Felsenstein Medical Reasearch Center, Tel Aviv University, Petah Tikva, 49100, Israel.
Expert Opin Biol Ther. 2011 Dec;11(12):1591-7. doi: 10.1517/14712598.2011.628933. Epub 2011 Oct 13.
Sciatic nerve injury is common and usually results in degeneration of the distal axons and muscle denervation. Chronic muscle atrophy and fibrosis limit the recovery of muscle function and severely compromises efforts to restore muscle function. Despite early diagnosis and modern surgical techniques there is still poor functional recovery.
Stem cell transplantation has been investigated as a promising treatment strategy for peripheral nerve injury, and has demonstrated utility in limiting neuronal damage. The focus has been on the isolation of stem cells from bone-marrow and adipose tissue in addition to embryonic and neuronal stem cells. Transplantation of these cells into transected sciatic nerve in animal models demonstrates clinical improvement, inducing vigorous nerve regeneration accompanied by myelin synthesis. Cell replacement, trophic factor production, extracellular matrix molecule synthesis, guidance, remyelination, microenvironmental stabilization and immune modulation have been postulated as possible mechanisms for stem cell implantation.
Although further research is still needed, this therapeutic approach will probably become a routine treatment technique in the coming years, especially with bone marrow mesenchymal stem cells. We believe that the most promising results were noted for the use of stem cells of this origin in the treatment of sciatic nerve injury.
坐骨神经损伤很常见,通常会导致远端轴突变性和肌肉失神经支配。慢性肌肉萎缩和纤维化限制了肌肉功能的恢复,严重影响了恢复肌肉功能的努力。尽管早期诊断和现代手术技术有所进步,但功能恢复仍然不佳。
干细胞移植已被研究作为治疗周围神经损伤的一种有前途的治疗策略,并已证明在限制神经元损伤方面具有实用性。研究重点是从骨髓和脂肪组织中分离干细胞,此外还有胚胎和神经干细胞。将这些细胞移植到动物模型的横断坐骨神经中,可观察到临床改善,引起强烈的神经再生,伴随着髓鞘合成。细胞替代、营养因子产生、细胞外基质分子合成、导向、髓鞘再生、微环境稳定和免疫调节被认为是干细胞植入的可能机制。
尽管仍需要进一步研究,但这种治疗方法在未来几年可能会成为一种常规治疗技术,尤其是骨髓间充质干细胞。我们认为,在治疗坐骨神经损伤方面,使用这种来源的干细胞最有希望取得结果。