Bloody Breakthrough: Menstrual Blood-Derived Stem Cell Therapy

What are periods? No, really. What is it that makes up the monthly bleeding that half of the population experiences?

It should come as no surprise that approximately 1.8 billion people menstruate every month worldwide (Rohatgi & Dash, 2023). However, less is widely known—and discussed—about the biological components of a period. Menstrual blood is composed of three distinct fluids: blood, vaginal fluid, and the shedding of the uterine lining during menstruation. For scientists, that same menstrual blood may also be the next cutting-edge tool in regenerative medicine. Researchers believe in its wide-ranging ability to treat degenerative conditions such as Alzheimer’s disease and to repair damaged or deteriorated organs such as the heart and skin.

Pioneered in 2007 by Xiaolong Meng et al., the discovery of menstrual blood-derived stem cells rattled the field of regenerative medicine. Stem cell therapy aims to repair injured or diseased cells using lab-grown stem cells, which are manipulated to develop into specialized cells such as nerve and cardiac cells. For example, for a person with heart disease, stem cells could be injected into heart muscle to differentiate–become mature and specialized–into cardiac cells, subsequently repairing the injured tissue.

While stem-cell therapy holds promise in paving the way for groundbreaking treatments, there are a host of challenges and ethical considerations associated with conventional methods of cell acquisition.

Menstrual blood-derived stem cells eliminate many associated ethical concerns and the need for invasive operations for acquiring stem cells. But most of all, menstrual-blood derived stem cells stand out in their accessibility. However, this begs the question: how viable are stem cells derived from menstrual blood?

Research indicates that menstrual blood-derived stem cells express a range of characteristics similar to those of both embryonic and adult stem cells, indicated by specific cell markers in certain conditions (Faramarzi et al., 2016). As opposed to adult stem cells derived from bone marrow, menstrual blood-derived stem cells have the capacity to undergo multi-lineage differentiation, allowing for a greater range in their treatment capabilities. Further research has also found that menstrual blood-derived stem cells are able to differentiate into cells in bone, fat, cartilage, liver, and cardiac muscle, to varying capacities (Sayeh Khanjani et al., 2014). Such versatility in treatment capabilities holds considerable promise for potential therapeutic applications in the future.

Expanding on this potential, a recent study conducted by Yanling Zhang et al. simulated the use of menstrual blood-derived stem cells to treat intrauterine adhesions, a condition resulting in scar-tissue buildup in the uterus, within mice (Zhang et al., 2016). Researchers treated the mice using menstrual blood derived-stem cells, taken from human menstrual blood, which were injected into the mice through their tails (Zhang et al., 2016). The injected cells were able to migrate to the injury site and transform into cells within the uterine lining (Zhang et al., 2016). Following the treatment, the mice made an incredible recovery, showing significant improvement in their uterine lining and fertility (Zhang et al., 2016). Zhang’s finding suggests that menstrual blood-derived stem cell therapy could be used as a novel method of treatment for intrauterine adhesions in humans.

Menstrual blood-derived stem cells have also demonstrated effectiveness in treating an array of other diseases in mouse models. These diseases include acute and chronic liver diseases, acute lung injury, epithelial ovarian cancer, Alzheimer’s disease, and neurodegenerative diseases, among others (Chen, Qu, Cheng, Chen, & Xiang, 2019). Beyond disease treatment, a simpler example of using menstrual blood for stem cell therapy is found in treating cutaneous wounds, which are injuries to the skin. The goal of cutaneous wound repair is to restore the damaged tissue to its original state, leaving no scars. Yanling Zhang et al. found that after mice were injected with menstrual blood-derived stem cells, they exhibited significantly improved wound healing and enhanced formation of new blood vessels at the injury site (2016). Beyond generating specific cells used in the rebuilding of damaged tissue, menstrual blood-derived stem cells also secreted several proteins used in cell signaling for wound repair post-injection, increasing their ability to heal wounds to their original state (Zhang et al., 2016).

While researchers are optimistic, there remains a degree of uncertainty in the efficacy of menstrual blood-derived stem cell therapy. Recent research has reported that menstrual blood-derived stem cells from donors over the age of 40 showed a diminished long-term proliferation capacity, raising concerns about the efficacy among different age groups of donors (Haining Lv, Hu, Cui, & Jia, 2018).

In the complex world of regenerative medicine, the potential of menstrual blood in stem-cell therapy remains yet to be fully discovered, but ongoing research offers hope in the next “bloody” breakthrough.

References

1. Chen, L., Qu, J., Cheng, T., Chen, X., & Xiang, C. (2019). Menstrual blood-derived stem cells: toward therapeutic mechanisms, novel strategies, and future perspectives in the treatment of diseases. 10(1). https://doi.org/10.1186/s13287-019-1503-7

2. Chen, L., Qu, J., & Xiang, C. (2019). The multi-functional roles of menstrual blood-derived stem cells in regenerative medicine. 10(1). https://doi.org/10.1186/s13287-018-1105-9

3. Faramarzi, H., Mehrabani, D., Fard, M., Akhavan, M., Zare, S., Bakhshalizadeh, S., … Shirazi, R. (2016). The Potential of Menstrual Blood-Derived Stem Cells in Differentiation to Epidermal Lineage: A Preliminary Report. World Journal of Plastic Surgery, 5(1), 26–31. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4904135/

4. Haining Lv, Hu, Y., Cui, Z., & Jia, H. (2018). Human menstrual blood: a renewable and sustainable source of stem cells for regenerative medicine. 9(1). https://doi.org/10.1186/s13287-018-1067-y

5. Rohatgi, A., & Dash, S. (2023). Period poverty and mental health of menstruators during COVID-19 pandemic: Lessons and implications for the future. Frontiers in Global Women’s Health, 4. https://doi.org/10.3389/fgwh.2023.1128169

6. Sayeh Khanjani, Mohammadreza Khanmohammadi, Amir-Hassan Zarnani, Mohammad Mehdi Akhondi, Ahani, A., Zahra Ghaempanah, … Somaieh Kazemnejad. (2014). Comparative Evaluation of Differentiation Potential of Menstrual Blood-Versus Bone Marrow- Derived Stem Cells into Hepatocyte-Like Cells. 9(2), e86075–e86075. https://doi.org/10.1371/journal.pone.0086075

7. Zhang, Y., Lin, X., Dai, Y., Hu, X., Zhu, H., Jiang, Y., & Zhang, S. (2016). Endometrial stem cells repair injured endometrium and induce angiogenesis via AKT and ERK pathways. 152(5), 389–402. https://doi.org/10.1530/rep-16-0286