外泌体复合PRP无细胞治疗SUI及其自噬调控机制研究

压力性尿失禁（SUI）是一种严重影响妇女身心健康的的社会和医疗问题。人尿源干细胞（hUSCs），具有自体取材、无创获得、来源无限等独特优点，应用尿源干细胞外泌体（hUSC-Exos）的无细胞治疗克服了干细胞的成瘤性和免疫排异问题，有着广阔的应用前景。本课题组的前期研究已表明hUSC-Exos能有效增加胶原合成、减少降解，明显改善尿动力学参数。富血小板血浆（PRP）注射治疗SUI也有一定疗效，但两者均存在局部组织注射后流失和洗脱，导致治愈率低、复发率高的问题。本研究设计了双注射器喷枪系统，将牛凝血酶和hUSC-Exos悬液、PRP悬液共同混合形成具有三维网状结构的hUSC-Exos-PRP凝胶，提高hUSC-Exos和PRP的局部生物浓度，促进组织修复，以取得SUI无细胞治疗的长期疗效。同时，本研究拟明确盆底组织修复的相关自噬调控机制，为进一步优化SUI的无细胞治疗方法提供科学依据。

Stress urinary incontinence (SUI) is a social and medical problem that seriously affects women's physical and mental health. The previous studies of our group have shown that non-invasive access to urine derived stem cell exosomes (hUSC-Exos) can effectively increase collagen synthesis, reduce degradation, and significantly improve the urodynamic parameters of SUI model rats. PRP injection treatment of SUI also has a certain effect, but both of them are lost and eluted after local injection, resulting in low cure rate and high recurrence rate. In this study, a double syringes spray gun system was designed, which combines bovine thrombin with hUSC-Exos suspension and PRP suspension to form a hUSC-Exos-PRP gel with a three-dimensional network structure. It improves the local biological concentration of hUSC-Exos and PRP, so as to promote tissue repair and achieve long-term efficacy of SUI cell-free therapy. Also, this study aims to clarify the regulatory mechanism of autophagy related to pelvic floor tissue repair and provide scientific basis for further optimizing the cell-free therapy of SUI.