Title : Dr. Mhatre’s laparoscopic peritoneal vaginoplasty (creating normal vagina) – Progenitor cell identification and genetic decoding of MRKH
Abstract:
The study shows peritoneal metaplastic conversion to normal vagina by LPV. The progenitor cell responsible for the metaplastic conversion was identified in the peritoneum and different stages of neo?vaginal development. The translational stemness markers NANOG, OCT4, and SOX2 responsible for the neovaginal formation were identified. Their appearance and concentration at different stages of conversion were demonstrated. The neo?vagina has shown upregulation of these translational stemness markers. The study demonstrates the expression of the specific genes (WNT4, WNT5A, and WNT7A) and their role in the formation of the neo?vagina. Furthering this research, manipulating and activating these genes by genetic engineering may lead to the treatment of developmental defects of Mullerian duct and developing the rudimentary uterus to normal size, obviating the need of transplant. To the best of our knowledge, this study is the first to show the metaplastic conversion of peritoneum to normal vagina, identifying the progenitor cell, expression of translational stemness markers, and upregulation of specific genes.