Davis Niall F, Cunnane Eoghan M, Mulvihill John J, Quinlan Mark R, Bolton Damien M, Walsh Michael T, Jack Gregory S
Department of Urology, The Austin Hospital, Melbourne, Australia.
School of Engineering, Bernal Institute and the Health Research Institute, University of Limerick, Limerick, Ireland.
Curr Stem Cell Res Ther. 2018;13(6):458-465. doi: 10.2174/1574888X13666180426113907.
The urinary bladder and urethra comprise the lower urinary tracts. Pathological conditions that affect both structures necessitate reconstructive urological intervention with autologous tissue sources that cause neuromechanical and metabolic complications. Stem-cell therapies may offer an attractive alternative as they can replicate important host derived cellular functions such as mitosis, proliferation, differentiation and apoptosis.
To provide an overview on the application of stem cell therapies for regenerating the lower urinary tracts and to discuss factors that need to be addressed before stem-cells can be reliably introduced into clinical urological practice.
Advantages of stem cells in reconstructive urology are their ability to self-renew and their durability. Mesenchymal stem cells (MSCs), embryonic stem cells (ESCs) and adult stem cells (ASCs) demonstrate excellent urological regenerative properties. Repairing defective lower urinary tract structures with various stem-cell derived therapies has been widely reported with encouraging results in vitro and in pre-clinical in vivo trials. Ethical considerations, cost, regulation, manufacturing and reimbursement need to be fully transparent before stem-cells are routinely applied to urological patients. International collaboration with consensus guidelines should be considered to facilitate standards that allow safe use of stem-cell therapies in urology.
Stem cells therapies in urology are developing rapidly with many important achievements to date. Despite promising in vitro and pre-clinical data; implementation of stem cells into daily urological practice is not imminent. Further investigation is required to determine whether stem-cells will provide better clinical outcomes than current urological tissue replacement strategies.
膀胱和尿道构成下尿路。影响这两个结构的病理状况需要采用自体组织来源进行重建性泌尿外科干预，而这会引发神经机械和代谢并发症。干细胞疗法可能提供一种有吸引力的替代方案，因为它们可以复制重要的宿主衍生细胞功能，如细胞有丝分裂、增殖、分化和凋亡。
概述干细胞疗法在再生下尿路方面的应用，并讨论在干细胞能够可靠地应用于临床泌尿外科实践之前需要解决的因素。
干细胞在重建性泌尿外科中的优势在于其自我更新能力和耐久性。间充质干细胞（MSC）、胚胎干细胞（ESC）和成体干细胞（ASC）均表现出优异的泌尿外科再生特性。使用各种干细胞衍生疗法修复有缺陷的下尿路结构已被广泛报道，在体外和临床前体内试验中均取得了令人鼓舞的结果。在干细胞常规应用于泌尿外科患者之前，伦理考量、成本、监管、生产和报销等问题需要完全透明。应考虑开展国际合作并制定共识指南，以促进制定允许在泌尿外科安全使用干细胞疗法的标准。
泌尿外科中的干细胞疗法发展迅速，迄今已取得许多重要成果。尽管体外和临床前数据很有前景，但干细胞在日常泌尿外科实践中的应用并非指日可待。需要进一步研究以确定干细胞是否会比当前的泌尿外科组织替代策略提供更好的临床结果。
