Qiu Jiaxin, Ma Huifen, Pei Yijin
From the Department of Physiology, Guangdong Medical University, NO. 1 Xincheng Avenue, Songshan Lake Science and Technology Industrial Park, Dongguan, Guangdong, China.
Exp Clin Transplant. 2023 Mar;21(3):197-210. doi: 10.6002/ect.2022.0327.
This study investigated the efficacy of stem cell transplantation for azoospermia, a major cause of male infertility. We conducted a systematic meta- analysis to assess the therapeutic effectiveness of stem cell transplant, using different transplant methods, injection sites, and stem cell types, and the reliability of this approach in different animal species. PubMed, the Cochrane Library, and Embase were searched for studies published from January 2006 to February 2022 that evaluated the use of stem cell transplant to treat azoospermia. We included 18 studies and conducted the analyses using Review Manager 5.2 software. Expression of the meiosis-related genes Vasa, Scp3, and Dazl and the average hematoxylin and eosin- positive staining area were improved after stem cell transplant. Subgroup analyses by mode of transplant showed higher expression of Scp3 and Dazl in the xenotransplant group. Although subgroup analyses by injection site showed that the seminiferous tubule group showed the most significant effect on Scp3 expression, spermatogenesis and repair of damaged testis were induced in the tunica albuginea group. The testicular torsion group also induced high levels of Scp3. Another subgroup analysis by stem cell type showed that umbilical cord mesenchymal stem cells promoted the highest expression of meiosis-related genes and successfully induced spermatogenesis and the repair of damaged testis. Urine-derived stem cells, spermatogonial stem cells, and amniotic fluid-derived stem cells showed significantly therapeutic effects; however, more studies are needed for definitive conclusions. Subgroup analyses by type of azoospermia animal model indicated that the use of stem cell transplant in rat or mouse models had an obvious therapeutic effect, but no significant therapeutic effect was seen in azoospermia hamsters. The meta-analysis confirmed that stem cell transplant can effectively treat azoospermia in animal models. Xenotransplant is shown to enhance the therapeutic effects of stem cell transplant on azoospermia.
本研究调查了干细胞移植治疗无精子症（男性不育的主要原因）的疗效。我们进行了一项系统的荟萃分析，以评估使用不同移植方法、注射部位和干细胞类型的干细胞移植的治疗效果，以及这种方法在不同动物物种中的可靠性。检索了PubMed、Cochrane图书馆和Embase，查找2006年1月至2022年2月发表的评估使用干细胞移植治疗无精子症的研究。我们纳入了18项研究，并使用Review Manager 5.2软件进行分析。干细胞移植后，减数分裂相关基因Vasa、Scp3和Dazl的表达以及苏木精和伊红平均阳性染色面积均有所改善。按移植方式进行的亚组分析显示，异种移植组中Scp3和Dazl的表达较高。尽管按注射部位进行的亚组分析表明，曲细精管组对Scp3表达的影响最为显著，但白膜组诱导了生精和受损睾丸的修复。睾丸扭转组也诱导了高水平的Scp3。按干细胞类型进行的另一亚组分析表明，脐带间充质干细胞促进了减数分裂相关基因的最高表达，并成功诱导了生精和受损睾丸的修复。尿液来源的干细胞、精原干细胞和羊水来源的干细胞显示出显著的治疗效果；然而，需要更多研究才能得出明确结论。按无精子症动物模型类型进行的亚组分析表明，在大鼠或小鼠模型中使用干细胞移植具有明显的治疗效果，但在无精子症仓鼠中未观察到显著的治疗效果。荟萃分析证实，干细胞移植可以有效治疗动物模型中的无精子症。异种移植显示可增强干细胞移植对无精子症的治疗效果。
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