摘要
压力性尿失禁(SUI)是女性常见的盆底功能障碍性疾病,严重影响患者的生活质量。传统保守治疗及手术治疗在改善症状方面具有一定效果,但难以从根本上修复尿道括约肌及盆底支持结构的损伤。随着再生医学和干细胞研究的不断发展,骨髓间充质干细胞(BMSCs)及其衍生外泌体因具备促进组织再生、改善盆底支持结构、调节炎症微环境等作用,逐渐成为SUI治疗研究的重要方向。研究显示,BMSCs可通过分化潜能及旁分泌效应促进尿道括约肌和盆底支持组织的修复,经基因修饰、生物材料结合等工程化手段可进一步增强其治疗效果。BMSCs衍生外泌体作为一种无细胞治疗策略,可调节炎症和改善组织弹性,在SUI的组织修复中发挥重要作用。而通过缺氧或炎症因子等条件对BMSCs进行预处理,可显著改变外泌体的组成和生物活性,进一步增强其抗炎、抗纤维化及组织修复能力。尽管相关研究取得进展,但其临床转化过程中仍存在细胞来源、移植方法、定植效率、安全性、质量控制及伦理等方面的挑战,有待进一步系统研究和规范化探索,以期为女性SUI的治疗提供理论依据与实践参考。
Stress urinary incontinence(SUI)is a common pelvic floor dysfunction in women,severely affecting quali⁃ty of life.While conventional therapies provide symptomatic relief,they often fail to repair the underlying damage to the urethral sphincter and pelvic support structures.With advances in regenerative medicine,bone marrow-derived mesenchy⁃mal stem cells(BMSCs)and their secreted exosomes have emerged as a promising therapeutic direction for SUI,owing to their abilities to promote tissue regeneration,improve pelvic support,and modulate the inflammatory microenvironment.Evidence indicates that BMSCs facilitate repair through differentiation and paracrine actions,and their efficacy can be fur⁃ther enhanced via engineering strategies like genetic modification or biomaterial combination.Exosomes derived from BM⁃SCs serve as a potent cell-free therapy,regulating inflammation and improving tissue elasticity.Preconditioning BMSCs(e.g.,under hypoxia or with inflammatory factors)can significantly alter exosomal composition and bioactivity,boosting their anti-inflammatory,anti-fibrotic,and regenerative potential.Despite promising progress,clinical translation faces challenges related to cell sourcing,delivery methods,engraftment efficiency,safety,quality control,and ethical issues,warranting further systematic investigation to provide theoretical basis and practical reference for the treatment of female SUI.
作者
蒋诺
洪莉
JIANG Nuo;HONG Li(Department of Obstetrics and Gynecology,Renmin Hospital of Wuhan University,Wuhan 430000,China)
出处
《山东医药》
2026年第1期155-158,共4页
Shandong Medical Journal
基金
国家自然科学基金项目(82571874,82371639)
湖北省科技创新项目(2025CCB011)。
关键词
骨髓间充质干细胞
压力性尿失禁
外泌体
生物工程技术
bone marrow-derived mesenchymal stem cells
stress urinary incontinence
exosomes
bioengineering techniques
