1Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Montpellier, 34093 France.
2Department of Gynecology and Obstetrics, University Hospital, Nîmes, 30900 France.
Commun Biol. 2019 May 22;2:196. doi: 10.1038/s42003-019-0447-x. eCollection 2019.
Intrauterine adhesions lead to partial or complete obliteration of the uterine cavity and have life-changing consequences for women. The leading cause of adhesions is believed to be loss of stroma resulting from trauma to the endometrium after surgery. Adhesions are formed when lost stroma is replaced by fibrous tissue that join the uterine walls. Few effective intrauterine anti-adhesion barriers for gynecological surgery exist. We designed a degradable anti-adhesion medical device prototype to prevent adhesion formation and recurrence and restore uterine morphology. We focused on ideal degradation time for complete uterine re-epithelialization for optimal anti-adhesion effect and clinical usability. We developed a triblock copolymer prototype [poly(lactide) combined with high molecular mass poly(ethylene oxide)]. Comparative pre-clinical studies demonstrated in vivo anti-adhesion efficacy. Ease of introduction and optimal deployment in a human uterus confirmed clinical usability. This article provides preliminary data to develop an intrauterine medical device and conduct a clinical trial.
宫腔粘连导致子宫腔部分或完全闭塞,对女性的生活产生了改变。宫腔粘连的主要原因被认为是手术导致子宫内膜基质丢失,而丢失的基质被纤维组织取代,导致子宫壁粘连。目前,用于妇科手术的宫腔内防粘连产品寥寥无几。我们设计了一种可降解的防粘连医疗器械原型,以预防粘连形成和复发,恢复子宫形态。我们专注于理想的降解时间,以实现完全的子宫再上皮化,从而达到最佳的防粘连效果和临床实用性。我们开发了一种嵌段共聚物原型[聚(乳酸)与高分子量聚(氧化乙烯)结合]。临床前比较研究证明了其体内防粘连的功效。易于引入和在人体子宫内的最佳部署证实了其临床实用性。本文提供了开发宫腔内医疗器械和进行临床试验的初步数据。