Cell Therapy for Anal Sphincter Incontinence: Where Do We Stand?
Cell Therapy for Anal Sphincter Incontinence: Where Do We Stand?
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作者：
Balaphas A;Meyer J;Meier RPH;Liot E;Buchs NC;Roche B;Toso C;Bühler LH;Gonelle-Gispert C;Ris F
肛门括约肌失禁是一种慢性疾病，严重影响患者的生活质量和社会成本。手术被认为是最好的治疗选择，但成功率令人失望。干/祖细胞疗法有望成为治疗肛门括约肌失禁的有效替代手术方法。然而，出版的文献是不同的。我们的目的是对肛门括约肌失禁细胞治疗的发展进行回顾，并对其缺陷进行批判性分析。肛门括约肌失禁的动物模型多种多样，并试图再现不同的临床情况（急性损伤或愈合的损伤，有或没有手术重建），但受到解剖学考虑的限制。用于治疗的细胞制剂按频率顺序来源于骨骼肌、骨髓或脂肪组织。这些制剂的表征往往不完整，干性并不总是得到解决。尽管对括约肌愈合过程和细胞制剂的确切作用机制缺乏了解，但在83名失禁患者中对这种治疗进行了评估，报告了令人鼓舞的结果。然而，需要进一步开发以建立正确的适应症，确定最适合的细胞类型，标准化细胞制备方法并验证细胞递送的途径和数量。
Anal sphincter incontinence is a chronic disease, which dramatically impairs quality of life and induces high costs for the society. Surgery, considered as the best curative option, shows a disappointing success rate. Stem/progenitor cell therapy is pledging, for anal sphincter incontinence, a substitute to surgery with higher efficacy. However, the published literature is disparate. Our aim was to perform a review on the development of cell therapy for anal sphincter incontinence with critical analyses of its pitfalls. Animal models for anal sphincter incontinence were varied and tried to reproduce distinct clinical situations (acute injury or healed injury with or without surgical reconstruction) but were limited by anatomical considerations. Cell preparations used for treatment, originated, in order of frequency, from skeletal muscle, bone marrow or fat tissue. The characterization of these preparations was often incomplete and stemness not always addressed. Despite a lack of understanding of sphincter healing processes and the exact mechanism of action of cell preparations, this treatment was evaluated in 83 incontinent patients, reporting encouraging results. However, further development is necessary to establish the correct indications, to determine the most-suited cell type, to standardize the cell preparation method and to validate the route and number of cell delivery.
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影响因子：
5.6
作者：
Baldari S;Di Rocco G;Piccoli M;Pozzobon M;Muraca M;Toietta G
通讯作者：
Toietta G
DOI：
10.1111/j.1471-0528.2006.00799.x
发表时间：
2006-02-01
影响因子：
5.8
作者：
Andrews, V;Sultan, AH;Jones, PW
通讯作者：
Jones, PW
影响因子：
6
作者：
Bohl JL;Zakhem E;Bitar KN
通讯作者：
Bitar KN
内部肛门括约肌扩大和替代。
影响因子：
3.6
作者：
de la Portilla F
通讯作者：
de la Portilla F
肠道组织工程：肠道再生医学的当前概念和未来愿景。
影响因子：
3.5
作者：
Bitar KN;Raghavan S
通讯作者：
Raghavan S