子宫内膜异位症与干细胞研究现状

doi:10.3877/cma.j.issn.1673-5250.2021.02.002

子宫内膜异位症(EMS)是妇科最常见良性疾病之一，但是其发病机制迄今尚未阐明，对其长期治疗疗效亦不满意。目前，"EMS起源的干细胞学说"为EMS研究提供了新思路。该学说在一定程度上解释了所有类型的EMS起源理论。随着目前对子宫内膜干细胞特性、特异性生物标志物等研究的逐渐深入，揭示参与子宫内膜异位病灶的干细胞，可能来源于子宫内膜、骨髓等，同时发现子宫内膜异位病灶的干细胞生物学特性发生一定改变。基于干细胞的EMS治疗策略研究也取得一定成果，对干细胞进行基因修饰，或抑制干细胞特性、减少子宫内膜来源干细胞和骨髓来源干细胞向子宫内膜异位病灶迁移和移植，为治疗EMS提供了新思路。笔者拟就EMS起源的干细胞学说，EMS的干细胞来源，包括子宫内膜来源的干/祖细胞与骨髓间充质干细胞(BMSC)，EMS干细胞的生物学特性及其临床意义4个方面，对干细胞与EMS相关理论及其研究现状进行阐述，旨在为EMS发病机制及诊疗策略研究提供参考。

关键词: 子宫内膜异位症, 干细胞, 子宫内膜干细胞, 骨髓间充质干细胞, 女(雌)性

Endometriosis (EMS) is one of the most common benign diseases in gynecology, but its pathogenesis is not clear so far and long-term effect of treatment is not satisfactory.In recent years, " the stem cell theory of EMS" has provided a new idea for researches of EMS. To some extent, this theory can be accounted for all types theories of origin of EMS. In recent years, studies on the characteristics and specific biological markers of endometrial stem cells have been gradually deepened, revealing that stem cells in ectopic lesions may be derived from endometrium and bone marrow, etc., and the biological characteristics of stem cells in ectopic lesions have changed to some extent.Researches on EMS treatment strategies based on stem cells have also made some achievements.Gene modification of stem cells, or inhibiting the characteristics of stem cells, reducing the migration and of endometrial-derived stem cells and bone marrow-derived stem cells to ectopic lesions, may provide some new ideas for the treatment of EMS.This article mainly elaborates on latest research progresses of theories and researches on stem cells and EMS from the following four aspects: stem cell theory of EMS, stem cell source of EMS, including endometrial-derived stem/progenitor cells and bone marrow mesenchymal stem cells (BMSC), biological characteristics of EMS stem cells and clinical significance in EMS treatment, in order to provide a reference for further study on pathogenesis, diagnosis and treatment strategy of EMS.

Key words: Endometriosis, Stem cells, Endometrial stem cells, Bone marrow mesenchymal stem cells, Female

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