间充质干细胞在抑制尿毒症患者动静脉内瘘血管内膜细胞增生的研究进展

罗彤; 鄢艳

doi:10.3969/j.issn.1671-4091.2025.03.012

中国血液净化 >

2025 , Vol. 24 >Issue 03: 226 - 230

DOI: https://doi.org/10.3969/j.issn.1671-4091.2025.03.012

综述

间充质干细胞在抑制尿毒症患者动静脉内瘘血管内膜细胞增生的研究进展

罗彤 ,
鄢艳

展开

330006 南昌，1南昌大学第一附属医院肾内科

收稿日期: 2024-09-19

修回日期: 2024-12-16

网络出版日期: 2025-03-12

基金资助

国家自然科学基金(82060148)

收起

Research progress in the use of mesenchymal stem cells to inhibit intimal hyperplasia in arteriovenous fistula in uremic patients

LUO Tong ,
YAN Yan

Expand

Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China

Received date: 2024-09-19

Revised date: 2024-12-16

Online published: 2025-03-12

Supported by

Fold

摘要

慢性肾脏病(chronic kidney disease，CKD)发病率逐年升高，持续进展的最终结局为终末期肾病(end-stage renal disease，ESRD)。维持性血液透析(maintenance hemodialysis, MHD)是ESRD患者的主要替代治疗方式之一，动静脉内瘘(arteriovenous fistula，AVF)是MHD患者血管通路的首选类型。然而，AVF功能障碍缩短了AVF使用时长，是血液透析患者常见的并发症之一。新生内膜增生(neointimal hyperplasia，NIH)导致的AVF狭窄是MHD患者AVF患病率增加的主要原因。全身药物治疗或局部治疗均可抑制AVF内膜增生，间充质干细胞因其多元分化、自我更新、组织修复、归巢、旁分泌等特性在血管内膜增生领域具有极大的潜能。本文主要通过对ESRD患者AVF内膜增生的机制及治疗进展、间充质干细胞的研究进展、改善血管内膜增生的作用机制等方面进行综述，寻找预防血管通路障碍发生的新思路。

关键词： 间充质干细胞; 尿毒症; 维持性血液透析; 动静脉内瘘; 内膜增生

本文引用格式

罗彤 , 鄢艳 . 间充质干细胞在抑制尿毒症患者动静脉内瘘血管内膜细胞增生的研究进展[J]. 中国血液净化, 2025 , 24(03) : 226 -230 . DOI: 10.3969/j.issn.1671-4091.2025.03.012

Abstract

The incidence of chronic kidney disease (CKD) is increasing year by year. Continuous progress of CKD may finally lead to end-stage renal disease (ESRD). Maintenance hemodialysis (MHD) is one of the alternative treatments for ESRD patients, and arteriovenous fistula (AVF) is the preferred type of blood access for MHD. However, AVF dysfunction occurs frequently, leading to a short lifetime of blood access. Narrowing of AVF by neointimal hyperplasia is the main cause of AVF dysfunction. Previous studies have shown that both systemic and local treatments may inhibit the intimal hyperplasia. Mesenchymal stem cells have the potentials of diverse differentiation, self-renewal, tissue repair, homing and paracrine activities, probably useful for the reversal of neointimal hyperplasia in AVF. This article reviews recent advances in the mechanism and treatment of AVF dysfunction, the use of mesenchymal stem cells, and the mechanisms underlying the reversal of neointimal hyperplasia, in order to find out new ideas for the prevention of AVF dysfunction.

Key words： Mesenchymal stem cell; Uremia; Maintenance hemodialysis; Arteriovenous fistula; Intimal hyperplasia

参考文献

[1] 朱思懿, 洪航, 边学燕, 等. 慢性肾脏病流行病学研究进展. 预防医学. 2023;35(09):770-3.
[2] Mitrofanova A, Merscher S, Fornoni A. Kidney lipid dysmetabolism and lipid droplet accumulation in chronic kidney disease. Nat Rev Nephrol. 2023;19(10):629-45.
[3] Grassmann A, Gioberge S, Moeller S, etal. End-stage renal disease: global demographics in 2005 and observed trends. Artif Organs. 2006;30(12):895-7.
[4] Gupta R, Woo K, Yi JA. Epidemiology of end-stage kidney disease. Semin Vasc Surg. 2021;34(1):71-8.
[5] Vazquez-Padron RI, Duque JC, Tabbara M, etal. Intimal Hyperplasia and Arteriovenous Fistula Failure: Looking Beyond Size Differences. Kidney360. 2021;2(8):1360-72.
[6] Ma S, Duan S, Liu Y, etal. Intimal Hyperplasia of Arteriovenous Fistula. Ann Vasc Surg. 2022;85:444-53.
[7] Jalaeefar A, Mohammadi Tofigh A, Gharib A, etal. Effects of N-acetylcysteine on arterial neo-intimal hyperplasia in rat model of arteriovenous fistula. J Vasc Access. 2019;20(2):190-4.
[8] Jeon JW, Kim HR, Lee E, etal. Effect of cilostazol on arteriovenous fistula in hemodialysis patients. Nefrologia (Engl Ed). 2021.
[9] Tabbara M, Duque JC, Martinez L, etal. Pre-existing and Postoperative Intimal Hyperplasia and Arteriovenous Fistula Outcomes. Am J Kidney Dis. 2016;68(3):455-64.
[10] Somarathna M, Hwang PT, Millican RC, etal. Nitric oxide releasing nanomatrix gel treatment inhibits venous intimal hyperplasia and improves vascular remodeling in a rodent arteriovenous fistula. Biomaterials. 2022;280:121254.
[11] Lan T, Luo M, Wei X. Mesenchymal stem/stromal cells in cancer therapy. J Hematol Oncol. 2021;14(1):195.
[12] Liu J, Gao J, Liang Z, etal. Mesenchymal stem cells and their microenvironment. Stem Cell Res Ther. 2022;13(1):429.
[13] Ding DC, Chang YH, Shyu WC, etal. Human umbilical cord mesenchymal stem cells: a new era for stem cell therapy. Cell Transplant. 2015;24(3):339-47.
[14] Hu C, Li L. Preconditioning influences mesenchymal stem cell properties in?vitro and in?vivo. J Cell Mol Med. 2018;22(3):1428-42.
[15] Gong W, Wang F, He Y, etal. Mesenchymal Stem Cell Therapy for Oral Inflammatory Diseases: Research Progress and Future Perspectives. Curr Stem Cell Res Ther. 2021;16(2):165-74.
[16] Chen F, Chen N, Xia C, etal. Mesenchymal Stem Cell Therapy in Kidney Diseases: Potential and Challenges. Cell Transplant. 2023;32:9636897231164251.
[17] Kouroupis D, Sanjurjo-Rodriguez C, Jones E, etal. Mesenchymal Stem Cell Functionalization for Enhanced Therapeutic Applications. Tissue Eng Part B Rev. 2019;25(1):55-77.
[18] Bagno L, Hatzistergos KE, Balkan W, etal. Mesenchymal Stem Cell-Based Therapy for Cardiovascular Disease: Progress and Challenges. Mol Ther. 2018;26(7):1610-23.
[19] Wang LT, Liu KJ, Sytwu HK, etal. Advances in mesenchymal stem cell therapy for immune and inflammatory diseases: Use of cell-free products and human pluripotent stem cell-derived mesenchymal stem cells. Stem Cells Transl Med. 2021;10(9):1288-303.
[20] Mishra VK, Shih HH, Parveen F, etal. Identifying the Therapeutic Significance of Mesenchymal Stem Cells. Cells. 2020;9(5).
[21] Zhao G, Ge Y, Zhang C, etal. Progress of Mesenchymal Stem Cell-Derived Exosomes in Tissue Repair. Curr Pharm Des. 2020;26(17):2022-37.
[22] Yue WM, Liu W, Bi YW, etal. Mesenchymal stem cells differentiate into an endothelial phenotype, reduce neointimal formation, and enhance endothelial function in a rat vein grafting model. Stem Cells Dev. 2008;17(4):785-93.
[23] Sun P, Wu H, Bai X, etal. Decellularized fish swim bladder patch loaded with mesenchymal stem cells inhibits neointimal hyperplasia. J Biomed Mater Res B Appl Biomater. 2023;111(3):551-9.
[24] 束波, 范芳. 基质细胞衍生因子1(SDF-1)预处理的骨髓间充质干细胞移植减轻大鼠颈动脉内皮和平滑肌细胞增生. 细胞与分子免疫学杂志. 2019;35(04):320-6.
[25] Kim AK, Kim MH, Kim DH, etal. Inhibitory effects of mesenchymal stem cells in intimal hyperplasia after balloon angioplasty. J Vasc Surg. 2016;63(2):510-7.
[26] Zou X, Liao Y, Liu Z, etal. Exosomes Derived from AT2R-Overexpressing BMSC Prevent Restenosis After Carotid Artery Injury by Attenuating the Injury-Induced Neointimal Hyperplasia. J Cardiovasc Transl Res. 2023;16(1):112-26.
[27] Wang D, Gao B, Yue J, etal. Exosomes from mesenchymal stem cells expressing miR-125b inhibit neointimal hyperplasia via myosin IE. J Cell Mol Med. 2019;23(2):1528-40.
[28] Homma J, Sekine H, Matsuura K, etal. Mesenchymal Stem Cell Sheets Exert Antistenotic Effects in a Rat Arterial Injury Model. Tissue Eng Part A. 2018;24(19-20):1545-53.
[29] Piryani AK, Kilari S, Takahashi E, etal. Rationale and Trial Design of MesEnchymal Stem Cell Trial in Preventing Venous Stenosis of Hemodialysis Vascular Access Arteriovenous Fistula (MEST AVF Trial). Kidney360. 2021;2(12):1945-52.
[30] Cai C, Kilari S, Zhao C, etal. Therapeutic Effect of Adipose Derived Mesenchymal Stem Cell Transplantation in Reducing Restenosis in a Murine Angioplasty Model. J Am Soc Nephrol. 2020;31(8):1781-95.
[31] Yang B, Brahmbhatt A, Nieves Torres E, etal. Tracking and Therapeutic Value of Human Adipose Tissue-derived Mesenchymal Stem Cell Transplantation in Reducing Venous Neointimal Hyperplasia Associated with Arteriovenous Fistula. Radiology. 2016;279(2):513-22.
[32] Barcena AJR, Perez JVD, Bernardino MR, etal. Bioresorbable Mesenchymal Stem Cell-Loaded Electrospun Polymeric Scaffold Inhibits Neointimal Hyperplasia Following Arteriovenous Fistula Formation in a Rat Model of Chronic Kidney Disease. Adv Healthc Mater. 2023;12(26):e2300960.

Options

文章导航

模态框（Modal）标题

摘要

本文引用格式

Abstract

参考文献