间充质干细胞治疗肺损伤的作用机制及研究进展

文题释义： 急性肺损伤：是各种直接和间接致伤因素导致的肺泡上皮细胞及毛细血管内皮细胞损伤，出现弥漫性肺间质及肺泡水肿，导致急性低氧性呼吸功能不全。以肺容积减少、肺顺应性降低、通气/血流比例失调为病理生理特征，其发展至严重阶段(氧合指数<200)被称为急性呼吸窘迫综合征。 外泌体：是细胞外泌囊泡中体积较小的一种，包含了复杂RNA和蛋白质的小膜泡(30-150 nm)，所有培养的细胞类型均可分泌外泌体，且外泌体天然存在于体液中，间充质干细胞分泌的外泌体是近来研究的热点，其可以直接或者激活细胞内的信号通路进而发挥保护损伤细胞的作用。 背景：间充质干细胞疗法作为一种新兴的治疗方案，在治疗肺损伤方面具有很大的前景优势。 目的：综述间充质干细胞治疗肺损伤的作用和保护机制，以期为临床治疗肺损伤提供理论依据。 方法：检索万方、CNKI、PubMed、Web of Science等数据库2001年5月至2019年5月期间关于间充质干细胞应用于肺损伤的文献，检索词分别为“间充质干细胞，肺损伤，肺”和“mesenchymal stem cells，lung injury，pulmonary injury”。排除陈旧以及重复的观点，将检索到的文献进行整理，共纳入53篇文献来进行分析。 结果与结论：①梳理了间充质干细胞的定义、生物学特性及治疗肺损伤的机制，发现其可通过自身作用以及产生多种细胞因子和外泌体来治疗肺损伤；②总结了间充质干细胞治疗肺损伤的相关信号通路，例如PI3K/AKT信号通路、Wnt信号通路、NF-κB信号通路；③总结发现间充质干细胞与其他药物联合应用可以增强治疗肺损伤的效果，例如与促红细胞生成素、皮质类固醇联合应用等；④上述研究为临床上应用间充质干细胞治疗肺损伤提供了理论依据。 ORCID: 0000-0002-4555-9102(梁贵友) 中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

Research progress of mesenchymal stem cells in treating lung injury

BACKGROUND:Mesenchymal stem cell therapy,as a new treatment strategy,has great treatment potential for lung injury.OBJECTIVE:To review the roles and protective mechanisms of mesenchymal stem cells in the treatment of lung injury,providing theoretical basis for clinical treatment of lung injury with mesenchymal stem cells.METHODS:We searched the articles about the treatment of mesenchymal stem cells for lung injury from May 2001 to May 2019 in WanFang,CNKI,PubMed and Web of Science databases.The retrieval terms were“mesenchymal stem cells,lung injury,pulmonary injury,lung”in Chinese and English.After excluding old and repetitive articles,a total of 53 articles were included for further analysis.RESULTS AND CONCLUSION:(1)After summarizing the definition and characteristics of mesenchymal stem cells and its mechanism of treating lung injury,we found that mesenchymal stem cells can treat lung injury by their own functions and by producing various cytokines and exosomes.(2)The related signaling pathways of mesenchymal stem cells in the treatment of lung injury are summarized,such as:PI3K/AKT signaling pathway,Wnt signaling pathway and nuclear factor-κB signaling pathway.(3)Combined use of mesenchymal stem cells and other drugs,such as erythropoietin and corticosteroids,can enhance the therapeutic effects on lung injury.(4)This article can provide theoretical basis for the treatment of lung injury with mesenchymal stem cells in the clinical practice.