Pelvic organ prolapse treatment hurdle overcome

Pelvic organ prolapse (POP) can be a debilitating condition, predominantly caused by the impact of childbirth. It affects an estimated one in four women, and one in two women over 50.

Pelvic organ prolapse researcher Professor Caroline Gargett from the Endometrial Stem Cell Biology Research Group at Hudson Institute
Professor Caroline Gargett

Despite how common it is, there are very few reliable treatments for POP and therefore an urgent need for a solution to this condition.

Hudson Institute of Medical Research scientists are using adult stem cells (mesenchymal stem cells) from the lining of a woman’s own uterus engineered with biodegradable materials in a world-first approach to develop safe, more effective treatments for pelvic organ prolapse.

Major pelvic organ prolapse treatment hurdle overcome

In the latest study led by Professor Caroline Gargett and published in Frontiers in Cell and Developmental Biology Hudson Institute researchers have demonstrated how they have overcome a major hurdle in the scientific process to produce enough high quality mesenchymal stem cells from samples from a woman’s endometrium – the lining of the uterus – for clinical use.

“We need to culture these rare endometrial stem cells for three to four weeks in the lab to generate sufficient numbers of the cells to create a product that can be used to treat POP,” Prof Gargett said.

“A common problem when we culture these stem cells in the lab for clinical use is that the cells age in the petri dish culture, and lose their potency, rendering them ineffective. This is a major hurdle to getting this treatment to people who need tissue healing – such as those with POP – or to treat inflammatory disorders,” Prof Gargett said.

“Our latest findings overcome this problem plaguing the scientific field and provide a way to accelerate the process of using a woman’s own endometrial stem cells to promote healing.

“When we culture these rare cells by adding another key ingredient – a small molecule (A83-01) – this prevents the cells from ageing and losing potency. They maintain their properties to proliferate and multiply, keeping them ‘young’.”

The research used cutting-edge genomic sequencing technologies to discover the important role of a signaling molecule, called Retinoic Acid Receptor B (RARB) in preventing endometrial stem cell ageing during the culture process.

Investigating a cell therapy treatment

“Growing a woman’s cells, sampled from her own endometrium, will generate large numbers of young, potent cells when combined in the lab with this key ingredient,” Prof Gargett said.

“These cells will be combined with a nanobiomaterial to provide a tissue engineering construct to treat POP.

“Generating a cell-based product of young, potent stem cells will substantially improve the outcome of an endometrial cell-based therapy for women who need it.”

What is pelvic organ prolapse?

Pelvic organ prolapse develops when tissues, pelvic floor muscles and ligaments that support the pelvic organs (bladder, uterus and bowel), become damaged, usually in childbirth, causing organs to shift or ‘drop’ into or outside the vagina. This can lead to debilitating symptoms, including poor bladder or bowel control and pain during sex.

The condition can be exacerbated by age, ethnicity, multiple births, obesity and family genetics. Menopause also has an effect. One in two postmenopausal women who have had children will experience POP, compared to one in four generally. Up to a third of women with POP require multiple treatments in their lifetime.

How is pelvic organ prolapse treated?

While milder cases of POP may be treated with medication or pelvic floor exercises, one in five women will need vaginal surgery, which has a 30 per cent failure rate.

Transvaginal meshes for the treatment of pelvic organ prolapse have been associated with severe adverse events and have been banned from clinical use in many countries.

Meshes for POP treatment in Australia were banned in 2017, mainly due to the undesirable foreign body response to synthetic non-degradable meshes. Therefore, there is an urgent need for safe, effective POP treatments.

Hudson Institute researchers are committed to finding new treatments for those affected by pelvic organ prolapse.

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Research Group leading this work