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ENGLISH ABSTRACT
骨髓间充质干细胞移植治疗青光眼视神经损伤研究进展
王姝婧
邵正波 [综述]
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20200302-00131
Advances in bone marrow mesenchymal stem cell transplantation for treatment of glaucomatous optic neuropathy
Wang Shujing
Shao Zhengbo
Authors Info & Affiliations
Wang Shujing
Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry Education, Future Medical Laboratory, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
Shao Zhengbo
Department of Ophthalmology, the Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry Education, Future Medical Laboratory, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
·
DOI： 10.3760/cma.j.cn115989-20200302-00131
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摘要

青光眼是以视网膜神经节细胞(RGCs)凋亡为基础，以视野缺损和视神经萎缩为特征的神经退行性疾病，视神经损伤后无法再生，最终导致视功能不可逆损害。近年来干细胞治疗成为组织修复和再生的研究热点，在神经退行性病变领域的应用受到广泛关注。骨髓间充质干细胞(BMSCs)具有自我增生和多向分化潜能，在特定条件下通过诱导能够向视网膜神经元样细胞进行转化，并经玻璃体腔注射、视网膜下腔注射以及自体归巢途径进行眼内移植，BMSCs在损伤视网膜局部发挥多重生物学作用；通过细胞替代、旁分泌营养因子和细胞因子以及外泌体等多种机制及信号通路，参与视神经以及视功能的保护和修复，减少RGCs的凋亡，延缓视网膜神经纤维层丢失和视神经萎缩，为青光眼等视神经退行性疾病受损细胞及视神经修复提供新的治疗手段。本文将通过BMSCs诱导分化、细胞移植途径以及BMSCs对青光眼视神经损伤修复的机制进行综述。

青光眼;骨髓间充质干细胞;视网膜神经节细胞;视神经;细胞移植
ABSTRACT

Glaucoma is a disorder that leads to retinal ganglion cells (RGCs) apoptosis, visual field loss and optic nerve degeneration.The RGCs death is irreversible, which limites their ability for axon regeneration after injury.Bone marrow mesenchymal stem cells (BMSCs) have shown promise as cell-incorporation, cell-supplements and paracrine-mediated therapy for compromised neurons, which have allowed the possibility of the pluripotent BMSCs based regeneration of retinal cells and repair of neurodegenerative diseases.Intravitreal injection, subretinal injection and autologous BMSCs homing transplantation were explored as therapy for various retinal injury conditions.These BMSCs primarily have paracrine trophic effects and can also incorporate into the damaged retina directly, which have regenerative and protective effects on the reduce of RGCs apoptosis and retinal nerve fiber loss, and multiple cell signals and mechanisms are involved.This review provides an update of the current evidence of BMSCs as treatment and potential limitations, and complications for glaucomatous RGCs dysfunction.The researches including induced-differentiation, transplantation methods and the potential neuroprotective mechanism of BMSCs as therapy for glaucomatous retinal degeneration were discussed.

Glaucoma;Bone marrow-derived stem cell;Retinal ganglion cell;Optic nerve;Cell transplantation
Shao Zhengbo, Email: mocdef.6ab21umhobgnehzoahs
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引用本文

王姝婧,邵正波. 骨髓间充质干细胞移植治疗青光眼视神经损伤研究进展[J]. 中华实验眼科杂志,2020,38(10)：881-884.

DOI:10.3760/cma.j.cn115989-20200302-00131

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青光眼是一种以眼压升高、视野缺损为主要特征的视神经退行性疾病，目前在全球不可治愈性致盲眼病中排名首位，而且患病人数逐年呈指数递增，给个人、家庭和社会均带来沉重的负担 [ 1 ]。青光眼的发病机制较为复杂，涉及神经元轴突损伤、营养因子剥夺、炎症反应、缺血及氧化应激、线粒体功能障碍等多种因素的相互作用 [ 2 , 3 ]，最终造成视网膜神经节细胞(retinal ganglion cells，RGCs)的凋亡、视神经纤维的丢失以及视神经萎缩 [ 4 ]。目前临床治疗青光眼的主要目的是控制眼压，挽救视力损失。然而这些方法并不能完全有效阻止青光眼视神经进行性损伤。因此，除了降低眼压外，如何修复受损的视神经从而保护患者残存的视力是青光眼治疗中的重要研究方向。近年来随着生物工程学和再生医学的发展，以干细胞移植为代表的细胞治疗改变了传统依靠药物和手术的医疗手段，为青光眼等神经退行性疾病的治疗带来了希望 [ 5 , 6 ]。干细胞是一类具有高度自我增生、更新和分化能力的未成熟细胞，在一定条件下能够向特定组织细胞类型进行分化，因此在疾病组织修复领域具有巨大潜力。干细胞通常来源于胚胎、可诱导重编程细胞以及成体组织 [ 7 , 8 ]。从临床应用角度，成体组织中骨髓间充质干细胞(bone marrow mesenchymal stem cells，BMSCs)易于分离和获取，具有多分化潜能，同时免疫原性低，且避免了其他种类干细胞存在的伦理争议，近年来被认为是青光眼视神经损伤修复的理想"种子细胞" [ 9 ]。
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备注信息
A
邵正波，Email： mocdef.6ab21umhobgnehzoahs
B
所有作者均声明不存在利益冲突
C
国家自然科学基金项目 (81970799)
黑龙江省博士后科研启动金项目 (LBH-Q18082)
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