170
of gene expression due to variation in the expression of master switch genes [ 70 ].
Transdifferentiation process is often associated with metaplasia and there are evi-
dences in literature to support that circulating stem cells is a source of metaplastic
transdifferentiation. In case of EnSCs, there also exists a theoretical risk for initia-
tion of endometriosis following their in vivo delivery though there is no experimen-
tal evidence for the same. Also, almost all the in vivo reports regarding the use of
EnSCs for regenerative therapy is in small laboratory animals, thus warrants further
studies in larger animal models before their large scale use in clinical trials.
10.10 Conclusions
Recent years have witnessed a rapid growth with regard to unravelling the therapeu-
tic possibilities of EnSCs in regenerative medicine. EnSCs were able to be har-
vested, characterised and their potency was studied using a variety of techniques
from the uterine tissue. Comparative studies revealed that EnSCs have similar char-
acteristic features as of bone marrow MSCs with respect to cytokine production,
miRNAs and gene expression. EnSCs, however, possess higher proliferation poten-
tial and plausibly higher angiogenic potential compared to bone marrow MSCs
although more studies are required to ascertain the later fact. Another important fact
to note is their suggested protective role in acute inflammatory conditions and potent
immunomodulatory effects.
Though the biological and clinical implications of EnSCs is a growing area of
research, the field is relatively new and still not completely understood. There is defi-
nitely a need for more studies in higher animal models in some of the aspects where
small laboratory animal studies have shown success. As with technological advance-
ments these cells become better characterised, their role in gynaecological disorders
associated with abnormal endometrial proliferation could also be delineated. This
facilitates an increased knowledge in understanding disease pathogenesis of a num-
ber of pathological conditions such as endometrial cancer, endometrial hyperplasia,
endometriosis and adenomyosis, thus enabling a suitable change in the way these
diseases are treated in the future. Given the existing promising therapeutic benefits
described in laboratory animal studies and in a few clinical trials, we envisage that
EnSCs could offer considerable assistance for the future of regenerative medicine.
References
- Verdi J, Tan A, Shoae-Hassani A, Seifalian KS. Endometrial stem cells in regenerative medi-
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87–101. - Sourial S, Tempest N, Hapangama DK. Theories on the pathogenesis of endometriosis. Int
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K.G. Aghila Rani and T. Madan