Stem cells could help treat uterine prolapse

Researchers at Melbourne's Monash Medical Research Institute (MMRI) have identified a readily accessible source of adult mesenchymal stem cells in the lining of the uterus that could help repair uterine prolapse.

Mesenchymal stem cells, which occur in skin, fat, and bone marrow, have the major advantage of being transferable between genetically dissimilar individuals without being rejected.

Dr Caroline Gargett's research group believes cultured uterine stem cells could be used to treat tens of thousands of Australian women who suffer prolapse -- the collapse of the uterus and vagina onto the pelvic floor because of over-stretching of their supporting ligaments in childbirth.

Gargett envisages that the adult stem cells would be harvested by a suction procedure called a Pipelle biopsy, performed under local anaesthetic. Her team discovered the adult stem cells at the base of the endometrium, which renew the thick, spongy lining of the uterus during each menstrual cycle.

"We have shown that they differentiate in vitro into cartilage-forming cells, in the same way as mesenchymal stem cells from fat or bone marrow," Gargett said.

She said while mesenchymal stem cells from fat tissue and bone marrow could potentially do the same job, harvesting the cells from bone marrow was a very painful procedure, and harvesting fat cells required a general anaesthetic.

In a recent seminar at MMRI, a leading European gynaecologist had described a procedure that involved supporting a prolapsed uterus with a biocompatible polymer mesh that would be colonised by cartilage-forming cells. The uterus offered a convenient source of immunologically neutral adult stem cells, that could be maintained in tissue culture.

Gargett said the technique still required "a lot of research", and might not reach the clinic for a decade.

She said some 22,000 women suffer from prolapse -- a "silent disorder" that involves much pain and embarrassment. The disorder is currently treated surgically, and some women required repeat surgery. The risk is higher in post-menopausal women.

"A woman who has had three pregnancies has a threefold risk of developing a prolapse that will require surgery, but there is a 10 per cent lifetime risk of prolapse in the general female population, and a third of these patients will develop complications that require further surgery," Gargett said.

The uterine stem cells could also help treat other, hernia-related problems, as well as endometriosis and muscular and skeletal disorders.