Hum. Reprod. ：用干细胞制造女性生殖器
生物谷报道：意大利有医生为两名天生欠缺阴道的女子进行崭新的干细胞手术，首次以病人的干细胞成功制造出阴道的黏膜组织，令病人可有正常的性生活和生育能力。
罕见先天病 患率四千分一
两名女子所患的罕见疾病Mayer-Von Rokitansky-Kuster-Hauser Syndrome(MRKHS)，每4,000至5,000名新生女婴，有一人会患有此病。患者一般会拥有正常的乳房、卵巢和子宫，但没有阴道，不能进行性行为或生育。此前，医学界会利用皮肤移植或以肠组织重建病人的阴道，但风险高、手术时间长和痛楚，而且术后需要很长时间才能长出正常的黏膜壁。
而此次医生是在病人原本长阴道的位置抽出0.5厘米的切片组织，然后使用酶将切片组织分解，再让干细胞制造新的黏膜。约15日后，待新黏膜层够厚才植回病人体内。
抽自身组识 培育后植体内
“一些女性是在第一次进行性行为时始发现自己患有此病，由于发现的时候通常年纪较轻，羞于向父母启齿，于是毕生都受此问题困扰，未能有正常的性生活。”马尔凯塞说。负责是次手术的马尔凯塞医生表示，接受手术的其中一名28岁女病人年前动过手术后，拥有健康的阴道，过着正常的婚姻生活。至于另一名17岁病人，则刚在5月29日完成手术，初步的切片检查显示，以干细胞制造的阴道组织正逐渐生长，并产生粘膜组织。
47岁的马尔凯塞，参考过往医学界为烧伤病者以干细胞培植新皮肤的方法，加以改良后，成功以干细胞制造女性的阴道黏膜组织。她表示，这对一些癌症妇女和有阴道问题的女性无疑是喜讯。马尔凯塞是次的研究论文已刊登在新一期的《Human Reproduction》。
原始出处:
Hum. Reprod. Advance Access published online on April 21, 2007
Human Reproduction, doi:10.1093/humrep/dem096
Vaginoplasty using autologous in vitro cultured vaginal tissue in a patient with Mayer–von-Rokitansky–Küster–Hauser syndrome
Pierluigi Benedetti Panici1,3, Filippo Bellati1, Terenzio Boni1, Federica Francescangeli2, Luigi Frati2 and Cinzia Marchese2
1 Department of Gynaecology, Obstetrics and Perinatology, University of Rome "La Sapienza", V.le Regina Elena, 324, 00161 Rome, Italy 2 Department of Experimental Medicine, University Sapienza, V.le Regina Elena, 324, 00161 Rome, Italy
3 Correspondence address. Tel: +39-3483410486; Fax: +39-06-49972615; E-mail: pierluigi.benedettipanici@uniroma1.it
Mayer–von-Rokitansky–Küster–Hauser syndrome (MRKHS) is characterized by vaginal agenesis with variable Müllerian duct abnormalities. The Abbè–McIndoe technique is considered a valid treatment option for vaginoplasty but no consensus has been reached on what material should be used for the neovagina canal wall lining. We report the first case of autologous vaginal tissue transplantation in a 28-year-old women with MRKHS. The patient was subjected to a 1 cm2 full-thickness mucosal biopsy from the vaginal vestibule. Following enzymatic dissociation, cells were inoculated onto collagen IV-coated plates and cultured for 2 weeks. The patient was subjected to a vaginoplasty with a modified Abbè–McIndoe vaginoplasty with 314 cm2 autologous in vitro cultured vaginal tissue for the canal lining. At 1 month from surgery, the vagina appeared normal in length and depth and a vaginal biopsy revealed normal vaginal tissue. The use of autologous in vitro cultured vaginal tissue to create a neovagina appears as an easy, minimally invasive and useful method.
Key words: autologous transplant/Mayer–von-Rokitansky–Küster–Hauser syndrome/vaginoplasty
Submitted on November 9, 2006; resubmitted on January 30, 2007; accepted on February 5, 2007.
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