To summarize the current state of knowledge regarding cell therapy for stress urinary incontinence (SUI) and to introduce new approaches of using regenerative pharmacology as an adjunct or replacement for cell therapy.
We reviewed the literature by searching PubMed®, Ovid, and Biological Abstracts. The years searched were from 1975 to December, 2015. The inclusion terms were separately, or in combination: "stress urinary incontinence, cell therapy, chemokine, vascularization, innervation, secretome, animal models". E-publication articles were not included. We did not exclude based on impact factor.
Cell therapy is currently proposed to restore functional muscle cells and aid in closure of the sphincter in women with sphincter-associated incontinence. The clinical trials have included small numbers of patients and results vary depending on the patient cohorts, and the cells used. Results of preclinical studies also vary, but report a more favorable outcome. This difference is most likely explained by animal modeling not being directly translatable to the human condition. However, preclinical studies have identified an exciting new approach to regeneration of the urinary sphincter by using the components of cells (secretomes) or chemokines that home reparative cells to the sites of injury.
Although cell therapy will continue to be explored, a regenerative pharmacologic approach to treatment of SUI holds the promise of bypassing the lengthy and expensive process of cell isolation and increase availability of treatment in many clinical settings. However, this approach will require careful preclinical modelling & attention to its health benefit/risk ratio.
The Journal of urology. 2016 Aug 17 [Epub ahead of print]
J Koudy Williams, Ashley Dean, Gopal Badlani, Karl-Erik Andersson
Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC. Electronic address: ., Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC., Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC; Department of Urology. Wake Forest University Health Sciences, Winston-Salem, NC., Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC; AIAS, Aarhus Institute for Advanced Sciences, Aarhus University, Aarhus Denmark.