[关键词]
[摘要]
原发性开角型青光眼(primary open angle glaucoma,POAG)是以持续性眼压增高导致视神经损伤为主要临床表现的一种疾病,其发病机制复杂,尚未明确,现阶段临床治疗相对困难。影响眼内压(intraocular pressure,IOP)高低的重要因素是房水引流是否通畅,而房水引流途径中小梁网(trabecular meshwork,TM)起重要调控作用。TM细胞的形态、数量、结构和功能改变均可使房水外流阻力增大,从而导致IOP升高。研究证实诱导多功能干细胞(induced pluripotent stem cells,iPSCs)、骨髓间充质干细胞(bone mesenchymal stem cells,BMSCs)和脂肪干细胞(adipose-derived stem cells,ADSCs)已被用于TM细胞的分化和再生,为POAG小梁网的干细胞替代治疗提供可靠的细胞来源。近年研究发现,小梁网干细胞(trabecular meshwork stem cells,TMSCs)在分化为TM细胞方面具有绝对优势,为细胞移植治疗青光眼提供新的靶向,这标志着干细胞治疗POAG进入一个新纪元,为青光眼治疗带来新的曙光。本文将对不同种类干细胞的小梁网移植进行综述,为细胞移植治疗POAG提供新思路。
[Key word]
[Abstract]
Primary open angle glaucoma is a kind of chronic disease characterized by progressive damage to the optic disc as a result of persistent elevation of intraocular pressure. The complicated and unidentified mechanism of primary open angle glaucoma makes its clinical treatment relatively difficult nowadays. In primary open angle glaucoma, IOP elevation is often a result of reduced aqueous humor flow through the trabecular meshwork, which plays an important regulating role in drainage process. The morphology, quantity, structure and function of trabecular meshwork cell can increase the outflow resistance of aqueous humor, leading to elevation of IOP. Research is proving that induced pluripotent stem cells(iPSCs), bone mesenchymal stem cells(BMSCs)and adipose-derived stem cells(ADSCs)have been used for trabecular meshwork cell differentiation and regeneration, providing a reliable cell source for trabecular meshwork stem cell replacement therapy in primary open angle glaucoma. Recent studies have showed that trabecular meshwork stem cells have absolute superiority in differentiating into trabecular meshwork cells, which provides new target for cell transplantation to treat glaucoma. This marks a new era of stem cell therapy for primary open angle glaucoma and also brings new hope to the treatment of glaucoma. This article reviews different types of stem cells for trabecular meshwork transplantation and may provide novel development of therapeutic strategies for primary open angle glaucoma with cell transplantation in the future.
[中图分类号]
[基金项目]
国家自然科学基金资助项目(No.81470633)