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绝对子宫因素不孕症的子宫再生医学现状

Current status of uterine regenerative medicine for absolute uterine factor infertility.

作者信息

Matoba Yusuke, Kisu Iori, Sera Asako, Yanokura Megumi, Banno Kouji, Aoki Daisuke

机构信息

Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan.

出版信息

Biomed Rep. 2019 Feb;10(2):79-86. doi: 10.3892/br.2019.1182. Epub 2019 Jan 4.

Abstract

Though assisted reproduction technology has been developed, a treatment for absolute uterine factor infertility (AUFI), such as defects in the uterus, has not yet been established. Regenerative medicine has been developed and applied clinically over recent years; however, whole solid organs still cannot be produced. Though uterine regeneration has the potential to be a treatment for AUFI, there have been only a few studies on uterine regeneration involving the myometrium . In the present report, those relevant articles are reviewed. A literature search was conducted in PubMed with a combination of key words, and 10 articles were found, including nine in rat models and one in a mouse model. Of these studies, eight used scaffolds and two were performed without scaffolds. In four of these studies, scaffolds were re-cellularized with various cells. In the remaining four studies, scaffolds were transplanted alone, or other structures were used. Though the methods differed, the injured uterus recovered well, morphologically and functionally, in every study. Only 10 articles were relevant to our investigation, but the results were favorable, if limited to partial regeneration. Recently, uterus transplantation (UTx) has been investigated as a treatment for AUFI. However, UTx has many problems in the medical, ethical and social fields. Though the artificial uterus was also researched and some improvements in this technology were reported, it will take long time for this to reach a clinically applicable stage. Though the results of uterine regeneration studies were promising, these studies were conducted using animal models, so further human studies and trials are needed.

摘要

尽管辅助生殖技术已经得到发展,但针对绝对子宫因素不孕症(AUFI)的治疗方法,如子宫缺陷,尚未确立。近年来,再生医学得到了发展并应用于临床;然而,完整的实体器官仍然无法制造。虽然子宫再生有可能成为治疗AUFI的方法,但关于子宫肌层的子宫再生研究却很少。在本报告中,对那些相关文章进行了综述。在PubMed上使用关键词组合进行文献检索,共找到10篇文章,其中包括9篇大鼠模型研究和1篇小鼠模型研究。在这些研究中,8项使用了支架,2项未使用支架。在其中4项研究中,支架用各种细胞进行了再细胞化处理。在其余4项研究中,单独移植了支架,或使用了其他结构。尽管方法不同,但在每项研究中,受损子宫在形态和功能上都恢复良好。与我们的研究相关的文章只有10篇,但如果仅限于部分再生,结果是令人满意的。最近,子宫移植(UTx)作为治疗AUFI的方法正在被研究。然而,UTx在医学、伦理和社会领域存在许多问题。尽管也对人工子宫进行了研究,并报告了该技术的一些改进,但要达到临床应用阶段还需要很长时间。尽管子宫再生研究的结果很有前景,但这些研究是在动物模型上进行的,因此还需要进一步的人体研究和试验。

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