轻、CT值好转
2017	谯智慧等^[44]	8	放射性肺纤维化	UC-MSCs	3.5个月	1.00×10⁶/kg	呼吸道症状减轻、CT值好转

表1 MSCs治疗放射性损伤的临床应用

时间	研究者	例数	损伤类型	移植细胞类型	治疗时间	治疗剂量	效果
2007	艾辉胜等^[40]	2	肠型放射病、极重度骨髓放射病	异基因造血干细胞联合BM-MSCs	照射后		恢复造血，未发生GVHD
					5 ~ 6 d	3.60×10⁶/kg
					CD34移植后14 d	5.80×10⁶/kg
2009	Kursova LV等^[41]	11	放射性肺损伤	BM-MSCs	—	6.25×10⁶/kg	症状好转
2009	Kursova LV等^[41]	11	放射性肺损伤	BM-MSCs	—	（1 ~ 2）×10⁸ cells	症状好转
2013	M Guo等^[42]	1	重度骨髓放射病、肠型放射病	BM-MSCs联合异基因外周血造血干细胞	受照后		造血恢复、肠道功能未恢复
					3 d	1.10×10⁷ cells/2ml
					8 d	1.55×10⁶ cells/2ml
					14 d	11.00×10⁷ cells/2ml
					23 d	6.30×10⁷ cells/2ml
					32 d	5.60×10⁷ cells/2ml
					37 d	5.10×10⁷ cells/2ml
					40 d	5.00×10⁷ cells/2ml
2016	刘玉龙等^[43]	1	轻度骨髓损伤、四度急性皮肤损伤	UC-MSCs	受照后		VEGF升高血象恢复；皮肤损伤愈合
					271 d	10.10×10⁷/U
					278 d	10.10×10⁷/U
2017	谯智慧等^[44]	8	放射性肺纤维化	UC-MSCs	受照后		呼吸道症状减轻、CT值好转
2017	谯智慧等^[44]	8	放射性肺纤维化	UC-MSCs	3.5个月	1.00×10⁶/kg	呼吸道症状减轻、CT值好转

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Mesenchymal stem cells in the treatment of acute radiation-induced injury

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