Research Institute for Uronephrology and Reproductive Health, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
J Tissue Eng Regen Med. 2018 Feb;12(2):e1108-e1121. doi: 10.1002/term.2444. Epub 2017 Aug 2.
Stress urinary incontinence (SUI) significantly diminishes the quality of patients' lives. Currently available surgical and nonsurgical therapies remain far from ideal. At present, advances in cellular technologies have stirred growing interest in the use of autologous cell treatments aimed to regain urinary control. The objective was to conduct a review of the literature and analyse preclinical and clinical studies dedicated to various cell therapies for SUI, assessing their effectiveness, safety, and future prospects. A systematic literature search in PubMed was conducted using the following key terms: "stem," "cell," "stress," "urinary," and "incontinence." A total of 32 preclinical studies and 15 clinical studies published between 1946 and December 2014 were included in the review. Most preclinical trials have used muscle-derived stem cells and adipose-derived stem cells. However, at present, the application of other types of cells, such as human amniotic fluid stem muscle-derived progenitor cells and bone marrow mesenchymal stromal cells, is becoming more extensive. While the evidence shows that these therapies are effective and safe, further work is required to standardize surgical techniques, as well as to identify indications for their use, doses and number of doses. Future research will have to focus on clinical applications of cell therapies; namely, it will have to determine indications for their use, doses of cells, optimal surgical techniques and methods, attractive cell sources, as well as to develop clinically relevant animal models and make inroads into understanding the mechanisms of SUI improvement by cell therapies.
压力性尿失禁(SUI)显著降低了患者的生活质量。目前可用的手术和非手术治疗方法远不理想。目前,细胞技术的进步激发了人们对使用自体细胞治疗以恢复尿控的兴趣日益增加。本研究旨在对各种用于 SUI 的细胞治疗的基础研究和临床研究进行综述,评估其有效性、安全性和未来前景。在 PubMed 中使用以下关键词进行了系统的文献检索:“stem”、“cell”、“stress”、“urinary”和“incontinence”。共纳入了 1946 年至 2014 年 12 月期间发表的 32 项基础研究和 15 项临床研究。大多数基础研究都使用了肌肉源性干细胞和脂肪源性干细胞。然而,目前,其他类型的细胞,如人羊水干细胞和骨髓间充质基质细胞的应用越来越广泛。虽然这些治疗方法有效且安全,但仍需要进一步的工作来标准化手术技术,并确定其使用的适应症、剂量和剂量数。未来的研究将必须专注于细胞治疗的临床应用;即,必须确定其使用的适应症、细胞剂量、最佳手术技术和方法、有吸引力的细胞来源,以及开发临床相关的动物模型,并深入了解细胞治疗改善 SUI 的机制。