Abstract:
Multiple sclerosis (MS) is a chronic inflammatory, autoimmune, and neurodegenerative disease of the central nervous system (CNS), characterized by demyelination and axonal loss. It is induced by attack of autoreactive lymphocytes on the myelin sheath and endogenous remyelination failure, eventually leading to accumulation of neurological disability. Disease-modifying agents can successfully address inflammatory relapses, but have low efficacy in progressive forms of MS, and cannot stop the progressive neurodegenerative process. Thus, the stem cell replacement therapy approach, which aims to overcome CNS cell loss and remyelination failure, is considered a promising alternative treatment. Although the mechanisms behind the beneficial effects of stem cell transplantation are not yet fully understood, neurotrophic support, immunomodulation, and cell replacement appear to play an important role, leading to a multifaceted fight against the pathology of the disease. The present systematic review is focusing on the efficacy of stem cells to migrate at the lesion sites of the CNS and develop functional oligodendrocytes remyelinating axons. While most studies confirm the improvement of neurological deficits after the administration of different stem cell types, many critical issues need to be clarified before they can be efficiently introduced into clinical practice.
摘要:
多发性硬化症(MS)是一种慢性炎症,自身免疫,和中枢神经系统(CNS)的神经退行性疾病,以脱髓鞘和轴突丢失为特征。它是由自身反应性淋巴细胞攻击髓鞘和内源性髓鞘再生失败引起的。最终导致神经残疾的积累。疾病调节剂可以成功解决炎症复发,但在进展型MS中疗效低,并且无法阻止进行性神经退行性过程。因此,干细胞替代疗法,旨在克服中枢神经系统细胞丢失和髓鞘再生失败,被认为是一种有希望的替代疗法。尽管干细胞移植有益作用背后的机制尚未完全了解,神经营养支持,免疫调节,细胞置换似乎起着重要的作用,导致与疾病病理的多方面斗争。本系统综述的重点是干细胞在中枢神经系统病变部位迁移并发展功能性少突胶质细胞髓鞘再生轴突的功效。虽然大多数研究证实了不同干细胞类型给药后神经功能缺损的改善,在将许多关键问题有效引入临床实践之前,需要对其进行澄清。