Stem Cell Therapy for Treatment of Stress Urinary Incontinence: The Current Status and Challenges

Zhou, Shengyan; Zhang, Kaile; Atala, Anthony; Khoury, Oula; Murphy, Sean V.; Zhao, Weixin; Fu, Qiang

doi:10.1155/2016/7060975

Cited by 35 publications

(32 citation statements)

References 54 publications

(55 reference statements)

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“…[42][43][44][45] Six common cell types that have been evaluated for treatment of female SUI inclusive of embryonic, muscle derived (satellite cells), bone marrow derived, 46 mesenchymal, adipose (ASCs), and urinary and human umbilical cord blood types. Also human amniotic fluid stem cells (hAFSCs) have been proposed as an alternative source, 47,48 and, while other potential stem cell sources do exist in mammalian systems, they have yet to be studied extensively for SUI. Finally, pluripotent stem cells (PSC) have been proposed as a potential contributor of smooth and skeletal sphincter components.…”

Section: Stem Cell Technologiesmentioning

confidence: 99%

Surgery for urinary incontinence in women: Report from the 6th international consultation on incontinence

Gomelsky

Athanasiou

Choo

et al. 2018

Neurourology and Urodynamics

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Urinary incontinence is a prevalent condition worldwide and causes a tremendous impact on a woman's quality of life. While conservative and non‐surgical therapies are options for treatment, surgery for stress urinary incontinence (SUI) is common. Options include colposuspension, slings (pubovaginal and midurethral), and periurethral bulking. While evidence supports each of these options in the treatment of SUI, each is associated with various rates of success and unique adverse event profiles. Urgency urinary incontinence (UUI) is initially treated with behavioral modification and pharmacologic means, with surgery reserved for those with refractory symptoms or significant complications from medication use. At present, intravesical onabotulinumtoxinA injections, percutaneous tibial nerve stimulation, and sacral neurostimulation are all viable options for refractory UUI/overactive bladder. As with surgical interventions for SUI, each of these is, likewise, associated with unique outcomes and adverse event profiles. Herein, we summarize the findings and conclusions from the 6th International Consultation on Incontinence (ICI) regarding surgical treatment of urinary incontinence in women.

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Section: Stem Cell Technologiesmentioning

confidence: 99%

Surgery for urinary incontinence in women: Report from the 6th international consultation on incontinence

Gomelsky

Athanasiou

Choo

et al. 2018

Neurourology and Urodynamics

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“…Autologous adipose-derived stem cells (ADSC), musclederived stem cells, muscular precursor cells, MSCs, and human MSCs have been used in preclinical studies evaluating stem cell therapy for urethral sphincter regeneration [28]. All stem cell types were shown to differentiate into myocytelineage stem cells upon injection, and all secreted substances that restored urethral sphincter function via paracrine effects.…”

Section: Stress Urinary Incontinencementioning

confidence: 99%

Current and Future Directions of Stem Cell Therapy for Bladder Dysfunction

Shin

Ryu

et al. 2019

Stem Cell Rev and Rep

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Stem cells are capable of self-renewal and differentiation into a range of cell types and promote the release of chemokines and progenitor cells necessary for tissue regeneration. Mesenchymal stem cells are multipotent progenitor cells with enhanced proliferation and differentiation capabilities and less tumorigenicity than conventional adult stem cells; these cells are also easier to acquire. Bladder dysfunction is often chronic in nature with limited treatment modalities due to its undetermined pathophysiology. Most treatments focus on symptom alleviation rather than pathognomonic changes repair. The potential of stem cell therapy for bladder dysfunction has been reported in preclinical models for stress urinary incontinence, overactive bladder, detrusor underactivity, and interstitial cystitis/bladder pain syndrome. Despite these findings, however, stem cell therapy is not yet available for clinical use. Only one pilot study on detrusor underactivity and a handful of clinical trials on stress urinary incontinence have reported the effects of stem cell treatment. This limitation may be due to stem cell function loss following ex vivo expansion, poor in vivo engraftment or survival after transplantation, or a lack of understanding of the precise mechanisms of action underlying therapeutic outcomes and in vivo behavior of stem cells administered to target organs. Efficacy comparisons with existing treatment modalities are also needed for the successful clinical application of stem cell therapies. This review describes the current status of stem cell research on treating bladder dysfunction and suggests future directions to facilitate clinical applications of this promising treatment modality, particularly for bladder dysfunction.

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“…Several treatments for SUI are currently available, of which mid-urethral sling surgery is the most common and effective therapeutic method [6]. Despite the common use of midurethral sling surgery, this procedure is associated with a high level of complications, and therefore there is a need for new medical treatment options [7].…”

Section: Introductionmentioning

confidence: 99%

“…Stem cell-based therapy has gained attention as a promising treatment for SUI in recent years [6][7][8]. Among the different types of stem cells, adipose-derived stem cells (ADSCs) have been widely used since they can be easily and abundantly obtained and because of their multiple differentiation potential and low immunogenicity.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Potential of Human Adipose-Derived Stem Cell Exosomes in Stress Urinary Incontinence – An in Vitro and in Vivo Study

Zhou

et al. 2018

Cell Physiol Biochem

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Background/Aims: To evaluate whether local injection of exosomes derived from human adipose-derived stem cells (hADSCs) facilitates recovery of stress urinary incontinence (SUI) in a rat model. Methods: For the in vitro study, a Cell Counting Kit-8 (CCK-8) array and proteomic analysis were performed. For the in vivo study, female rats were divided into four groups: sham, SUI, adipose-derived stem cell (ADSC), and exosomes (n = 12 each). The SUI model was generated by pudendal nerve transection and vaginal dilation. Vehicle, hADSCs, or exosomes were injected into the peripheral urethra. After 2, 4, and 8 weeks, the rats underwent cystometrography and leak point pressure (LPP) testing, and tissues were harvested for histochemical analyses. Results: The CCK-8 experiment demonstrated that ADSC-derived exosomes could enhance the growth of skeletal muscle and Schwann cell lines in a dose-dependent manner. Proteomic analysis revealed that ADSC-derived exosomes contained various proteins of different signaling pathways. Some of these proteins are associated with the PI3K-Akt, Jak-STAT, and Wnt pathways, which are related to skeletal muscle and nerve regeneration and proliferation. In vivo experiments illustrated that rats of the exosome group had higher bladder capacity and LPP, and had more striated muscle fibers and peripheral nerve fibers in the urethra than rats of the SUI group. Both urethral function and histology of rats in the exosome group were slightly better than those in the ADSC group. Conclusions: Local injection of hADSC-derived exosomes improved functional and histological recovery after SUI.

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Stem Cell Therapy for Treatment of Stress Urinary Incontinence: The Current Status and Challenges

Cited by 35 publications

References 54 publications

Surgery for urinary incontinence in women: Report from the 6th international consultation on incontinence

Surgery for urinary incontinence in women: Report from the 6th international consultation on incontinence

Current and Future Directions of Stem Cell Therapy for Bladder Dysfunction

Therapeutic Potential of Human Adipose-Derived Stem Cell Exosomes in Stress Urinary Incontinence – An in Vitro and in Vivo Study

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