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干细胞治疗早发性卵巢功能不全的研究进展
栾旭
芦小单
米旭光
林秀英
武梦雪
樊美玲
方艳秋
作者及单位信息
·
DOI： 10.3760/cma.j.cn101441-20200901-00471
Stem cell therapy in the treatment of premature ovarian failure
Luan Xu
Lu Xiaodan
Mi Xuguang
Lin Xiuying
Wu Mengxue
Fan Meiling
Fang Yanqiu
Authors Info & Affiliations
Luan Xu
School of Clinical Medicine, Changchun Chinese Medicine University, Changchun 130021,China
Lu Xiaodan
Reproductive Medical Center, Jilin Province General Hospital, Changchun 130021, China
Mi Xuguang
Reproductive Medical Center, Jilin Province General Hospital, Changchun 130021, China
Lin Xiuying
Reproductive Medical Center, Jilin Province General Hospital, Changchun 130021, China
Wu Mengxue
School of Clinical Medicine, Changchun Chinese Medicine University, Changchun 130021,China
Fan Meiling
Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun 130021, China
Fang Yanqiu
Reproductive Medical Center, Jilin Province General Hospital, Changchun 130021, China
·
DOI： 10.3760/cma.j.cn101441-20200901-00471
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摘要

早发性卵巢功能不全已成为困扰育龄妇女的主要问题，到目前为止，尚无有效的治疗方法。干细胞具有自我更新和多向分化潜能，越来越被考虑用于卵巢功能不全的治疗。从骨髓、脐带、外周血和羊水中等提取的干细胞可以迁移到卵巢并增殖，在特定的卵巢环境下分化成熟，分泌相关因子，促进卵巢功能修复，增加卵巢各级卵泡质量和颗粒细胞的数量，改善内分泌功能，在一定程度上恢复生育能力。本文就各类干细胞治疗早发性卵巢功能不全的相关研究进展进行综述。

早发性卵巢功能不全;干细胞;颗粒细胞
ABSTRACT

Premature ovarian insufficiency has become a major problem that plagues women of childbearing age. So far, there is no effective treatment method. Stem cells have the potential for self-renewal and multidirectional differentiation, and are increasingly being considered for the treatment of ovarian insufficiency. Stem cells extracted from bone marrow, umbilical cord, peripheral blood, and amniotic fluid can migrate to the ovary and proliferate, differentiate and mature in a specific ovarian environment, secrete related factors, promote ovarian function repair, and increase the quality of ovarian follicles and the number of granulosa cells at all levels. Improve endocrine function and restore fertility to a certain extent. This article reviews the research progress of various types of stem cells in the treatment of premature ovarian insufficiency.

Premature ovarian insufficiency;Stem cells;Granulosa cells
Fang Qiuyan, Email: mocdef.3ab61gnaf.qy, Tel: +86-431-85595642
引用本文

栾旭,芦小单,米旭光,等. 干细胞治疗早发性卵巢功能不全的研究进展[J]. 中华生殖与避孕杂志,2021,41(11)：1031-1035.

DOI:10.3760/cma.j.cn101441-20200901-00471

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2016年，欧洲人类生殖与胚胎协会（European Society for Human Reproduction and Embryology，ESHRE）提出以早发性卵巢功能不全（premature ovarian insufficiency，POI）代替原有的卵巢早衰（premature ovarian failure，POF）概念 ［ 1 ］ ，将诊断标准中卵泡刺激素（follicular stimulating hormone，FSH）由单次检测值高于40 IU/L改为2次检测值高于25 IU/L，旨在对卵巢功能不全进行早诊断、早干预。POI的特点是低雌激素、高促性腺激素、闭经等，且这些因素会导致女性不孕和绝经前综合征。POI还会提高心血管疾病、性功能障碍和骨质疏松症等疾病的发生风险。POI发生在40岁以下的育龄期妇女，而且近年来呈现出年轻化的趋势 ［ 2 ］ 。全球女性人群中，每100个人中就有1人受到卵巢功能不全的困扰 ［ 3 ］ 。
卵泡由卵母细胞、颗粒细胞和卵泡膜细胞3种类型细胞组成。颗粒细胞表达FSH受体和黄体生成素受体，卵泡膜细胞表达黄体生成素受体，这两种激素对卵泡的生长和发育必不可少。已有研究表明，FSH受体和黄体生成素受体等基因突变会影响卵泡功能，在POI的发生发展中起重要作用 ［ 4 , 5 ］ 。另外，内分泌、旁分泌、线粒体功能障碍和代谢因素都会影响卵泡池和卵母细胞的质量。因此，POI的病因仍不清楚，且尚缺乏治愈手段。近年，干细胞因其多向分化潜能，应用于多种退行性疾病和损伤性疾病的治疗，为POI的临床治疗提供了一种新方向。以往的研究中，用于卵巢功能不全治疗的干细胞有间充质干细胞（mesenchymal stem cells，MSCs）、胚胎干细胞（embryonic stem cells，ESCs）、诱导多能干细胞（induced pluripotent stem cells，iPSCs）、生殖系干细胞（germline stem cells，GSCs）等。近年研究报道干细胞来源外泌体具有改善卵巢功能的作用。本文就干细胞治疗POI的研究进展进行综述。
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备注信息
A
方艳秋，Email： mocdef.3ab61gnaf.qy，电话：+86-431-85595642
B

栾旭负责论文撰写；芦小单、米旭光、林秀英负责批评性审阅；武梦雪负责论文修改；樊美玲负责论文指导；方艳秋负责论文指导和提供经费支持

C
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D
吉林省科技厅项目 (20180201028YY，20200403081SF，20200801019GH，20200404125YY)
吉林省人才开发资金 (2019026)
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