干细胞移植治疗糖尿病及癌症即将到来？

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Coming soon: Cell therapies for diabetes, cancer?
Therapies using stem cell transplants are advancing promising treatments for such conditions as Alzheimer’s Disease, neurological diseases and spinal cord injury, and heart disease. Now, scientists think that stem cell transplants may ultimately benefit those who suffer from diabetes or cancer.

对于Alzheimer病、神经内科疾病、脊髓损伤以及心脏病来说，干细胞移植是一种日益被看好的治疗手段。现在，科学家设想这种办法将使那些受糖尿病和癌症折磨的人最终获益。

However, important questions need answers: Given the shortage of human pancreatic islet tissue, can stem cells be used to provide insulin cells that can be stored and secreted from a bioartifical pancreas? Can islet cells be frozen for long periods of time, retain their integrity and be transplanted? If tumors contain cancer stem cells, how can the stem cells be targeted and destroyed to provide improved therapies?

然而，有一些重要的问题需要回答：在移植给了那些胰岛细胞缺少的人之后，干细胞是否能够从生物人工胰腺中提供贮存和分泌胰岛素的细胞？在经过长时间的冷冻后，胰岛细胞是否可以保持完整并且能够被移植？如果肿瘤中有肿瘤干细胞，通过什么手段能使这些细胞被定向消灭，从而提供一种改进的疗法。

To raise and help answer some of these questions, the current double issue of Cell Transplantation (Vol.17, Nos. 1&2) is devoted to research presented at the Japan Society of Organ Preservation and Medical Biology (JSOPM meeting in Tokyo in November, 2006. The research within the pages of this special issue demonstrates how stem cell research in Japan is pushing towards therapies for diabetes and cancer and beyond.

为了提出并帮助解决这些问题，最新的《Cell Transplantation》(Vol.17, Nos. 1&2)刊登了日本器官保存与生物医学协会目前所进行的研究。这项研究阐述了在日本的关于糖尿病和癌症的干细胞治疗研究的情况。

According to Naoya Kobayashi, MD, PhD, of the Department of Surgery, Okayama University Graduate School of medicine and Dentistry and Special Editor of the Japanese issue of CELL TRANSPLANTATION, the shortage of donor organs for transplantation is a “big challenge,” but research on stem cells and artificial cells for transplantation are “encouraging” and may provide valuable therapeutics for a host of diseases, including diabetes and cancer.

依照冈山大学医学院外科教授、《CELL TRANSPLANTATION 》日文版特约编辑Naoya Kobayashi的说法，移植时供体的缺乏是一个巨大的挑战，但是关于干细胞和人造细胞的移植研究是鼓舞人心的，并且可以为包括糖尿病和癌症等一大类疾病提供有价值的治疗。

Artificial pancreas for diabetes sufferers

为糖尿病患者提供的人造胰腺

The construction of a safe and functional bioartifical pancreas (BAP), complete with cells that can secrete insulin in response to blood sugar concentrations, can be developed using stem cells as alternatives to normal human pancreatic islets, which are in short supply. The multipotency and active proliferation properties of stem cells, allows scientists to work on methods of inducing adult stem cells to differentiate into pancreatic cells.

由能依照血糖变化而分泌胰岛素的干细胞的构建安全且有功能的人工生物胰腺（BAP），可开发利用干细胞来替代正常的供应短缺的人体胰岛细胞。干细胞具有的多分化潜能和活跃增殖能力，使科学家能把成体干细胞诱导分化成胰腺细胞。

“We are trying to design and develop a subcutaneously implant bag-type of BAP,” said Dr. Kobayashi. “In tests on animal models, subcutaneously implanted BAPS have shown excellent induction of new blood vessels.”

Kobayashi说： “我们试图设计一种能够移植到皮下的袋***AP。在动物实验中，皮下植入的BAP已经能够诱导出新生血管。”

Alternative ways of circumventing the short supply of viable human pancreatic islet tissue by allowing storage of cells are also being explored.

为解决供应不足，开发能够保存的人类胰岛组织的可行的方法正在研究中。

Freezing islet cells to save them

冷冻胰岛细胞来保存它们

Cryopreservation (freezing) of pancreatic islet cells from non-heart beating donors has been studied in animal models. Studies have shown that islet structure was well maintained after thawing, although the number of islets decreased. Techniques for freezing human islet cells from non-heart beating donors are being developed with an emphasis on evaluating the thawed islet morphology, possible contamination and quality of endocrine function.

从没有心跳的供体身上深低温保存胰岛细胞已经在动物模型中展开研究。研究表明尽管胰岛细胞的数量减少了，但功能在经过溶解之后仍然保持。从没有心跳的供体身上获取人胰腺细胞后冷冻的技术正在开发，并且评估融化细胞的形态、潜在的污染以及内分泌功能。

Cancer stem cells: Key to a cure?

肿瘤干细胞：治疗的关键？

Researchers have proposed that cancer cells, like normal cells, include stem cells that are able to differentiate.

研究人员认为肿瘤细胞像正常细胞一样，包含能够分化的干细胞。

“Many questions surround this proposal,” observes Dr. Kobayashi. “For example, do cancer stem cells exist in all cancers? Have normal stem cells become malignant, though mutation or some other process? What are the markers for cancer stem cells? Are cancer stem cells resistant to existing treatments?”

Kobayashi说：“这项计划还存在许多的问题，例如，是否所有的肿瘤组织中均存在肿瘤干细胞？是正常干细胞通过变异或者其它途径恶变了吗？肿瘤干细胞的标志物是什么？肿瘤干细胞是否对目前的治疗手段存在耐受？”

Current research is aimed at not only answering these questions, but also whether reducing the number of stem cells may lead to a reduced cancer risk.

目前的研究目标不仅是要回答这些问题，而且是是否通过减少这些干细胞的数量可以减少肿瘤的危险性。

“Tamoxifen, used to successfully prevent primary breast cancer, works by reducing the number of stem cells,” comments Dr. Kobayashi.

Kobayashi 解释道：“被成功用来预防原发性乳腺癌的三苯氧胺机制是能够减少干细胞的数量。”

Researchers speculated that if a substance specific to cancer stem cells can be discovered, cancer will be able to be detected at an earlier stage. However, even if cancer has been successfully treated, if a single cancer stem cell remains cancer, could spread and form new tumors.

研究人员推测如果在肿瘤干细胞内发现一种特别的物质，肿瘤就可以在早期被检测出来。然而即便肿瘤被成功的治疗，如果一个单个的肿瘤干细胞还存在，就能够使肿瘤扩散并形成新的肿块。

Also, it appears that cancer stem cells have the ability to repair DNA damage more effectively than do cancer cells, thus adding to a tumor’s drug resistance. Thus, treatment strategies based on the existence of cancer stem cells - which are reported to be resistant to standard anti-cancer drugs - may take a leap forward when stem cells can be targeted.

同样，肿瘤干细胞似乎看起来比肿瘤细胞拥有更有效的修复DNA损伤的能力，因而增加了肿瘤的抗药性。因此，当干细胞能够被定向的消灭，以对常规的抗肿瘤药物有耐药性的肿瘤干细胞存在为根据的治疗策略，在治疗上可能是一个飞跃。

“A further question arises as to whether only cancer stem cells can be targeted without damaging normal stem cells,” added Dr. Kobayashi.

Kobayashi补充说：“进一步的问题是，是否只有肿瘤干细胞可以被定向消灭，而不会损伤正常细胞。”

Artificial cells

人造细胞

Although human adult stem cells are ideal for cell therapy via transplantation, keeping available cells alive over the long term is difficult.

尽管人成体干细胞对于细胞移植治疗来说是理想的，长时间保持有活性的细胞存活是困难的。

“We are making efforts to economically establish “reversible immortalized” human cell lines that can be grown in tissue cultures and used for future gene transfers,” explained Dr. Kobayashi. “Achieving immortalization, a two-stage process, is not without challenges.”

Kobayashi解释说：“我们正在努力去经济的确立能够在组织培养中生长的“可逆永生化”的人细胞系。达到永生，需要一个分为两步的过程，这充满了挑战。”

According to Dr. Kobayashi, research focusing on “reversible immortalization” is being carried out to make safe and secure cell lines with the immortalization gene able to be removed once cell proliferation has been achieved.

根据Kobayashi的说法， 研究重点\"可逆永生化\" ，是使拥有永生化基因的细胞系在细胞增殖取得后，能够安全稳妥被分离，这正在紧锣密鼓的进行之中。


干细胞移植治疗肝硬化已经在国内成功