Considerations for the clinical use of stem cells in genitourinary regenerative medicine

Abstract

The genitourinary tract can be affected by several pathologies which require repair or replacement to recover biological functions. Current therapeutic strategies are challenged by a growing shortage of adequate tissues. Therefore, new options must be considered for the treatment of patients, with the use of stem cells (SCs) being attractive. Two different strategies can be derived from stem cell use: Cell therapy and tissue therapy, mainly through tissue engineering. The recent advances using these approaches are described in this review, with a focus on stromal/mesenchymal cells found in adipose tissue. Indeed, the accessibility, high yield at harvest as well as anti-fibrotic, immunomodulatory and proangiogenic properties make adipose-derived stromal/SCs promising alternatives to the therapies currently offered to patients. Finally, an innovative technique allowing tissue reconstruction without exogenous material, the self-assembly approach, will be presented. Despite advances, more studies are needed to translate such approaches from the bench to clinics in urology. For the 21 st century, cell and tissue therapies based on SCs are certainly the future of genitourinary regenerative medicine.

Tissue Engineering for Penile Reconstruction

“…Its principle is based on the association of four elements ( Figure 3 ): first, the cells can present more or less stemness and come from different stages of development [ 75 , 76 ]. Nevertheless, for clinical applications, autologous cells should be favored.…”

Tissue Engineering for Gastrointestinal and Genitourinary Tracts

“…Multiple cell types have been used for tissue reconstruction to produce grafts or study models [23]. We will detail them in the following lines.…”

Tissue Engineering for Gastrointestinal and Genitourinary Tracts

“…Regulatory agencies currently approve many such cells that are used in clinical trials. Among the most widely used one can find the mesenchymal stem cells (MSC) [34], especially from bone marrow (BM-MSC), the adipose-derived stem cells (ASC) [35] but also stem/progenitor cells from the urothelial and vaginal epithelium, or urine-derived stem cells (USCs) [23,36] for example. These cells are generally relatively easy to extract and give quite attractive yields in the case of ASCs.…”

“…Scaffold formation is based on biomaterials and cells, mainly stem cells. Full review articles have been recently published and will interest readers [23,45,65,253].…”