Stem cell therapy for the premature ovarian failure 

Can we treat premature ovarian failure with stem cell therapy?

Key Points

Highlight:

• Several kinds of stem cells such as mesenchymal stem cells, extra-embryonic stem cells, induced pluripotent stem cells, and ovarian stem cells are used in Premature ovarian failure (POF) stem cell therapy.

Key points:

• Premature ovarian failure (POF) is one of the common disorders found in women.
• The cause of POF is not fully known, but various factors have been suggested.
• Genetics: X and autosomes chromosome abnormalities.
• Enzymatic: Protein and enzyme defects involved in the steroidogenic pathway.
• Autoimmunity:  Addison’s disease, Vitiligo and etc.
• Environmental: Viral infections such as varicella zoster virus, cytomegalovirus, and mumps virus.
• The diverse approaches to treat the POF includes;
• Hormone replacement therapy, Melatonin supplement, Dehydroepiandrosterone, Immunomodulation therapy.
• Several applications of stem cell therapy in the treatment of POF.
• Mesenchymal stem cell
• It is a readily available and poorly immunogenic multi-potent stem cell.
• Dr. Lai group reported in 2015 that human endometrial improved estrous cycle and restored fertility in POF mice.
• Extra-embryonic stem cells
• The amniotic fluid stem cell is derived from the extra-embryonic layer.
• Dr. Zhang group in 2017 found the increased healthy and mature follicles in the ovary of POF mouse after injection of human amniotic epithelial cells.
• Induced pluripotent stem cells
• OCT4, LIN28, SOX2h, and NANOG have important roles in reprogramming human somatic cell into the pluripotent stem cell.
• Dr. Liu group showed in 2017 that transplanting of human induced pluripotent stem cells into POF mice caused growth in ovarian tissues, expression of ovarian granulosa cell markers.
• Ovarian stem cell
• The presence of germ-line stem cells in ovary will improve infertility treatment.

Limitation:

• Further characterization needs to be established for isolation and development of the stem cells.
• The detection and identification of the cause of POF require further study. 

Lay Summary

Premature ovarian failure (POF) is one of the common disorders found in women. The cause of POF is not fully known, but various factors have been suggested. In genetically, X and autosomes chromosome abnormalities could result in some POF. The defects in the steroidogenic pathway and environmental factors including viral infections and smoking can attribute to POF. Furthermore, autoimmune diseases such as Addison’s, disease and vitiligo, are associated with POF.

As a result of the complexity of POF, different remedies have been suggested. However, none of them have been completely effective to be approved as the best treatment. Therefore, Dr. Yousefi from Tabriz University from Iran summarized in the journal named "Biomedicine and Pharmacotherapy" current understanding of POF and future directions, specifically utilizing a stem cell therapy.

Stem cells have general properties such as the ability to divide, they are unspecialized and are able to renew themselves. In stem cell-based therapy for infertility, embryonic stem cell, mesenchymal stem cells, stem cells from extra-embryonic tissues, induced pluripotent stem cells and ovarian stem cell are used. In recent studies, the use of different types of stem cells for the treatment of POF has been reported. In 2015, Dr. Lai group reported that human endometrial mesenchymal stem cells improved estrous cycle and restored fertility in POF mice. Another group found that injection of human amniotic epithelial cells increased healthy and mature follicles in the ovary of POF mouse.

Different types of stem cells with their therapeutic potential have been used in the last decade. However, further characterization needs to be established for isolation and development of the stem cells. Also, the detection and identification of the cause of POF require further study.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29567538