Autologous stem cell transplantation in refractory Asherman's syndrome: A novel cell based therapy.
Autologous stem cell transplantation in refractory Asherman's syndrome: A novel cell based therapy.
复制标题
DOI：
10.4103/0974-1208.138864
复制
发表时间：
2014-04
影响因子：
--
通讯作者：
Dharmendra S
中科院分区：
文献类型：
--
作者：
Singh N;Mohanty S;Seth T;Shankar M;Bhaskaran S;Dharmendra S
有大量证据表明，成人干细胞群体存在于人类子宫内膜中，因此，它是建议，无论是内源性子宫内膜干/祖细胞可以被激活或骨髓来源的干细胞可以移植到子宫腔中的子宫内膜再生的Asherman综合征（AS）。目的是评估子宫内膜下自体干细胞植入难治性AS妇女在获得月经和生育能力方面的作用。三级护理转诊中心。前瞻性病例系列。纳入了6例既往宫腔镜粘连松解术标准治疗失败的难治性AS病例。将单核细胞移植到子宫内膜下，然后口服外源性雌激素治疗。在3、6和9个月时评估子宫内膜厚度（ET）。使用STATA 9.0版对研究变量进行描述性统计和统计分析。平均MNC计数为103.3 × 106（±20.45），平均CD 34+计数为203，642（± 269，274）。ET（mm）在3个月（4.05 ± 1.40）、6个月（5.46 ± 1.36）、9个月（5.48 ± 1.14）较治疗前（1.38 ± 0.39）显著升高（P < 0.05）。6例患者中有5例恢复月经。自体干细胞移植导致子宫内膜再生，6例中有5例月经恢复。自体干细胞移植是治疗难治性动脉粥样硬化的一种新的细胞治疗方法。
There is substantial evidence that adult stem cell populations exist in human endometrium, and hence it is suggested that either endogenous endometrial stem/progenitor cells can be activated or bone marrow derived stem cells can be transplanted in the uterine cavity for endometrial regeneration in Asherman's syndrome (AS). The objective was to evaluate the role of sub-endometrial autologous stem cell implantation in women with refractory AS in attaining menstruation and fertility. Tertiary care referral center. Prospective case series. Six cases of refractory AS with failed standard treatment option of hysteroscopic adhesiolysis in the past were included. Mononuclear stem cells (MNCs) were implanted in sub-endometrial zone followed by exogenous oral estrogen therapy. Endometrial thickness (ET) was assessed at 3, 6, and 9 months. Descriptive statistics and statistical analysis of study variables was carried out using STATA version 9.0. The mean MNC count was 103.3 × 106 (±20.45) with mean CD34+ count being 203,642 (±269,274). Mean of ET (mm) at 3 months (4.05 ± 1.40), 6 months (5.46 ± 1.36) and 9 months (5.48 ± 1.14) were significantly (P < 0.05) increased from pretreatment level (1.38 ± 0.39). Five out of six patients resumed menstruation. The autologous stem cell implantation leads to endometrial regeneration reflected by restoration of menstruation in five out of six cases. Autologous stem cell implantation is a promising novel cell based therapy for refractory AS.