背景：心脏干细胞移植到心肌梗死区，可以有效改善心室重塑，提高心脏功能，但移植细胞在梗死区的缺氧微环境中存活率较低。研究表明缺氧诱导因子1α可在缺氧条件下稳定表达，同时增加心肌细胞的活性及存活能力。目的：分别从心脏干细胞的特点，缺氧诱导因子1α保护心脏的作用机制，载体的选择及移植途径等方面来具体阐述缺氧诱导因子1α基因转染心脏干细胞治疗心肌梗死的研究进展。方法：应用计算机检索CNKI和PubMed数据库中2000年1月至2015年1月关于心脏干细胞和缺氧诱导因子1α的文章，在标题和摘要中以“心脏干细胞、缺氧诱导因子1α、移植途径”或“Cardiac stem cels, Hypoxia Inducible Factor 1(HIF-1a), gene delivery”为检索词进行检索，最终选择关于心脏干细胞、缺氧诱导因子1、基因载体的37篇文献进行综述。结果与结论：多项研究证实缺氧诱导因子1α可以在缺氧的环境中提高心脏干细胞的生存率。大量动物实验证实了心脏干细胞和缺氧诱导因子1α对梗死缺氧区域具有保护和修复作用。目前缺氧诱导因子1α基因转染心脏干细胞尚未有成功的报道，但并不影响研究者对相关领域的探索，相信在不久的未来，基因修饰心脏干细胞将会在临床得到广泛应用。%BACKGROUND:Cardiac stem cels transplanted to the myocardial infarction area can effectively improve ventricular remodeling and promote heart function. But the survival rate of transplanted cels is lower in the infracted area under hypoxic microenvironment. Hypoxia inducing factor 1 alpha under anoxic conditions can stably express, and meanwhile increase the activity and survival ability of myocardial cels. OBJECTIVE:To elaborate the research progress in hypoxia inducing factor 1 alpha-transfected cardiac stem cels for treatment of myocardial infarction from the folowing aspects: cardiac stem cel characteristics, mechanism underlying myocardial protection of hypoxia inducing factor 1 alpha, selection of carriers and transplantation approach. METHODS: A computer-based search of CNKI and PubMed was performed for articles related to cardiac stem cels and hypoxia inducing factor 1 alpha published from January 2000 to January 2015. The keywords were “cardiac stem cels, hypoxia inducible factor 1(HIF-1a), gene delivery” in Chinese and English, respectively, which appeared in the title and abstract. Finaly, 37 relevant articles were enroled in result analysis. RESULTS AND CONCLUSION:Several studies have confirmed that hypoxia inducing factor 1 alpha can improve the survival rate of cardiac stem cels under anoxic conditions. Increasing evidences from animal experiments have shown that cardiac stem cels and hypoxia inducing factor 1 alpha exert protective and repairing effects on myocardial infarction. Currently, there is no successful report about hypoxia inducing factor 1 alpha gene transfection of cardiac stem cels, but relevant studies are proceeding. Gene modified cardiac stem cels are expected to be widely used in clinic.
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