不同来源间充质干细胞治疗卵巢早衰的机制  

Mechanism of different sources of mesenchymal stem cells in treatment of premature ovarian failure

作　　者：刘艳艳 马园园 黄向华[1] 张敬坤[1] Liu Yanyan;Ma Yuanyuan;Huang Xianghua;Zhang Jingkun(The Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei Province,China)

机构地区：[1]河北医科大学第二医院,河北省石家庄市050000

出　　处：《中国组织工程研究》2025年第13期2764-2773,共10页Chinese Journal of Tissue Engineering Research

基　　金：河北省自然科学基金(H2021206463),项目负责人:张敬坤;河北省医学科学研究课题计划项目(20210080,20240487),项目负责人:张敬坤。

摘　　要：背景:已经有大量细胞及动物实验证实了间充质干细胞具有改善卵巢功能的作用,部分临床试验也已完成并初步证实了其有效性,为卵巢早衰女性带来了希望。目的:总结并分析近年来关于不同来源间充质干细胞治疗卵巢早衰的机制、研究进展及相关临床试验,为间充质干细胞治疗卵巢早衰的进一步研究及临床应用提供理论依据。方法:以“间充质干细胞,卵巢早衰”及“mesenchymal stem cells,premature ovarian failure”分别作为中、英文关键词,在中国知网、万方数据库、中华医学库及PubMed数据库对相关文献进行检索,最终纳入符合要求的72篇文献进行综述。结果与结论:目前常用于治疗卵巢早衰的间充质干细胞种类有7类,分别为脐带间充质干细胞、骨髓间充质干细胞、胎盘间充质干细胞、经血间充质干细胞、羊膜间充质干细胞、羊水间充质干细胞及脂肪间充质干细胞,涉及作用机制主要包括抑制凋亡促进增殖、抗炎及抑制氧化应激、归巢、促血管生成、抗纤维化、旁分泌、免疫调节、自噬及改善微环境。细胞和动物实验均表明不同来源间充质干细胞可以通过各种机制对卵巢早衰有较好的干预效果,一定程度上延缓了卵巢早衰的进展。如果将来能成功运用于临床,能够很大程度上缓解患者来自心理及生理上的痛苦。但目前临床研究因干细胞来源伦理、具体给药方式及剂量、是否引发严重不良反应等方面缺乏全面且准确的证据,故在未来仍需进行深入探讨,同时远期安全性也有待进一步观察。BACKGROUND:A large number of cell and animal tests have confirmed the effect of mesenchymal stem cells on improving ovarian function,and some clinical trials have been completed and their effectiveness has been preliminarily confirmed,bringing hope to women with premature ovarian failure.OBJECTIVE:To summarize and analyze the mechanism,research progress,and related clinical trials of mesenchymal stem cells from different sources in the treatment of premature ovarian failure in recent years,so as to provide a theoretical basis for further research and clinical application of mesenchymal stem cell therapy for premature ovarian failure.RESULTS AND CONCLUSION:Currently,there are seven types of commonly used mesenchymal stem cells for premature ovarian failure,which are umbilical cord mesenchymal stem cells,bone marrow mesenchymal stem cells,placental mesenchymal stem cells,menstrual blood mesenchymal stem cells,amniotic mesenchymal stem cells,amniotic fluid mesenchymal stem cells,and adipose mesenchymal stem cells.The mechanisms include inhibiting apoptosis and promoting proliferation,anti-inflammatory and inhibiting oxidative stress,homing,promoting angiogenesis,anti-fibrosis,parasecretory,immune regulation,autophagy,and improving microenvironment.Cell and animal experiments have proven that different sources of mesenchymal stem cells can have better intervention effect on premature ovarian failure through various mechanisms,and delay the progress of premature ovarian failure to a certain extent.If it can be successfully applied to the clinic in the future,it can alleviate the psychological and physical pain of patients to a great extent.However,due to the lack of comprehensive and accurate evidence in clinical studies such as stem cell source,administration mode and dose,adverse reactions,etc.,further studies are still needed to confirm it in the future,and its long-term safety needs to be further observed.

关 键 词：卵巢早衰 间充质干细胞 颗粒细胞 卵泡 机制 作用方式 临床试验 诊疗 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R711.4