宫腔粘连中水凝胶促内膜修复的研究与进展  

Research and advance of hydrogel-promoted endometrial repair in intrauterine adhesions

作　　者：邬浩明 王瑶 陈圆梦 朱慧莉 李开南[1] 熊成东 胡旭麟 Wu Haoming;Wang Yao;Chen Yuanmeng;Zhu Huili;Li Kainan;Xiong Chengdong;Hu Xulin(Clinical Medical College/Affiliated Hospital of Chengdu University,Chengdu 610081,Sichuan Province,China;Department of Reproductive Medicine,Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education,West China Second University Hospital of Sichuan University,Chengdu 610041,Sichuan Province,China;University of Chinese Academy of Sciences,Beijing 100049,China;State Key Laboratory of Biotherapy,Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]成都大学临床医学院/附属医院,四川省成都市610081 [2]四川大学华西第二医院生殖医学科-出生缺陷与相关妇儿疾病教育部重点实验室,四川省成都市610041 [3]中国科学院大学,北京市100049 [4]四川大学生物治疗国家重点实验室,四川省成都市610041

出　　处：《中国组织工程研究》2024年第17期2774-2781,共8页Chinese Journal of Tissue Engineering Research

基　　金：四川省自然科学基金(23NSFSC5880),项目负责人:胡旭麟;成都市医学科研课题(2022004),项目负责人:胡旭麟;四川省卫生健康委员会医学科技项目(21PJ127),项目负责人:王瑶;成都市医学科研课题项目(2022291),项目负责人:王瑶;国家自然科学基金项目(81601258),项目负责人:朱慧莉;成都市科技项目(2021-YF05-01612-SN),项目负责人:朱慧莉。

摘　　要：背景:防止宫腔粘连复发的关键是重建具有正常功能的子宫内膜,国内外对于宫腔粘连复发治疗的最新突破在于利用可降解材料制备水凝胶类物质防止粘连复发。目的:综述宫腔粘连中水凝胶促内膜修复的研究进展。方法:系统检索PubMed数据库、Web of Science、中国知网、万方数据库,以“宫腔粘连,子宫内膜损伤,子宫内膜再生,水凝胶,Intrauterine adhesions,Endometrial injury,Endometrium regeneration,hydrogel”为关键词,收集各数据库1990年1月至2023年3月发表的相关文献。结果与结论:近年来国内外关于宫腔粘连中水凝胶促内膜修复的研究取得了一定进展,对于宫腔粘连的防治和促进内膜修复具有重要作用:①水凝胶作为组织工程中一大重要载体,它本身具有优秀的生物相容性、生物降解性和三维网状结构,可以更好地应用在宫腔粘连治疗中;②以水凝胶为基础的搭载体系,可以通过运输药物/生物制剂/干细胞来促进子宫内膜上皮细胞的增殖分化,并恢复正常子宫形态,防止粘连复发;③透明质酸类水凝胶在满足良好生物相容性的同时还可以促进内膜上皮细胞的增殖分化,且在子宫内会被相应的酶类物质水解,不会影响机体正常代谢,是目前临床常用的子宫防粘连剂,也是组织工程研究中最常用的一种水凝胶载体;④以温敏特性出众的泊洛沙姆水凝胶可以在进入体内迅速凝胶化,快速形成物理屏障,并可对搭载物质起到缓释作用和提供细胞生长/黏附平台;⑤利用不同特性材料制备治疗性水凝胶的前景广阔,比如温敏特性水凝胶、pH响应性水凝胶以及光敏水凝胶等,但还存在诸多问题需要解决,例如水凝胶体系的安全性以及降解产物是否引起免疫反应、对正常机体经期是否具有影响等问题,还需要大量动物实验及临床试验来验证其安全性和有效性,不断完善治疗策略。BACKGROUND:The key to preventing the recurrence of intrauterine adhesions is to reconstruct the endometrium with normal function.The latest breakthrough in the treatment of recurrent intrauterine adhesions in and outside China is the use of degradable materials to prepare hydrogels to prevent the recurrence of adhesions.OBJECTIVE:To review the research advance in hydrogel-promoted endometrial repair in intrauterine adhesions.METHODS:PubMed,Web of Science,China National Knowledge Infrastructure(CNKI),and WanFang databases were searched systematically,with the keywords“intrauterine adhesions,endometrial injury,endometrium regeneration,hydrogel”in Chinese and English.Relevant articles published in each database from January 1990 to March 2023 were collected.RESULTS AND CONCLUSION:In recent years,research on hydrogel-promoted endometrial repair in uterine adhesions in and outside China has made some progress and plays an important role in the prevention and treatment of intrauterine adhesions and the promotion of endometrial repair:(1)As an important carrier in tissue engineering,hydrogel itself has excellent biocompatibility,biodegradability and three-dimensional network structure,which can be better applied in the treatment of intrauterine adhesions.(2)The hydrogel-based carrier system can promote the proliferation and differentiation of endometrial epithelial cells by transporting drugs/biologics/stem cells,and restore normal uterine morphology to prevent adhesion recurrence.(3)Hyaluronic acid hydrogels can not only meet good biocompatibility,but also promote the proliferation and differentiation of endometrial epithelial cells,and will be hydrolyzed by corresponding enzymes in utero,without affecting the normal metabolism of the body.They are currently commonly used uterine anti-adhesion agents in the clinic and are also the most commonly used hydrogel carriers in tissue engineering research.(4)Poloxamer hydrogel with excellent temperature-sensitive properties can rapidly gelate into the body,quickly form a p

关 键 词：宫腔粘连 水凝胶 修复 子宫内膜再生 生长因子 干细胞 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学] R-1