Vassena R, Eguizabal C, Heindryckx B, Sermon K, Simon C, van Pelt A M M, Veiga A, Zambelli F
Clinica EUGIN, Barcelona, Spain
Cell Therapy and Stem Cell Laboratory, Basque Center for Transfusion and Human Tissues, Galdakao, Spain.
Hum Reprod. 2015 Sep;30(9):2014-21. doi: 10.1093/humrep/dev181. Epub 2015 Jul 22.
Are there effective and clinically validated stem cell-based therapies for reproductive diseases?
At the moment, clinically validated stem cell treatments for reproductive diseases and alterations are not available.
Research in stem cells and regenerative medicine is growing in scope, and its translation to the clinic is heralded by the recent initiation of controlled clinical trials with pluripotent derived cells. Unfortunately, stem cell 'treatments' are currently offered to patients outside of the controlled framework of scientifically sound research and regulated clinical trials. Both physicians and patients in reproductive medicine are often unsure about stem cells therapeutic options.
STUDY DESIGN, SIZE, DURATION: An international working group was assembled to review critically the available scientific literature in both the human species and animal models.
PARTICIPANTS/MATERIALS, SETTING, METHODS: This review includes work published in English until December 2014, and available through Pubmed.
A few areas of research in stem cell and reproductive medicine were identified: in vitro gamete production, endometrial regeneration, erectile dysfunction amelioration, vaginal reconstruction. The stem cells studied range from pluripotent (embryonic stem cells and induced pluripotent stem cells) to monopotent stem cells, such as spermatogonial stem cells or mesenchymal stem cells. The vast majority of studies have been carried out in animal models, with data that are preliminary at best.
LIMITATIONS, REASONS FOR CAUTION: This review was not conducted in a systematic fashion, and reports in publications not indexed in Pubmed were not analyzed.
A much broader clinical knowledge will have to be acquired before translation to the clinic of stem cell therapies in reproductive medicine; patients and physicians should be wary of unfounded claims of improvement of existing medical conditions; at the moment, effective stem cell treatment for reproductive diseases and alterations is not available.
STUDY FUNDING/COMPETING INTERESTS: None.
NA.
是否存在针对生殖疾病的有效且经过临床验证的基于干细胞的疗法?
目前,尚无经过临床验证的针对生殖疾病和病变的干细胞治疗方法。
干细胞和再生医学的研究范围正在不断扩大,多能干细胞衍生细胞的对照临床试验近期启动,预示着其向临床应用的转化。不幸的是,目前干细胞“治疗”是在科学合理研究和规范临床试验的对照框架之外提供给患者的。生殖医学领域的医生和患者通常对干细胞治疗选择感到不确定。
研究设计、规模、持续时间:成立了一个国际工作组,对人类和动物模型中的现有科学文献进行严格审查。
参与者/材料、环境、方法:本综述包括截至2014年12月以英文发表并可通过PubMed获取的研究成果。
确定了干细胞与生殖医学的几个研究领域:体外配子生成、子宫内膜再生、勃起功能障碍改善、阴道重建。所研究的干细胞范围从多能干细胞(胚胎干细胞和诱导多能干细胞)到单能干细胞,如精原干细胞或间充质干细胞。绝大多数研究是在动物模型中进行的,数据充其量只是初步的。
局限性、谨慎的理由:本综述并非以系统的方式进行,未分析未被PubMed索引的出版物中的报告。
在将干细胞疗法转化应用于生殖医学临床之前,必须获取更广泛的临床知识;患者和医生应警惕对现有医疗状况改善的无端宣称;目前,尚无针对生殖疾病和病变的有效干细胞治疗方法。
研究资金/利益冲突:无。
无。