Current Obstetrics and Gynecology Reports, Journal Year: 2025, Volume and Issue: 14(1)
Published: Feb. 4, 2025
Language: Английский
Human Reproduction Update, Journal Year: 2024, Volume and Issue: 30(5), P. 584 - 613
Published: May 25, 2024
Abstract BACKGROUND The establishment and maintenance of pregnancy depend on endometrial competence. Asherman syndrome (AS) intrauterine adhesions (IUA), or atrophy (EA) thin endometrium (TE), can either originate autonomously arise as a result from conditions (i.e. endometritis congenital hypoplasia), medical interventions (e.g. surgeries, hormonal therapies, uterine curettage radiotherapy). Affected patients may present an altered inadequate lining that hinders embryo implantation increases the risk poor outcomes miscarriage. In humans, AS/IUA EA/TE are mainly treated with surgeries pharmacotherapy, however reported efficacy these therapeutic approaches remains unclear. Thus, novel regenerative techniques utilizing stem cells, growth factors, tissue engineering have emerged to improve reproductive outcomes. OBJECTIVE AND RATIONALE This review comprehensively summarizes methodologies emerging biotechnologies (cellular, acellular, bioengineering approaches) treat human pathologies. Regenerative therapies derived tissues blood which were studied in preclinical models (in vitro vivo) clinical trials discussed. SEARCH METHODS A systematic search full-text articles available PubMed Embase was conducted identify original peer-reviewed studies published English between January 2000 September 2023. terms included: human, uterus, endometrium, syndrome, adhesions, atrophy, endometritis, hypoplasia, curettage, radiotherapy, therapy, bioengineering, vesicles, platelet-rich plasma, biomaterials, microfluidic, bioprinting, organoids, hydrogel, scaffold, sheet, miRNA, sildenafil, nitroglycerine, aspirin, hormone, progesterone, estrogen. Preclinical cellular, strategies repair regenerate included. Additional identified through manual searches. OUTCOMES From total 4366 records identified, 164 (3.8%) included for review. Due heterogeneity study design measured outcome parameters both studies, findings evaluated qualitatively quantitatively without meta-analysis. Groups using cell-based treatments pathologies commonly employed mesenchymal cells (MSCs) bone marrow umbilical cord. Alternatively, acellular based plasma (PRP) extracellular vesicles gaining popularity. These accompanied by emergence matrix (ECM)-derived hydrogels synthetic biosimilars sustain local delivery reporting promising results. Combined target multiple aspects regeneration remain testing but shown translational value. highlights myriad material sources, administration methods, carriers been tested. WIDER IMPLICATIONS Therapies promote proliferation, vascular development, help restore function and, ultimately, fertility. Based existing evidence, cost, accessibility, availability we propose development triple-hit strategies, potentially combining high-yield MSCs cord) (PRP), possibly integrated ECM hydrogels. Advances together insights will pave way developing personalized treatment regimens infertility-causing disorders such AS/IUA, EA/TE, endometritis. REGISTRATION NUMBER https://osf.io/th8yf/
Language: Английский
Citations
20
Nature Reviews Endocrinology, Journal Year: 2022, Volume and Issue: 18(12), P. 727 - 743
Published: Sept. 1, 2022
Language: Английский
Citations
47
International Journal of Gynecology & Obstetrics, Journal Year: 2023, Volume and Issue: 162(S2), P. 29 - 42
Published: Aug. 1, 2023
Abstract Abnormal uterine bleeding (AUB) is common, often debilitating, and may affect over 50% of reproductive‐aged women girls. Whereas AUB a collection symptoms that include intermenstrual abnormalities in period duration, cycle length, regularity, it heavy menstrual (HMB) most contributory to iron deficiency related anemia. It apparent AUB, general, HMB, particular, remain underrecognized underreported. FIGO created two systems for assessing classifying AUB. System 1 defines the pattern using four primary descriptors: frequency, flow volume. 2 provides structured classification system possible causes acronym PALM‐COEIN. “PALM” refers structural (Polyp, Adenomyosis, Leiomyoma, Malignancy), “COEI” nonstructural (Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic). The “N” reserved those entities are currently not otherwise classified. Using as gateway streamlines investigation girls with Understanding pathogenesis “PALM‐COEIN” helps interpret investigations onward management Numerous evidence gaps exist concerning AUB; however, if researchers trialists universally adopt Systems assessment diagnosis clear translatable research findings can be applied globally.
Language: Английский
Citations
31
Fertility and Sterility, Journal Year: 2024, Volume and Issue: 122(1), P. 20 - 30
Published: May 8, 2024
Uterine fibroids (UFs) are the most common female benign pelvic tumors, affecting >60% of patients aged 30-44 years. asymptomatic in a large percentage cases and may be identified incidentally using transvaginal ultrasound or magnetic resonance imaging scan. However, approximately 30% cases, UFs affect quality life women's health, with abnormal uterine bleeding heavy menstrual being complaints, along iron deficiency (ID) ID anemia. Medical treatments used for UFs-related include symptomatic agents, such as nonsteroidal antiinflammatory drugs tranexamic acid, hormonal therapies, including combined oral contraceptives, gonadotropin-releasing hormone agonists antagonists, levonorgestrel intrauterine systems, selective progesterone receptor modulators, aromatase inhibitors. Nevertheless, few approved specifically UF treatment, them manage symptoms. Surgical options fertility-sparing treatments, myomectomy, nonconservative options, hysterectomy, especially perimenopausal women who not responding to any treatment. Radiologic interventions also available: artery embolization, high-intensity focused resonance-guided ultrasound, radiofrequency ablation. Furthermore, management anemia, consequence acute chronic bleeding, should taken into account use replacement therapy both during medical treatment before after surgical procedure. In case UFs, location, size, multiple coexistent adenomyosis guide choice shared decision-making process, considering long- short-term goals expected by patient, pregnancy desire wish preserve uterus independently reproductive goals.
Language: Английский
Citations
16
Cell Proliferation, Journal Year: 2025, Volume and Issue: unknown
Published: March 20, 2025
ABSTRACT Uterine fibroids (UFs) are the most common benign gynecologic tumours affecting women of reproductive age. This study aims to deepen understanding UFs complex aetiology through harnessing power 3D organoid models derived from human myometrial stem cells emulate in vivo behaviour these tumours. Isolated SCs were cultured over 7 days under a defined culture system. Immunohistochemistry, Immunofluorescence, stiffness, RNA Sequencing was conducted, and differential gene expression assessed using RT‐PCR. The organoids exhibited diverse populations cells, including smooth muscle, fibroblasts. Excessive ECM deposition shown via Collagen Fibronectin expression. We confirmed that our expressed oestrogen receptor pattern similar their corresponding tissue, as well responded steroid hormone. Interestingly, we revealed significant racial disparities accumulation within different groups. augmented is theorised enhance tissue Young's modulus. Additionally, research demonstrated decreases fibrotic markers upon treatment with Vitamin D3 Doxercalciferol. Furthermore, pro‐fibroid effects environmental phthalates further elucidate potential factors contributing UF pathology. model can serve robust platform underlying molecular mechanisms UFs, besides offering invaluable insights for therapeutic interventions.
Language: Английский
Citations
1
Fertility and Sterility, Journal Year: 2022, Volume and Issue: 118(4), P. 605 - 606
Published: Sept. 29, 2022
Language: Английский
Citations
33
Human Reproduction Update, Journal Year: 2023, Volume and Issue: 29(4), P. 457 - 485
Published: Feb. 28, 2023
Abnormal uterine bleeding (AUB) has a significant socioeconomic impact since it considerably impacts quality of life. Therapeutic options are frequently based on trial and error do not target disease aetiology. Pathophysiological insight in this is required for the development novel treatment options. If no underlying cause found AUB (e.g. fibroids, adenomyosis, polyps), endometrial-AUB (AUB-E) usually caused by primary endometrium disorder. When induced prescribed (exogenous) hormones, classified as iatrogenic-AUB (AUB-I). Considering vascular modulation function, AUB-E AUB-I both could potentially result from abnormal vascularization due to alterations process angiogenesis maturation.
Language: Английский
Citations
23
Journal of Controlled Release, Journal Year: 2023, Volume and Issue: 362, P. 692 - 714
Published: Sept. 19, 2023
Language: Английский
Citations
23
Human Reproduction, Journal Year: 2023, Volume and Issue: 39(1), P. 1 - 17
Published: Nov. 10, 2023
Abstract The potential for repeated ovulation and menstruation is thought to have provided a Darwinian advantage during the Palaeolithic. Reproductive conditions remained relatively stable until pre-industrial era, characterized by late menarche, very young age at first birth, multiple pregnancies, prolonged periods of lactational amenorrhoea. For hundreds thousands years, menstruators experienced few ovulatory cycles, even though they were genetically adapted ovulate menstruate every month. In post-industrial menarche gradually declined, birth progressively increased, breastfeeding became optional often short duration. This created mismatch between genetic adaptation socio-environmental evolution, so that what was initially probable reproductive subsequently contributed increased susceptibility diseases associated with lifetime oestrogen exposure, such as ovarian, endometrial breast cancer and, hypothetically, also those number menstruations, endometriosis adenomyosis. incidence shows steep progressive increase around 25 but given consistently reported delay in diagnosis, actual curve should be shifted left, supporting possibility disease has its roots adolescence. raises question whether, from an evolutionary point view, anovulation amenorrhoea not still considered physiological state, especially postmenarchal period. However, frequency recent decades been demonstrated, although this deserves further epidemiological investigation. addition, occurs minority individuals exposed retrograde menstruation, other important pathogenic factors scrutinised. Research resumed explore more detail transtubal reflux only blood, cells, whether are systematically present peritoneal fluid after menstruation. If repetitive early years shown risk adenomyosis development progression susceptible individuals, hormonal interventions could used secondary prevention symptomatic adolescents.
Language: Английский
Citations
19
MedComm, Journal Year: 2023, Volume and Issue: 4(6)
Published: Dec. 1, 2023
Abstract The endometrium is a unique human tissue with an extraordinary ability to undergo hormone‐regulated cycle encompassing shedding, bleeding, scarless repair, and regeneration throughout the female reproductive cycle. cyclical repair of manifest as changes in endometrial epithelialization, glandular regeneration, vascularization. mechanisms encompass inflammation, coagulation, fibrinolytic system balance. However, specific conditions such endometriosis or TCRA treatment can disrupt process regeneration. There uncertainty about traditional clinical treatments' efficacy side effects, finding new therapeutic interventions essential. Researchers have made substantial progress perspective regenerative medicine toward maintaining recent years. Such encompasses integration biomaterials, tissue‐engineered scaffolds, stem cell therapies, 3D printing. This review analyzes mechanisms, diseases, associated discusses advantages disadvantages currently employed practice. Additionally, it highlights significant this domain. Finally, we cells biologics among available medicine, providing insights into future strategies.
Language: Английский
Citations
17