IVI Foundation, Health Research Institute La Fe, 46026 Valencia, Spain.
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 05610, USA.
Int J Mol Sci. 2022 Dec 14;23(24):15942. doi: 10.3390/ijms232415942.
There are several conditions that lead to female infertility, where traditional or conventional treatments have limited efficacy. In these challenging scenarios, stem cell (SC) therapies have been investigated as alternative treatment strategies. Human umbilical cord (hUC) mesenchymal stem cells (hUC-MSC), along with their secreted paracrine factors, extracts, and biomolecules, have emerged as promising therapeutic alternatives in regenerative medicine, due to their remarkable potential to promote anti-inflammatory and regenerative processes more efficiently than other autologous treatments. Similarly, hUC blood derivatives, such as platelet-rich plasma (PRP), or isolated plasma elements, such as growth factors, have also demonstrated potential. This literature review aims to summarize the recent therapeutic advances based on hUC-MSCs, hUC blood, and/or other plasma derivatives (e.g., extracellular vesicles, hUC-PRP, and growth factors) in the context of female reproductive medicine. We present an in-depth analysis of the principal molecules mediating tissue regeneration, compiling the application of these therapies in preclinical and clinical studies, within the context of the human reproductive tract. Despite the recent advances in bioengineering strategies that sustain delivery and amplify the scope of the therapeutic benefits, further clinical trials are required prior to the wide implementation of these alternative therapies in reproductive medicine.
有几种情况会导致女性不孕,传统或常规治疗的疗效有限。在这些具有挑战性的情况下,干细胞(SC)治疗已被作为替代治疗策略进行了研究。人脐带(hUC)间充质干细胞(hUC-MSC)及其分泌的旁分泌因子、提取物和生物分子,由于其在促进抗炎和再生过程方面具有比其他自体治疗更显著的潜力,已成为再生医学中很有前途的治疗选择。同样,hUC 血液衍生物,如富含血小板的血浆(PRP),或分离的血浆成分,如生长因子,也显示出了潜力。本文旨在综述基于 hUC-MSC、hUC 血液和/或其他血浆衍生物(如细胞外囊泡、hUC-PRP 和生长因子)的最新治疗进展,以探讨其在女性生殖医学中的应用。我们对介导组织再生的主要分子进行了深入分析,整理了这些疗法在临床前和临床研究中的应用,范围涵盖了人类生殖道。尽管在维持输送和扩大治疗效益范围的生物工程策略方面取得了最新进展,但在这些替代疗法广泛应用于生殖医学之前,还需要进行更多的临床试验。