- A new
strategy has been developed that utilizes induced pluripotent stem (iPS)
cells, which can be reprogrammed to produce healthy uterine cells
healthy uterine cells can replace the diseased endometrial tissue, thereby
providing a way to treat endometriosis
cell-based therapy approach could be used in the future to bioengineer a
whole uterus, which will be capable of preventing various uterine
diseases, including endometriosis
A new study by scientists at Northwestern University has
found that the human uterus can be bioengineered by using stem cells and this
could revolutionize the treatment of conditions such as endometriosis,
endometrial cancer, and uterine-factor infertility.
The study is the first of its kind that reports the use of induced pluripotent stem (iPS) cells
that can be reprogrammed
to produce uterine cells in humans. These iPS cells can be bioengineered from
adult stem cells present in the patient's own body and used to replace cells
that have been damaged due to disease. These cells are recognized by the immune
system as "self" and not "foreign", as a result of which they can be used for
auto-transplantation into the same person.
these healthy uterine cells can be used to replace the diseased endometrial
tissue, without being rejected by the immune system.
‘Endometriosis could soon be treated by a new technique that uses stem cells (induced pluripotent stem or iPS cells), which can be reprogrammed to produce healthy uterine cells. These healthy cells will replace the diseased tissue, thereby providing a potential therapeutic approach to cure the disease. This technique could help develop a bioengineered uterus in the future.’
The study, published in Stem Cell Reports
, an online publication of Cell Press, was led by Dr. Serdar Bulun, MD, Chair of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago,
Illinois, USA. The team also included Dr. Kaoru Miyazaki from Northwestern University and Dr. Tetsuo Maruyama from Keio University, Tokyo, Japan.
What are Stem Cells?
Stem cells are
cells in the body that have the ability to develop into specialized cells.
These cells can replace cells and tissues that have been damaged or lost
due to disease. Stem cells are of three types:
- Embryonic Stem Cells: These cells supply new cells to the
growing embryo, as it develops into a fetus. These cells are pluripotent
and have the ability to differentiate into any cell type.
- Adult Stem Cells: These cells supply new cells as an
organism grows and replaces cells that may be damaged. These cells are
multipotent and can only differentiate into a specific cell type.
- Induced Pluripotent Stem (iPS)
Cells: These stem
cells are engineered in the lab by taking adult stem cells such as skin or
blood cells and inducing or reprogramming them to differentiate into other
cells. iPS cells, like embryonic stem cells, are pluripotent i.e. they
have the capacity to differentiate into any cell type. In the present
study, iPS cells have been used.
What is Endometriosis?
is a disease in which tissues
that normally line the inner layer of the uterus (endometrium) grows outside
the uterus on other pelvic organs, such as the ovaries or Fallopian tubes.
These tissues thicken and bleed, just like the endometrium during the menstrual
cycle. Common symptoms of endometriosis include pain, abnormal periods, and
chronic gynecological disorder affects
percent women of reproductive age worldwide
. This amounts to
approximately 200 million cases
. There is no effective long-term treatment
for endometriosis and it can sometimes lead to ovarian cancer
Why is the Study a Major Breakthrough?
This study has shed new light on how to go about treating
endometriosis by replacing the diseased endometrial cells with healthy cells,
derived from the woman's own blood or skin.
Dr. Serdar Bulun, who has over 25 years of experience in
developing new treatments for endometriosis and also the senior author of the
study, said: "This is huge. We've opened
the door to treating endometriosis."
He added: "These women with endometriosis start suffering from the disease at a
very early age, so we end up seeing young high school girls getting addicted to
opioids, which totally destroys their academic potential and social lives."
What is the Impact of
the Study on Endometriosis?
In endometriosis, the endometrial cells do not respond to a hormone
called progesterone, which is required for implantation of the fertilized ovum
in the uterus. As a result, these defective endometrial stromal fibroblasts
travel through the Fallopian tubes and then onto the ovaries and other adjacent
tissues in the lower abdomen.
Dr. Bulun said: "Now
that this study has demonstrated that these cells can be reproduced and respond
properly to progesterone, the next step would be to replace the diseased cells
in the uterus with these newly programmed, healthy uterine cells."
With rapid improvements in cell-based therapy techniques, it will be
possible to replace the defective cells that cause pain and inflammation within
the uterus, with normal uterine cells, resulting in alleviation of these
symptoms. Importantly, the newly generated endometrial tissue will be more
conducive for implantation.
Dr. Bulun is optimistic that in the future it may be possible to generate
a whole uterus by this cell-based therapeutic approach, using the patient's own
However, Dr. Bulun cautions: "Uterine transplantation has been tried, but the
biggest obstacle to success has been the rejection of someone else's uterus
with the patient's immune response. This problem could be solved if a whole
uterus can be bioengineered by populating a scaffold with the patient's own iPS
cells reprogrammed to form a uterus. However, this is a long shot."
The study was funded by the National Institutes of
Health's Eunice Kennedy Shriver National Institute of Child Health and Human
Development, Rockville, MD, USA.
- Generation of Progesterone-Responsive Endometrial Stromal Fibroblasts from Human Induced Pluripotent Stem Cells: Role of the WNT/CTNNB1 Pathway - https://doi.org/10.1016/j.stemcr.2018.10.002