中国神经再生研究(英文版) ›› 2022, Vol. 17 ›› Issue (9): 1937-1944.doi: 10.4103/1673-5374.335692

• 综述:视神经损伤修复保护与再生 • 上一篇    下一篇

骨髓来源单核干细胞治疗视网膜变性

  

  • 出版日期:2022-09-15 发布日期:2022-03-05

Bone marrow-derived mononuclear stem cells in the treatment of retinal degenerations

Diego García-Ayuso1, 2, *, #, Johnny Di Pierdomenico1, 2, #, David García-Bernal2, 3, Manuel Vidal-Sanz1, 2 , María P. Villegas-Pérez1, 2   

  1. 1Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia, Campus de Ciencias de la salud, Murcia, Spain; 2Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB-Virgen de la Arrixaca), Murcia, Spain; 3Servicio de Hematología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
  • Online:2022-09-15 Published:2022-03-05
  • Contact: Diego García-Ayuso, PhD, diegogarcia@um.es.
  • Supported by:
    This work was supported by Fundación Lucha contra la Ceguera (FUNDALUCE) to MPVP; Fundación Robles Chillida to DGA; Fundación Séneca, Agencia de Ciencia y Tecnología Región de Murcia (19881/GERM/15 to MVS); and the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III, Fondo Europeo de Desarrollo Regional “Una Manera de Hacer Europa” (SAF2015-67643-P to MVS, PI19/00203 to MPVP and DGA, RD16/0008/0026 to MPVP; RED2018-102499-T to MVS).

摘要: Neural Regen Res: 单个核干细胞眼内注射治疗视网膜退行性疾病
视网膜退行性疾病以多种形式(遗传性、获得性或诱导性)影响外视网膜,其特点是光感受器丧失,是目前世界上导致不可逆转视力丧失的主要原因。目前,能够预防、恢复或逆转光感受器变性或继发性视网膜重塑的治疗方法很少,继发于光感受器丧失并可能导致其他视网膜细胞死亡。因此,这些疾病是当今眼科研究领域的最大挑战之一。骨髓来源的单个核干细胞移植已显示出治疗光感受器变性的有希望的结果。这些细胞可能具有减缓光感受器损失的潜力,因此应该应用于光感受器退化的早期阶段。由于它们可能的旁分泌作用,它们可具有广泛的临床应用,因为它们可能同时影响几种视网膜细胞类型,并且光感受器变性可能涉及不同的细胞和/或从一种细胞类型开始,然后影响相邻的细胞。骨髓来源的单个核干细胞的眼内注射也增强了旨在保护光感受器的其他治疗的结果。
来自西班牙穆尔西亚大学的Diego García-Ayuso团队认为,光感受器退化目前是不可逆和无法治疗的视力丧失的主要原因。在光感受器变性领域,传统研究集中在寻找替代死光感受器的疗法,例如光感受器假体或移植。现在普遍认为,所有与光感受器变性有关的疾病都有一个共同的结局:视网膜的完全重塑和随后的视网膜内层的改变。因此,重要的是在早期阶段停止或减缓光感受器退化,这将增加上述旨在替代光感受器的治疗取得成功的时间窗口。骨髓来源单个核干细胞移植到视网膜可能具有有益效果,可通过不同的作用机制实现,主要作用似乎是旁分泌神经营养作用。这可以解释为什么它们在不同的眼部疾病中具有积极作用,而不管其病理生理学如何。建议这种移植可以与其他疗法结合使用,以提高其治疗效果。关于骨髓来源单个核干细胞移植到眼睛中仍然存在一些未解决的问题,需要进一步的研究来阐明这一领域,特别是阐明这些细胞的存活、作用机制和治疗潜力。  
文章在《中国神经再生研究(英文版)》杂志2022年 9 月 9 期发表。

Abstract: Retinal degenerative diseases affecting the outer retina in its many forms (inherited, acquired or induced) are characterized by photoreceptor loss, and represent currently a leading cause of irreversible vision loss in the world. At present, there are very few treatments capable of preventing, recovering or reversing photoreceptor degeneration or the secondary retinal remodeling, which follows photoreceptor loss and can also cause the death of other retinal cells. Thus, these diseases are nowadays one of the greatest challenges in the field of ophthalmological research. Bone marrow derived-mononuclear stem cell transplantation has shown promising results for the treatment of photoreceptor degenerations. These cells may have the potential to slow down photoreceptor loss, and therefore should be applied in the early stages of photoreceptor degenerations. Furthermore, because of their possible paracrine effects, they may have a wide range of clinical applications, since they can potentially impact on several retinal cell types at once and photoreceptor degenerations can involve different cells and/or begin in one cell type and then affect adjacent cells. The intraocular injection of bone marrow derived-mononuclear stem cells also enhances the outcomes of other treatments aimed to protect photoreceptors. Therefore, it is likely that future investigations may combine bone marrow derived-mononuclear stem cell therapy with other systemic or intraocular treatments to obtain greater therapeutic effects in degenerative retinal diseases.

Key words: age-related macular degeneration, bone marrow stem cells, intravitreal injection, macroglia, microglia, photoreceptor degeneration, retinal ganglion cells, retinitis pigmentosa, subretinal injection, transplant