"The role of mesenchymal stem cells in the treatment of pelvic floor dysfunction in women"

Abstract

The term ‘’pelvic floor dysfunction’’ refers to all the disorders which are associated with the pelvic floor muscle system. The incidence of these diseases in women is constantly increasing during the last years and is leading to decreased quality of life. The current treatments can be categorized to non-invasive techniques -which often fail to provide a definitive solution- and invasive techniques -which may lead to postoperative complications. It is therefore clear that the development of innovative stem-cell based therapies can be a cornerstone in the treatment of the disease. Stem cells are undifferentiated cells characterized by two unique characteristics: self-renewal capacity and pluripotency and can be derived either from the embryo and fetal tissues or from the adult tissues. Depending on their potential for differentiation, they are classified into totipotent, pluripotent, multipotent, oligopotent and unipotent. The most investigated population of stem cells used for applications in regenerative medicine are mesenchymal stem cells, which are effective in treating many diseases thanks to their properties of migration, tissue repair, immunomodulation and cell death control. Specifically, in the present study, mesenchymal stem cells are the population studied for the treatment of pelvic floor dysfunction since they can act directly to the area of the lesion through migration or indirectly thanks to the paracrine signaling which leads to nutritional and immunomodulatory effects.

Up to date, a massive number of preclinical studies have been performed to investigate the treatment of pelvic floor dysfunction through tissue engineering or secretion products and the results demonstrate the strong ability of tissue regeneration and immune modifications possessed by mesenchymal stem cells. Of course, the small animal models used in preclinical trials only partially mimic the symptoms of the disease, which is why clinical trials are necessary for more valid conclusions. The use of human mesenchymal stem cells in clinical testing is possible thanks to their safe profile, the many sources that can be found and the ease of isolation. Although few, existing clinical trials are enhancing the effectiveness of cell therapy using mesenchymal stem cells for pelvic floor disorders and paving the way for even more studies in the future. The definitive treatment of the disease based on regenerative medicine will be an important achievement of science as it will improve the quality of life of a large number of patients, avoiding the after-surgery discomforts and complications.

LOUKOPOULOS Themistoklis