Article(id=1208154041985646962, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1208154038609228128, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.2022.02.0178, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1633968000000, receivedDateStr=2021-10-12, revisedDate=null, revisedDateStr=null, acceptedDate=1639324800000, acceptedDateStr=2021-12-13, onlineDate=1765975970026, onlineDateStr=2025-12-17, pubDate=1645977600000, pubDateStr=2022-02-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1765975970026, onlineIssueDateStr=2025-12-17, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1765975970026, creator=13701087609, updateTime=1765975970026, updator=13701087609, issue=Issue{id=1208154038609228128, tenantId=1146029695717560320, journalId=1189873630562394117, year='2022', volume='47', issue='2', pageStart='107', pageEnd='212', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1765975969218, creator=13701087609, updateTime=1765976148463, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1208154790459192257, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1208154038609228128, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1208154790459192258, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1208154038609228128, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=178, endPage=185, ext={EN=ArticleExt(id=1208154042342162807, articleId=1208154041985646962, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Research progression on preadipocyte and its clinical application potential, columnId=1190243275882729994, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Review, runingTitle=null, highlight=null, articleAbstract=

Adipose tissue is inextricably linked to nutritional balance and metabolic diseases, and the way of adipocytes differentiation will directly affect the health of adipose tissue. Preadipocytes are cells that are present at adipose depot and restricted to becoming mature adipocytes specificity. Their favorable differentiation ability to differentiate into healthy mature adipocytes as well as undergo hyperplasia (the expansion of adipose tissue by de novo adipocytes) rather than hypertrophy (the expansion of adipose tissue by increasing the size of already being adipocytes) is crucial for regenerative medicine and obesity-related diseases.Despite much effort has focused on the factors and mechanism about preadipocyte's adipogenic differentiation, the precise regulatory mechanism is still not completely clear. Based on the related research in recent years, this review discusses the ambiguous definition, the origin and terminal differentiation of preadipocytes in brief, summarizes the surface markers of preadipocytes in detail which include stem cell surface markers (such as CD29, CD34, CD38 and SCA1), perivascular markers (such as PDGFRα and PDGFRβ), ZFP423 (zinc-finger protein 423), Pref-1/DLK1 (preadipocyte factor 1). The deep look at preadipocytes provides new ideas for clinical diagnosis and treatment. The clinical application potential of preadipocytes in the treatment of soft tissue defects, obesity-related metabolic diseases, tumors (breast cancer and prostate cancer), and wound healing is further discussed in this review.

, correspAuthors=Wei-Dong Tian, authorNote=null, correspAuthorsNote=
*E-mail:
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脂肪组织与营养平衡和代谢性疾病密切相关,其中脂肪细胞的分化方式将直接影响脂肪组织的健康。前成脂细胞,是脂肪组织中一群能且仅能向成熟脂肪细胞分化的细胞,因其良好的成脂潜能,在再生医学和肥胖相关疾病的治疗中起着重要作用。本综述根据近年来前成脂细胞的相关研究成果,对前成脂细胞定义的不确定性进行了讨论,初步探讨了前成脂细胞的起源及终末分化,归纳总结了常见的前成脂细胞表面标志物,最后对前成脂细胞在软组织修复重建、肥胖相关代谢性疾病,以及肿瘤和伤口愈合方面的临床应用潜能进行了展望。

, correspAuthors=田卫东, authorNote=null, correspAuthorsNote=
田卫东,E-mail:
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周晓洁,硕士研究生,主要从事脂肪再生方面的研究

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周晓洁,硕士研究生,主要从事脂肪再生方面的研究

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前成脂细胞及其临床应用潜能研究进展
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周晓洁 , 于湄 , 田卫东 *
解放军医学杂志 | 综述 2022,47(2): 178-185
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解放军医学杂志 | 综述 2022, 47(2): 178-185
前成脂细胞及其临床应用潜能研究进展
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周晓洁, 于湄, 田卫东*
作者信息
  • 四川大学华西口腔医学院/口腔再生医学国家地方联合工程实验室,成都 610041
  • 周晓洁,硕士研究生,主要从事脂肪再生方面的研究

通讯作者:

田卫东,E-mail:
Research progression on preadipocyte and its clinical application potential
Xiao-Jie Zhou, Mei Yu, Wei-Dong Tian*
Affiliations
  • National Engineering Laboratory for Oral Regenerative Medicine/West China School of Stomatology, Sichuan University, Chengdu 610041, China
出版时间: 2022-02-28 doi: 10.11855/j.issn.0577-7402.2022.02.0178
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脂肪组织与营养平衡和代谢性疾病密切相关,其中脂肪细胞的分化方式将直接影响脂肪组织的健康。前成脂细胞,是脂肪组织中一群能且仅能向成熟脂肪细胞分化的细胞,因其良好的成脂潜能,在再生医学和肥胖相关疾病的治疗中起着重要作用。本综述根据近年来前成脂细胞的相关研究成果,对前成脂细胞定义的不确定性进行了讨论,初步探讨了前成脂细胞的起源及终末分化,归纳总结了常见的前成脂细胞表面标志物,最后对前成脂细胞在软组织修复重建、肥胖相关代谢性疾病,以及肿瘤和伤口愈合方面的临床应用潜能进行了展望。

前成脂细胞  /  表面标志物  /  成脂分化  /  临床应用潜能

Adipose tissue is inextricably linked to nutritional balance and metabolic diseases, and the way of adipocytes differentiation will directly affect the health of adipose tissue. Preadipocytes are cells that are present at adipose depot and restricted to becoming mature adipocytes specificity. Their favorable differentiation ability to differentiate into healthy mature adipocytes as well as undergo hyperplasia (the expansion of adipose tissue by de novo adipocytes) rather than hypertrophy (the expansion of adipose tissue by increasing the size of already being adipocytes) is crucial for regenerative medicine and obesity-related diseases.Despite much effort has focused on the factors and mechanism about preadipocyte's adipogenic differentiation, the precise regulatory mechanism is still not completely clear. Based on the related research in recent years, this review discusses the ambiguous definition, the origin and terminal differentiation of preadipocytes in brief, summarizes the surface markers of preadipocytes in detail which include stem cell surface markers (such as CD29, CD34, CD38 and SCA1), perivascular markers (such as PDGFRα and PDGFRβ), ZFP423 (zinc-finger protein 423), Pref-1/DLK1 (preadipocyte factor 1). The deep look at preadipocytes provides new ideas for clinical diagnosis and treatment. The clinical application potential of preadipocytes in the treatment of soft tissue defects, obesity-related metabolic diseases, tumors (breast cancer and prostate cancer), and wound healing is further discussed in this review.

preadipocytes  /  surface markers  /  adipogenic differentiation  /  clinical application potential
周晓洁, 于湄, 田卫东. 前成脂细胞及其临床应用潜能研究进展. 解放军医学杂志, 2022 , 47 (2) : 178 -185 . DOI: 10.11855/j.issn.0577-7402.2022.02.0178
Xiao-Jie Zhou, Mei Yu, Wei-Dong Tian. Research progression on preadipocyte and its clinical application potential[J]. Medical Journal of Chinese People’s Liberation Army, 2022 , 47 (2) : 178 -185 . DOI: 10.11855/j.issn.0577-7402.2022.02.0178
脂肪组织的体积扩张主要有两种方式:以增大脂肪细胞体积为主的肥大(hypertrophy)和以增加脂肪细胞数量为主的增生(hyperplasia)[1]。其中,脂肪细胞数量的增加是通过间充质干细胞分化为脂肪细胞实现的,也称为成脂分化[2],主要分为两个步骤:定向(commitment)和分化(differentiation)[3-4]。定向是指间充质干细胞丧失其多向分化潜能而特定地向脂肪细胞发展的过程,在这个过程中细胞的特异性逐渐凸显出来,形成一类能且仅能向脂肪谱系分化的细胞,称为前成脂细胞[5]。分化指前成脂细胞经诱导分化为成熟脂肪细胞的过程[6]。尽管多个团队针对前成脂细胞的定向和分化及其影响因素进行了一系列研究,但其具体的调控机制尚不完全清楚[7]。本文归纳总结了近年来关于前成脂细胞的研究进展,主要对其定义、起源、终末分化及常见的表面标志物进行阐述,以揭示前成脂细胞在软组织修复重建、肥胖相关代谢性疾病、肿瘤以及伤口愈合方面的临床应用潜能。
前成脂细胞是成脂分化进程中的中间细胞类型,具有很强的异质性[5,8-9],目前对于其定义尚存在一定的争议。主流的观点认为,从脂肪组织基质血管组分(stromal vascular fraction,SVF)中分离出来并能最终形成成熟脂肪细胞的前体细胞为前成脂细胞(preadipocyte),也称前体脂肪细胞(adipose progenitor cell)、脂肪前体细胞(adipose presursor)或脂肪细胞前体细胞(adipocyte presursor)[7,10],其特征是特定脂肪谱系的定向细胞群[5,11-12],只能增殖、分化为成熟的脂肪细胞[13-15],且具有成熟脂肪细胞的部分特征,如参与脂质运输和合成,调节胰岛素敏感性及脂肪细胞特异性蛋白[脂肪酸结合蛋白4(fatty acid-binding protein 4,FABP4)、葡萄糖转运蛋白(glucose transporter type,GLUT)、瘦素(leptin)、脂联素(adiponectin)等]的分泌[3,6]。前成脂细胞与脂肪干细胞(adipose derived stem cells,ASC)最大的区别在于,ASC具有间充质干细胞的多向分化潜能,而前成脂细胞只能脂向分化。也有学者对前成脂细胞有不同的定义,如Cristancho等[15]将前成脂细胞描述为未成熟的细胞,在无外源性促脂肪形成刺激的情况下,不能自发完成脂肪细胞的终末分化。Cho等[5]认为,前成脂细胞是脂肪前体细胞分化出的一个亚细胞群,两者的成脂分化能力存在明显差异,且因前成脂细胞的存在所形成的微环境可促进脂肪前体细胞向脂肪谱系的定向分化[7,16]
现阶段,脂肪细胞发育的胚胎起源仍处于未完全明确的状态,因此脂肪细胞的起源一直是脂肪生物学研究的焦点[17-19]。2004年,Planat-Benard等[20]发现,体外培养去分化的成熟脂肪细胞具有内皮细胞表型,表明脂肪细胞和血管内皮细胞可能存在共同的祖细胞。2008年,田卫东课题组在小鼠脂肪基质细胞中发现一群同时拥有成骨和成脂特性的细胞,并将其定义为成骨成脂祖细胞(osteo-adipo progenitors,OAPs),该细胞在体外可分别被诱导分化为成熟的骨细胞或脂肪细胞,指出成骨细胞和脂肪细胞均可能起源于OAPs[21]。同年,Graff团队采用过氧化物酶体增殖物激活受体γ(peroxisome proliferator-activated receptor gamma,PPARγ)标记转基因小鼠的脂肪细胞,通过谱系追踪技术发现脂肪前体细胞位于脂肪组织的血管中,因而提出前成脂细胞起源于血管壁细胞的观点[22-23]。2012年,Gupta研究组通过免疫组化检测锌指蛋白423(zinc-finger protein 423,ZFP423)-绿色荧光蛋白(GFP)在体内的表达,也证实了白色脂肪细胞和棕色脂肪细胞均起源于血管壁细胞[24-25],至此,前成脂细胞起源于血管壁细胞的观点逐渐成为共识。然而,这些标记技术均同时标记了血管壁细胞和血管外膜细胞,并未明确脂肪细胞的具体来源,因此,Evans研究组于2017年采用Tbx18技术单独标记血管壁细胞,通过更精确的谱系示踪,否定了前成脂细胞起源于血管壁细胞的观点,指出其更可能起源于血管外膜成纤维细胞[26]
前成脂细胞的终末分化与其分类密切相关,不同类型的前成脂细胞的终末分化也有所不同。根据组织结构和微观特征,脂肪组织可分为三种不同类型:白色脂肪、棕色脂肪和米色脂肪,终末分化为不同脂肪组织中成熟脂肪细胞的前体细胞也存在差异[27]。白色脂肪组织中的前成脂细胞倾向于被血小板衍生生长因子受体β(platelet-derived growth factor-receptor β,PDGFRβ)标记,而米色脂肪组织中的前成脂细胞倾向于被PDGFRα标记[7,28]。2017年,Berry等[29]通过遗传谱系示踪发现,在冷刺激下,表达平滑肌肌动蛋白(smooth muscle actin,SMA)的前成脂细胞易分化为米色脂肪细胞;而Long等[27]发现米色脂肪组织中的前成脂细胞也表现出平滑肌样特性。以上研究结果均表明具有平滑肌样特性的前成脂细胞倾向于向米色脂肪细胞进行终末分化。2019年,Watt研究组通过流式细胞术、基因表达谱以及代谢和蛋白组学分析,在人类白色脂肪组织中鉴定出三种前成脂细胞亚型,其中高表达CD34的前成脂细胞易分化为装载脂滴的成熟脂肪细胞,而低表达或不表达CD34的细胞更倾向于分化为米色脂肪细胞[30]。前成脂细胞的终末分化不仅与脂肪类型相关,微环境的改变对前成脂细胞的终末分化也具有重要影响。成脂分化过程受多种因素包括信号通路如Wnt信号通路[31-35]、转化生长因子β(transforming growth factor beta,TGF-β)信号通路[4,36]、骨形成蛋白(bone morphogenetic protein,BMP)信号通路[4]、胰岛素样生长因子1(insulin-like growth factor 1,IGF-1)信号通路[4]、环磷酸腺苷(cyclic adenosine monophosphate,cAMP)信号通路[4]及调控蛋白[受体蛋白、细胞因子、酶[23,31,36-37]、microRNAs[38-42]、激素[43-45]等]的调控。目前,已经有大量文献围绕PPARγ和C/EBPα(CCAAT-enhancer-binding protein alpha)这两个成脂的核心因素[4]进行了详尽的阐述[3-4,8,46-48],在本文中则不再赘述。
尽管目前有多个研究小组致力于阐明前成脂细胞的特定表型,但对于早期前成脂细胞的独特蛋白标志物和基因表达仍无定论。
由于前成脂细胞在成脂分化进程中处于干细胞与成熟脂肪细胞之间,因此,前成脂细胞也会带有某些干细胞的典型表面标志物,如较常见的CD29、CD34和干细胞抗原1(stem cell antigen 1,SCA1)[18]。为明确标记区分前成脂细胞,多个研究小组采用了传统干细胞表面标志物与某些特定表面标志物联合使用的方法[7]。Yoshimura等[49]曾在2006年用CD31(–)、CD45(–)、CD34(+)、CD90(+)、CD105(–)、CD146(–)标记前成脂细胞;2008年,Rodeheffer等[11]根据CD29、CD34的表达情况将SVF中的细胞用流式细胞术分为四群:CD29(–)/CD34(–),CD29low/CD34(–),CD29low/CD34(+),CD29high/CD34(+)。分别对这四群细胞进行体外成脂诱导,发现只有CD29和CD34双阳性表达且CD29为高表达的细胞群可分化为脂肪细胞,故将从肥胖小鼠附睾中采用CD29(+)、CD34(+)、SCA1(+)、CD31(–)、CD45(–)和Ter119(–)标记方法分离出的细胞称为前成脂细胞。2010年,Quirici等[50]指出,表达CD34和低亲和力神经生长因子受体(low affinity growth factor receptor,L-NGFR)CD271的细胞拥有良好的成脂分化能力,利用这种双阳性组合标记分离的前成脂细胞可用于今后的临床再生医学。此外,Carrière等[51]发现,从脂肪组织中分选出来的CD45(-)、CD31(-)、CD34(+)、CD38(+)细胞在体外培养时表现出较低的增殖能力和较高的成脂分化能力,且CD38(+)细胞数量与机体肥胖的发生息息相关,由此提出CD38也可作为前成脂细胞的表面标志物。
尽管在2017年Evans研究组否定了前成脂细胞起源于血管壁细胞的观点,但谱系追踪结果确实发现脂肪前体细胞位于脂肪组织的血管中,因此部分血管周围标志物,如PDGFRα和PDGFRβ,也经常被用来标记前成脂细胞[28]。2019年,Raajendiran等[30]发现,人类脂肪组织中存在一群表达PDGFRα且高表达CD9的前成脂细胞,这类细胞与肥胖相关的代谢紊乱密切相关。从内脏脂肪中分选出的LY6C(–)、CD9(–)、PDGFRβ(+)前成脂细胞具有较高的成脂潜能,在含胰岛素的培养基中可分化为成熟的脂肪细胞[52]。最近,Han等[53]利用双同源重组的交叉遗传学策略,实现了更精准的谱系追踪和遗传靶向操作,发现只有PDGFRα阳性,或PDGFRβ和PDGFRα双阳性的细胞才能分化形成成熟的脂肪细胞,且PDGFRβ和PDGFRα双阳性细胞具有更强的成脂分化能力,这一研究成果为成熟个体内前成脂细胞的标记奠定了更坚实的理论基础。
ZFP423属于早期的B细胞因子(early B-cell factor,EBF),在脑、眼、嗅上皮、脾和心脏中均有表达,1997年Tsai等[54]通过酵母双杂交技术将其筛选分离出来。2010年,Gupta等[55]发现,ZFP423可调节前成脂细胞PPARγ基因的表达,使此类细胞能够进行成脂分化;同时还检测了前成脂细胞与无成脂功能的成纤维细胞中ZFP423的转录表达水平,发现前成脂细胞中ZFP423的表达较成纤维细胞明显增高,指出ZFP423为前成脂细胞成脂分化过程中的转录调节因子。随后,Vishvanath等[25]采用ZFP423-GFP转基因小鼠证实,在皮下和内脏脂肪中表达ZFP423的细胞可稳定地形成脂肪细胞,且这些细胞在体外诱导实验中也呈现出较强的成脂潜能,因此认为表达ZFP423的细胞为前成脂细胞。
Pref-1是一种含有反式膜蛋白的表皮生长因子样蛋白,能够被肿瘤坏死因子-α转化酶(TACE)剪切为可溶性的自分泌或旁分泌因子,阻止前成脂细胞进一步分化为成熟的脂肪细胞,对于维持前成脂细胞的状态非常重要[56]。在脂肪形成过程中,Pref-1的表达早于ZFP423,且只出现在前成脂细胞向脂肪细胞分化的早期阶段,中晚期则不表达[26]。因此,Pref-1的表达水平仅在细胞成脂分化的早期升高,在分化的后期逐渐降低[27]
以干细胞技术为代表的再生医学技术,是继药物治疗和手术治疗之后的“第三次医学革命”,已成为各国政府高度关注的重大科学命题。2015年,国家卫计委和国家食品药品监管总局组织制定了《干细胞临床研究管理办法(试行)》和《干细胞制剂质量控制和临床前研究指导原则(试行)》,建立了以医疗机构为干细胞制剂和临床研究质量管理的责任主体,干细胞临床研究机构和项目双备案的管理机制[57]。2021年2月10日,国家卫健委在答复十三届人大会议《关于加快胚胎干细胞立法,促进和规范干细胞领域发展的建议》中明确提出要进一步鼓励、支持、推动和规范干细胞研究转化和产业发展[58]。随着干细胞治疗在多种疾病中取得了良好效果,近年来干细胞研究逐渐成为健康领域公众关注的热点。与骨髓或脐带等来源的间充质干细胞相比,脂肪组织来源的干细胞具有突出的优点,包括含量丰富[59-60],可通过抽脂的方式获取,患者的风险和痛苦均较小等[12,61]。相对于脂肪干细胞,前成脂细胞因失去了多向分化潜能,其临床应用相对局限,但由于前成脂细胞具有更强的成脂分化能力[5],随着提取及培养方式的逐渐优化[62-64],在成脂相关疾病的治疗中可真正实现用量少、疗效好的目标,具有极其可观的临床应用潜能。
目前,临床上主要采用脂肪组织移植和游离自体脂肪填充的方法来进行软组织整形和重建[65],前成脂细胞因其特有的成脂潜能而具有无可替代的天然优势。
对于少量的软组织充填,单纯采用自体脂肪移植即可呈现出满意的效果,但对于部分因外伤或肿瘤等导致软组织大面积缺损的患者,单纯自体脂肪移植后可能会出现一系列问题[66],包括移植部位皮肤炎症,移植组织吸收坏死或发生组织蜂窝织炎等[67-69]。为了提高自体脂肪移植的成功率,有研究利用含有前成脂细胞的SVF辅助脂肪移植治疗面部和胸部软组织不足[70-71]。Wang等[72]通过病例对照研究发现这类细胞辅助脂肪移植可明显提高移植组织的成活率,且其安全性更有保障[73]
毫无疑问,脂肪组织中的前成脂细胞在组织更新和修复方面具有巨大的应用潜力,我们应该全面了解前成脂细胞、生物材料与临床应用之间的相互关系,以进一步确保整形外科手术的安全性和有效性。
肥胖相关的各种代谢性疾病一直困扰着数百万人,多项研究表明,这类疾病主要是因为过多的能量储存在脂肪细胞的脂滴中,造成脂肪细胞过载进而出现代谢障碍,而脂肪细胞中脂滴过载大多是由于前成脂细胞成脂潜能衰退引起的[74]。2019年,Andersen等[74]通过腹腔镜手术从肥胖人群和健康人群的网膜处提取内脏脂肪组织,分离培养其中的前成脂细胞,发现肥胖人群的前成脂细胞表现出明显的成脂能力不足,在体外进行成脂诱导后形成的脂滴数量明显减少,基因转录谱测序结果显示,与健康人群相比,肥胖人群内脏脂肪来源的前成脂细胞在成脂分化过程中的上调基因有172个,而下调基因多达447个,这些差异表达的基因与脂肪酸代谢、胰岛素信号通路和氧化磷酸化有关。值得庆幸的是,前成脂细胞的健康状态是可逆的,通过在特定基因组区域(如NAT10SHC1PITX1FRMPD4)重组DNA甲基化,使细胞重新编程,可将受损的前成脂细胞逆转为健康的前成脂细胞,促进健康脂肪的形成,从而达到改善肥胖、2型糖尿病及脂肪肝等代谢性疾病的目的[75-78]
此外,前成脂细胞的分化过程易受各种因素的影响,因而提高了靶向调控此类细胞的可能性。有研究发现,腰果酸可通过下调Hsp90/Akt信号通路抑制前成脂细胞的分化[79];姜黄素可诱导前成脂细胞凋亡,从而抑制成脂过程[80];荷叶素可参与调节棕色和米色脂肪细胞的发育,改善机体代谢水平[81];果汁中的酚类提取物可抑制3T3-L1前成脂细胞中PPARγ和C/EBPα的表达,进一步减少成熟脂肪细胞中三酰甘油的聚集[82-83];低剂量的异甘草素(isoliquiritigenin,ILG)可诱导白色脂肪来源的前成脂细胞向米色脂肪细胞分化,激活米色或棕色脂肪,有利于预防肥胖,增强葡萄糖耐受及胰岛素抵抗,改善由肌肉生长抑素缺失介导的肝脏脂肪变性[84]。这些植物提取物不仅能从日常饮食中获取,市场上也已有相应的生物制剂保健品,其主要机制均为通过调节前成脂细胞的代谢,进一步抑制病理性脂肪组织的形成。
肥胖是各种肿瘤发生的一个重要危险因素,对机体而言,肥胖导致的慢性炎症环境除可使肿瘤的发病率和病死率增高外,还可增加肿瘤复发的风险[85]。Gwak等[86]在关于前列腺癌的研究中发现,肿瘤微环境中的趋化因子CXCL8、CCL2、CXCL10和CCL20可促进前成脂细胞和肿瘤相关巨噬细胞在肿瘤发生部位的浸润,促使病灶处的炎性因子IL-6表达升高,进一步增强前列腺癌细胞的迁移和侵袭能力,加速了癌症的发展和转移[86-87]。与其他肿瘤相比,前成脂细胞与乳腺癌之间的生物学联系最为密切[88],在乳腺癌早期阶段,前成脂细胞可通过分泌IL-6促进癌细胞的增殖和迁移,加速早期乳腺癌的发展[89]。但前成脂细胞与肿瘤细胞的体外共培养实验和乳腺癌患者自体脂肪移植的临床研究结果均显示,前成脂细胞对乳腺癌细胞的促进作用只限于增殖和迁移,并不包括侵袭[90],因此,临床上采用含有前成脂细胞的SVF进行自体脂肪移植作为乳腺癌术后二期修复的安全性可得到保证[90]。另有研究指出,肥胖导致乳腺癌进展加速的主要原因为:肿瘤周围成熟的脂肪细胞通过释放游离脂肪酸、酮体等代谢产物提高了自身及周围肿瘤细胞的代谢水平,从而加速了肿瘤生长[91]。健康的前成脂细胞不仅不会加速肿瘤发展进程,还能起到一定的缓解作用。2018年,Visweswaran等[88]发现,来自健康个体的前成脂细胞的条件培养基可通过旁分泌作用下调Wnt信号通路的主要靶蛋白(β-catenin、Cyclin D1)表达,降低乳腺肿瘤细胞线粒体的膜电位,从而诱导肿瘤细胞凋亡[88],进而抑制乳腺癌的发展。由此可见,深入了解前成脂细胞在肿瘤发展进程中的作用,可能有助于更好地开展相关肿瘤的临床诊治工作。
前成脂细胞在伤口愈合中的作用是多方面的,包括促进愈合、预防感染和减少瘢痕组织形成。在伤口愈合过程中,多种细胞协同作用,共同完成表皮和真皮的修复,除免疫细胞、成纤维细胞和角质形成细胞外,来自脂肪谱系的细胞群也在这个过程中发挥着重要作用[92]。2013年,Schmidt等[92]对小鼠皮肤伤口处的前成脂细胞进行了检测,发现在伤口愈合的5 d和7 d,皮肤伤口处的前成脂细胞数量明显增多,机体通过刺激前成脂细胞增殖,加速其分化为脂肪细胞以填充皮肤创口,促进伤口愈合。此时,如前成脂细胞的分化受到抑制(如使用GW9662),脂肪细胞、成纤维细胞的形成和细胞外基质蛋白的沉积均会受到影响,最终导致伤口长期无法愈合[92-93]
当伤口不慎被细菌感染时,感染伤口处ZFP423和Pref-1标记的前成脂细胞数量较清洁伤口处更多,增多的前成脂细胞进一步分化形成脂肪细胞,成熟的脂肪细胞可产生抗菌肽以抑制细菌生长,积极参与机体的自身防御反应,防止感染的进一步发展和扩散[94]
在伤口愈合的最后阶段,如何减少瘢痕组织的形成是患者和医师关注的重点。瘢痕形成的一个重要特征是肌成纤维细胞的过量聚集,2015年,Marangoni等[95]通过转基因小鼠体内谱系示踪发现这部分肌成纤维细胞主要起源于该处脂肪组织中的前成脂细胞,微环境中的TGF-β可刺激前成脂细胞由成脂表型向成纤维表型转化,最终导致伤口愈合后严重的皮肤纤维化、瘢痕增生以及皮内脂肪组织丢失。这一研究成果肯定了前成脂细胞对减轻瘢痕的重要性,为改善伤口愈合后的瘢痕情况提供了新视野。
前成脂细胞是成脂的关键,更是成脂的基础,不仅在脂肪形成过程中发挥重要作用,还可进一步调节机体的代谢水平,影响肿瘤发展进程及促进皮肤伤口愈合。因此,对前成脂细胞的进一步研究具有深远的意义。尽管目前对前成脂细胞的认识仍不全面,但随着基础及临床研究的深入开展,前成脂细胞的应用价值将会被进一步挖掘,为今后的临床应用提供更多可能。
  • 国家重点研发计划(2017YFA0104800)
  • 四川省科技计划重点研发项目(2019YFS0312)
  • 四川省科技计划重点研发项目(2019YFS0515)
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2022年第47卷第2期
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doi: 10.11855/j.issn.0577-7402.2022.02.0178
  • 接收时间:2021-10-12
  • 首发时间:2025-12-17
  • 出版时间:2022-02-28
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  • 收稿日期:2021-10-12
  • 录用日期:2021-12-13
基金
National Key Research and Development Program of China(2017YFA0104800)
国家重点研发计划(2017YFA0104800)
Key Technology Research and Development Program of Sichuan Province(2019YFS0312)
四川省科技计划重点研发项目(2019YFS0312)
Key Technology Research and Development Program of Sichuan Province(2019YFS0515)
四川省科技计划重点研发项目(2019YFS0515)
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    四川大学华西口腔医学院/口腔再生医学国家地方联合工程实验室,成都 610041

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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