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中华细胞与干细胞杂志(电子版) ›› 2026, Vol. 16 ›› Issue (05) : 305 -313. doi: 10.3877/cma.j.issn.2095-1221.2026.05.007

综述

多系分化应激耐受细胞在组织损伤修复中的研究进展
陈博扬1,2, 孔垂玉1, 周庆1,†()   
  1. 1210008 南京大学医学院附属鼓楼医院心脏外科
    2351100 莆田,莆田学院附属医院心胸外科
  • 收稿日期:2025-10-27 出版日期:2026-10-01
  • 通信作者: 周庆
  • 基金资助:
    国家自然科学基金(82170496、82300311); 江苏省自然科学基金(BK20241720); 福建省自然科学基金(2026J0011931); 江苏省科协青年科技人才托举工程(JSTJ-2024-382); 南京市医学科技发展资金资助项目杰出青年基金(JQX24002); 莆田市科技计划项目(2025NJYL081)

Advances in multilineage-differentiating stress-enduring cells for tissue injury repair

Boyang Chen1,2, Chuiyu Kong1, Qing Zhou1,†()   

  1. 1Department of Cardiac Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
    2Department of Thoracic and Cardiovascular Surgery, the Affiliated Hospital of Putian University, Putian 351100, China
  • Received:2025-10-27 Published:2026-10-01
  • Corresponding author: Qing Zhou
引用本文:

陈博扬, 孔垂玉, 周庆. 多系分化应激耐受细胞在组织损伤修复中的研究进展[J/OL]. 中华细胞与干细胞杂志(电子版), 2026, 16(05): 305-313.

Boyang Chen, Chuiyu Kong, Qing Zhou. Advances in multilineage-differentiating stress-enduring cells for tissue injury repair[J/OL]. Chinese Journal of Cell and Stem Cell(Electronic Edition), 2026, 16(05): 305-313.

在再生医学领域,开发兼具修复潜力与安全性的"即用型"细胞疗法是核心目标之一。多系分化应激耐受细胞(Muse细胞)是一类内源性间充质干细胞亚群,以阶段特异性胚胎抗原-3阳性、非致瘤性及三胚层分化潜能为主要特征。其修复机制涉及以鞘氨醇-1-磷酸及其受体2 (SIP-SIPR2)轴为核心的损伤组织归巢,通过吞噬凋亡细胞碎片进行的快速原位分化,以及由人类白细胞抗原G表达介导的免疫耐受特性。其安全性基于独特的分子调控网络,通过抑癌因子let-7而非致癌基因维持多能性。临床前研究已证实其在神经、心血管及肝脏等多种损伤模型中的修复作用,而早期临床试验证实其在多种疾病中的良好安全性。尽管Muse细胞的临床转化仍面临细胞来源稀有、规模化生产以及临床前与临床结果差异等挑战,但"无细胞疗法"和激活内源性Muse细胞的策略,是值得关注的未来发展方向。

A key objective in regenerative medicine is the development of "off-the-shelf" cell therapies that combine reparative potential with a strong safety profile. Multilineage-differentiating stress-enduring (Muse) cells are an endogenous subpopulation of mesenchymal stem cells, primarily characterized by stage-specific embryonic antigen-3 (SSEA-3) positivity, non-tumorigenicity, and the potential for tri-lineage differentiation. Their reparative mechanisms involve homing to damaged tissues mediated by the sphingosine-1-phosphate and its receptor 2 (S1P-S1PR2) axis, rapid in situ differentiation via the phagocytosis of apoptotic cell fragments, and immune tolerance conferred by the expression of human leukocyte antigen-G. The safety profile of Muse cells is predicated on a unique molecular regulatory network that maintains pluripotency through the tumor suppressor let-7, rather than through oncogenes. Preclinical studies have corroborated their reparative efficacy in various injury models, including those of the neurological, cardiovascular, and hepatic systems, while early clinical trials have demonstrated their favorable safety profile across multiple diseases. Although the clinical translation of Muse cells continues to face challenges such as the rarity of cell sources, scalable manufacturing, and discrepancies between preclinical and clinical outcomes, "cell-free" therapies and strategies aimed at activating endogenous Muse cells serve as noteworthy directions for future development.

图1 Muse细胞的提取注:MSCs为间充质干细胞;MACS为磁珠分选;FACS为流式细胞分选
图2 Muse细胞多元化修复机制注:S1P-S1PR2为鞘氨醇-1-磷酸/受体2轴;SDF-1α-CXCR4为基质细胞衍生因子-1α-趋化因子受体4轴;HLA-G为人类白细胞抗原G
表1 Muse细胞主要临床试验汇总
适应证 临床试验注册号 分期 试验设计 患者数量(例) 干预措施 主要结果 参考文献
急性心肌梗死 JapicCTI-183834 Phase 1 开放标签,单臂非对照 3 CL2020:1.5×107 cells,Ⅳ 安全性:未报告与药物相关的药物不良反应、严重不良事件或主要不良心血管事件;
疗效(至第12周):LVEF从40.7提升至52.0 (P < 0.001);WMSI从1.594降低至1.188
[65]
亚急性缺血性脑卒中 JapicCTI-184103 Phase 2 随机,双盲,安慰剂对照 65 CL2020:1.5 ×107 cells,Ⅳ 安全性:DR发生率:CL2020组28% vs安慰剂组10%;CL2020组报告1例可能相关的4级癫痫持续状态。(3例初期结果);
疗效(mRS ≤ 2,第12周):CL2020组40.0%vs安慰剂组10.0%;治疗组95%CI下限(21.1%)超过预设阈值(8.7 %);
统计分析(mRS评分偏移分析):共同比值比(OR)为3.69(95 %CI:0.83 ~ 16.47;P = 0.087)
[26]
脊髓损伤 jRCT1080224764 Phase 2 开放标签,非对照 10 CL2020:1.5×107 cells,Ⅳ 安全性:报告2例SAE,均判定与治疗无关;
疗效(ISNCSCI总运动评分自基线变化):第12周:+13.6分;第52周:+15.4分;所有随访时间点的改善均有统计学意义(P  < 0.05)
[66]
肌萎缩侧索硬化 jRCT2063200047 Phase 2 开放标签,非对照 25 CL2020:1.5× 107 cells,Ⅳ (重复给药) 安全性:重复给药方案耐受性良好,未报告与治疗相关的SAE;
疗效(ALSFRS-R评分月度下降率):5例患者中有3例疾病进展减缓或停止
[67]
新生儿缺氧缺血性脑病 NCT04261335(SHIELD试验) Phase 1 开放标签,剂量递增 11 CL2020:2×105或1×106 cells/kg,Ⅳ 安全性:未报告SAE;唯一可能相关的AE为轻度、一过性γ-GGT升高;
疗效(探索性):67%的患儿在随访时发育商达到正常水平(≥85)
[68,69]
营养不良型大疱性表皮松解症 JapicCTI-184563 Phase 1/2 开放标签,非对照 6 自体或同种异体Muse cells,Ⅳ 安全性:报告1例可能相关的AE (上肢感觉异常),已自愈;
疗效:溃疡面积第4周平均减少46.32%,但第12周恢复至基线;疼痛VAS第2周改善(P = 0.003);瘙痒VAS在第12周和第20周恶化
[70]
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