WFIRM, Wake Forest University School of Medicine, Winston Salem, NC, USA; AIAS, Aarhus Institute for Advanced Sciences, Aarhus University, Aarhus, Denmark.
Adv Drug Deliv Rev. 2015 Mar;82-83:117-22. doi: 10.1016/j.addr.2014.10.017. Epub 2014 Oct 23.
The current treatments of bladder dysfunctions, such as bladder overactivity and impaired ability to empty, have limitations, and new treatment alternatives are needed. Stem cell transplantation and tissue engineering have shown promising results in preclinical studies. Stem cells were originally thought to act by differentiating into various cell types, thereby replacing damaged cells and restoring functional deficits. Even if such a mechanism cannot be excluded, the current belief is that a main action is exerted by the stem cells secreting bioactive factors that direct other stem cells to the target organ. In addition, stem cells may exert a number of other effects that can improve bladder dysfunction, since they may have antiapoptotic, antifibrotic, and immunomodulatory properties, and can induce neovascularization. Tissue engineering for bladder replacement, which has had varying success in different animal species, has reached the proof-of-concept state in humans, but recent research suggests that the present approaches may not be optimal. Further studies on new approaches, using animal models with translational predictability, seem necessary for further progress.
目前针对膀胱功能障碍（如膀胱过度活动和排空障碍）的治疗方法存在局限性，需要新的治疗选择。干细胞移植和组织工程在临床前研究中显示出了有前景的结果。最初，人们认为干细胞通过分化为各种细胞类型来发挥作用，从而替代受损细胞并恢复功能缺陷。即使不能排除这种机制，目前的观点认为，干细胞的主要作用是通过分泌生物活性因子来发挥作用，这些因子可以指导其他干细胞到达靶器官。此外，干细胞可能通过多种其他作用来改善膀胱功能障碍，因为它们具有抗凋亡、抗纤维化和免疫调节特性，并能诱导新血管生成。用于膀胱替代的组织工程在不同动物物种中取得了不同程度的成功，已在人类中达到概念验证阶段，但最近的研究表明，目前的方法可能并不理想。使用具有转化预测性的动物模型进行新方法的进一步研究，对于进一步进展似乎是必要的。
