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Stammzelltherapie und „Tissue Engineering“ in der regenerativen Urologie

Stem cell therapy and tissue engineering in regenerative urology

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Zusammenfassung

Hintergrund

Bisher gibt es für den unteren Harntrakt keine klinisch etablierte, funktionelle Therapiemöglichkeit mittels „Tissue Engineering“. Aus der Dichte experimenteller Daten, initialen klinischen Studien und Einzelfallberichten zeichnet sich immer deutlicher ab, dass in Zukunft die Verwendung von Stammzellen die Lücke bei der Behandlung von Blasenspeicher und -entleerungsstörungen, erektiler Dysfunktion und morphologischen urothelialen Defekten des unteren Harntraktes mittels dieser individualisierten Therapie und biomedizinischer Anwendungsmöglichkeit schließen könnte.

Ergebnisse

Als Resultat der umfangreichen Forschungsarbeit in den letzten Jahren stehen die Charakterisierung verschiedener Stammzellpopulationen und die Evaluation unterschiedlicher, urologischer Therapieoptionen. Dabei wurden Aspekte der optimalen Applikation, der Migration, der Sekretion spezifischer Faktoren und des Grades der Entdifferenzierung dieser Stammzellen hinsichtlich einer höheren, therapeutischen Effektivität untersucht. Besonderes Augenmerk lag zudem auf Angiogenese und Innervation, von denen eine erfolgreiche funktionelle Geweberegeneration letztlich abhängig ist.

Schlussfolgerung

Verschiedene klinische Indikationen zur Stammzelltherapie und Geweberekonstruktion bahnen sich an und werden gegenwärtig in präklinischen und klinischen Phase-I-Studien geprüft. Diese fokussieren auf die Behandlung der Belastungsinkontinenz, Harnröhrenrekonstruktion und Vermeidung der erektilen Dysfunktion als mögliche Folge von onkologischer Beckenchirurgie.

Abstract

Background

So far there is no clinically established, effective tissue engineering therapy for dysfunction or defects of the lower urinary tract. The concentration of experimental data, initial clinical studies and individual case reports underlines that stem cell treatment for bladder storage and voiding problems, erectile dysfunction and other urothelial defects of the lower urinary tract could close the gap between individualized therapy and potential biomedical applications.

Results

As a result of fundamental research work over the last decade a characterization of various stem cell populations and evaluation of different urological therapy options could be performed. Thereby, aspects of optimal administration, migration, secretion of bioactive factors and stage of differentiation of stem cells with respect to an improved efficiency of treatment were investigated. Because successful tissue regeneration depends on angiogenesis and innervation, particular attention was paid to these important factors.

Conclusions

Various clinical indications for stem cell treatment and tissue reconstruction that may be required after radical prostatectomy, such as stress urinary incontinence, urethral reconstruction and erectile dysfunction have materialized and are currently being verified in preclinical studies and phase I trials.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Vaegler, B. Amend, W. Aicher, A. Stenzl und K.-D. Sievert geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik für Urologie, Universitätsklinik Tübingen, Eberhard-Karls-Universität Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Deutschland

    M. Vaegler, B. Amend, W. Aicher, A. Stenzl & K.-D. Sievert

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Vaegler, M., Amend, B., Aicher, W. et al. Stammzelltherapie und „Tissue Engineering“ in der regenerativen Urologie. Urologe 52, 1671–1678 (2013). https://doi.org/10.1007/s00120-013-3328-9

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