Académique Documents
Professionnel Documents
Culture Documents
ISSN 1817-3055
IDOSI Publications, 2014
DOI: 10.5829/idosi.wjms.2014.10.1.1137
M. Edessy, 2Hala N. Hosni, 1Y. Wafa, 3S. Bakry, 1Y. Shady and 1M. Kamel
Abstract: Stem cells (SC) are the foundation cells for every organ, tissue and cell in the body. They are
undifferentiated "blank" cells that do not yet have a specific function. Under proper conditions, they begin to
develop into specialized tissue and organs. They are self-sustaining and can replicate themselves for long
periods of time. They have the remarkable potential to develop into many different cell types in the body. They
serves as a sort of repair system for the body, they can theoretically divide without limit to replenish other cells
as long as the person or animal is still alive. Premature ovarian failure (POF) is the loss of ovarian function in
women less than 40 years. It is associated with sex steroid deficiency, amenorrhea, infertility and elevated serum
gonadotropins. POF occurs in 1 % of women. In majority of cases the underlying cause is not identified.
Management essentially involves hormone replacement and infertility treatment. This work aimed to evaluate
the therapeutic potential of Autologous MSC transplantation in women suffering from Premature Ovarian
Failure. Ten properly selected patients scheduled for Mesenchymal stem cells (MSC) transplantation at AlAzhar University Hospitals. Mesenchymal stem cells (MSC) preparation from the bone marrow of the iliac crest
was injected in the ovaries by laparscopy. Endometrial fractional biopsy is Immunohistochemically (IH) stained
and evaluated according to Edessy stem cells score (ESS). The results indicated that after transplantation one
case resumed menstruation after 3 months and 2 cases (20%) showed focal secretory changes after being
atrophic endometrium. These cases were of ESS 5 and 6. It could be concluded stem cell transplantation is a
promising procedure for cases of POF regarding the clinical, histopathological (HP) and IH outcome. The ESS
is a suitable score for evaluating stem cell expression.
Key words: Autologous MSC
ESS
POF
INTRODUCTION
12
ESS:
Factor
Score
---------------------------------------------------------------------------------------------------------------------------------------0
1
2
1- Intensity of sc marker.
2- Percentage of SC.
3- Focality
4- Distribution
5- Site of SC
Negative to mild
0
None
None
None
Moderate
0-50%
Focal
Epithelial or mesenchymal
Cytoplasmic or nuclear
13
Strong
>50-100%
Diffuse
Epithelial and mesenchymal
Cytoplasmic and nuclear
RESULTS
Cases
HP
--------------------------------------------------------------------------------------------------------Before
After
IH
sc
ESS
---------------------------------Before
After
1
2
3
4
5
6
7
8
9
10
AE
AE
AE
AE
AE
AE
AE
AE
AE
DPE
-ve
-ve
-ve
-ve
+ve
-ve
-ve
-ve
-ve
+ve
0/10
0/10
0/10
0/10
0/10
0/10
0/10
0/10
0/10
0/10
AE
AE showing low glands/ stromal ratio.
AE showing low glands/ stromal ratio.
AE
DPE with FSE changes.
PAE showing low glands/ stromal ratio with decidualized stroma.
AE
AE
AE
DPE with FSE changes.
0/10
0/10
0/10
0/10
6/10
0/10
0/10
0/10
0/10
5/10
AE= Atrophic endometrium. DPE= Disordered proliferative endometrium. PAE= Pill Pattern atrophic endometrium. FSE= focal secretory endometrium.
Table 2: The clinical outcome in relation to the sc expression after transplantation.
SC
----------------------------------------------------------------------------------------------------------------------------------Return of menstruation
-ve.
+ve
Yes
0 /8 (0 %)
1/2 (50%)
P
<0.001
No
8/8 (100%)
1/2 (50%)
<0.001
ESS
Return of menstruation
No (8)
No (2)
Yes
0 (0%)
1(50%)
<0.001
No
8(100%)
1(50%)
<0.001
14
AE
8(80%)
0(0%)
P
<0.001
0(0%)
2(40%)
<0.001
2.
CONCLUSION
The
Autologus
mesenchymal
stem
cells
transplantion showed promising results regarding the
clinical outcome in the form of menstruation (10%) and the
endometrial changes in the form of secretory changes
(20%). Both the promising results showed +ve stem cell
expression and ESS 5.
REFERENCES
1.
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