MSC-based therapy in female pelvic floor disorders
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ell & Bioscience Open Access
REVIEW
MSC‑based therapy in female pelvic floor disorders Yizhen Sima and Yisong Chen*
Abstract Mesenchymal stem cells (MSCs), also referred to as multipotent stromal cells or mesenchymal stromal cells, are present in multiple tissues and capable of differentiating into diverse cell lineages, holding a great promise in developing cell-based therapy for a wide range of conditions. Pelvic floor disorders (PFDs) is a common degenerative disease in women and may diminish a woman’s quality of life at any age. Since the treatments for this disease are limited by the high rates of recurrence and surgical complications, seeking an ideal therapy in the restoration of pelvic floor function is an urgent issue at present. Herein, we summarize the cell sources of MSCs used for PFDs and discuss the potential mechanisms of MSCs in treating PFDs. Specifically, we also provide a comprehensive review of current preclinical and clinical trials dedicated to investigating MSC-based therapy for PFDs. The novel therapy has presented promising therapeutic effects which include relieving the symptoms of urinary or fecal incontinence, improving the biological properties of implanted meshes and promoting the injured tissue repair. Nevertheless, MSC-based therapies for PFDs are still experimental and the unstated issues on their safety and efficacy should be carefully addressed before their clinical applications. Keywords: Mesenchymal stem cells, Mesenchymal stem cells transplantation, Cell- and tissue-based therapy, Pelvic floor disorders Background Pelvic floor disorders (PFDs) are a group of degenerative conditions that include urinary incontinence (UI), fecal incontinence, pelvic organ prolapse (POP), and other sensory or emptying abnormalities of the lower urinary and gastrointestinal tracts, caused by the weakening of pelvic floor supportive tissues and occurring independently or simultaneously. PFDs have an extremely high prevalence in women, affecting almost 25% of women older than 20 years in the United States, and UI is the most common disorder with a prevalence of 17% in the general population [1]. Stress urinary incontinence (SUI) is the subtype of UI, and about 50% of UI patients are classified as having SUI [2]. Despite being a common *Correspondence: [email protected] Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, 128 Shen Yang Road, Shanghai 200011, People’s Republic of China
disease, the exact etiology and pathogenesis of PFDs remain poorly understood. Many risk factors are related to PFDs [3], including parity, vaginal delivery, age, menopause, chronic cough, obesity, and constipation. These factors may cause abnormal metabolism of extracellular matrix and dysfunction of the pelvic supportive tissues such as cardinal and uterosacral ligaments [4], levator ani muscle [5], and urethral sphincter [6], contributing to the development of PFDs. Although the treatment principles for PFDs vary from different manifestations of the patients, current managements fo
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