Adult stem cells in endometrial regeneration: Molecular insights and clinical applications.
Adult stem cells in endometrial regeneration: Molecular insights and clinical applications.
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成体干细胞在子宫内膜再生中的分子洞察和临床应用。
DOI：
10.1002/mrd.23476
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发表时间：
2021-06
影响因子：
2.5
通讯作者：
Chen X
中科院分区：
文献类型：
--
作者：
Lv Q;Wang L;Luo X;Chen X
子宫内膜损伤是女性生殖问题的重要原因，表现为月经异常、不孕、反复流产等并发症。这些病症统称为“阿舍曼综合征”(AS)，通常与反复人工流产、反复诊断性刮宫和宫内感染有关。癌症治疗还会对幸存者的子宫内膜功能产生意想不到的有害副作用，与卵巢效应无关。子宫内膜干细胞通过直接分化或旁分泌作用参与子宫内膜的再生和修复。非子宫内膜成体干细胞，例如骨髓间充质干细胞和脐带间充质干细胞，具有自体和同种异体应用，也可以在 AS 动物模型和人类研究中修复受损的子宫内膜组织。然而，对于肿瘤逆转后受损子宫内膜尤其是子宫内膜癌的修复仍缺乏研究。在此，我们回顾了子宫内膜再生的生物学机制，以及成体干细胞治疗受损子宫内膜的研究进展和挑战，并讨论了它们在癌症缓解后修复子宫内膜的潜在应用，特别是在子宫内膜癌中。此类细胞的成功应用将改善 AS 或癌症患者的生殖参数。意义：子宫内膜是胚胎生长的沃土，但子宫内膜的损伤会极大地损害女性的生育能力。成体干细胞联合或不联合组织工程支架材料在修复因良性病变而损伤的子宫内膜方面取得了很大进展。然而，由于缺乏对恶性肿瘤或肿瘤治疗引起的受损子宫内膜修复的研究，此类基于干细胞的疗法的安全性和有效性需要进一步探讨。本综述重点关注成体干细胞在子宫内膜再生中的分子见解和临床应用潜力，并讨论了肿瘤幸存者干细胞疗法中可能面临的挑战或困难。成体干细胞相关新项目的开发将有助于安全有效地修复受损的子宫内膜，满足肿瘤幸存者的生育需求。
Endometrial damage is an important cause of female reproductive problems, manifested as menstrual abnormalities, infertility, recurrent pregnancy loss, and other complications. These conditions are collectively termed “Asherman syndrome” (AS) and are typically associated with recurrent induced pregnancy terminations, repeated diagnostic curettage and intrauterine infections. Cancer treatment also has unexpected detrimental side effects on endometrial function in survivors independently of ovarian effects. Endometrial stem cells act in the regeneration of the endometrium and in repair through direct differentiation or paracrine effects. Nonendometrial adult stem cells, such as bone marrow‐derived mesenchymal stem cells and umbilical cord‐derived mesenchymal stem cells, with autologous and allogenic applications, can also repair injured endometrial tissue in animal models of AS and in human studies. However, there remains a lack of research on the repair of the damaged endometrium after the reversal of tumors, especially endometrial cancers. Here, we review the biological mechanisms of endometrial regeneration, and research progress and challenges for adult stem cell therapy for damaged endometrium, and discuss the potential applications of their use for endometrial repair after cancer remission, especially in endometrial cancers. Successful application of such cells will improve reproductive parameters in patients with AS or cancer. Significance: The endometrium is the fertile ground for embryos, but damage to the endometrium will greatly impair female fertility. Adult stem cells combined with tissue engineering scaffold materials or not have made great progress in repairing the injured endometrium due to benign lesions. However, due to the lack of research on the repair of the damaged endometrium caused by malignant tumors or tumor therapies, the safety and effectiveness of such stem cell‐based therapies need to be further explored. This review focuses on the molecular insights and clinical application potential of adult stem cells in endometrial regeneration and discusses the possible challenges or difficulties that need to be overcome in stem cell‐based therapies for tumor survivors. The development of adult stem cell‐related new programs will help repair damaged endometrium safely and effectively and meet fertility needs in tumor survivors.
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