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对卵巢早衰女性进行自体月经血源性间充质基质细胞的卵巢内给药。

Intraovarian Administration of Autologous Menstrual Blood Derived-Mesenchymal Stromal Cells in Women with Premature Ovarian Failure.

作者信息

Zafardoust Simin, Kazemnejad Somaieh, Darzi Maryam, Fathi-Kazerooni Mina, Saffarian Zahra, Khalili Niloofar, Edalatkhah Haleh, Mirzadegan Ebrahim, Khorasani Somayeh

机构信息

Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.

Nanobiotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.

出版信息

Arch Med Res. 2023 Feb;54(2):135-144. doi: 10.1016/j.arcmed.2022.12.015. Epub 2023 Jan 25.

Abstract

BACKGROUND

Premature ovarian failure (POF) is a well-known cause of infertility, particularly in women under the age of 40. POF is also associated with elevated gonadotropin levels, amenorrhea and sex-hormone deficiency.

AIM OF THE STUDY

In this study, the therapeutic potential of autologous mesenchymal stromal cells obtained from menstrual blood (Men-MSCs) for patients with POF was evaluated.

METHODS

15 POF patients were included in the study. The cultured Men-MSCs were confirmed by flow cytometry, karyotype, endotoxin and mycoplasma and were then injected into the patients' right ovary by vaginal ultrasound guidance and under general anesthesia and aseptic conditions. Changes in patients' anti-Müllerian hormone (AMH), antral follicle count (AFC), follicle-stimulating hormone (FSH), luteal hormone (LH), and estradiol (E2) levels, as well as general flushing and vaginal dryness were followed up to one year after treatment.

RESULTS

All patients were satisfied with a decrease in general flushing and vaginal dryness. 4 patients (2.9%) showed a spontaneous return of menstruation without additional pharmacological treatment. There was a significant difference in AFC (0 vs. 1 ± 0.92 count, p value ≤0.001%), FSH (74 ± 22.9 vs. 54.8 ± 17.5 mIU/mL, p-value ≤0.05%), E2 (10.2 ± 6 vs. 21.8 ± 11.5 pg/mL p-value ≤0.01%), LH (74 ± 22.9 vs. 54.8 ± 17.5 IU/L,p-value ≤0.01%) during 3 months post-injection. However, there were no significant changes in AMH (p-value ≥0.05%). There were also no significant differences in assessed parameters between 3 and 6 months after cell injection.

CONCLUSION

According to the findings of this study, administration of Men-MSCs improved ovarian function and menstrual restoration in some POF patients.

摘要

背景

卵巢早衰(POF)是导致不孕的一个众所周知的原因,尤其是在40岁以下的女性中。POF还与促性腺激素水平升高、闭经和性激素缺乏有关。

研究目的

在本研究中,评估了从月经血中获取的自体间充质基质细胞(Men-MSCs)对POF患者的治疗潜力。

方法

15名POF患者被纳入研究。通过流式细胞术、核型分析、内毒素和支原体检测对培养的Men-MSCs进行确认,然后在阴道超声引导下、全身麻醉和无菌条件下将其注入患者的右侧卵巢。在治疗后长达一年的时间里,随访患者的抗苗勒管激素(AMH)、窦卵泡计数(AFC)、促卵泡生成素(FSH)、黄体生成素(LH)和雌二醇(E2)水平的变化,以及全身潮热和阴道干涩情况。

结果

所有患者对全身潮热和阴道干涩的减轻都感到满意。4名患者(2.9%)在未进行额外药物治疗的情况下出现了月经自然恢复。注射后3个月时,AFC(0个对1±0.92个,p值≤0.001%)、FSH(74±22.9对54.8±17.5 mIU/mL,p值≤0.05%)、E2(10.2±6对21.8±11.5 pg/mL,p值≤0.01%)、LH(74±22.9对54.8±17.5 IU/L,p值≤0.01%)有显著差异。然而,AMH没有显著变化(p值≥0.05%)。细胞注射后3个月和6个月之间评估的参数也没有显著差异。

结论

根据本研究的结果,Men-MSCs的给药改善了一些POF患者的卵巢功能和月经恢复情况。

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