干细胞疗法在治疗非梗阻性无精子症中的应用

非梗阻性无精子症(NOA)是男性不育的重大难题。干细胞是一群具有自我更新和多向分化能力的细胞。胚胎干细胞和诱导多能干细胞能够通过分化产生精子,但面临着伦理的制约且有成瘤风险。精原干细胞能够通过分化产生单倍体配子,但人精原干细胞培养仍较困难。间充质干细胞通过旁分泌作用促进精子生成。间质干细胞能够分泌睾酮影响精子生成。多种干细胞二维平面共培养及3D睾丸类器官培养更好地模拟了睾丸生精微环境,促进精子生成。干细胞在NOA中的治疗中取得一定的进展,但仍存在不足与困难。本文主要对目前各种干细胞治疗NOA的研究进行总结,介绍了各种干细胞在无精子症治疗中的应用前景与存在缺陷,为干细胞在NOA中的研究及应用提供参考。

Stem cell therapy for non-obstructive azoospermia

Non-obstructive azoospermia(NOA) is an important factor that causes male infertility. Stem cells are a group of cells capable of self-renewal and multi-directional differentiation, and embryonic stem cells and induced pluripotent stem cells can generate spermatozoa through differentiation, which, however, is confronted with ethical constraints and the risk of tumorigenesis. Spermatogonial stem cells can produce haploid gametes by differentiation but human spermatogonial stem cells are difficult to be cultured in vitro. Mesenchymal stem cells promote spermatogenesis through paracrine activity, and Leydig stem cells act on sperm production by secreting testosterone. 2 D co-culture of multiple stem cells and 3 D testicular organ culture can promote spermatogenesis by simulating a better spermatogenic microenvironment of the testis. Some progress has been achieved in the treatment of NOA by stem cell therapy despite existing problems and difficulties. This review summarizes the advances in the studies of stem cell therapy for NOA and introduces its application prospects and existing problems so as to provide some reference for the relevant researches and application.