Stem cells are capable of self-renewal and differentiation into a range of cell types and promote the release of chemokines and progenitor cells necessary for tissue regeneration. Mesenchymal stem cells are multipotent progenitor cells with enhanced proliferation and differentiation capabilities and less tumorigenicity than conventional adult stem cells; these cells are also easier to acquire. Bladder dysfunction is often chronic in nature with limited treatment modalities due to its undetermined pathophysiology. Most treatments focus on symptom alleviation rather than pathognomonic changes repair. The potential of stem cell therapy for bladder dysfunction has been reported in preclinical models for stress urinary incontinence, overactive bladder, detrusor underactivity, and interstitial cystitis/bladder pain syndrome. Despite these findings, however, stem cell therapy is not yet available for clinical use. Only one pilot study on detrusor underactivity and a handful of clinical trials on stress urinary incontinence have reported the effects of stem cell treatment. This limitation may be due to stem cell function loss following ex vivo expansion, poor in vivo engraftment or survival after transplantation, or a lack of understanding of the precise mechanisms of action underlying therapeutic outcomes and in vivo behavior of stem cells administered to target organs. Efficacy comparisons with existing treatment modalities are also needed for the successful clinical application of stem cell therapies. This review describes the current status of stem cell research on treating bladder dysfunction and suggests future directions to facilitate clinical applications of this promising treatment modality, particularly for bladder dysfunction.

中文翻译：

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膀胱功能障碍干细胞治疗的当前和未来方向。

干细胞能够自我更新和分化成多种细胞类型，并促进组织再生所必需的趋化因子和祖细胞的释放。间充质干细胞是多能祖细胞，具有比常规成年干细胞更高的增殖和分化能力，并具有更低的致瘤性。这些细胞也更容易获得。由于其不确定的病理生理学，膀胱功能障碍通常是慢性的，治疗方式有限。大多数治疗都集中在症状缓解上，而不是病理性的变化修复。在压力性尿失禁，膀胱过度活动症，逼尿肌功能不足和间质性膀胱炎/膀胱疼痛综合征的临床前模型中，已经报道了干细胞疗法治疗膀胱功能障碍的潜力。尽管有这些发现，然而，干细胞疗法尚不能用于临床。只有一项关于逼尿肌功能不足的试验性研究和一些针对压力性尿失禁的临床试验报告了干细胞治疗的效果。这种局限性可能是由于离体扩增后干细胞功能丧失，移植后体内植入不良或存活不足，或者缺乏对治疗结果和施用于靶器官的干细胞体内行为的确切作用机理的了解。要成功地将干细胞疗法应用于临床，还需要将疗效与现有治疗方法进行比较。