原位辅助性部分肝移植

 自1989年原位辅助性部分肝移植成功应用于临床治疗急性肝功能衰竭以来,适应证逐渐扩大至肝功能衰竭、遗传代谢疾病、终末期肝硬化。随技术不断进步趋于成熟,并发症发生率显著降低,远期存活率明显上升,对部分疾病治疗效果达到甚至优于原位肝移植术,并衍生出多米诺原位辅助性部分肝移植等新术式,显著拓展了供体来源及受益人群,成为肝脏疾病重要的治疗手段。本文介绍原位辅助性部分肝移植术的发展历程及研究进展。     

肝硬化肝切除术后肝再生及评估指标研究

原发性肝癌是我国的常见病、多发病,且90%的患者合并有肝硬化,肝切除术是主要的治疗方法,而肝脏在受到损害或切除之后,可以显示出强大的再生能力,这一现象早已被人们所发现并研究.就肝硬化肝切除术后肝再生、肝再生受损机制以及肝再生评估予以综述.     

Transplanted bone marrow regenerates liver by cell fusion

Results from several experimental systems suggest that cells from one tissue type can form other tissue types after transplantation. This could be due to the presence of multipotential or several types of adult stem cells in donor tissues, or alternatively, to fusion of donor and recipient cells. In a model of tyrosinaemia type I, mice with mutations in the fumarylacetoacetate hydrolase gene (Fah-/-) regain normal liver function after transplantation of Fah+/+ bone marrow cells, and form regenerating liver nodules with normal histology that express Fah. Here we show that these hepatic nodules contain more mutant than wild-type Fah alleles, and that their hepatocytes express both donor and host genes, consistent with polyploid genome formation by fusion of host and donor cells. Using bone marrow cells marked with integrated foamy virus vectors that express green fluorescent protein, we identify common proviral junctions in hepatic nodules and haematopoietic cells. We also show that the haematopoietic donor genome adopts a more hepatocyte-specific expression profile after cell fusion, as the wild-type Fah gene was activated and the pan-haematopoietic CD45 marker was no longer expressed.     

Differentiation of human embryonic stem cells along a hepatocyte lineage and its application in liver regeneration

Hepatocyte transplantation and bioarUficial liver （BAL） as alternatives to liver transplantation offer the possibility of effective treatment for many inherited and acquired hepatic disorders. Unfortunately, the limited availability of donated livers and the variability of their derived hepatocytes make it difficult to obtain enough viable human hepatocytes for the hepatocyte-based therapies. Embryonic stem cells （ESCs）, which could be isolated directly from the blastocyst inner cell mass, have permanent self-renewal capability and developmental pluripotency and therefore might be an ideal cell source in the treatment of hepatic discords. However, differentiation of hESCs into hepatocytes with significant numbers remains a challenge. This review updates our current understanding of differentiation of ESCs into hepatic lineage cells, their future therapeutic uses and problems in liver regeneration.     

诱导多能干细胞与心脏再生

诱导多能干细胞(induced pluripotent stem cells, iPSCs)研究的快速发展为心血管转化医学研究领域提供了新的策略. 诱导多能干细胞不仅具有与胚胎干细胞类似的多能性, 且巧妙地回避了胚胎干细胞面临的伦理学问题和免疫排斥反应. 心肌细胞等成体心血管细胞在发生心血管疾病后增殖能力有限, 而iPSCs 来源的心血管细胞在心脏再生治疗中颇具应用前景,是理想的细胞来源, 因此在基础医学和转化医学研究领域受到广泛关注. 就iPSCs 的发展过程及其在心脏再生中的应用作一综述, 并探讨目前iPSCs 在心脏再生临床转化中亟待解决的问题.     

Intrathymic inoculation of donor liver specific antigen alleviates rejection of liver allotransplantation

Use and effects of liver specific antigen in orthotopic liver transplantations were researched in this study. Group I: syngeneic control (Wistar-to-Wistar); Group II: acute rejection (SD-to-Wistar); Group III: Thymic inoculation of SD rat LSA day 7 before transplantation. The observation of common situation and survival time, rejection grades, NF-KappaB activity of splenocytes and IL-2mRNA expression of grafted liver were used to analyze acute rejection severity and immune state of animals in different groups. The common situation of group I was very well after transplantation and no signs of rejection were found. Recipients of group II lost body weight progressively. All dead within day 9 to day 13 posttransplantation; median survival time was 10.7+/-0.51 days. It was an optimal acute rejection control. As for group III, 5 out of 6 recipients survived for a long time and common situation was remarkably better than that of group II. Its rejection grades were significantly lower than that of group II(P < 0.05). NF-KappaB activity was only detected in group I at day 5 and day 7 after transplantation, whereas high activity of NF-KappaB was detected at all time points in group II and the low NF-KappaB activity detected in group III was significantly lower than that of group II(P < 0.05). No IL-2mRNA expression was detected at any time point in group I, whereas high level expression was detected at all time points in group II and the low level expression only detected at day 3 in group III was significantly lower than that of group II(P < 0.05). Conclusion: LSA is an important transplantation antigen which is involved directly in the immunorejection of liver transplantation. We report here for the first time that intrathymic inoculation of LSA can alleviate the rejection of liver allotransplantation; and that grafts can survive for a long time thereby, thus leading to a novel way to achieve liver transplantation immunotolerance.     

De novo cardiomyocytes from within the activated adult heart after injury

A significant bottleneck in cardiovascular regenerative medicine is the identification of a viable source of stem/progenitor cells that could contribute new muscle after ischaemic heart disease and acute myocardial infarction. A therapeutic ideal--relative to cell transplantation--would be to stimulate a resident source, thus avoiding the caveats of limited graft survival, restricted homing to the site of injury and host immune rejection. Here we demonstrate in mice that the adult heart contains a resident stem or progenitor cell population, which has the potential to contribute bona fide terminally differentiated cardiomyocytes after myocardial infarction. We reveal a novel genetic label of the activated adult progenitors via re-expression of a key embryonic epicardial gene, Wilm's tumour 1 (Wt1), through priming by thymosin β4, a peptide previously shown to restore vascular potential to adult epicardium-derived progenitor cells with injury. Cumulative evidence indicates an epicardial origin of the progenitor population, and embryonic reprogramming results in the mobilization of this population and concomitant differentiation to give rise to de novo cardiomyocytes. Cell transplantation confirmed a progenitor source and chromosome painting of labelled donor cells revealed transdifferentiation to a myocyte fate in the absence of cell fusion. Derived cardiomyocytes are shown here to structurally and functionally integrate with resident muscle; as such, stimulation of this adult progenitor pool represents a significant step towards resident-cell-based therapy in human ischaemic heart disease.     

干细胞与心肌再生

由于成年心肌细胞通常不能再生,严重的心肌损伤会导致心肌不可逆的重构坏死, 从而发生心功能失调. 干细胞再生治疗为心肌再生提供了很好的策略. 为了寻找合适的干细胞类型, 促进心肌再生, 有效改善心功能, 需要更好地了解心肌修复和再生的分子基础. 已有研究发现多种干细胞可促进心肌再生. 描述了骨髓干细胞的促血管新生及心肌分化的能力在心梗治疗中的作用, 还讨论了心脏侧群干细胞以及诱导型多能干细胞在心肌再生中的作用和分子机制. 所阐述的最新数据有利于拓展干细胞治疗的有效潜能及临床影响.     

Cell fusion is the principal source of bone-marrow-derived hepatocytes

Evidence suggests that haematopoietic stem cells might have unexpected developmental plasticity, highlighting therapeutic potential. For example, bone-marrow-derived hepatocytes can repopulate the liver of mice with fumarylacetoacetate hydrolase deficiency and correct their liver disease. To determine the underlying mechanism in this murine model, we performed serial transplantation of bone-marrow-derived hepatocytes. Here we show by Southern blot analysis that the repopulating hepatocytes in the liver were heterozygous for alleles unique to the donor marrow, in contrast to the original homozygous donor cells. Furthermore, cytogenetic analysis of hepatocytes transplanted from female donor mice into male recipients demonstrated 80,XXXY (diploid to diploid fusion) and 120,XXXXYY (diploid to tetraploid fusion) karyotypes, indicative of fusion between donor and host cells. We conclude that hepatocytes derived form bone marrow arise from cell fusion and not by differentiation of haematopoietic stem cells.     

血管内皮生长因子(VEGF)与肝再生

血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)能特异地直接作用于血管内皮细胞,刺激血管内皮细胞的分裂、增殖并诱导血管的形成.它通过与血管内皮细胞的受体结合发挥作用.肝受到各种损伤包括部分肝切除后,肝再生就得以启动.在肝再生过程中,VEGF对内皮细胞的生长增殖起有效促进作用,并且能诱导组织胶原酶、血纤维蛋白酶原的激活,增加血管的通透性,这对血管再生起着极其重要的作用.而血管再生是肝再生的一个重要组成部分,它不仅能给肝细胞提供血液支持,而且能促进肝脏结构的重构.因此VEGF在肝再生过程中具有重要的作用.     

骨髓间充质干细胞向肝样细胞分化的研究进展

摘要: 由各种因素导致的重症肝病的终末治疗的最好手段一直是原位肝移植,但长期以来肝供体的缺乏和免疫排斥引起的一系列问题极大地限制了该手术的运用,同时,在肝脏相关药物的筛选中,原代肝细胞难于培养且易在培养过程中变异,而随着骨髓间充质干细胞研究的深入,越来越多的证据表明骨髓间充质干细胞具有向肝细胞分化的潜能。因此,骨髓间充质干细胞诱导分化而成的肝样细胞在再生医疗和药物筛选领域具有较好的运用前景,本文就间充质干细胞的分离培养及其生物学特性,肝样细胞的诱导培养条件,生物学特性及其运用前景加以综述。     

Innate immune recognition and regulation in liver injury: A brief report from a series of studies

The discovery of innate immune receptors and the emergence of liver immunology （high content of NK and NKT cells in liver） led to the second research summit in innate immunity since the finding of NK cells in the middle 1970s. Liver disease is one of the most dangerous threats to humans, and the progress in innate immunology and liver immunology made it possible to re-explain the cellular and mo- lecular immune mechanisms of liver disease. In the past ten years, we have found that innate recognition of hepatic NK and NKT subsets were involved in murine liver injury. We established a novel NK cell-dependent acute murine hepatitis model by activating Toll-like receptor-3 （TLR-3） with an injection of poly I：C, which may mimic mild viral hepatitis （such as Chronic Hepatitis B）. We observed that a network of innate immune cells including NK, NKT and Kupffer cells is involved in liver immune injury in our established NK cell-dependent murine,model. We noted that TLR-3 on Kupffer cells activated by pretreatment with poly I： C might protect against bacterial toxin （LPS）-induced fulminant hepatitis by down-regulating TLR-4 function, while TLR-3 pre-activation of NK cells might reduce Con A-induced NKT cell-mediated fulminant hepatitis by blocking NKT cell recruitment to the liver. We also found that the oversensitivity to injury by immune stimulation in HBV （hepatitis B virus） transgenic mice （full HBV gene-tg or HBs-tg） correlated to the over-expression of Real, an NKG2D （natural killer cell group 2D） ligand of NK cells or CDld, a ligand of TCR-V14 of NKT cells, on HBV＋ hepatocytes, which leads to an innate immune response against hepatocytes and is critical in liver immune injury and regeneration.     

输注体外诱导的同种反应性淋巴细胞诱导大鼠肝脏移植免疫耐受的研究

目的 观察输注体外诱导的同种反应性淋巴细胞,是否可以延长大鼠移植肝脏的存活时间,从而探索一条诱导肝移植免疫耐受的新途径.方法 以供者Lewis大鼠淋巴细胞作为刺激物,体外刺激受者BN大鼠淋巴细胞增殖,应用CFSE（羧基荧光素二醋酸盐琥珀酰亚胺酯）标记法检测增殖情况;将增殖后的BN大鼠淋巴细胞经照射灭活后输注给同品系的BN大鼠,并行Lewis到BN的肝移植,观察肝移植后BN大鼠生存期.结果 同种反应性淋巴细胞体外能够活跃增殖;采用同种反应性淋巴细胞输注可以显著延长肝移植大鼠的存活时间（P＜0.05）.结论 体外诱导的同种反应性淋巴细胞输注,有可能成为诱导抗原特异性免疫耐受的一种新途径.     

Self-renewal and expansion of single transplanted muscle stem cells

Adult muscle satellite cells have a principal role in postnatal skeletal muscle growth and regeneration. Satellite cells reside as quiescent cells underneath the basal lamina that surrounds muscle fibres and respond to damage by giving rise to transient amplifying cells (progenitors) and myoblasts that fuse with myofibres. Recent experiments showed that, in contrast to cultured myoblasts, satellite cells freshly isolated or satellite cells derived from the transplantation of one intact myofibre contribute robustly to muscle repair. However, because satellite cells are known to be heterogeneous, clonal analysis is required to demonstrate stem cell function. Here we show that when a single luciferase-expressing muscle stem cell is transplanted into the muscle of mice it is capable of extensive proliferation, contributes to muscle fibres, and Pax7(+)luciferase(+) mononucleated cells can be readily re-isolated, providing evidence of muscle stem cell self-renewal. In addition, we show using in vivo bioluminescence imaging that the dynamics of muscle stem cell behaviour during muscle repair can be followed in a manner not possible using traditional retrospective histological analyses. By imaging luciferase activity, real-time quantitative and kinetic analyses show that donor-derived muscle stem cells proliferate and engraft rapidly after injection until homeostasis is reached. On injury, donor-derived mononucleated cells generate massive waves of cell proliferation. Together, these results show that the progeny of a single luciferase-expressing muscle stem cell can both self-renew and differentiate after transplantation in mice, providing new evidence at the clonal level that self-renewal is an autonomous property of a single adult muscle stem cell.     

大鼠肝ADAMs种类鉴定及肝再生过程中ADAMsmRNA差异分析

以 2 / 3肝切除 (patialhepatectomy ,PH)大鼠为材料 ,利用PT -PCR技术 ,通过ADAMs通用引物初步分析了肝脏中ADAMs种类及PH后恢复 4h和 36h时ADAMsmRNA差异。结果表明 :PH后不同恢复时间ADAMsmRNA的扩增谱带没有差异 ,但扩增谱带的强弱有变化 ;cDNA克隆和测序分析表明 ,大鼠肝脏有ADAM15和ADAM 19mRNA同源序列。     

Human embryonic stem cells-derived endothelial cell therapy facilitates kidney regeneration by stimulating renal resident stem cell proliferation in acute kidney injury

Endothelial cell therapy has been implicated to enhance tissue regeneration and vascularization in ischemic kidney. However, no published study has yet examined direct effects of endothelial cell treatment in kidney recovery. This study investigated the therapeutic efficacy of endothelial cells in a mouse model with acute kidney injury (AKI). Thus, human embryonic stem cells-derived endothelial cells (hESC-ECs) labeled with a reporter system encoding a double fusion reporter gene for firefly luciferase (Fluc) and green fluorescent protein (GFP) were characterized by Fluc imaging and immunofluoresence staining. Cultured hESC-ECs (1×106) were injected into ischemic kidney shortly after AKI. Survival of the transplanted hESC-ECs was monitored in vivo from day 1 to 14 after endothelial cell transplantation and potential impact of hESC-EC treatment on renal regeneration was assessed by histological analyses. We report that a substantial level of bioluminescence activity was detected 24 h after hESC-EC injection followed by a gradual decline from 1 to 14 d. Human ESC-ECs markedly accelerated kidney cell proliferation in response to ischaemia-induced damage, indicated by an elevated number of BrdU+ cells. Co-expression of Sca-1, a kidney stem cell proliferation marker, and BrdU further suggested that the observed stimulation in renal cell regeneration was, at least in part, due to increased proliferation of renal resident stem cells especially within the medullary cords and arteriole. Differentiation of hESC-ECs to smooth muscle cells was also observed at an early stage of kidney recovery. In summary, our results suggest that endothelial cell therapy facilitates kidney recovery by promoting vascularization, trans-differentiation and endogenous renal stem cell proliferation in AKI.     

Advances in mammalian spermatogonial stem cell transplantation

Spermatogonial stem cell (SSC) transplantation is a novel technique by which testicular cells from normal, transgenic or mutant donor are introduced into the seminiferous tubules of recipient testes through microinjection. Subsequently, donor SSCs survive,migrate, anchor and proliferate in the recipient testis, furthermore, initiate spermatogenesis and even produce sperms capable of fertilization. This technique provides a new approach for the researches of spermatogenesis mechanism, regeneration of spermatogenesis in sterile individuals and reproduction of transgenic animals. This review focuses on the methodological breakthroughs and highlights the recent findings that have substantially increased understanding of SSC biology. The article provides a comprehensive overview of this technique and its multiple applications in basic science and medicine. And the perspective direction of this field in the near future is proposed.     

On the “plasticity”of adult stem cells and its application in regenerative medicine

In recent years, with the increasingly further studies on embryonic stem cells and the recognition of the biologic characteristics of adult stem cells, it has been discovered that adult stem cells have another phenomenon of “plasticity” in addition to the characteristics of strong potential for self-renewal, proliferation and multi-differentiation, which brings us the hope for regenerative medicine—renewing new organ or tissue cells to replace those damaged by injury or diseases. Although the mechanism of “plasticity” and its application in the regenerative medicine are still in doubt, thorough exploration in these subjects would open up broad prospects for the use in cell and tissue engineering in the near future.     

Germ cell transplantation in infertility mouse

This work investigated the spermatogenesis in an infertility BALB/c-nu mouse model by reinfusing germline stem cells into seminiferous tubules. Donor germ cells were isolated from male FVB/NJ-GFP trensgenic mice. Seminiferous tubule microinjection was applied to achieve intratubular germ cell transfer. The germ cells were injected into exposed testes of the infertility mice. We used green fluorescence and DNA analysis of donor cells from GFP transgenic mice as genetic marker. The natural mating and Southern blot methods were applied to analyze the effect of sperm cell transplantation and the sperm function after seminiferous tubule microinjection. The spermatogenesis was morphologically observed from the seminiferous tubules in 41/60 （68.33%） of the injected recipient mice using allogeneic donor cells. In the colonized testes, matured spermatozoa were seen in the lumen of the seminiferous tubules. In this research, BALB/c-nu infertility mouse model, the recipient animal, was used to avoid immunological rejection of donor cells, and germ cell transplantation was applied to overcome infertility caused by busulfan treatment. These results demonstrate that this technique of germ cell transplantation is of great use. Germ cell transplantation could be potentially valuable to oncological patients.