心肌梗死研究中的内皮祖细胞异质性：外泌体疗法的挑战与机遇
Endothelial Progenitor Cell Heterogeneity in Myocardial Infarction Research: Challenges and Opportunities for Exosome Therapy
DOI: 10.12677/acm.2026.1693187, PDF,    科研立项经费支持
作者: 彭 田*, 刘朝丰, 彭 维, 王小琴, 初钰洁：大理大学临床医学院，云南 大理；杨 瑛#：大理大学第一附属医院心血管内科，云南 大理
关键词: 内皮祖细胞；异质性；外泌体；miR-126；心肌梗死；标准化；Endothelial Progenitor Cells； Heterogeneity； Exosomes； miR-126； Myocardial Infarction； Standardization
摘要: 背景：内皮祖细胞(EPCs)有促血管新生的能力，可以对心肌梗死修复有帮助。但“EPCs”是一个功能性统称而非可精确定义的细胞类型，不同实验室采用不同的分离方法和表面标志物，获得的是生物学特性迥异的细胞混合物。这一异质性导致研究结论碎片化，制约了临床转化。目的：本文将梳理EPCs异质性的来源及研究结论的影响，并探讨将外泌体作为标准化治疗可行性。主要内容：EPCs定义的演变，通过亚型的生物学特征和功能差异，分析分离方法、表型鉴定策略对细胞亚群组成的影响及结论冲突。以EPCs来源外泌体递送miR-126激活PTEN/PI3K/AKT通路为例，讲述外泌体如何绕过细胞异质性，并且提出从“细胞身份定义”转向“外泌体内容物定义”的框架。结论：EPCs异质性阻碍了临床转化，外泌体治疗有望绕过EPCs异质性，为心肌梗死的标准化治疗提供新思路，加速临床转化。
Abstract: Background: Endothelial progenitor cells (EPCs) have angiogenic potential and may aid in the repair of myocardial infarction. However, “EPCs” is a functional umbrella term rather than a precisely defined cell type; different laboratories use varying isolation methods and surface markers, yielding cell mixtures with markedly different biological characteristics. This heterogeneity leads to fragmented research findings and hinders clinical translation. Objective: This paper will examine the sources of EPCs heterogeneity and the implications of research findings, and explore the feasibility of using exosomes as a standardized treatment. Main Content: The evolution of the definition of EPCs; an analysis of the impact of separation methods and phenotypic identification strategies on the composition of cell subsets, as well as conflicting conclusions, based on the biological characteristics and functional differences among subtypes. Using the example of miR-126 delivery via EPCs-derived exosomes to activate the PTEN/PI3K/AKT pathway, this section explains how exosomes circumvent cellular heterogeneity and proposes a framework that shifts from a “cell identity-based definition” to an “exosome content-based definition”. Conclusion: EPCs heterogeneity hinders clinical translation; exosome therapy holds promise for overcoming this heterogeneity, offering a new approach to standardized treatment for myocardial infarction and accelerating clinical translation.
文章引用：彭田, 杨瑛, 刘朝丰, 彭维, 王小琴, 初钰洁. 心肌梗死研究中的内皮祖细胞异质性：外泌体疗法的挑战与机遇[J]. 临床医学进展, 2026, 16(9): 1481-1491. https://doi.org/10.12677/acm.2026.1693187

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