LBGM, Laboratoire de Biochimie et de Génétique Moléculaire, Université de l'île de la Réunion, Saint-Denis Messag Cedex, France.
J Cell Mol Med. 2010 Jan;14(1-2):135-42. doi: 10.1111/j.1582-4934.2009.00915.x. Epub 2009 Oct 3.
Stress urinary incontinence (SUI), the most common type of incontinence in women, is a frequent and costly ailment responsible for an alteration in the quality of life. Although medical treatment gives some rather deceiving results, surgical techniques that include colposuspension or tension-free vaginal tape, employed in cases of urethral support defect, give a 5-year cure rate of more than 80%. However, these techniques could lead to complications or recurrence of symptoms. Recently, the initiation of urethral cell therapy has been undertaken by doctors and researchers. One principal source of autologous adult stem cells is generally used: muscle precursor cells (MPCs) which are the progenitors of skeletal muscle cells. Recently, a few research groups have shown interest in the MPCs and their potential for the treatment of urinary incontinence. However, using MPCs or fibroblasts isolated from a striated muscle biopsy could be questionable on several points. One of them is the in vitro cultivation of cells, which raises issues over the potential cost of the technique. Besides, numerous studies have shown the multipotent or even the pluripotent nature of stromal vascular fraction (SVF) or adipose-derived stem cells (ASCs) from adipose tissue. These cells are capable of acquiring in vitro many different phenotypes. Furthermore, recent animal studies have highlighted the potential interest of SVF cells or ASCs in cell therapy, in particular for mesodermal tissue repair and revascularization. Moreover, the potential interest of SVF cells or ASCs for the treatment of urinary incontinence in women is supported by many other characteristics of these cells that are discussed here. Because access to these cells via lipoaspiration is simple, and because they are found in very large numbers in adipose tissue, their future potential as a stem cell reservoir for use in urethral or other types of cell therapy is enormous.
压力性尿失禁（SUI）是女性最常见的尿失禁类型，是一种常见且代价高昂的疾病，会改变生活质量。尽管药物治疗有一定效果，但对于尿道支撑缺陷的病例，采用阴道吊带（colposuspension）或无张力阴道吊带（tension-free vaginal tape）等外科技术的 5 年治愈率超过 80%。然而，这些技术可能会导致并发症或症状复发。最近，尿道细胞疗法的开展受到了医生和研究人员的关注。自体成体干细胞的主要来源一般是：肌肉前体细胞（MPCs），它是骨骼肌细胞的前体。最近，一些研究小组对 MPCs 及其治疗尿失禁的潜力产生了兴趣。然而，使用 MPCs 或从横纹肌活检中分离出的成纤维细胞，在几个方面可能存在疑问。其中之一是细胞的体外培养，这涉及到该技术潜在的成本问题。此外，许多研究表明，来源于脂肪组织的基质血管成分（SVF）或脂肪来源的干细胞（ASCs）具有多能性，甚至多潜能性。这些细胞能够在体外获得许多不同的表型。此外，最近的动物研究强调了 SVF 细胞或 ASCs 用于细胞治疗的潜在意义，特别是对于中胚层组织修复和再血管化。此外，SVF 细胞或 ASCs 治疗女性尿失禁的潜在意义还得到了这些细胞的许多其他特性的支持，本文将对此进行讨论。由于可以通过脂肪抽吸获得这些细胞，而且它们在脂肪组织中数量非常多，因此它们作为尿道或其他类型细胞治疗用干细胞库的未来潜力巨大。
