Mezenhimske matične/stromalne celice (MSC) imajo osrednjo vlogo v mikrookolju kostnega mozga ter izražajo izrazite imunomodulatorne in regenerativne lastnosti, zaradi česar predstavljajo privlačno terapevtsko možnost v hematologiji in pri krvnih rakih. Hkrati pa lahko MSC v določenih okoliščinah podpirajo tudi preživetje in rast malignih celic, zato mora biti njihova uporaba v hemato-onkologiji skrbno nadzorovana in strokovno vodena.
MSC podpirajo hematopoetske matične celice ter se uporabljajo za izboljšanje uspešnosti vraščanja (engraftmenta) in kliničnih izidov po presaditvi krvotvornih matičnih celic (HSCT) pri levkemijah in drugih hematoloških boleznih (Lan idr., 2021; Smallbone idr., 2025). Njihovi imunosupresivni učinki se izkoriščajo za zdravljenje ali preprečevanje reakcije presadka proti gostitelju (GVHD) ter za obnovo poškodovanega kostnega mozga po kemoterapiji ali radioterapiji (Wu idr., 2024; Lan idr., 2021; Najar idr., 2022; Smallbone idr., 2025).
MSC in njihovi eksosomi lahko vplivajo na levkemično mikrookolje, povzročajo zaustavitev celičnega cikla, spodbujajo apoptozo ter zmanjšujejo kemorezistenco pri nekaterih oblikah levkemije, kar nakazuje njihov neposreden protilevkemični potencial in možnost sinergije s standardnimi terapijami (Saadh idr., 2025; Wu idr., 2024; Fathi idr., 2019; Ahmad idr., 2025). Gensko spremenjene MSC se razvijajo kot t. i. »trojanski konji« za usmerjeno dostavo citokinov, samomorilnih genov, protiteles ali koagulacijskih faktorjev pri levkemijah, limfomih, mielomu ter dednih krvnih boleznih, kot sta anemija in hemofilija (Hmadcha idr., 2020; Shomali idr., 2020; Chulpanova idr., 2018; Kangari idr., 2024).
| Strategija | Terapevtski cilj v hematologiji/hemato-onkologiji | Reference |
|---|---|---|
| Sočasna aplikacija MSC s HSCT | Izboljšanje vraščanja presadka, zmanjšanje GVHD, obnova niše kostnega mozga | (Wu et al., 2024; Lan et al., 2021; Crippa et al., 2019; Najar et al., 2022; Smallbone et al., 2025) |
| MSC derived exosomes | Brezcelično uravnavanje vnetja, kemorezistence in tumorske rasti | (Saadh et al., 2025; Ahmad et al., 2025; Lin et al., 2022) |
| MSC kot nosilci genov/zdravil | Usmerjena dostava protirakavih genov, citokinov in terapevtskih dejavnikov pri krvnih boleznih | (Hmadcha et al., 2020; Shomali et al., 2020; Chulpanova et al., 2018) |
Slika 1: Glavne klinične in eksperimentalne uporabe mezenhimskih matičnih celic v hematologiji.
Mezenhimske matične celice (MSC) so pomembno terapevtsko orodje v hematoonkologiji: podpirajo presaditev hematopoetskih matičnih celic (HSCT), uravnavajo imunski odziv, omogočajo dostavo terapevtskih učinkovin ter prek eksosomov ponujajo obetavne brezcelične terapevtske strategije.
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