Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu Province, China; Fourth Clinical Medicine College, Nanjing Medical University, Nanjing, Jiangsu Province, China.
Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu Province, China.
Tissue Cell. 2022 Feb;74:101676. doi: 10.1016/j.tice.2021.101676. Epub 2021 Nov 9.
Both intrauterine adhesions (IUA) and premature ovarian failure (POF) have plagued women all over the world for a long time. It is well known that all invasive operations involving the uterus can disrupt its structural and functional integrity to a varying degree, which inevitably lead to abnormal scar formation, such as IUA, also known as Asherman's syndrome with symptoms like hypomenorrhea or infertility. Another reproductive disorder that causes infertility is primary ovarian insufficiency (POI) or POF, which is a degenerative phenomenon in the ovary among women under the age of 40. In recent years, various types of stem cells, especially mesenchymal stem cells (MSCs) have been widely used in reproductive medicine due to their properties, such as immunoregulation, anti-inflammation, angiogenesis, anti-apoptosis, and trophicity. However, the extensive clinical application of cell therapy is impeded by their safety, cost, and manufacturing. In this review, we sought to summarize the recent advances in using different types of MSCs in treating uterine scars and POF. We also describe several biological pathways and molecules involved in animal studies and clinical application; extracellular vesicles secreted by MSCs may be a promising attractive tool to ensure the treatment of infertility by restoring normal reproductive function.
宫腔粘连（IUA）和卵巢早衰（POF）长期以来一直困扰着世界各地的女性。众所周知，所有涉及子宫的侵入性手术都会在不同程度上破坏其结构和功能的完整性，这不可避免地导致异常瘢痕形成，如 IUA，也称为 Asherman 综合征，其症状包括月经过少或不孕。另一种导致不孕的生殖障碍是原发性卵巢功能不全（POI）或 POF，这是 40 岁以下女性卵巢的退行性现象。近年来，由于间充质干细胞（MSCs）等特性，如免疫调节、抗炎、血管生成、抗细胞凋亡和营养作用，各种类型的干细胞，特别是间充质干细胞（MSCs）已广泛应用于生殖医学。然而，细胞治疗的广泛临床应用受到其安全性、成本和制造的限制。在这篇综述中，我们试图总结使用不同类型的 MSCs 治疗子宫瘢痕和 POF 的最新进展。我们还描述了动物研究和临床应用中涉及的几种生物学途径和分子；MSC 分泌的细胞外囊泡可能是一种很有前途的有吸引力的工具，可通过恢复正常生殖功能来确保治疗不孕。
