非肾脏来源的成体干细胞移植治疗肾脏疾病的进展

摘要

该文将着重探讨非肾脏来源的成体干细胞移植在治疗肾脏疾病中的研究进展.尽管骨髓造血干细胞(hematopietic stem cell,HSC)移植治疗肾脏疾病的机制存在争议,但是研究表明骨髓HSC能促进肾脏缺血再灌注损伤、IgA肾病和狼疮性肾炎等肾脏疾病的修复.间充质干细胞能归巢到受损肾脏,并通过旁分泌/自分泌机制,分泌细胞因子和释放微泡,发挥激活肾内细胞、促进血管生成、抑制氧化应激、抗凋亡、抗炎和抗纤维化等效应.成纤维细胞、系膜细胞、肾小管上皮细胞和尿液上皮细胞均可重编程为诱导多能干细胞,并通过诱导分化成特定类型的肾脏细胞.诱导肾脏疾病特异的多能干细胞为解决肾脏移植中肾源不足和治疗肾脏疾病(如糖尿病肾病和常染色体显性遗传性多囊肾病等遗传性肾脏疾病),提供了新的方法.%This review focuses on the current literatures on the therapeutic potential of non-renal derived adult stem cell transplantation for kidney disease.Although the therapeutic mechanism remains debatable,some reports suggest that hematopoietic stem cell transplantation holds potential for treatment of renal diseases such as renal ischemia reperfusion injury,IgA nephropathy and lupus nephritis.Mesenchymal stem cell(MSC) are capable of homing to injured kidney and contribute to activate intrinsic kidney cells,promote angiogenesis,inhibit oxidative stress and reduce apoptosis,inflammation and renal fibrosis.These renoprotective effects are likely mediated by paracrine/autocrine mechanism via cytokine and microvesicles from MSC.Pluripotent stem cells may be induced from fibroblast,mesangial cells,renal tubular epithelial cell and urine epithelial cell.Induced pluripotent stem cell(iPSC) can differentiate into renal lineage cells.The derivation of kidney disease-specific iPSC opens new avenues for the resolution to limited donor availability in kidney transplantation and for treating kidney diseases such as diabetic nephropathy and autosomal dominant polycystic kidney disease.