# Stem cell-derived smooth muscle progenitor cells for vaginal wall prolapse

> **NIH NIH R21** · STANFORD UNIVERSITY · 2021 · $197,125

## Abstract

Project Summary
Pelvic organ prolapse is a debilitating condition characterized by the downward movement of the vaginal wall
and/or the uterus through the vaginal opening. Other pelvic structures such as the bladder, bowel, and rectum
can also descend behind the vagina and uterus resulting in a variety of genito-urinary and bowel symptoms
that severely impact quality of life. Deficiencies in connective tissue and smooth muscle cells of the vagina
have been associated with pelvic organ prolapse. Consequently, it is thought that the deficient vaginal wall
may be a significant factor in the progression of pelvic organ prolapse.
Normal and damaged tissues are generally replaced by continuous recruitment and differentiation from tissue-
specific stem cell populations in the body. However, this process is compromised with aging, resulting in an
increase in prevalence of degenerative conditions especially after injury. Vaginal birth trauma and age-
dependent tissue changes are major contributors to pelvic organ prolapse. Surgical treatment is the main
option with a 30% risk of reoperation. There is a clear need for preventive and new treatment strategies.
In the past decade, stem cell-based therapies have become attractive options to improve biocompatibility and
tissue integration. The most commonly studied stem cell type is the adult mesenchymal stem cell (MSC)
because these can be harvested and expanded in culture from patient’s adipose tissue, bone marrow, and
endometrial tissue. While preliminary results appear promising, clinical results are not robust. Given the
tremendous advances in stem cell technologies, specifically the ability to introduce a set of genes to derive
pluripotent stem cells from somatic cells (a.k.a. induced pluripotent stem cells or iPSCs), there is now
significant effort underway in translating this cell type into clinical therapies for multiple diseases. iPSCs can be
differentiated into somatic cells of all lineages with rejuvenated properties.
A differentiation protocol has been optimized to produce a homogenous population of smooth muscle
progenitor cells (pSMC) from patient iPSCs. The overarching hypothesis is that pSMC, derived from patient
iPSCs, will exert dual effects in damaged pelvic tissues: 1. pSMC will induce extracellular matrix protein
deposition by host connective tissue, and 2. engraftment of pSMC will improve contractile properties of a
weakened vaginal wall. These effects will result in restoration of the defects in the vaginal wall affected by
pelvic organ prolapse. In this R21 proposal, animal and cell studies to test these hypotheses are outlined.

## Key facts

- **NIH application ID:** 10148796
- **Project number:** 5R21HD102224-02
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** BERTHA CHEN
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $197,125
- **Award type:** 5
- **Project period:** 2020-06-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10148796

## Citation

> US National Institutes of Health, RePORTER application 10148796, Stem cell-derived smooth muscle progenitor cells for vaginal wall prolapse (5R21HD102224-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10148796. Licensed CC0.

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