干细胞治疗女性压力性尿失禁研究进展
Research Progress on Stem Cell Therapy for Female Stress Urinary Incontinence
DOI: 10.12677/acm.2025.1551357, PDF,   
作者: 孔凡政, 陈 诚*：重庆医科大学，重庆；重庆市人民医院妇产科，重庆；刘晶霞：重庆医科大学，重庆
关键词: 干细胞；压力性尿失禁；综述；Stem Cells； Stress Urinary Incontinence； Review
摘要: 压力性尿失禁(stress urinary incontinence, SUI)是一个影响女性身心健康的难题，近年来，随着我国人口政策的调整、社会老龄化的发展，其发病率也逐年上升。压力性尿失禁不仅严重降低了患者的生活质量，还增加了患者焦虑、抑郁等精神心理负担。现有疗法只能缓解患者症状，无法彻底治愈。干细胞是一类具有多向分化、自我更新能力的细胞，随着细胞生物学和组织工程技术的发展，其潜在的临床治疗作用引起了人们的关注。本文总结了近年来干细胞在治疗压力性尿失禁中的研究进展，并对其局限性和未来应用进行了讨论和展望。
Abstract: Stress urinary incontinence is a challenging issue affecting women’s physical and mental health. In recent years, with adjustments in population policies and the development of social aging in China, its incidence has been increasing annually. Stress urinary incontinence not only severely reduces patients’ quality of life but also increases their psychological burdens such as anxiety and depression. Current therapies can only alleviate symptoms without providing a complete cure. Stem cells are a type of cell with multi-directional differentiation and self-renewal capabilities. With advancements in cell biology and tissue engineering technology, their potential clinical therapeutic effects have garnered attention. This paper summarizes recent research progress on the use of stem cells in treating stress urinary incontinence, discusses their limitations, and explores future applications.
文章引用：孔凡政, 刘晶霞, 陈诚. 干细胞治疗女性压力性尿失禁研究进展[J]. 临床医学进展, 2025, 15(5): 180-187. https://doi.org/10.12677/acm.2025.1551357

参考文献

[1] Guralnick, M.L., Fritel, X., Tarcan, T., Espuna‐Pons, M. and Rosier, P.F.W.M. (2018) ICS Educational Module: Cough Stress Test in the Evaluation of Female Urinary Incontinence: Introducing the ICS‐Uniform Cough Stress Test. Neurourology and Urodynamics, 37, 1849-1855. [Google Scholar] [CrossRef] [PubMed]
[2] Wu, J.M. (2021) Stress Incontinence in Women. New England Journal of Medicine, 384, 2428-2436. [Google Scholar] [CrossRef] [PubMed]
[3] Pang, H., Lv, J., Xu, T., Li, Z., Gong, J., Liu, Q., et al. (2021) Incidence and Risk Factors of Female Urinary Incontinence: A 4‐year Longitudinal Study among 24 985 Adult Women in China. BJOG: An International Journal of Obstetrics & Gynaecology, 129, 580-589. [Google Scholar] [CrossRef] [PubMed]
[4] Aoki, Y., Brown, H.W., Brubaker, L., Cornu, J.N., Daly, J.O. and Cartwright, R. (2017) Urinary Incontinence in Women. Nature Reviews Disease Primers, 3, Article No. 17042. [Google Scholar] [CrossRef] [PubMed]
[5] Lukacz, E.S., Santiago-Lastra, Y., Albo, M.E. and Brubaker, L. (2017) Urinary Incontinence in Women. JAMA, 318, 1592-1604. [Google Scholar] [CrossRef] [PubMed]
[6] 中华医学会妇产科学分会妇科盆底学组. 女性压力性尿失禁诊断和治疗指南(2017) [J]. 中华妇产科杂志, 2017, 52(5): 289-293.
[7] 王建龙, 李欣, 张耀光, 等. 经闭孔尿道中段悬吊术治疗高龄女性压力性尿失禁患者精神状态研究[J]. 中国微创外科杂志, 2015(10): 913-916.
[8] Fernández-Francos, S., Eiro, N., González-Galiano, N. and Vizoso, F.J. (2021) Mesenchymal Stem Cell-Based Therapy as an Alternative to the Treatment of Acute Respiratory Distress Syndrome: Current Evidence and Future Perspectives. International Journal of Molecular Sciences, 22, Article 7850. [Google Scholar] [CrossRef] [PubMed]
[9] Ghieh, F., Jurjus, R., Ibrahim, A., Geagea, A.G., Daouk, H., El Baba, B., et al. (2015) The Use of Stem Cells in Burn Wound Healing: A Review. BioMed Research International, 2015, Article ID: 684084. [Google Scholar] [CrossRef] [PubMed]
[10] Vinarov, A., Atala, A., Yoo, J., Slusarenco, R., Zhumataev, M., Zhito, A., et al. (2017) Cell Therapy for Stress Urinary Incontinence: Present‐Day Frontiers. Journal of Tissue Engineering and Regenerative Medicine, 12, e1108-e1121. [Google Scholar] [CrossRef] [PubMed]
[11] Musavi, L., Brandacher, G., Hoke, A., Darrach, H., Lee, W.P.A., Kumar, A., et al. (2018) Muscle-Derived Stem Cells: Important Players in Peripheral Nerve Repair. Expert Opinion on Therapeutic Targets, 22, 1009-1016. [Google Scholar] [CrossRef] [PubMed]
[12] Tamaki, T., Uchiyama, Y., Hirata, M., Hashimoto, H., Nakajima, N., Saito, K., et al. (2015) Therapeutic Isolation and Expansion of Human Skeletal Muscle-Derived Stem Cells for the Use of Muscle-Nerve-Blood Vessel Reconstitution. Frontiers in Physiology, 6, Article 165. [Google Scholar] [CrossRef] [PubMed]
[13] Wang, Y., Xu, H., Liu, X., Liu, L. and Liang, Z. (2011) Inhibition of Fibroblast Differentiation of Muscle-Derived Stem Cells in Cell Implantation Treatment of Stress Urinary Incontinence. Cellular Reprogramming, 13, 459-464. [Google Scholar] [CrossRef] [PubMed]
[14] Schmid, F.A., Williams, J.K., Kessler, T.M., Stenzl, A., Aicher, W.K., Andersson, K., et al. (2021) Treatment of Stress Urinary Incontinence with Muscle Stem Cells and Stem Cell Components: Chances, Challenges and Future Prospects. International Journal of Molecular Sciences, 22, Article 3981. [Google Scholar] [CrossRef] [PubMed]
[15] Cui, L., Meng, Q., Wen, J., Gao, Z., Yan, Z., Tian, Y., et al. (2018) A Functional Comparison of Treatment of Intrinsic Sphincter Deficiency with Muscle‐Derived and Adipose Tissue‐Derived Stem Cells. IUBMB Life, 70, 976-984. [Google Scholar] [CrossRef] [PubMed]
[16] Xu, Y., Song, Y.F. and Lin, Z.X. (2010) Transplantation of Muscle-Derived Stem Cells Plus Biodegradable Fibrin Glue Restores the Urethral Sphincter in a Pudendal Nerve-Transected Rat Model. Brazilian Journal of Medical and Biological Research, 43, 1076-1083. [Google Scholar] [CrossRef] [PubMed]
[17] Barakat, B., Franke, K., Schakaki, S., Hijazi, S., Hasselhof, V. and Vögeli, T. (2020) Stem Cell Applications in Regenerative Medicine for Stress Urinary Incontinence: A Review of Effectiveness Based on Clinical Trials. Arab Journal of Urology, 18, 194-205. [Google Scholar] [CrossRef] [PubMed]
[18] Mariotti, G., Salciccia, S., Viscuso, P., Bevilacqua, G., Casale, P., Frisenda, M., et al. (2023) Regenerative Medicine-Based Treatment of Stress Urinary Incontinence with Mesenchymal Stem Cells: A Systematic Review and Meta-Analysis. Current Stem Cell Research & Therapy, 18, 429-437. [Google Scholar] [CrossRef] [PubMed]
[19] Daneshpajooh, A., et al. (2022) Comparing Periurethral Injection of Autologous Muscle-Derived Stem Cells and Fibroblasts with Mid-Urethral Sling Surgery in the Treatment of Female Stress Urinary Incontinence: A Randomized Clinical Trial. Journal of Stem Cells and Regenerative Medicine, 18, 43-51.
[20] Bacakova, L., Zarubova, J., Travnickova, M., Musilkova, J., Pajorova, J., Slepicka, P., et al. (2018) Stem Cells: Their Source, Potency and Use in Regenerative Therapies with Focus on Adipose-Derived Stem Cells—A Review. Biotechnology Advances, 36, 1111-1126. [Google Scholar] [CrossRef] [PubMed]
[21] Li, M., Li, G., Lei, H., Guan, R., Yang, B., Gao, Z., et al. (2016) Therapeutic Potential of Adipose-Derived Stem Cell-Based Microtissues in a Rat Model of Stress Urinary Incontinence. Urology, 97, 277.e1-277.e7. [Google Scholar] [CrossRef] [PubMed]
[22] Li, G., Yu, C., Yu, P., Peng, Q., Wang, Q., Ren, S., et al. (2022) Periurethral and Intravenous Injections of Adipose-Derived Stem Cells to Promote Local Tissue Recovery in a Rat Model of Stress Urinary Incontinence. Urology, 167, 82-89. [Google Scholar] [CrossRef] [PubMed]
[23] Wang, Y., Zhou, S., Yang, R., Rahman, M., Sequeira, R.C., Cao, N., et al. (2020) Magnetic Targeting of Super-Paramagnetic Iron Oxide Nanoparticle Labeled Myogenic-Induced Adipose-Derived Stem Cells in a Rat Model of Stress Urinary Incontinence. Nanomedicine: Nanotechnology, Biology and Medicine, 30, Article ID: 102281. [Google Scholar] [CrossRef] [PubMed]
[24] Kuismanen, K., Sartoneva, R., Haimi, S., Mannerström, B., Tomás, E., Miettinen, S., et al. (2014) Autologous Adipose Stem Cells in Treatment of Female Stress Urinary Incontinence: Results of a Pilot Study. Stem Cells Translational Medicine, 3, 936-941. [Google Scholar] [CrossRef] [PubMed]
[25] Arjmand, B., Safavi, M., Heidari, R., et al. (2017) Concomitant Transurethral and Transvaginal-Periurethral Injection of Autologous Adipose-Derived Stem Cells for Treatment of FEMALE stress Urinary Incontinence: A Phase One Clinical Trial. Acta Medica Iranica, 55, 368-374.
[26] Garcia-Arranz, M., Alonso-Gregorio, S., Fontana-Portella, P., Bravo, E., Diez Sebastian, J., Fernandez-Santos, M.E., et al. (2020) Two Phase I/II Clinical Trials for the Treatment of Urinary Incontinence with Autologous Mesenchymal Stem Cells. Stem Cells Translational Medicine, 9, 1500-1508. [Google Scholar] [CrossRef] [PubMed]
[27] Ding, D., Shyu, W. and Lin, S. (2011) Mesenchymal Stem Cells. Cell Transplantation, 20, 5-14. [Google Scholar] [CrossRef] [PubMed]
[28] Fu, X., Liu, G., Halim, A., Ju, Y., Luo, Q. and Song, G. (2019) Mesenchymal Stem Cell Migration and Tissue Repair. Cells, 8, Article 784. [Google Scholar] [CrossRef] [PubMed]
[29] Kim, S., Na, H.S., Kwon, D., Joo, S.Y., Kim, H.S. and Ahn, Y. (2010) Bone-Marrow-Derived Mesenchymal Stem Cell Transplantation Enhances Closing Pressure and Leak Point Pressure in a Female Urinary Incontinence Rat Model. Urologia Internationalis, 86, 110-116. [Google Scholar] [CrossRef] [PubMed]
[30] Corcos, J., Loutochin, O., Campeau, L., Eliopoulos, N., Bouchentouf, M., Blok, B., et al. (2010) Bone Marrow Mesenchymal Stromal Cell Therapy for External Urethral Sphincter Restoration in a Rat Model of Stress Urinary Incontinence. Neurourology and Urodynamics, 30, 447-455. [Google Scholar] [CrossRef] [PubMed]
[31] Jiang, H., Ji, L., Li, H., Song, Q., Bano, Y., Chen, L., et al. (2020) Combined Treatment with Ccr1-Overexpressing Mesenchymal Stem Cells and CCL7 Enhances Engraftment and Promotes the Recovery of Simulated Birth Injury-Induced Stress Urinary Incontinence in Rats. Frontiers in Surgery, 7, Article 40. [Google Scholar] [CrossRef] [PubMed]
[32] Janssen, K., Lin, D.L., Hanzlicek, B., Deng, K., Balog, B.M., van der Vaart, C.H., et al. (2019) Multiple Doses of Stem Cells Maintain Urethral Function in a Model of Neuromuscular Injury Resulting in Stress Urinary Incontinence. American Journal of Physiology-Renal Physiology, 317, F1047-F1057. [Google Scholar] [CrossRef] [PubMed]
[33] Jiang, M., Liu, J., Liu, W., Zhu, X., Bano, Y., Liao, H., et al. (2021) Bone Marrow Stem Cells Secretome Accelerates Simulated Birth Trauma-Induced Stress Urinary Incontinence Recovery in Rats. Aging, 13, 10517-10534. [Google Scholar] [CrossRef] [PubMed]
[34] Lee, C.N., Jang, J.B., Kim, J.Y., Koh, C., Baek, J.Y. and Lee, K.J. (2010) Human Cord Blood Stem Cell Therapy for Treatment of Stress Urinary Incontinence. Journal of Korean Medical Science, 25, 813-816. [Google Scholar] [CrossRef] [PubMed]
[35] Ding, D., Chang, Y., Shyu, W. and Lin, S. (2015) Human Umbilical Cord Mesenchymal Stem Cells: A New Era for Stem Cell Therapy. Cell Transplantation, 24, 339-347. [Google Scholar] [CrossRef] [PubMed]
[36] Mitchell, K.E., Weiss, M.L., Mitchell, B.M., Martin, P., Davis, D., Morales, L., et al. (2003) Matrix Cells from Wharton’s Jelly Form Neurons and Glia. STEM CELLS, 21, 50-60. [Google Scholar] [CrossRef] [PubMed]
[37] Lim, J., Jang, J., Kim, J., Moon, S., Lee, C. and Lee, K. (2010) Human Umbilical Cord Blood Mononuclear Cell Transplantation in Rats with Intrinsic Sphincter Deficiency. Journal of Korean Medical Science, 25, 663-670. [Google Scholar] [CrossRef] [PubMed]
[38] 罗新, 姚润斯, 宋泓, 等. 人脐带间充质干细胞移植治疗大鼠压力性尿失禁的研究[J]. 中华妇产科杂志, 2013, 48(8): 579-583.
[39] Pei, W., Lu, T., Wang, K., Ji, M., Zhang, S., Chen, F., et al. (2018) Biological Characterization and Pluripotent Identification of Ovine Amniotic Fluid Stem Cells. Cytotechnology, 70, 1009-1021. [Google Scholar] [CrossRef] [PubMed]
[40] Choi, J.Y., Chun, S.Y., Kim, B.S., Kim, H.T., Yoo, E.S., Shon, Y., et al. (2015) Pre-Clinical Efficacy and Safety Evaluation of Human Amniotic Fluid-Derived Stem Cell Injection in a Mouse Model of Urinary Incontinence. Yonsei Medical Journal, 56, 648-657. [Google Scholar] [CrossRef] [PubMed]
[41] Kim, B.S., Chun, S.Y., Lee, J.K., Lim, H.J., Bae, J., Chung, H., et al. (2012) Human Amniotic Fluid Stem Cell Injection Therapy for Urethral Sphincter Regeneration in an Animal Model. BMC Medicine, 10, Article No. 94. [Google Scholar] [CrossRef] [PubMed]
[42] Adamowicz, J., Kloskowski, T., Tworkiewicz, J., Pokrywczyńska, M. and Drewa, T. (2012) Urine Is a Highly Cytotoxic Agent: Does It Influence Stem Cell Therapies in Urology? Transplantation Proceedings, 44, 1439-1441. [Google Scholar] [CrossRef] [PubMed]
[43] Lang, R., Liu, G., Shi, Y., Bharadwaj, S., Leng, X., Zhou, X., et al. (2013) Self-Renewal and Differentiation Capacity of Urine-Derived Stem Cells after Urine Preservation for 24 Hours. PLOS ONE, 8, e53980. [Google Scholar] [CrossRef] [PubMed]
[44] Liu, G., Pareta, R.A., Wu, R., Shi, Y., Zhou, X., Liu, H., et al. (2013) Skeletal Myogenic Differentiation of Urine-Derived Stem Cells and Angiogenesis Using Microbeads Loaded with Growth Factors. Biomaterials, 34, 1311-1326. [Google Scholar] [CrossRef] [PubMed]
[45] Wu, S., Wang, Z., Bharadwaj, S., Hodges, S.J., Atala, A. and Zhang, Y. (2011) Implantation of Autologous Urine Derived Stem Cells Expressing Vascular Endothelial Growth Factor for Potential Use in Genitourinary Reconstruction. Journal of Urology, 186, 640-647. [Google Scholar] [CrossRef] [PubMed]
[46] Zordani, A., Pisciotta, A., Bertoni, L., Bertani, G., Vallarola, A., Giuliani, D., et al. (2019) Regenerative Potential of Human Dental Pulp Stem Cells in the Treatment of Stress Urinary Incontinence: In Vitro and in Vivo Study. Cell Proliferation, 52, e12675. [Google Scholar] [CrossRef] [PubMed]
[47] Mahboubeh, M., Hamid, P., Azar, D., Mohammad Ali, B., Alireza, F. and Mohsen, B. (2023) Short and Medium-Term Results of the Autologous Adult Mucosa Stem Cell Therapy Compared with Mini-Sling Surgery in the Treatment of Women’s Stress Urinary Incontinence: A Randomized Clinical Trial. Current Stem Cell Research & Therapy, 18, 276-283. [Google Scholar] [CrossRef] [PubMed]
[48] Ni, J., Li, H., Zhou, Y., Gu, B., Xu, Y., Fu, Q., et al. (2018) Therapeutic Potential of Human Adipose-Derived Stem Cell Exosomes in Stress Urinary Incontinence—An in Vitro and in Vivo Study. Cellular Physiology and Biochemistry, 48, 1710-1722. [Google Scholar] [CrossRef] [PubMed]
[49] Wu, R., Huang, C., Wu, Q., Jia, X., Liu, M., Xue, Z., et al. (2019) Exosomes Secreted by Urine-Derived Stem Cells Improve Stress Urinary Incontinence by Promoting Repair of Pubococcygeus Muscle Injury in Rats. Stem Cell Research & Therapy, 10, Article No. 80. [Google Scholar] [CrossRef] [PubMed]
[50] Xu, Y., Jiang, Y., Xia, C., Wang, Y., Zhao, Z. and Li, T. (2020) Stem Cell Therapy for Osteonecrosis of Femoral Head: Opportunities and Challenges. Regenerative Therapy, 15, 295-304. [Google Scholar] [CrossRef] [PubMed]

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