机械牵张诱导的骨髓间充质干细胞与人脱细胞羊膜复合组织移植治疗盆底功能障碍性疾病的研究

Pelvic floor dysfunction (PFD) seriously affects life quality of middle and old aged women. This disease is related to pelvic floor tissues damage, especially ligament damage, and the incidence of this disease is about 40%. The traditional treatment has many shortcomings, such as a lot of complications and a high rate of recurrence, so people gradually turn their attention to treatments using stem cells. In preliminary study, we found for the first time that, by indirect co-culture of pelvic floor ligament fibroblast with mechanical strain, rat bone marrow mesenchymal stem cells (BMSCs) can be induced to differentiate to pelvic floor ligament fibroblast. The differentiated BMSCs can repair ligament tissue damage. This research plans to firstly use indirect co-culture of pelvic floor ligament fibroblast with mechanical strain, and then induce BMSCs to differentiate to pelvic floor ligament fibroblast in in-vitro specific mechanical microenvironment. Differentiation degree can be judged by testing the content change of collagen, elastin, LOX and Fibulin-5 in BMSCs. Thereafter, the well-differentiated BMSCs are inoculated to human acellular amniotic membrane to culture. At last, the human acellular amniotic membrane with BMSCs is transplanted to diseased rat with PFD to study the possibility of treating PFD. This research can hopefully provide a new idea for treating PFD with stem cell, and therefore have comparatively important scientific significance and good application prospect.

盆底功能障碍性疾病（PFD）严重影响中老年妇女的生活质量，其发病与盆底支持组织特别是韧带的损伤密切有关，发病率约为40%。传统治疗存在并发症多、复发率高等诸多不足，人们逐渐将目光转向干细胞治疗。我们前期研究首次发现，与机械牵张刺激的盆底韧带成纤维细胞间接共培养可诱导大鼠骨髓间充质干细胞(BMSCs)向盆底韧带成纤维细胞分化，而分化的BMSCs可修复损伤的韧带。本研究拟首先利用与机械牵张刺激的盆底韧带成纤维细胞间接共培养，在体外特定力学微环境下，诱导BMSCs向盆底韧带成纤维细胞分化，通过检测BMSCs中胶原蛋白、弹性蛋白、LOX及Fibulin-5含量的变化判断其分化程度，然后将诱导分化良好的BMSCs接种人脱细胞羊膜培养，最后将负载BMSCs的人脱细胞羊膜移植到PFD患鼠，研究其治疗PFD的可行性。本研究有望为利用干细胞治疗PFD提供新的思路，具有较为重要的科学意义和良好的远期应用前景。

盆底功能障碍性疾病（PFD）严重影响中老年妇女的生活质量，其发病与盆底支持组织特别是韧带的损伤密切有关，发病率约为40%。传统治疗存在并发症多、复发率高等诸多不足，人们逐渐将目光转向干细胞治疗。与机械牵张刺激的盆底韧带成纤维细胞间接共培养可诱导大鼠骨髓间充质干细胞(BMSCs)向盆底韧带成纤维细胞分化，而分化的BMSCs可修复损伤的韧带。我们利用与机械牵张刺激的盆底韧带成纤维细胞间接共培养，在体外特定力学微环境下，诱导BMSCs向盆底韧带成纤维细胞分化，然后将诱导分化良好的BMSCs接种人脱细胞羊膜培养，最后将负载BMSCs的人脱细胞羊膜移植到PFD患鼠，研究结果表明这种方法可以有效改善PFD大鼠的生存质量。本研究结果为利用干细胞治疗PFD提供新的思路，具有较为重要的科学意义和良好的远期应用前景。