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治疗 Asherman 综合征和子宫内膜萎缩的策略:从经典的实验模型到新的生物工程方法。

Strategies for managing Asherman's syndrome and endometrial atrophy: Since the classical experimental models to the new bioengineering approach.

机构信息

Fundación Instituto Valenciano de Infertilidad (FIVI), La Fe Health Research Institute, Valencia, Spain.

University of Valencia, Valencia, Spain.

出版信息

Mol Reprod Dev. 2021 Aug;88(8):527-543. doi: 10.1002/mrd.23523. Epub 2021 Jul 22.

Abstract

Endometrial function is essential for embryo implantation and pregnancy, but managing endometrial thickness that is too thin to support pregnancy or an endometrium of compromised functionality due to intrauterine adhesions is an ongoing challenge in reproductive medicine. Here, we review current and emerging therapeutic and experimental options for endometrial regeneration with a focus on animal models used to study solutions for Asherman's syndrome and endometrial atrophy, which both involve a damaged endometrium. A review of existing literature was performed that confirmed the lack of consensus on endometrial therapeutic options, though promising new alternatives have emerged in recent years (platelet-rich plasma, exosomes derived from stem cells, bioengineering-based techniques, endometrial organoids, among others). In the future, basic research using established experimental models of endometrial pathologies (combined with new high-tech solutions) and human clinical trials with large population sizes are needed to evaluate these emerging and new endometrial therapies.

摘要

子宫内膜功能对于胚胎着床和妊娠至关重要,但是管理由于宫腔粘连而导致无法支持妊娠的过薄的子宫内膜或功能受损的子宫内膜仍然是生殖医学中的一个持续挑战。在这里,我们回顾了当前和新兴的子宫内膜再生治疗和实验选择,重点关注用于研究 Asherman 综合征和子宫内膜萎缩解决方案的动物模型,这两种情况都涉及受损的子宫内膜。对现有文献的回顾证实了对于子宫内膜治疗选择缺乏共识,尽管近年来出现了一些有前途的新替代方案(富含血小板的血浆、源自干细胞的外泌体、基于生物工程的技术、子宫内膜类器官等)。未来,需要使用已建立的子宫内膜病变实验模型进行基础研究(结合新的高科技解决方案)以及进行大规模人群的人类临床试验,以评估这些新兴的和新的子宫内膜治疗方法。

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