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Cell-Based Therapy for the Deficient Urinary Sphincter

  • Surgical Techniques (J Cadeddu and A Stenzl, Section Editors)
  • Published:
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Abstract

When sterile culture techniques of mammalian cells first became state of the art, there was tremendous anticipation that such cells could be eventually applied for therapeutic purposes. The discovery of adult human stem or progenitor cells further motivated scientists to pursue research in cell-based therapies. Although evidence from animal studies suggests that application of cells yields measurable benefits, in urology and many other disciplines, progenitor-cell-based therapies are not yet routinely clinically available. Stress urinary incontinence (SUI) is a condition affecting a large number of patients. The etiology of SUI includes, but is not limited to, degeneration of the urinary sphincter muscle tissue and loss of innervation, as well as anatomical and biomechanical causes. Therefore, different regimens were developed to treat SUI. However, at present, a curative functional treatment is not at hand. A progenitor-cell-based therapy that can tackle the etiology of incontinence, rather than the consequences, is a promising strategy. Therefore, several research teams have intensified their efforts to develop such a therapy for incontinence. Here, we introduce candidate stem and progenitor cells suitable for SUI treatment, show how the functional homogeneity and state of maturity of differentiated cells crucial for proper tissue integration can be assessed electrophysiologically prior to their clinical application, and discuss the trophic potential of adult mesenchymal stromal (or stem) cells in regeneration of neuronal function.

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Abbreviations

ASC:

Adipose-derived stem cells (alias atMSC)

bmMSC:

Bone marrow-derived MSC

ESC:

Embryonic stem cell

iPSC:

Induced pluripotent stem cells

MC:

Muscle cell

MEA:

Micro-electrode array

MP:

Myogenic progenitor

MSC:

Mesenchymal stromal cells, previously termed mesenchymal stem cells

pMSC:

Term placenta-derived MSC

ReST:

Regenerative Sphincter Therapy, an EU supported research network

RiPSC:

RNA-mediated induced pluripotent stem cells

SCI:

Spinal cord injury

SMC:

Smooth muscle cell

SUI:

Stress urinary incontinence

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Acknowledgments

We thank Tanja Abruzzese and Jan Maerz for their excellent technical help and Chaim Goziga for help in preparation of the artwork. Our own work briefly summarized in this review was in part supported by grants from the BMBF, DFG, fortüne, and Landesstiftung BW, and in part by institutional funding.

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Conflict of Interest

Dr. Melanie L. Hart reported no potential conflicts of interest relevant to this article.

Dr. Katharina M. H. Neumayer reported no potential conflicts of interest relevant to this article.

Dr. Martin Vaegler reported no potential conflicts of interest relevant to this article.

Dr. Lisa Daum reported no potential conflicts of interest relevant to this article.

Dr. Bastian Amend reported no potential conflicts of interest relevant to this article.

Dr. Karl D. Sievert reported no potential conflicts of interest relevant to this article.

Dr. Simone Di Giovanni reported no potential conflicts of interest relevant to this article.

Dr. Udo Kraushaar reported no potential conflicts of interest relevant to this article.

Dr. Elke Guenther reported no potential conflicts of interest relevant to this article.

Dr. Arnulf Stenzl serves as a Section Editor for Current Urology Reports.

Dr. Wilhelm K. Aicher reported no potential conflicts of interest relevant to this article.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. KFO273, Department of Urology, UKT, University of Tuebingen, Paul-Ehrlich-Str. 15, 72076, Tuebingen, Germany

    Melanie L. Hart, Katharina M. H. Neumayer, Martin Vaegler, Lisa Daum, Karl D. Sievert, Arnulf Stenzl & Wilhelm K. Aicher

  2. Department of Urology, University of Tuebingen Hospital, Tuebingen, Germany

    Bastian Amend, Karl D. Sievert & Arnulf Stenzl

  3. HIH, Hertie Institute for Brain Research, University of Tuebingen, Tuebingen, Germany

    Simone Di Giovanni

  4. Department of Electrophysiology, NMI Natural and Medical Sciences Institute at the University Tuebingen, Reutlingen, Germany

    Udo Kraushaar & Elke Guenther

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  1. Melanie L. Hart
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Hart, M.L., Neumayer, K.M.H., Vaegler, M. et al. Cell-Based Therapy for the Deficient Urinary Sphincter. Curr Urol Rep 14, 476–487 (2013). https://doi.org/10.1007/s11934-013-0352-7

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