Geng Zixiang, Guo Hailing, Li Yifei, Liu Ying, Zhao Yongfang
Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
Front Cell Dev Biol. 2023 Feb 15;11:1090997. doi: 10.3389/fcell.2023.1090997. eCollection 2023.
Primary ovarian insufficiency (POI) is an essential cause of young female fertility loss. At present, there are many treatments for primary ovarian insufficiency, but due to the complexity of the pathogenesis of primary ovarian insufficiency, the efficacy still could not be satisfactory. Stem cell transplantation is a feasible intervention protocol for primary ovarian insufficiency. However, its wide application in the clinic is limited by some defects such as tumorigenic and controversial ethical issues. Stem cell-derived extracellular vesicles (EVs) represent an important mode of intercellular communication attracting increasing interest. It is well documented that stem cell-derived extracellular vesicles for primary ovarian insufficiency with exciting therapeutic effects. Studies have found that stem cell-derived extracellular vesicles could improve ovarian reserve, increase the growth of follicles, reduce follicle atresia, and restore hormone levels of FSH and E2. Its mechanisms include inhibiting ovarian granulosa cells (GCs) apoptosis, reactive oxygen species, and inflammatory response and promoting granulosa cells proliferation and angiogenesis. Thus, stem cell-derived extracellular vesicles are a promising and potential method for primary ovarian insufficiency patients. However, stem cell-derived extracellular vesicles are still a long way from clinical translation. This review will provide an overview of the role and the mechanisms of stem cell-derived extracellular vesicles in primary ovarian insufficiency, and further elaborate on the current challenges. It may suggest new directions for future research.
原发性卵巢功能不全（POI）是年轻女性生育能力丧失的重要原因。目前，原发性卵巢功能不全有多种治疗方法，但由于原发性卵巢功能不全发病机制复杂，疗效仍不尽人意。干细胞移植是原发性卵巢功能不全一种可行的干预方案。然而，其在临床上的广泛应用受到致瘤性和有争议的伦理问题等缺陷的限制。干细胞衍生的细胞外囊泡（EVs）是一种越来越受关注的细胞间通讯重要方式。有充分的文献记载，干细胞衍生的细胞外囊泡对原发性卵巢功能不全具有令人兴奋的治疗作用。研究发现，干细胞衍生的细胞外囊泡可以改善卵巢储备，增加卵泡生长，减少卵泡闭锁，并恢复促卵泡激素（FSH）和雌二醇（E2）的激素水平。其机制包括抑制卵巢颗粒细胞（GCs）凋亡、活性氧和炎症反应，促进颗粒细胞增殖和血管生成。因此，干细胞衍生的细胞外囊泡对原发性卵巢功能不全患者来说是一种有前景和潜力的方法。然而，干细胞衍生的细胞外囊泡距离临床转化仍有很长的路要走。本综述将概述干细胞衍生的细胞外囊泡在原发性卵巢功能不全中的作用和机制，并进一步阐述当前面临的挑战。它可能为未来的研究指明新的方向。
