摘要
早发性卵巢功能不全(premature ovarian insufficiency,POI)是一种严重影响女性生理和生殖功能的复杂内分泌疾病,已成为育龄期女性不孕的主要原因之一,其临床特征为闭经或月经稀发、低雌激素或雌激素缺乏以及促性腺激素水平升高。POI的发病率呈上升趋势,且病因及发病机制尚不明确。目前临床上针对POI的常规治疗方法仍无法从根本上改善卵巢功能和解决生育问题。随着再生医学的发展,间充质干细胞(mesenchymal stem cells,MSCs)已成为POI治疗的研究热点之一,其外泌体也作为一种新型的“无细胞治疗”方法而备受关注。多项动物研究显示,MSCs及其外泌体通过调控颗粒细胞增殖与凋亡、促进卵巢血管新生、增强抗氧化应激能力、抑制卵巢组织纤维化、促进卵泡发育与成熟以及调节卵巢局部免疫微环境等多重机制,发挥对POI的治疗作用。此外,相关临床研究也已取得一定进展。本文对MSCs及其外泌体治疗POI的相关机制及临床疗效进行综述,旨在为POI的深入研究及临床转化提供参考和依据。
Premature ovarian insufficiency(POI)is a complex endocrine disorder that significantly affects the physiological and reproductive functions of women,and it has become one of the main causes of infertility in women of childbearing age.The clinical features of POI include amenorrhea or oligomenorrhea,low estrogen or estrogen deficiency,and an increase in the level of gonadotropin.The incidence rate of POI tends to increase,yet its etiology and pathogenesis remain unclear.At present,the conventional treatment methods for POI have limited efficacy in fundamentally improving ovarian function or addressing the fertility issue.With the development of regenerative medicine,mesenchymal stem cells(MSCs)have become one of the research hotspots in POI therapy,and their exosomes have attracted wide attention as a promising“cell-free therapy”.A number of animal experimental studies have shown that MSCs and their exosomes can exert a therapeutic effect on POI by affecting granulosa cell proliferation and apoptosis,promoting ovarian angiogenesis,reducing oxidative stress and fibrosis,enhancing follicular development,and regulating immunity.In addition,related clinical studies have also made some progress.This article reviews the mechanisms and clinical effect of MSCs and their exosomes in the treatment of POI,in order to provide a reference for further research and bench-to-bedside translation of POI therapies.
作者
张耀东
李佳林
娄艳茹
徐慧玉
杨蕊
Zhang Yaodong;Li Jialin;Lou Yanru;Xu Huiyu;Yang Rui(Center for Reproductive Medicine,Department of Obstetrics and Gynecology,Peking University Third Hospital/State Key Laboratory of Female Fertility Promotion/National Clinical Research Center for Obstetrics and Gynecology/Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology)
出处
《重庆医科大学学报》
北大核心
2025年第6期758-764,共7页
Journal of Chongqing Medical University
基金
首都卫生发展科研专项资助项目(编号:2024-2-40911)
国家重点研发计划课题资助项目(编号:2021YFC2700605)
国家自然科学基金资助项目(编号:82171632)
北京大学临床医学+X青年专项资助项目(编号:PKU2024LCXQ047)。
关键词
早发性卵巢功能不全
间充质干细胞
外泌体
再生医学
premature ovarian insufficiency
mesenchymal stem cell
exosome
regenerative medicine
