Aboushwareb Tamer, Atala Anthony
Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Nat Clin Pract Urol. 2008 Nov;5(11):621-31. doi: 10.1038/ncpuro1228. Epub 2008 Oct 14.
The shortage of donors for organ transplantation has stimulated research on stem cells as a potential resource for cell-based therapy in all human tissues. Stem cells have been used for regenerative medicine applications in many organ systems, including the genitourinary system. The potential applications for stem cell therapy have, however, been restricted by the ethical issues associated with embryonic stem cell research. Instead, scientists have explored other cell sources, including progenitor and stem cells derived from adult tissues and stem cells derived from the amniotic fluid and placenta. In addition, novel techniques for generating stem cells in the laboratory are being developed. These techniques include somatic cell nuclear transfer, in which the nucleus of an adult somatic cell is placed into an oocyte, and reprogramming of adult cells to induce stem-cell-like behavior. Such techniques are now being used in tissue engineering applications, and some of the most successful experiments have been in the field of urology. Techniques to regenerate bladder tissue have reached the clinic, and exciting progress is being made in other areas, such as regeneration of the kidney and urethra. Cell therapy as a treatment for incontinence and infertility might soon become a reality. Physicians should be optimistic that regenerative medicine and tissue engineering will one day provide mainstream treatment options for urologic disorders.
器官移植供体的短缺促使人们对干细胞展开研究，将其作为所有人体组织基于细胞治疗的潜在资源。干细胞已被用于许多器官系统的再生医学应用，包括泌尿生殖系统。然而，干细胞治疗的潜在应用受到了与胚胎干细胞研究相关的伦理问题的限制。取而代之的是，科学家们探索了其他细胞来源，包括源自成人组织的祖细胞和干细胞以及源自羊水和胎盘的干细胞。此外，实验室中生成干细胞的新技术也在不断发展。这些技术包括体细胞核移植，即将成人体细胞的细胞核植入卵母细胞，以及对成人细胞进行重编程以诱导干细胞样行为。此类技术目前正应用于组织工程领域，一些最为成功的实验是在泌尿外科领域。膀胱组织再生技术已进入临床，并且在其他领域，如肾脏和尿道再生方面也取得了令人振奋的进展。细胞疗法作为治疗尿失禁和不孕症的手段可能很快会成为现实。医生们应持乐观态度，相信再生医学和组织工程终有一天会为泌尿系统疾病提供主流治疗选择。
