间充质干细胞及其外泌体治疗早发性卵巢功能不全的临床研究及其进展

Clinical Studies of MSCs and MSCs-Derived Exosomes in Premature Ovarian Insufficiency,and Research Progress

早发性卵巢功能不全(premature ovarian insufficiency,POI)是育龄期女性不孕的常见原因之一,发病率逐年上升,对女性生理及心理健康造成了重要影响。POI病因多样、机制复杂,临床上现有的治疗手段有限,最常用的激素替代治疗以改善患者症状为主,无法从根本上恢复卵巢功能。随着再生医学的发展,发现间充质干细胞(mesenchymal stem cells,MSCs)及其外泌体(exosomes,EXOs)移植能够通过促进颗粒细胞(granulosa cells,GCs)增殖、抑制GCs凋亡、抗炎、抗氧化、抗纤维化、促进血管生成和卵泡发育以及调节免疫等机制修复卵巢功能,提高POI患者的生育能力,为POI治疗带来新的前景,但其安全性、有效性仍待进一步研究验证。

Premature ovarian insufficiency(POI)is one of the common causes of infertility in women of reproductive age,which has a serious impact on women′s physiological and psychological health.The incidence of POI is increasing year by year,and the etiology and mechanism of POI are diverse and complex.The existing therapeutic methods in clinic are limited.Hormone replacement therapy,the most commonly used method,focuses on improving patients′symptoms and fails to fundamentally restore the ovarian function.With the development of regenerative medicine,the transplantation of mesenchymal stem cells(MSCs)and MSCs-derived exosomes(MSCs-EXOs)has been found to be able to repair the ovarian function and improve the fertility of POI patients by promoting granulosa cells(GCs)proliferation,inhibiting GCs apoptosis,anti-inflammation,anti-oxidation,antifibrosis,and by promoting angiogenesis and follicle development,as well as regulating immunity and other mechanisms,which brings new prospects for POI treatment.However,its safety and effectiveness still need to be further studied and verified.