CD34+细胞异质性在心血管损伤与修复中的多重角色

doi:10.3969/j.issn.1674-8115.2025.12.012

摘要/Abstract

摘要：

心血管损伤与修复依赖于多种细胞的募集、增殖与分化。CD34⁺细胞作为一类以分化簇34（cluster of differentiation 34，CD34）蛋白为标志物的异质性细胞群体，长期被视为心血管再生与修复的关键靶点。该类细胞可展现出高度的异质性与多向分化潜能，在特定的微环境信号调控下，能够分化为内皮细胞、平滑肌细胞、成纤维细胞、炎症细胞等多种谱系，在内皮修复、组织纤维化、免疫调节等过程中发挥重要作用。在心血管疾病中CD34⁺细胞可介导双重调控作用：既能促进组织修复与再生，又可能加剧病理损伤。尽管CD34⁺细胞疗法在心血管疾病中已具有良好的治疗潜力，但其向临床转化的过程仍面临诸多挑战与瓶颈。基于此，该文系统梳理了CD34⁺细胞的来源、分化轨迹与功能异质性，总结其在心血管基础研究与临床转化中的最新进展，旨在为深化疾病机制理解、开发新型精准治疗策略提供新视角。

关键词: CD34⁺细胞, 心血管疾病, 内皮修复, 内皮祖细胞, CD34⁺细胞治疗

Abstract:

Cardiovascular injury and repair rely on the coordinated recruitment, proliferation, and differentiation of multiple cell types. As a heterogeneous cell population defined by the cluster of differentiation 34 (CD34) protein, CD34⁺ cells have long been regarded as key targets for cardiovascular regeneration and repair. These cells exhibit pronounced heterogeneity and pluripotent differentiation potential. Under the regulation of specific microenvironmental signals, they can differentiate into multiple lineages, such as endothelial cells, smooth muscle cells, fibroblasts, and inflammatory cells, thereby contributing to endothelial repair, tissue fibrosis, and immune modulation. In cardiovascular disease, CD34⁺ cells exert dual effects: they may facilitate tissue repair and regeneration while also potentially exacerbating pathological injury. Although CD34⁺ cell therapies have shown therapeutic promise in cardiovascular diseases, their clinical translation still faces numerous challenges and bottlenecks. Here, current evidence on the sources, differentiation trajectories, and functional heterogeneity of CD34⁺ cells is synthesized, and recent advances spanning basic research and clinical translation are summarized, with the aim of refining mechanistic understanding and informing the development of precise therapeutic strategies.

Key words: CD34? cell, cardiovascular disease, endothelial repair, endothelial progenitor cell, CD34⁺ cell therapy

中图分类号:

秦梓豪, 袁洪, 陆瑶, 冷一铭. CD34⁺细胞异质性在心血管损伤与修复中的多重角色[J]. 上海交通大学学报（医学版）, 2025, 45(12): 1662-1670.

QIN Zihao, YUAN Hong, LU Yao, LENG Yiming. Multiple roles of CD34⁺ cell heterogeneity in cardiovascular injury and repair[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(12): 1662-1670.

图/表 4

图1 血管壁CD34⁺细胞的来源与分化方向Note： SMC—smooth muscle cell.

Fig 1 Origins and differentiation pathways of CD34+ cells in the vascular wall

表1 CD34⁺细胞及其分化细胞的组织分布、表型标志物与功能概览

Tab 1 Overview of tissue distribution， phenotypic markers， and functions of CD34⁺ cells and their differentiated lineages

Cell subset	Distribution	Marker	Principal function
HSCs	Bone marrow, peripheral blood	Lin^-, CD34⁺, CD38^-, CD90⁺, CD45RA^-	Hematopoiesis and long-term reconstitution
EPCs	Bone marrow, peripheral blood, vascular intima, multiple organs	CD34⁺, CD133⁺, VEGFR2⁺, CD31⁺, VE-cadherin⁺, vWF⁺, CD45^-	Endothelial repair and angiogenesis
Inflammatory cells	Bone marrow, peripheral blood, tissues	CD45⁺	Immune responses and inflammation
Fibroblasts	Interstitium across organs	CD34⁺, PDGFRα⁺, PI16⁺ (mouse)	Matrix production, tissue repair, and regulation of fibrosis
Fibroblast progenitors	Multiple organs	CD34⁺ Sca1⁺(mouse), PI16⁺ (mouse), POSTN⁺	Differentiation into fibroblasts/myofibroblasts
SMCs	Multiple organs	αSMA⁺, MYH11⁺, SM22α⁺, CNN1⁺	Contractility and vascular tone, and remodeling in injury/fibrosis
SMPCs	Multiple organs	Sca1⁺ (mouse), CD34⁺, PDGFRβ⁺	Differentiation into SMCs and fibroblast-like lineages
MSCs	Bone marrow, adipose tissue, multiple organs	CD29⁺, CD44⁺, CD73⁺, CD90⁺, CD105⁺, CD34⁺	Osteogenic, chondrogenic, and adipogenic differentiation

图2 CD34⁺细胞向内皮细胞分化的信号调控网络Note： CXCR4—C-X-C chemokine receptor 4; IGF—insulin-like growth factor; FGF-2—fibroblast growth factor 2; PKC—protein kinase C; Ras—rat sarcoma virus oncogene; Raf—rapidly accelerated fibrosarcoma kinase; MEK—mitogen-activated protein kinase; ERK—extracellular signal-regulated kinase; PI3K—phosphoinositide 3-kinase; AKT—protein kinase B; eNOS—endothelial nitric oxide synthase; P53—tumor protein p53; MT3—metallothionein 3.

Fig 2 Signal regulatory network governing the differentiation of CD34⁺ cells into endothelial cells

图3 CD34⁺细胞向平滑肌细胞和成纤维细胞分化的信号调控网络Note： PPARγ—peroxisome proliferator-activated receptor γ; GSK3β—glycogen synthase kinase 3β; Wnt—wingless-type MMTV integration site family member; Fz—frizzled receptor; LPR5/6—low-density lipoprotein receptor-related protein 5/6; TGF-βR—transforming growth factor-β receptor; PDGFR—platelet-derived growth factor receptor; ADAM10—a disintegrin and metalloproteinase domain-containing protein 10; NICD—Notch intracellular domain; PTCH1—patched 1; GLIA—glioma-associated oncogene homolog A; GLI2/3—glioma-associated oncogene homolog 2/3.

Fig 3 Signaling regulatory network governing the differentiation of CD34⁺ cells into smooth muscle cells and fibroblasts

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