Mesenchymal Stem Cell Transplantation to Heal Mother’s Childbirth Injury

Occasionally. vaginal birth can lead to injury in the mother. Some of these injuries are relatively light and the mother heals rather quickly, but others can be more severe. Stress urinary incontinence (SUI) affects 4-35% of women who have given birth via vaginal delivery. SUI causes unintentional leakage from the bladder during heavy exercise, laughter, coughing, sneezing, heavy lifting, or jumping. SUI can cause discomfort, embarrassment, and some degree of social isolation. Unfortunately the treatments for SUI range from surgery to physiotherapy and they do little good.

In order to provide better options for mothers, researchers at the Cleveland Clinic’s Department of Biomedical Engineering have used female rats with birth-induced injuries as a model system. In this model system, injections of mesenchymal stem cells improved recovery from childbirth-induced injuries.

Previous work by this research group showed that injected mesenchymal stem cells tended to move into the spleen. However, if the urethra and vagina were damaged by childbirth trauma prior to mesenchymal stem cell injections, the cells targeted the damaged tissues and secreted trophic factors, which stimulated the differentiation and survival of remaining cells, and also induced the mesenchymal stem cells to engraft into the smooth muscles around the urethra and vagina. These activities accelerated and improved recovery of the animals from SUI.

Margot S. Damaser from the Cleveland Clinic said, “Stem cell-based therapy has recently gained attention as a promising treatment for SUI. Stem cell therapies may be more feasible and less invasive than current therapies.”

Other kinds of stem cells have been used to experimentally treat SUI in laboratory animals. Autologous or self-donated muscle stem cells have been used to treat SUI in animals and in human clinical trials. Fat-based stem cells have also been used, but only in animal models.

Damaser believes that mesenchymal stem cells have the added advantage of not being recognized by the immune system and therefore the possibility to implanting stem cells from an unrelated donor is a possibility for older patients.

“Since rat MSCs were used in this study, the results can only be applied to rat models of injury-treated rats,: said Damaser. “Human adult stem cells need to be investigated in future studies to see if these findings also apply to humans.”

Other researchers think that this procedure might serve as a treatment for SUI in older women. “This study provides evidence that mesenchymal stem cell transplantation could favorably impact a side effect of delivery and aging by releasing factors that can influence the urethra and vagina to treat stress urinary incontinence,” said Amit N Patel, director of cardiovascular regenerative medicine at the University of Utah. “Further studies are required to confirm that this animal study translates to humans.”