Beutler Katarzyna, Jankowska-Konsur Alina, Nowicka Danuta
University Centre of General Dermatology and Oncodermatology, Wroclaw Medical University, 50-368 Wroclaw, Poland.
Division of Aesthetic Dermatology and Regenerative Medicine of the Skin, Wroclaw Medical University, 50-368 Wroclaw, Poland.
Int J Mol Sci. 2025 Sep 10;26(18):8808. doi: 10.3390/ijms26188808.
Vulvar lichen sclerosus (VLS) involves chronic inflammation, immune dysregulation, and abnormal extracellular matrix remodeling, involving extracellular matrix protein 1 (ECM1) and non-coding RNAs, particularly miR-155. Platelet-rich plasma (PRP) and adipose-derived mesenchymal stem cells (ADSCs) offer regenerative potential through the release of growth factors and cytokines that promote angiogenesis, fibroblast proliferation, collagen synthesis, and tissue repair, which could potentially compensate for the disordered matrix in VLS. This systematic review aimed to evaluate the current evidence on the efficacy and safety of PRP, ADSCs, and active substances administered through mesotherapy to adult women with VLS. A search of the PubMed, Scopus, and Web of Science databases identified 251 records, of which 13 studies met the inclusion criteria (RCTs and cohort studies involving women aged ≥ 18 years who were treated with PRP, ADSCs, or mesotherapy). The reviewed studies suggest that these therapies may improve clinical symptoms, quality of life, sexual function, and tissue quality. However, their application may be constrained by procedural invasiveness and potential immunologic risks. Moreover, the current evidence base is limited by small sample sizes, a lack of control groups, and short follow-up periods. Larger, well-designed randomized controlled trials with long-term follow-up are needed to confirm their therapeutic value and establish clear clinical guidelines.
外阴硬化性苔藓（VLS）涉及慢性炎症、免疫失调和细胞外基质重塑异常，涉及细胞外基质蛋白1（ECM1）和非编码RNA，尤其是miR-155。富血小板血浆（PRP）和脂肪来源的间充质干细胞（ADSCs）通过释放促进血管生成、成纤维细胞增殖、胶原蛋白合成和组织修复的生长因子和细胞因子发挥再生潜力，这可能弥补VLS中紊乱的基质。本系统评价旨在评估目前关于PRP、ADSCs以及通过美塑疗法给予成年VLS女性的活性物质的疗效和安全性的证据。检索PubMed、Scopus和Web of Science数据库后共识别出251条记录，其中13项研究符合纳入标准（涉及年龄≥18岁、接受PRP、ADSCs或美塑疗法治疗的女性的随机对照试验和队列研究）。综述的研究表明，这些疗法可能改善临床症状、生活质量、性功能和组织质量。然而，它们的应用可能受到操作侵入性和潜在免疫风险的限制。此外，目前的证据基础受到样本量小、缺乏对照组和随访期短的限制。需要开展更大规模、设计良好且有长期随访的随机对照试验，以确认其治疗价值并制定明确的临床指南。
