Применение мезенхимальных стромальных клеток при трансплантации солидных органов: вызовы и перспективы (систематический обзор)

Трансплантация донорских органов продолжает оставаться «золотым стандартом» при спасении жизни пациентов с терминальной стадией органного поражения и направлена на продление и улучшение качества жизни реципиентов. Однако, несмотря на прогрессивное развитие, трансплантация органов по-прежнему сталкивается с серьезными вызовами, такими как дефицит донорских органов и последствия длительной иммуносупрессии. В связи с этим активно ведется поиск терапевтических подходов, способных повысить эффективность аллогенной трансплантации органов. Мезенхимальные стромальные клетки (МСК) способны существенно усиливать и ускорять восстановительные процессы в поврежденных органах, могут стимулировать ангиогенез и предотвращать апоптоз клеток, воспаление и формирование фиброза, обладают иммуномодулирующими свойствами. МСК привлекают внимание исследователей и врачей благодаря набору уникальных свойств, которые могут быть полезны при трансплантации солидных органов. В обзоре дан критический анализ и обобщены фактические клинические данные, касающиеся исследования терапевтического эффекта МСК при трансплантации органов. Поиск литературы проводился в электронных базах данных Medline/PubMed (www/ncbi.nlm.nih.gov/pubmed) и eLIBRARY/Российский индекс научного цитирования (https://www.elibrary.ru). Критерием включения было клиническое использование МСК для улучшения состояния реципиентов почки, печени, легких, сердца и поджелудочной железы и повышения качества трансплантатов. Критериями исключения статей были применение МСК для лечения больных, которым не проводили трансплантацию, а также статьи, описывающие действие продуктов МСК (экзосомы, везикулы и кондиционированные среды), и научные работы, выполненные в условиях in vitro и in vivo (без участия пациентов), а также материалы конференций, обзоры и препринты статей. Для анализа литературы была выбрана 31 оригинальная статья на английском и русском языках. Также в обзоре обсуждаются перспективы применения МСК в трансплантологии.

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