Asherman’s Syndrome: Analysis of the effectiveness of stem cell-based therapy
DOI:
https://doi.org/10.52076/eacad-v3i1.108Keywords:
Asherman's Syndrome; Stem cells; Endometrium.Abstract
Asherman Syndrome (AS) is the partial or complete obliteration of the uterine cavity and/or cervical canal with uterine synechiae, resulting in amenorrhea, infertility and recurrent pregnancy loss, which varies with the severity of the lesions. Conventional treatment is hysteroscopy adhesiolysis, which aims to remove intrauterine adhesions and reconstruct the uterine cavity. One of the promising alternative treatments with a high success rate is based on the systemic or intrauterine inoculation of stem cells, which consists of regenerating endometrial tissue and reversing the damage. Thus, the aim of the following review is to analyze the effectiveness of stem cell-based therapy in Asherman Syndrome. This is a systematic literature review that used the PubMed, SciELO, Cochrane Library and LILACS platforms as databases for researching scientific articles, with a time frame between 2016 and 2022, in English. According to the search engine, 6 results were found after the exclusion criteria in PubMed, Cochrane Library and LILACS databases. Therefore, stem cell-based therapy was found to be effective in the treatment of AS, as endometrial stem cells derived from autologous adult stem cells have a high angiogenic potential and can regenerate a damaged endometrium, thickening the endometrium, returning to menstruation and increasing the rate of pregnancy and protected pregnancy. However, further studies should be carried out in order to ensure greater safety for patients, as there are side effects that can be harmful, such as endometriosis, endometrial hyperplasia and endometrial cancer.
References
Azizi, R., Aghebati-Maleki, L., Nouri, M., Marofi, F., Negargar, S., & Yousefi, M. (2018). Stem cell therapy in Asherman syndrome and thin endometrium: Stem cell-based therapy. Biomedicine & Pharmacotherapy, 102, 333-343.
Benor, A., Gay, S., & DeCherney, A. (2020). An update on stem cell therapy for Asherman syndrome. Journal of Assisted Reproduction and Genetics, 37(7), 1511-1529.
Çil, N., Yaka, M., Ünal, M. S., Dodurga, Y., Tan, S., Seçme, M., ... & Mete, G. A. (2020). Adipose derived mesenchymal stem cell treatment in experimental asherman syndrome induced rats. Molecular Biology Reports, 47(6), 4541-4552.
Deane, J. A., Gualano, R. C., & Gargett, C. E. (2013). Regenerating endometrium from stem/progenitor cells: is it abnormal in endometriosis, Asherman's syndrome and infertility?. Current Opinion in Obstetrics and Gynecology, 25(3), 193-200.
Gao, L., Huang, Z., Lin, H., Tian, Y., Li, P., & Lin, S. (2019). Bone marrow mesenchymal stem cells (BMSCs) restore functional endometrium in the rat model for severe Asherman syndrome. Reproductive Sciences, 26(3), 436-444.
Gao, Y., Wu, G., Xu, Y., Zhao, D., & Zheng, L. (2021). Stem Cell-Based Therapy for Asherman Syndrome: Promises and Challenges. Cell Transplantation, 30, 09636897211020734.
Gharibeh, N., Aghebati-Maleki, L., Madani, J., Pourakbari, R., Yousefi, M., & Ahmadian Heris, J. (2022). Cell-based therapy in thin endometrium and Asherman syndrome. Stem Cell Research & Therapy, 13(1), 1-13.
Hou, X., Liu, Y., Streuli, I., Dällenbach, P., Dubuisson, J., Ansaldi, Y., & Pluchino, N. (2019). Endometrial regeneration in Asherman's syndrome: clinical and translational evidence of stem cell therapies. Current Stem Cell Research & Therapy, 14(6), 454-459.
Jiang, X., Li, X., Fei, X., Shen, J., Chen, J., Guo, M., & Li, Y. (2021). Endometrial membrane organoids from human embryonic stem cell combined with the 3D Matrigel for endometrium regeneration in asherman syndrome. Bioactive materials, 6(11), 3935-3946.
Khan, Z., & Goldberg, J. M. (2018). Hysteroscopic management of Asherman's syndrome. Journal of minimally invasive gynecology, 25(2), 218-228.
Liu, F., Hu, S., Yang, H., Li, Z., Huang, K., Su, T., ... & Cheng, K. (2019). Hyaluronic acid hydrogel integrated with mesenchymal stem cell‐secretome to treat endometrial injury in a rat model of Asherman's syndrome. Advanced healthcare materials, 8(14), 1900411.
Lv, Q., Wang, L., Luo, X., & Chen, X. (2021). Adult stem cells in endometrial regeneration: Molecular insights and clinical applications. Molecular Reproduction and Development, 88(6), 379-394.
Park, M., Hong, S. H., Park, S. H., Kim, Y. S., Yang, S. C., Kim, H. R., ... & Song, H. (2020). Perivascular stem cell-derived Cyclophilin A improves uterine environment with Asherman’s syndrome via HIF1α-dependent angiogenesis. Molecular Therapy, 28(8), 1818-1832.
Patrício, J. N. A. (2018). Síndrome de Asherman: novas perspetivas terapêuticas (Doctoral dissertation).
Santamaria, X., Cabanillas, S., Cervelló, I., Arbona, C., Raga, F., Ferro, J., ... & Simón, C. (2016). Autologous cell therapy with CD133+ bone marrow-derived stem cells for refractory Asherman's syndrome and endometrial atrophy: a pilot cohort study. Human Reproduction, 31(5), 1087-1096.
Saribas, G. S., Ozogul, C., Tiryaki, M., Pinarli, F. A., & Kilic, S. H. (2020). Effects of uterus derived mesenchymal stem cells and their exosomes on Asherman’s syndrome. Acta Histochemica, 122(1), 151465.
Singh, N., Mohanty, S., Seth, T., Shankar, M., Bhaskaran, S. e Dharmendra, S. (2014). Transplante autólogo de células-tronco na síndrome de Asherman refratária: Uma nova terapia baseada em células. Journal of human reproductive sciences, 7(2), 93-98. https://doi.org/10.4103/0974-1208.138864
Singh, N., Shekhar, B., Mohanty, S., Kumar, S., Seth, T., & Girish, B. (2020). Autologous Bone Marrow-Derived Stem Cell Therapy for Asherman's Syndrome and Endometrial Atrophy: A 5-Year Follow-up Study. Journal of human reproductive sciences, 13(1), 31–37.
Zhang, Y., Shi, L., Lin, X., Zhou, F., Xin, L., Xu, W., ... & Zhang, S. (2021). Unresponsive thin endometrium caused by Asherman syndrome treated with umbilical cord mesenchymal stem cells on collagen scaffolds: a pilot study. Stem cell research & therapy, 12(1), 1-14.
Zhao, Y., Luo, Q., Zhang, X., Qin, Y., Hao, J., Kong, D., ... & Wang, H. (2020). Clinical Efficacy and Safety of Stem Cell-Based Therapy in Treating Asherman Syndrome: A System Review and Meta-Analysis. Stem cells international, 2020.
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Copyright (c) 2022 Gustavo Soares Gomes Barros Fonseca; Maria Beatriz Celedonio Coelho; Ana Valéria Brandão de Sá Costa; Júlia Soares Gomes Barros Fonsêca; Paula Soares Machado; Blenda Michelle Eloi Bezerra Lima Sousa Barros; André Vinícius Reis Queiroga; Bárbara Luysla Silva Curvina; Filipe Augusto Lopes Cajubá de Britto; Kivia Ariana Rodrigues Vieira; Vítor Saraiva Guerra; Ana Clara Sampaio Lima Vasconcelos; Bianca Vitória Teixeira Maluf; Guilherme Fialho Ortegal; Julianne Souza Prazeres; Luiza da Silva Nunes Oliveira Lobato; Narjara Sâmya Rodrigues Pereira; Karollyne Soares de Melo Trindade; Constantino Ferreira de Castro Filho; Camilla Menezes de Carvalho; Roberto Augusto Lopes Cajubá de Britto; Juliana Pessoa Ferreira; Maria Clara Chaves Braga; Hanna Michelle Melo Garcia; Rebeca Clery da Rocha Nogueira; Rebeca Machado Castro Sousa; Arthur da Rocha Nogueira; Virna Maria Araujo de Oliveira; Lorena Barros Dias; João Víctor Pacheco Florentino; Isabela Coelho Brito Soares
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