中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (33): 5394-5403.doi: 10.12307/2023.711
• 干细胞综述 stem cell review • 上一篇 下一篇
周禾山1,谭龙旺2,刘 闯1,张 驰1
收稿日期:
2022-10-09
接受日期:
2022-11-21
出版日期:
2023-11-28
发布日期:
2023-03-31
通讯作者:
谭龙旺,主任医师,教授,硕士生导师,陕西中医药大学附属医院脊柱骨科主任。陕西中医药大学附属医院脊柱骨科,陕西省咸阳市 712000
作者简介:
周禾山,男,1995年生,陕西省人,汉族,陕西中医药大学第一临床医学院在读硕士,主要从事脊柱脊髓疾病的基础与临床研究。
基金资助:
Zhou Heshan1, Tan Longwang2, Liu Chuang1, Zhang Chi1
Received:
2022-10-09
Accepted:
2022-11-21
Online:
2023-11-28
Published:
2023-03-31
Contact:
Tan Longwang, Chief physician, Professor, Master’s supervisor, Department of Spinal Orthopedics, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, Shaanxi Province, China
About author:
Zhou Heshan, Master candidate, Shaanxi University of Chinese Medicine, Xianyang 712000, Shaanxi Province, China
Supported by:
摘要:
文题释义:
脊髓损伤:是指脊髓组织受到外部因素影响后,导致相应损伤平面以下神经功能障碍的疾病,主要包括原发性损伤和继发性损伤,由于神经系统的自我修复能力有限,目前尚无有效治疗方法。结果与结论:①在使用天然外泌体治疗脊髓损伤的过程中,外泌体的活性容易受到抑制,且存在半衰期短和靶向性差等弊端。②在外泌体制备过程中,通过相应预处理手段,可以进一步优化天然外泌体在脊髓损伤中的功能和疗效,降低发生不良反应的可能性。③常见预处理方法包括外泌体的预培养、外泌体的物质预搭载及生物材料预联合,此3种预处理方法各有利弊,是从不同维度上对外泌体的干预,其中外泌体物质预搭载所构建的药物递送体系在目前得到了最多的应用,且技术相对较为成熟,在部分领域已开展临床研究,具备良好的前景。④其他干预方法对外泌体的优化作用也在实验中被证实,这些干预措施并非相互独立,将其有机结合,实现多层面的预处理,以期实现脊髓损伤后的完整修复。⑤恰当的预处理措施可以在保证外泌体结构的同时,提高外泌体的靶向性与稳定性,延长外泌体的半衰期,加强外泌体在脊髓损伤部位的定植,进而促进脊髓损伤的修复和神经功能的改善,以达到治疗目的。⑥由此可见,外泌体在脊髓损伤领域有着巨大的潜力和广阔的前景,对外泌体进行预处理和工程化改造,是未来外泌体发展的必由之路,应推动其从基础实验逐步迈入临床研究中,以早日实现外泌体在脊髓损伤领域的临床应用。
https://orcid.org/0000-0002-9753-2702(周禾山);https://orcid.org/0000-0003-1745-2057(谭龙旺)
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
中图分类号:
周禾山, 谭龙旺, 刘 闯, 张 驰. 预处理方法改善外泌体在脊髓损伤中的作用[J]. 中国组织工程研究, 2023, 27(33): 5394-5403.
Zhou Heshan, Tan Longwang, Liu Chuang, Zhang Chi. Pretreatment methods improve the role of exosomes in spinal cord injury[J]. Chinese Journal of Tissue Engineering Research, 2023, 27(33): 5394-5403.
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1.1.6 检索策略 文献检索过程,以PubMed数据库为例,具体策略见图1。
1.1.7 检索文献量 初步检索到文献317篇,其中英文文献245篇,中文文献72篇。
1.3 文献质量评估与数据提取 通过文献检索共获取文献317篇,根据纳排标准,阅读文章标题及摘要,排除与该综述关联性较差及重复文献后,去除161篇文献,进一步阅读原文,排除65篇,最终保留91篇文献进行综述。文献筛选流程,见图2。
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文题释义:
脊髓损伤:是指脊髓组织受到外部因素影响后,导致相应损伤平面以下神经功能障碍的疾病,主要包括原发性损伤和继发性损伤,由于神经系统的自我修复能力有限,目前尚无有效治疗方法。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
常见预处理方法包括外泌体的预培养,外泌体的物质预搭载,生物材料预联合3种:第一预培养包括改变外泌体的培养方式及培养环境,除常规培养外,运用生物材料构建的三维培养模式,其优势在于可以维持细胞形态,加强细胞间的相互作用,产生干性更强,更具生理相关性的外泌体,但在三维基质材料的构建及外泌体的收集上存在一定难度,是阻碍其大规模运用的难点。培养环境方面主要为外泌体的低氧预处理,通过模拟机体损伤后的低氧环境,能增强外泌体的生物学功能和活性,优势在于方法便捷易于操作,其缺点为外泌体内活性物质不可控,且在何种氧气浓度及处理时间下外泌体达到最优尚需进一步探究。第二,外泌体的物质预搭载,通过前装载及后装载的方式,将小分子药物、核酸类物质、蛋白质、生长因子等物质搭载到外泌体中,优点为利用外泌体的穿透性和低免疫原性,可以实现药物的精准干预和稳定释放,延长其在体内的半衰期,技术相对成熟;缺点是构建外泌体的物质递送体系存在一定难度,前装载方法无法保证载药量,后装载方法容易影响外泌体的表征,带来新的不良反应,同时药物可能在非靶向器官聚集,导致副反应发生。第三,生物材料预联合,将外泌体和生物材料相结合,包括天然生物材料水凝胶及合成类水凝胶,可以架构出一种全新的外泌体输送方法;优点在于既可以利用水凝胶补充损伤部位的细胞外基质,还可以负载外泌体到达损伤部位,实现外泌体持续、稳定的释放。弊端在于符合脊髓生理特性,可缓释外泌体的水凝胶材料构建在技术上还存在一定难度,天然生物材料存在机械强度不足,结构不稳定等缺点,人工合成生物材料细胞亲和力较差,其降解产物可能会产生不良反应。
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
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