少突胶质前体细胞移植对早产儿脑白质损伤的保护作用

Neuroprotective effects of oligodendrocyte precursor cells on white matter damage in preterm infants

摘要:

脑白质损伤是早产儿最常见的脑损伤形式，以少突胶质前体细胞（OPCs）损伤所造成的髓鞘脱失为特点。脑白质损伤后由于缺乏有效的治疗措施，幸存的患儿多遗留神经系统后遗症。细胞移植是近年来发现的对治疗白质损伤具有应用潜力的措施，目前细胞移植研究中常用的细胞是OPCs。OPCs兼有迁移和髓鞘化能力，是移植治疗最佳的种子细胞。研究发现OPCs移植不仅替代受损的细胞重建白质结构和功能，还能抑制神经元的凋亡，促进内源性神经干细胞的增殖，并促进血脑屏障的修复。但OPCs移植的临床应用还面临许多挑战，如有效性及致瘤风险、免疫排斥等安全性问题。该文就髓鞘发育、OPCs的获取、治疗机制及应用等方面做一综述，并分析了目前OPCs移植的挑战，以期为早产儿脑白质损伤的临床治疗提供新导向。

Abstract:

White matter damage, characterized by demyelination due to the damage of oligodendrocyte precursor cells (OPCs), is the most common type of brain damage in preterm infants. Survivors are often subject to long-term neurodevelopmental sequelae because of the lack of effective treatment. In recent years, it has been found that cell transplantation has the potential for the treatment of white matter damage. OPCs are frequently used cells in cell transplantation therapy. With abilities of migration and myelinization, OPCs are the best seed cells for the treatment of white matter damage. Several studies have found that OPCs may not only replace impaired cells to reconstruct the structure and function of white matter, but also inhibit neuronal apoptosis, promote the proliferation of endogenous neural stem cells, and enhance the repairment of the blood-brain barrier. However, the clinical application of OPC transplantation therapy faces many challenges, such as the effectiveness, risk of tumorigenesis and immune rejection. With reference to these studies, this article reviewed the development of myelination, the obtainment of OPCs, the therapeutic mechanism as well as application research, and analyzed the current challenges of OPC transplantation, in order to provide a new direction for clinical treatment of white matter damage in preterm infants.