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Stem cells in urology

Nature Clinical Practice Urology volume 5, pages 621–631 (2008)Cite this article

Abstract

The shortage of donors for organ transplantation has stimulated research on stem cells as a potential resource for cell-based therapy in all human tissues. Stem cells have been used for regenerative medicine applications in many organ systems, including the genitourinary system. The potential applications for stem cell therapy have, however, been restricted by the ethical issues associated with embryonic stem cell research. Instead, scientists have explored other cell sources, including progenitor and stem cells derived from adult tissues and stem cells derived from the amniotic fluid and placenta. In addition, novel techniques for generating stem cells in the laboratory are being developed. These techniques include somatic cell nuclear transfer, in which the nucleus of an adult somatic cell is placed into an oocyte, and reprogramming of adult cells to induce stem-cell-like behavior. Such techniques are now being used in tissue engineering applications, and some of the most successful experiments have been in the field of urology. Techniques to regenerate bladder tissue have reached the clinic, and exciting progress is being made in other areas, such as regeneration of the kidney and urethra. Cell therapy as a treatment for incontinence and infertility might soon become a reality. Physicians should be optimistic that regenerative medicine and tissue engineering will one day provide mainstream treatment options for urologic disorders.

Key Points

  • Regenerative medicine and tissue engineering strategies are becoming a viable option for replacing diseased or damaged organs, particularly in the urinary tract

  • Adult stem cells would be an ideal source of autologous cells for production of new organs, but because they can be difficult to isolate and expand in vitro, their use has been limited

  • Embryonic stem cells provide an almost limitless source of cells for regenerative applications, but ethical concerns limit their use; thus, techniques such as somatic cell nuclear transfer and reprogramming are being developed so that embryonic-like stem cells can be obtained without the destruction of an embryo

  • Amniotic fluid and placenta have been shown to contain pluripotent cells that can be driven to differentiate into a wide variety of specific cell types, and these cells might be useful for tissue engineering applications

  • Tissue engineering strategies for regenerating components of the urinary tract, such as the kidney, bladder, and urethra, are extremely promising; tissue engineering strategies for repairing urethral tissue are in clinical use, and laboratory-grown bladders have been implanted into patients

  • While more study is needed, regenerative medicine and tissue engineering might one day produce mainstream treatments for organ failure

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Figure 1: Somatic cell nuclear transfer is a procedure that is used to create embryonic stem cells that are genetically identical to a specific individual.
Figure 2: Different methods of generating male and female gametes from embryonic stem cells.

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Acknowledgements

The authors wish to thank Dr Jennifer L Olson for editorial assistance with this manuscript.

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  1. T Aboushwareb is a Research Instructor at the Wake Forest Institute for Regenerative Medicine and A Atala is the Director of the Wake Forest Institute for Regenerative Medicine and the WH Boyce Professor and Chair of the Department of Urology, at the Wake Forest University School of Medicine, Winston-Salem, NC, USA.,

    Tamer Aboushwareb & Anthony Atala

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Correspondence to Anthony Atala.

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Competing interests

T Aboushwareb has declared that he has conducted research supported by Tengion. A Atala has declared that he has acted as a consultant for and holds stock in Tengion and Plureon, companies involved in developing tissue engineering and stem cell technologies.

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Aboushwareb, T., Atala, A. Stem cells in urology. Nat Rev Urol 5, 621–631 (2008). https://doi.org/10.1038/ncpuro1228

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