卵母细胞线粒体移植及其伦理问题  

Clinical Practice of Oocyte Mitochondrial Transplantation and Ethical Issue

作　　者：崔毓桂[1] 贾洪燕 施陈楠 严正杰[1] 刘嘉茵(审校)[1] 马翔(审校)[1] CUI Yu-gui;JIA Hong-yan;SHI Chen-nan;YAN Zheng-jie;LIU Jia-yin;MA Xiang(Center of Clinical Reproductive Medicine,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;Lianyungang Maternity and Childcare Hospital,Kangda College of Nanjing Medical University,Lianyungang 222000,Jiangsu Province,China;Center of Reproductive Medicine,Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu Province,China)

机构地区：[1]南京医科大学第一附属医院生殖医学科,210029 [2]南京医科大学康达学院附属连云港妇幼保健院 [3]南通大学附属医院生殖医学中心

出　　处：《国际生殖健康／计划生育杂志》2023年第2期89-94,共6页Journal of International Reproductive Health/Family Planning

基　　金：国家自然科学基金(82171593,81730041);江苏省卫生厅临床医学中心(创新平台)(YXZXB2016001)。

摘　　要：卵母细胞发育依赖于线粒体的能量代谢,高龄女性卵母细胞质量下降与线粒体功能障碍密切相关。同时,卵母细胞线粒体也为早期胚胎发育积聚足够的能量。卵母细胞线粒体移植可应用于线粒体DNA(mitochondrial DNA,mtDNA)突变或微缺失引起的线粒体疾病,近年来较多报道其在卵母细胞线粒体功能障碍相关的高龄、卵巢反应差及反复体外受精-胚胎移植失败等女性患者中的应用。线粒体移植分为异体线粒体移植和自体线粒体移植,后者可降低mtDNA异质性和突变的风险,并且避免了伦理问题。但该技术仍具有巨大挑战,需要进一步基础实验研究、技术研发和动物模型的安全性验证。Oocyte development depends on the mitochondrial energy metabolism,while the decline of oocyte quality in advanced women is closely related to mitochondrial dysfunction.Oocyte mitochondria also provide the sufficient energy accumulation for early embryonic development.Oocyte mitochondrial transplantation has been used in the clinical practice of mitochondrial dysfunction diseases caused by the mutations or microdeletions of mitochondrial DNA(mtDNA).In recent years,many clinical trials have been reported that oocyte mitochondrial transplantation was used in the advanced women with poor oocyte quality,poor ovarian response and repeated failure of in vitro fertilization and embryo transfer that were related to the mitochondrial function impairment.Mitochondrial transplantation can be divided into the allogeneic mitochondrial transplantation and the autologous mitochondrial transplantation.The autologous mitochondrial transplantation can reduce the risk of mtDNA heterogeneity and mtDNA mutation and avoid ethical problems.However,mitochondrial transplantation still has great challenges in technology,which requires further basic experiment,technological development and safety verification with animal models.

关 键 词：卵母细胞 胚胎发育 线粒体 线粒体疾病 能量代谢 线粒体移植 

分 类 号：R-052[医药卫生]