Cheng Juan, Zhao Zhi-Wei, Wen Ji-Rui, Wang Ling, Huang Li-Wei, Yang Yan-Lin, Zhao Feng-Nian, Xiao Jing-Yue, Fang Fei, Wu Jiang, Miao Ya-Li
Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, West China Second University Hospital, West China Campus, Sichuan University, Chengdu 610041, Sichuan Province, China.
West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Clin Cases. 2020 Apr 26;8(8):1400-1413. doi: 10.12998/wjcc.v8.i8.1400.
Pelvic floor disorders (PFDs) represent a group of common and frequently-occurring diseases that seriously affect the life quality of women, generally including stress urinary incontinence and pelvic organ prolapse. Surgery has been used as a treatment for PFD, but almost 30% of patients require subsequent surgery due to a high incidence of postoperative complications and high recurrence rates. Therefore, investigations of new therapeutic strategies are urgently needed. Stem cells possess strong multi-differentiation, self-renewal, immunomodulation, and angiogenesis abilities and they are able to differentiate into various cell types of pelvic floor tissues and thus provide a potential therapeutic approach for PFD. Recently, various studies using different autologous stem cells have achieved promising results by improving the pelvic ligament and muscle regeneration and conferring the tissue elasticity and strength to the damaged tissue in PFD, as well as reduced inflammatory reactions, collagen deposition, and foreign body reaction. However, with relatively high rates of complications such as bladder stone formation and wound infections, further studies are necessary to investigate the role of stem cells as maintainers of tissue homeostasis and modulators in early interventions including therapies using new stem cell sources, exosomes, and tissue-engineering combined with stem cell-based implants, among others. This review describes the types of stem cells and the possible interaction mechanisms in PFD treatment, with the hope of providing more promising stem cell treatment strategies for PFD in the future.
盆底功能障碍（PFDs）是一组常见且多发的疾病，严重影响女性的生活质量，通常包括压力性尿失禁和盆腔器官脱垂。手术一直被用作治疗PFD的方法，但由于术后并发症发生率高和复发率高，近30%的患者需要后续手术。因此，迫切需要研究新的治疗策略。干细胞具有强大的多分化、自我更新、免疫调节和血管生成能力，能够分化为盆底组织的各种细胞类型，从而为PFD提供一种潜在的治疗方法。最近，各种使用不同自体干细胞的研究通过改善盆腔韧带和肌肉再生、赋予受损组织组织弹性和强度以及减少炎症反应、胶原蛋白沉积和异物反应，取得了令人鼓舞的结果。然而，由于膀胱结石形成和伤口感染等并发症发生率相对较高，有必要进一步研究干细胞作为组织稳态维持者和早期干预调节剂的作用，包括使用新的干细胞来源、外泌体以及与基于干细胞的植入物相结合的组织工程等疗法。本综述描述了干细胞的类型以及在PFD治疗中可能的相互作用机制，希望未来能为PFD提供更有前景的干细胞治疗策略。
