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儿科男性癌症患者生育力保存策略的进展:不成熟睾丸组织冷冻保存和移植的综述。

Advancements in fertility preservation strategies for pediatric male cancer patients: a review of cryopreservation and transplantation of immature testicular tissue.

机构信息

School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.

Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC.

出版信息

Reprod Biol Endocrinol. 2024 Apr 18;22(1):47. doi: 10.1186/s12958-024-01219-5.

Abstract

Recently, there has been increasing emphasis on the gonadotoxic effects of cancer therapy in prepubertal boys. As advances in oncology treatments continue to enhance survival rates for prepubertal boys, the need for preserving their functional testicular tissue for future reproduction becomes increasingly vital. Therefore, we explore cutting-edge strategies in fertility preservation, focusing on the cryopreservation and transplantation of immature testicular tissue as a promising avenue. The evolution of cryopreservation techniques, from controlled slow freezing to more recent advancements in vitrification, with an assessment of their strengths and limitations was exhibited. Detailed analysis of cryoprotectants, exposure times, and protocols underscores their impact on immature testicular tissue viability. In transplantation strategy, studies have revealed that the scrotal site may be the preferred location for immature testicular tissue grafting in both autotransplantation and xenotransplantation scenarios. Moreover, the use of biomaterial scaffolds during graft transplantation has shown promise in enhancing graft survival and stimulating spermatogenesis in immature testicular tissue over time. This comprehensive review provides a holistic approach to optimize the preservation strategy of human immature testicular tissue in the future.

摘要

最近,人们越来越关注癌症治疗对青春期前男孩的性腺毒性作用。随着肿瘤治疗的进展不断提高青春期前男孩的生存率,为未来的生殖功能保存其功能性睾丸组织变得越来越重要。因此,我们探讨了生育力保存的最新策略,重点关注不成熟睾丸组织的冷冻保存和移植,这是一种很有前途的方法。我们展示了冷冻保存技术的演变,从控制性慢速冷冻到最近的玻璃化技术进步,并评估了它们的优缺点。详细分析了冷冻保护剂、暴露时间和方案,强调了它们对不成熟睾丸组织活力的影响。在移植策略方面,研究表明,在自体移植和异种移植的情况下,不成熟睾丸组织移植的首选部位可能是阴囊。此外,在移植过程中使用生物材料支架有望提高移植物的存活率,并随着时间的推移刺激不成熟睾丸组织的生精作用。这篇综述提供了一种全面的方法,以优化未来人类不成熟睾丸组织的保存策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f29/11025181/fe67a98fca21/12958_2024_1219_Fig1_HTML.jpg

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