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肝硬化是一种临床常见的肝病良性终末期表现。目前临床上尚缺乏有效的治疗措施。肝脏移植是最理想的治疗方法,但受供体肝脏来源限制,且费用昂贵。近年来开展的自体骨髓干细胞(BMSCs)移植治疗,为肝硬化的治疗带来了新的希望。BMSCs主要包括造型血干细胞和间充质干细胞,其具有可塑性,体外通过生长因子,体内利用特定微环境均可诱导BMSCs分化为肝前体细胞和成熟肝细胞,并明显改善肝功能。从动物实验到临床研究亦表明,BMSCs具有来源丰富、费用低廉、损伤小、自体移植不栓塞、无排斥反应等优点,为治疗肝病带来了新思路,有望成为生物人工肝的细胞来源。本文就BMSCs移植治疗肝硬化的研究现状,尤其是移植途径以及在肝脏内定居、迁移和分化机制的示踪观察方法和存在的问题作一综述,以期为从事肝病研究的同仁提供参考依据。通过对BMSCs移植从基础研究及临床应用的最新进展的描述,展示BMSCs在肝硬化治疗方面良好的治疗前景。
Cirrhosis is a common clinical benign end-stage liver disease. Currently there is a lack of effective clinical treatment. Liver transplantation is the best treatment, but it is limited by the donor liver and is expensive. In recent years, autologous bone marrow stem cells (BMSCs) transplantation has brought new hope for the treatment of liver cirrhosis. BMSCs mainly include the shape blood stem cells and mesenchymal stem cells, which have plasticity. In vitro, BMSCs can be induced to differentiate into precursor liver cells and mature liver cells by using growth factors in vitro, and liver function can be markedly improved. From animal experiments to clinical studies have also shown that BMSCs have the advantages of rich sources, low cost, small injury, non-embolization autologous transplantation, non-rejection reaction, etc., bring new ideas for the treatment of liver disease, is expected to become a biological source of artificial liver cells. This review summarizes the current research status of BMSCs transplantation in the treatment of liver cirrhosis, especially the methods of transplanting and tracing the mechanism of colonization, migration and differentiation in the liver and the existing problems, in order to provide a reference for colleagues engaged in liver disease research. Through the description of the latest advances in basic research and clinical application of BMSCs transplantation, BMSCs are shown to have good therapeutic prospects in the treatment of cirrhosis.