Ljubić Aleksandar, Dinić Marija, Švraka Dajana, Vujović Svetlana
Pronatal Hospital, 11000 Belgrade, Serbia.
Academy of Sciences and Arts of Bosnia and Herzegovina, 71000 Sarajevo, Bosnia and Herzegovina.
Int J Mol Sci. 2024 Dec 25;26(1):69. doi: 10.3390/ijms26010069.
Dual-double stem cell therapy, which integrates mesenchymal stem cells (MSCs) and hematopoietic stem cells (HSCs), represents a cutting-edge approach in regenerative medicine, particularly for conditions such as ovarian decline, premature ovarian insufficiency (POI), and induced ovarian failure. This therapy leverages the unique properties of MSCs and HSCs, enhancing tissue repair, immune modulation, and overall regenerative outcomes. MSCs, known for their ability to differentiate into various cell types, provide a supportive microenvironment and secrete bioactive molecules that promote angiogenesis and reduce inflammation. HSCs, crucial for hematopoiesis and immune function, further enhance this environment by supporting hematopoietic processes and immune regulation. Clinical evidence increasingly supports the effectiveness of stem cell therapy in ovarian regeneration. Studies have demonstrated improved folliculogenesis, normalization of hormone profiles, and successful pregnancies in patients with POI. Furthermore, recent clinical trials in various medical fields underline the superior potential of dual-double therapy compared to monotherapies involving MSCs or HSCs alone, enhancing tissue repair and functional outcomes. However, despite these benefits, the therapy presents risks that require careful consideration. For autologous MSC therapy involving expanded cell populations, risks include tumorigenic potential, with evidence of sarcoma formation in certain cases of cultured MSCs. In contrast, autologous non-expanded MSC and HSC therapies may be limited by low cell yields, potentially compromising therapeutic efficacy. Additionally, non-expanded HSC therapy poses risks of insufficient cell numbers for successful engraftment and delayed immune reconstitution. These considerations underscore the importance of quality control and rigorous screening to optimize safety and efficacy. This article explores the mechanisms of action, clinical applications, and potential complications of dual-double stem cell therapy, underscoring the need for continued research and optimized protocols to enhance safety and outcomes in ovarian insufficiency and related conditions, offering new hope for affected women.
双干细胞疗法将间充质干细胞（MSCs）和造血干细胞（HSCs）相结合，是再生医学中的一种前沿方法，尤其适用于卵巢功能衰退、卵巢早衰（POI）和诱导性卵巢功能衰竭等病症。该疗法利用了间充质干细胞和造血干细胞的独特特性，增强了组织修复、免疫调节和整体再生效果。间充质干细胞以其分化为各种细胞类型的能力而闻名，它提供了一个支持性的微环境，并分泌促进血管生成和减轻炎症的生物活性分子。造血干细胞对造血和免疫功能至关重要，通过支持造血过程和免疫调节进一步改善这种环境。临床证据越来越多地支持干细胞疗法在卵巢再生中的有效性。研究表明，POI患者的卵泡生成得到改善、激素水平正常化，并且成功怀孕。此外，最近在各个医学领域的临床试验强调了双干细胞疗法相对于单独使用间充质干细胞或造血干细胞的单一疗法具有更大的潜力，可增强组织修复和功能效果。然而尽管有这些益处，该疗法仍存在需要仔细考虑的风险。对于涉及扩增细胞群体的自体间充质干细胞疗法，风险包括致瘤潜力，在某些培养的间充质干细胞病例中有肉瘤形成的证据。相比之下，自体未扩增的间充质干细胞和造血干细胞疗法可能受到细胞产量低的限制，这可能会影响治疗效果。此外，未扩增的造血干细胞疗法存在细胞数量不足而无法成功植入以及免疫重建延迟的风险。这些考虑凸显了质量控制和严格筛选对于优化安全性和有效性的重要性。本文探讨了双干细胞疗法的作用机制、临床应用和潜在并发症，强调需要持续研究和优化方案，以提高卵巢功能不全及相关病症的安全性和治疗效果，为受影响的女性带来新希望。
