编者按:Philippe Menasché教授为巴黎第五大学心胸外科教授,乔治蓬皮杜欧洲医院心力衰竭外科主任,法国国家卫生和医学研究所心血管疾病细胞疗法实验室的主任。其已在细胞疗法领域研究长达15余年,于2000年完成了世界首例严重心力衰竭患者进行心肌内移植自体骨骼肌成肌细胞的手术。在AHA年会现场,针对干细胞疗法,《国际循环》记者采访了Menasché教授。
<International Circulation>: We have learned that you are very accomplished in the field of using stem cells for the treatment of heart failure. What is the mechanism of functional benefit for cardiac progenitor cells? Can it bring long term benefit after being transplanted into the human body?
《国际循环》:我们了解到您在心衰的干细胞疗法研究方面很有造诣。心脏干细胞发挥功能性获益的机制是什么?植入人体后能否带来长期获益?
Dr. Menasche : The mechanisms by which cells are acting is not yet quite clear. However, it seems that the grafted cells do not really build a new myocardial tissue by themselves, but rather they secrete factors which probably activate endogenous signaling pathways, leading to some form of cardioprotection. That is why the predominant hypothesis is the paracrine hypothesis whereby cells secrete these factors, which will stimulate would healing to some extent.
Menasche教授:心脏干细胞发挥功能获益的机制尚不十分清楚。然而,移植入人体的细胞并不能独立建立一个新的心肌组织,而是通过激活内源性信号通路促使一些细胞因子分泌,从而发挥心脏保护作用。这也是为何现在的主流假说是旁分泌假说的原因。
<International Circulation>: Your study group has done some research on the human embryonic stem cell derived cardiac progenitors. Could you tell us the results you have found?
《国际循环》:您的研究团队对胚胎干细胞来源的心脏祖细胞进行了研究,取得了哪些研究结果?
Dr. Menasche: The study that we are starting with human embryonic stem cell derived progenitors is really starting so I cannot comment on that. It is clear that because these cells are allergenic, they will trigger an immune response. We try to control that by short periods of immune suppression based on conventional drugs. That said, it may not be such an issue that after a couple of days or weeks or months, cells will be cleared by the immune system provided that they have initially resided in the tissue long enough to secrete the factors I was talking about which are supposed to foster endogenous repair pathways.
Menasche教授:关于胚胎干细胞来源的心脏祖细胞的研究,我们刚刚开展不久,结果尚不方便透漏。但是,这种细胞有致敏性,会激发炎性反应。我们试图通过使用传统药物对这一特性进行短期的免疫抑制。也就是说,经过这么处理后,这种细胞在植入人体数天、数周或数月,将不会被自身的免疫系统清除,因为他们已经在体内定植了足够长的时间,能够分泌一些细胞因子来促进内源性修复。