综述干细胞在子宫内膜修复中的应用

Basic Research and Clinical Transformation of Stem Cells in Endometrial Repair

人类子宫内膜是一个高度再生的器官,在女性一生中经历了400多次脱落和再生。子宫内膜厚度可以反映内膜功能状态,受到过度损伤的子宫内膜无法到达正常厚度,从而影响胚胎着床及临床妊娠。虽然临床对薄型子宫内膜治疗的方法较多,但总体治疗效果欠佳。干细胞因具有多向分化和自我更新的潜能而展现出广阔的治疗前景,包括胚胎干细胞、成体干细胞和诱导多能干细胞。目前大量研究已证实子宫内膜中存在干细胞样细胞,从而使子宫内膜具有很强的再生能力,随着对干细胞研究的深入,有研究诱导干细胞向子宫内膜细胞定向分化并增生,以促进子宫内膜生长,进而用于治疗薄型子宫内膜。现主要就骨髓间质干细胞(bone marrow mesenchymal stem cells, BMSCs)、经血干细胞(menstrual stem cell, Mescs)、子宫内膜干细胞(endometrial stem cells, EDSCs)、胎盘间充质细胞(placental mesenchymal cells, PMSCs)、子宫肌层细胞(myometrial cells, MyoSC)及脐带血干细胞(umbilical cord blood stem cell, UC-MSCs)共6个方面对子宫内膜修复治疗的研究进展及临床应用进行综述。

The human endometrium is a highly regenerative organ that has experienced more than 400 times shedding and regeneration in a woman’s life. Endometrial thickness can reflect the intimal function state, and the endometrium that is over-damaged cannot reach the normal thickness, thus affecting embryo implantation and clinical pregnancy. Although there are many methods for the treatment of thin endometrium in clinical practice, the overall treatment effect is not good. Stem cells exhibit broad therapeutic potential due to their potential for multi-directional differentiation and self-renewal, including embryonic stem cells, adult stem cells, and induced pluripotent stem cells. At present, a large number of studies have confirmed the presence of stem cell-like cells in the endometrium, so that the endometrium has a strong ability to regenerate. With the deepening of research on stem cells, studies have induced the differentiation and proliferation of stem cells into endometrial cells to promote Endometrial growth, which in turn is used to treat the thin endometrium. The research will review the research progress of BMSCs (bone marrow mesenchymal stem cells), Mescs (menstrual stem cell), EDSCs (endometrial stem cells), PMSCs (placental mesenchymal cells), MyoSC (myometrial cells) and UC-MSCs (umbilical cord blood stem cell) in endometrial repair.