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      Autologous cell therapy with CD133+ bone marrow-derived stem cells for refractory Asherman's syndrome and endometrial atrophy: a pilot cohort study

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          Abstract

          Could cell therapy using autologous peripheral blood CD133+ bone marrow-derived stem cells (BMDSCs) offer a safe and efficient therapeutic approach for patients with refractory Asherman's syndrome (AS) and/or endometrial atrophy (EA) and a wish to conceive?

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          Multilineage potential of adult human mesenchymal stem cells.

          M F Pittenger, A M Mackay, S C Beck … (1999)
          Human mesenchymal stem cells are thought to be multipotent cells, which are present in adult marrow, that can replicate as undifferentiated cells and that have the potential to differentiate to lineages of mesenchymal tissues, including bone, cartilage, fat, tendon, muscle, and marrow stroma. Cells that have the characteristics of human mesenchymal stem cells were isolated from marrow aspirates of volunteer donors. These cells displayed a stable phenotype and remained as a monolayer in vitro. These adult stem cells could be induced to differentiate exclusively into the adipocytic, chondrocytic, or osteocytic lineages. Individual stem cells were identified that, when expanded to colonies, retained their multilineage potential.
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            Endothelial progenitor cells: characterization and role in vascular biology.

            Carmen Urbich, Stefanie Dimmeler (2004)
            Infusion of different hematopoietic stem cell populations and ex vivo expanded endothelial progenitor cells augments neovascularization of tissue after ischemia and contributes to reendothelialization after endothelial injury, thereby, providing a novel therapeutic option. However, controversy exists with respect to the identification and the origin of endothelial progenitor cells. Overall, there is consensus that endothelial progenitor cells can derive from the bone marrow and that CD133/VEGFR2 cells represent a population with endothelial progenitor capacity. However, increasing evidence suggests that there are additional bone marrow-derived cell populations (eg, myeloid cells, "side population" cells, and mesenchymal cells) and non-bone marrow-derived cells, which also can give rise to endothelial cells. The characterization of the different progenitor cell populations and their functional properties are discussed. Mobilization and endothelial progenitor cell-mediated neovascularization is critically regulated. Stimulatory (eg, statins and exercise) or inhibitory factors (risk factors for coronary artery disease) modulate progenitor cell levels and, thereby, affect the vascular repair capacity. Moreover, recruitment and incorporation of endothelial progenitor cells requires a coordinated sequence of multistep adhesive and signaling events including adhesion and migration (eg, by integrins), chemoattraction (eg, by SDF-1/CXCR4), and finally the differentiation to endothelial cells. This review summarizes the mechanisms regulating endothelial progenitor cell-mediated neovascularization and reendothelialization.
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              Asherman syndrome--one century later.

              Dan Yu, Yat-May Wong, Ying Cheong … (2008)
              To provide an update on the current knowledge of Asherman syndrome. Literature review. The worldwide reports of this disease. Patients with Asherman syndrome who presented with amenorrhea or hypomenorrhea, infertility, or recurrent pregnancy loss. Hysteroscopy and hysteroscopic surgery have been the gold standard of diagnosis and treatment respectively for this condition. The etiology, pathology, symptomatology, diagnosis, treatment, and reproductive outcomes were analyzed. This syndrome occurs mainly as a result of trauma to the gravid uterine cavity, which leads to the formation of intrauterine and/or intracervical adhesions. Despite the advances in hysteroscopic surgery, the treatment of moderate to severe Asherman syndrome still presents a challenge. Furthermore, pregnancy after treatment remains high risk with complications including spontaneous abortion, preterm delivery, intrauterine growth restriction, placenta accrete or praevia, or even uterine rupture. The management of moderate to severe disease still poses a challenge, and the prognosis of severe disease remains poor. Close antenatal surveillance and monitoring are necessary for women who conceive after treatment.
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                Author and article information

                Journal
                Title: Human Reproduction
                Abbreviated Title: Hum. Reprod.
                Publisher: Oxford University Press (OUP)
                ISSN (Print): 0268-1161
                ISSN (Electronic): 1460-2350
                Publication date Created: April 21 2016
                Publication date Created: May 2016
                Publication date (Print): May 2016
                Publication date (Electronic): March 22 2016
                Volume: 31
                Issue: 5
                Pages: 1087-1096
                Article
                DOI: 10.1093/humrep/dew042
                PubMed ID: 27005892
                SO-VID: 5c9e62c2-257e-4306-b9e3-26fb07e02514
                Copyright © © 2016
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