干细胞疗法在放射性直肠损伤中的治疗前景与机制探索
Therapeutic Prospects and Mechanism Exploration of Stem Cell Therapy in Radiation-Induced Rectal Injury
DOI: 10.12677/acm.2026.1662274, PDF,   
作者: 向 宇, 王 佳*：重庆医科大学附属大学城医院妇产科，重庆；曾宗跃：重庆医科大学附属第一医院检验科，重庆
关键词: 干细胞治疗；放射性直肠损伤；肠道干细胞；间充质干细胞；类器官；Stem Cell Therapy； Radiation-Induced Proctopathy； Intestinal Stem Cells； Mesenchymal Stem Cells； Organoids
摘要: 放射性直肠损伤(Radiation-induced Rectal Injury, RRI)是盆腔放疗后常见的严重并发症，其核心病理特征为慢性炎症、微血管破坏与进行性纤维化，传统疗法仅能缓解症状而难以实现组织修复。近年研究揭示，Lgr5+肠道干细胞在辐射后特异性耗竭，伴随Wnt/Notch信号通路抑制及纤维化基质形成的物理–生化双重屏障，共同造成隐窝再生能力丧失与干细胞微环境崩溃，但这一“不可逆”过程可能存在可干预的治疗窗口。干细胞治疗为此提供了新范式：间充质干细胞(Mesenchymal stem cell, MSCs)通过旁分泌调控炎症–血管–纤维化轴；肠道类器官移植可原位重建上皮结构与功能；诱导多能干细胞衍生体系突破供体限制；外泌体介导的无细胞疗法则提升安全性与可行性。
Abstract: Radiation-induced rectal injury is a common and serious complication following pelvic radiotherapy. Its core pathological features include chronic inflammation, microvascular damage, and progressive fibrosis. Conventional therapies can only alleviate symptoms but are inadequate for achieving tissue repair. Recent studies have revealed that Lgr5+ intestinal stem cells are specifically depleted after radiation, and the inhibition of Wnt/Notch signaling pathways, combined with the physicochemical dual barrier formed by fibrotic stroma, collectively leads to the loss of crypt regenerative capacity and collapse of the stem cell niche. Nevertheless, this “irreversible” process may present a therapeutic window for intervention. Stem cell therapy offers a new paradigm: mesenchymal stem cells modulate the inflammation-angiogenesis-fibrosis axis via paracrine signaling; intestinal organoid transplantation enables in situ reconstruction of epithelial structure and function; induced pluripotent stem cell-derived systems overcome donor limitations; and exosome-mediated cell-free therapies enhance safety and feasibility.
文章引用：向宇, 曾宗跃, 王佳. 干细胞疗法在放射性直肠损伤中的治疗前景与机制探索[J]. 临床医学进展, 2026, 16(6): 756-764. https://doi.org/10.12677/acm.2026.1662274

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