摘要

隨著國人飲食精緻化及生活壓力增加，心血管疾病好發年齡也逐漸下降。目前，有許多治療方法被發展用來治療缺血性心臟血管問題，其中包含著有臨床藥物的使用(血管擴張劑, β交感神經阻斷劑及鈣離子阻斷劑)與介入性心導管技術(冠狀動脈繞道手術及狹窄冠狀動脈擴張術)的突破，已有改善病人因缺血性心臟病的損傷，但是缺血性心臟病卻是主要的致命原因，病人若未能及時接受臨床的治療及恢復循環，可能再出現嚴重的心臟問題，然而隨著醫療日益進步，再生醫學利用幹細胞分化增生等特性替未來的醫療開啟新世界的大門。幹細胞的治療可以修復壞死心肌組織與促進新生血管循環方式，有效地改善心臟收縮性，可說是極具有潛力的治療方式。本實驗目的在評估利用共同培養法 (Co-culture transwell system)給予間質幹細胞(Mesenchymal stem cells)治療H9C2心肌細胞於氧氣及葡萄糖剝奪(oxygen and glucose deprivation, OGD)模擬缺血缺氧再灌流(ischemia-reperfusion, I/R)模式之保護作用，我們發現間質幹細胞可以有效抑制心肌細胞在缺氧缺血環境中死亡，提高存活率並抑制減緩細胞凋亡(apoptosis)途徑如 DNA片段化及 Sub-G1 形成而提高存活率。我們利用間葉幹細胞共同培養心肌細胞的方式希望可以提供未來臨床上缺血性心臟治療上另一種選擇。

關鍵詞: 心肌損傷、間質幹細胞、共同培養法、細胞凋亡

Abstract

With the refinement of diet and the augmentation of life stress, Taiwanese people are getting cardiovascular diseases at a younger age. There have been breakthroughs in a lot of ischemic cardiovascular disease treatments, including clinical drugs (vasodilator; βblocker; calcium channel blocker) and cardiac catheterization intervention (coronary bypass surgery; coronary angioplasty). Both cam improve ischemic heart disease (IHD) injuries. However, IHD is primarily lethal.  Without prompt clinical treatment-caused circulation, severe cardiac problems would probably become recurrent. Anyhow, with the progress of health care, regenerative medicine plies stem cell characteristics, such as proliferation and differentiation, opening the door to prospective health care. Stem cell therapy, which is extremely potential in medical treatment, can repair necrotic myocardium and advance new vessel circulation and cardiac contractility. Therefore, the objective of our study is to evaluate and apply protective effects of the mesenchymal stem cells (MSC) co-culture with cardiomyocyte (H9c2) in oxygen-glucose deprivation (OGD) that mimicked ischemia-reperfusion (I/R). The results showed that MSC can effectively inhibit OGD-induced H9C2 death and enhance survival rate. It is expected that the co-culture with H9C2 can be an option for clinical treatment of IHD.

Keywords: Myocardium Injury, Mesenchymal Stem Cell, Co-culture, Apoptosis