间充质干细胞治疗宫腔粘连的研究进展

宫腔粘连本质上是损伤或感染等因素导致子宫内膜受损并发生内膜纤维化。宫腔粘连的发病机制包括上皮-间质转化、过度的炎症反应、血管生成障碍、低雌激素状态及子宫内膜干细胞缺失。现有的临床治疗如宫腔镜下粘连分离术、激素治疗、物理屏障植入等,均不能有效改善中重度宫腔粘连患者情况及预防粘连复发。近年研究发现,间充质干细胞在修复组织及再生医学方面有巨大潜力。目前,主要用于宫腔粘连研究的有子宫内膜间充质干细胞、骨髓间充质干细胞、脂肪间充质干细胞及妊娠附属物来源的间充质干细胞。它们主要通过免疫调控、分化、损伤趋化及旁分泌作用,来重建子宫内膜组织,改善子宫内膜功能,是宫腔粘连患者的新希望。

Research Progress of Mesenchymal Stem Cells in Treatment of Intrauterine Adhesions

Essentially, intrauterine adhesion (IUA) is a endometrial damage and fibrosis due to injury, infection and other factors. The pathogenesis of IUA includes epithelial-mesenchymal transformation, excessive inflammatory response, dysangiogenesis, low estrogen status and endometrial stem cell loss. The clinical treatments at present, such as hysteroscopic adhesion separation, hormone therapy, physical barrier implantation, etc., cannot effectively improve the IUA condition of patients with moderate to severe IUA, and cannot also prevent the recurrence of adhesion. In recent years, mesenchymal stem cells have showed the great potential in tissue repair and regenerative medicine. At present, the main stem cells used in IUA study are endometrial mesenchymal stem cell, bone marrow mesenchymal stem cell, fat mesenchymal stem cell and gestational appendage derived mesenchymal stem cell. Through immune regulation, differentiation and paracrine, the mesenchymal stem cell can rebuild endometrial tissue and improve endometrial function, which is a new hope for patients with intrauterine adhesion.