间充质干细胞及细胞外囊泡修复子宫内膜损伤  

Mesenchymal stem cells and extracellular vesicles in repair of endometrial injury

作　　者：熊正花 周江洪 沈怡 韩雪松 Xiong Zhenghua;Zhou Jianghong;Shen Yi;Han Xuesong(Department of Gynecology of First Affiliated Hospital of Kunming Medical University,Kunming 650032,Yunnan Province,China;Department of Gynecology of Yan’an Hospital Affiliated to Kunming Medical University/Yan’an Hospital of Kunming City,Kunming 650051,Yunnan)

机构地区：[1]昆明医科大学第一附属医院妇科,云南省昆明市650032 [2]昆明医科大学附属延安医院/昆明市延安医院妇科,云南省昆明市650051

出　　处：《中国组织工程研究》2025年第31期6782-6791,共10页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金项目(81960269),项目负责人:韩雪松;云南省“万人计划”名医专项(RLHXS20210331),项目负责人:韩雪松;云南省医学领军人才培养计划项目(L-2019005),项目负责人:韩雪松;云南省科技厅-昆明医科大学联合专项重点项目(202401AY070001-374),项目负责人:韩雪松;云南省教育厅科学研究基金项目(2024Y242),项目负责人:熊正花。

摘　　要：背景:子宫内膜损伤是育龄期女性常见的良性疾病,严重影响女性的生育和生殖健康。近年来,间充质干细胞及其分泌的细胞外囊泡作为一种新的治疗策略,在子宫内膜损伤修复中备受关注。目的:综述间充质干细胞及其细胞外囊泡在子宫内膜损伤治疗中的应用,全面介绍子宫内膜损伤的发病机制、治疗效果,探讨间充质干细胞及细胞外囊泡治疗子宫内膜损伤的潜力与挑战,以期为进一步的基础和临床研究提供理论依据。方法:检索中国知网和中华医学全文数据库的中文文献,检索词为“间充质干细胞,间充质干细胞来源细胞外囊泡,外泌体,子宫内膜损伤,宫腔粘连,Asherman综合征”;检索PubMed数据库中的英文文献,英文检索词为“mesenchymal stem cells,extracellular vesicles derived from mesenchymal stem cells,exosome,endometrial injury,intrauterine adhesion,Asherman’s syndrome”,通过人工阅读的方法,排除重复文献或与子宫内膜损伤不相关的文献,最终纳入87篇文献。结果与结论:间充质干细胞及其细胞外囊泡能够通过多种分子机制参与子宫内膜损伤的修复,如抗纤维化、促进血管生成和细胞增殖、细胞归巢、免疫调节、内膜容受性调节等,细胞和动物实验已取得大量研究成果,临床研究的初步结果也取得了一定的疗效,包括增加子宫内膜厚度、改善月经量和生育能力。但是,间充质干细胞及其细胞外囊泡治疗子宫内膜损伤的应用研究仍面临着困难和挑战。在治疗过程中,需要进一步提高间充质干细胞及其细胞外囊泡的质量和稳定性,明确其在细胞增殖、迁移、分化等过程中的调控作用。此外,还需开展大规模、多中心的临床试验,以验证间充质干细胞及其细胞外囊泡在子宫内膜损伤修复中的长期安全性和有效性,并确定最佳的治疗剂量和给药途径。随着科学技术的进步和生物工程材料的辅助应用,BACKGROUND:Endometrial injury is a common benign disease in women of reproductive age,which seriously affects their fertility and reproductive health.In recent years,mesenchymal stem cells and their secreted extracellular vesicles,as a new therapeutic strategy,have received much attention in the repair of endometrial injury.OBJECTIVE:To review the application of mesenchymal stem cells and their secreted extracellular vesicles in the treatment of endometrial injury,to comprehensively understand the therapeutic mechanism and efficacy of endometrial injury,and to discuss the potential and challenges of the application of mesenchymal stem cells and their secreted extracellular vesicles in the treatment of endometrial injury,in order to provide theoretical basis for further basic and clinical research.METHODS:Literature searches were conducted in the China National Knowledge Infrastructure(CNKI),Chinese Medical Full-text Database,and PubMed electronic databases using search terms“mesenchymal stem cells,extracellular vesicles derived from mesenchymal stem cells,exosome,endometrial injury,intrauterine adhesion,Asherman’s syndrome”in Chinese and English.Articles were selected through manual screening to exclude duplicates and irrelevant studies,resulting in the inclusion of 87 articles.RESULTS AND CONCLUSION:Mesenchymal stem cells and their secreted extracellular vesicles can participate in endometrial damage repair through a variety of molecular mechanisms,such as anti-fibrosis,promoting angiogenesis and cell proliferation,cell homing,immune regulation,and endometrial receptibility regulation.A large number of research results have been achieved in cell and animal experiments,and preliminary results of clinical studies have also achieved certain curative effects,including increased endometrial thickness,improved menstrual volume and fertility.However,difficulty and challenges persist in the application of mesenchymal stem cells and their secreted extracellular vesicles for endometrial injury treatment.During treat

关 键 词：干细胞 间充质干细胞 细胞外囊泡 旁分泌 宫腔粘连 子宫内膜 组织修复 工程化干细胞 工程化细胞外囊泡 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R711.74