Extracellular matrix as a therapeutic target: the potential of biomimetics in the treatment of chronic diseases of the urogenital tract

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Abstract

The article presents the latest findings on the structural and functional organization of the extracellular matrix (ECM), its role in maintaining tissue homeostasis, regulation of cell proliferation, migration, differentiation and apoptosis. ECM is considered as a dynamic, actively remodeling system that ensures not only the mechanical integrity of tissues but also cell-matrix interaction. The main components of ECM are described in detail: fibrillar proteins, adhesive glycoproteins, proteoglycans, glycosaminoglycans and remodeling enzymes. The paper discusses the concept of chronological aging of ECM caused by the age-related decrease in the synthetic activity of fibroblasts and an increase in the activity of matrix metalloproteinases.

This article examines the pathogenetic aspects of stress urinary incontinence and genitourinary syndrome of menopause associated with the degradation of the collagen-elastin matrix, impaired collagen ratios, imbalance in metalloproteinases and their tissue inhibitors, as well as estrogen deficiency and chronic inflammation. The therapeutic strategy for matrix-oriented regeneration has been established using multicomponent biomimetics of ECM that can replicate the composition, architecture and signaling properties of the native matrix.

The paper describes a range of domestically produced biomimetic hydrogels, a multicomponent biomimetic ECM ‘SPHEROgel’ designed for matrix-oriented regeneration that restores tissue architecture and cell-matrix interaction. The LIGHT, MEDIUM, and LONG variants are available, differing in particle size and bioresorption kinetics, which allows for a personalized choice depending on the clinical requirement. Clinical observations are presented demonstrating the effectiveness of personalized approach to selecting modifications of biomimetic hydrogel, which is a pathogenetically sound and safe method of matrix-oriented therapy for chronic diseases of the urogenital tract.

Conclusion. ECM is not a passive scaffold, but an active dynamic system that determines cellular fate, tissue homeostasis and reparative potential.

About the authors

Daiana A. Boris

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Author for correspondence.
Email: dayana_boris@mail.ru
ORCID iD: 0000-0002-0387-4040
SPIN-code: 4832-0643

obstetrician-gynecologist, doctor of ultrasound diagnostics, Senior Researcher at the Department of Aesthetic Gynecology and Rehabilitation

Russian Federation, Moscow

Inna A. Apolikhina

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: i_apolikhina@oparina4.ru
ORCID iD: 0000-0002-4581-6295
SPIN-code: 6282-7435

Dr. Med. Sci., Professor, Head of the Department of Aesthetic Gynecology and Rehabilitation, Professor, Department of Obstetrics, Gynecology, Perinatology and Reproductology

Russian Federation, Moscow; Moscow

References

  1. Karamanos N.K., Theocharis A.D., Piperigkou Z., Manou D., Passi A., Skandalis S.S. et al. A guide to the composition and functions of the extracellular matrix. FEBS J. 2021; 288(24): 6850-912. https://dx.doi.org/10.1111/febs.15776
  2. Theocharis A.D., Manou D., Karamanos N.K. The extracellular matrix as a multitasking player in disease. FEBS J. 2019; 286(15): 2830-69. https:// dx.doi.org/10.1111/febs.14818
  3. Hynes R.O. The extracellular matrix: not just pretty fibrils. Science. 2009; 326(5957): 1216-9. https://dx.doi.org/10.1126/science.1176009
  4. Monteiro-Lobato G.M., Russo P.S.T., Winck F.V., Catalani L.H. Proteomic analysis of decellularized extracellular matrix: achieving a competent biomaterial for osteogenesis. Biomed. Res. Int. 2022; 2022: 6884370. https:// dx.doi.org/10.1155/2022/6884370
  5. Севастьянов В.И., Перова Н.В. Многокомпонентные гидрогелевые биополимерные миметики внеклеточного матрикса в технологиях регенеративной медицины. Opinion Leader. 2025; 8(81): 38-55. [Sevastyanov V.I., Perova N.V. Multicomponent hydrogel biopolymer mimetics of extracellular matrix in technologies of regenerative medicine. Opinion Leader. 2025; 8(81): 39-55 (in Russian)].
  6. McKee T.J., Perlman G., Morris M., Komarova S.V. Extracellular matrix composition of connective tissues: a systematic review and meta-analysis. Sci. Rep. 2019; 9(1): 10542. https://dx.doi.org/10.1038/s41598-019-46896-0
  7. Севастьянов В.И., Перова Н.В. Биополимерный гетерогенный гидрогель Сферо®ГЕЛЬ – инъекционный биодеградируемый имплантат для заместительной и регенеративной медицины. Практическая медицина. 2014; 8(84): 120-6. [Sevastyanov V.I., Perova N.V. Bio-polymer heterogenic hydrogel Sphero®GEL — an injection biodegradable implant for substitutive and regenerative medicine. Practical Medicine. 2014; 8(84): 120-6 (in Russian)].
  8. Балан В.Е., Харичева Е.И., Пономарева Ю.В., Тихомирова Е.В., Журавель А.С., Орлова С.А. Склероатрофический лихен вульвы: возможно ли решение проблемы? Российский вестник акушера-гинеколога. 2025; 25(5): 47-53. https://dx.doi.org/10.17116/rosakush20252505147 [Balan V.E., Kharicheva E.I., Ponomareva Yu.V., Tikhomirova E.V., Zhuravel’ A.S., Orlova S.A. Scleroatrophic lichen of the vulva: is it possible to solve the problem? Russian Bulletin of Obstetrician-Gynecologist. 2025; 25(5): 47-53 (in Russian). https://dx.doi.org/10.17116/rosakush20252505147].
  9. Huang L., Zhao Z., Wen J., Ling W., Miao Y., Wu J. Cellular senescence: A pathogenic mechanism of pelvic organ prolapse (review). Mol. Med. Rep. 2020; 22(3): 2155-62. https://dx.doi.org/10.3892/mmr.2020.11339
  10. Fasola E., Bosoni D. Dynamic quadripolar radiofrequency: pilot study of a new high-tech strategy for prevention and treatment of vulvar atrophy. Aesthet. Surg. J. 2019; 39(5): 544-52. http://dx.doi.org/10.1093/asj/sjy180
  11. Аполихина И.А., Юренева С.В., Малышкина Д.А. Генитоуринарный менопаузальный синдром: современные подходы к диагностике и лечению. Акушерство и гинекология. 2020; 12(Приложение): 4-8. [Apolikhina I.A., Yureneva S.V., Malyshkina D.A. Genitourinary menopausal syndrome: modern approaches to diagnosis and treatment. Obstetrics and Gynecology. 2020. 12(Suppl.): 4-8 (in Russian)].
  12. Sevastianov V.I., Basok Y.B., eds. Biomimetics of extracellular matrices for cell and tissue engineered medical products. Newcastle upon Tyne, UK: Cambridge Scholars Publishing; 2023.
  13. Farhat W., Hasan A., Lucia L., Becquart F., Ayoub A., Kobeissy F. Hydrogels for advanced stem cell therapies: a biomimetic materials approach for enhancing natural tissue function. IEEE Rev. Biomed. Eng. 2019; 12: 333-51. https://dx.doi.org/10.1109/RBME.2018.2824335
  14. Сивков А.В., Ромих В.В., Кукушкина Л.Ю., Пантелеев В.В. Первый опыт применения имплантируемого объемообразующего материала «Сферо®ГЕЛЬ» при стрессовом недержании мочи у женщин. Экспериментальная и клиническая урология. 2022; 15(3): 130-41. https://dx.doi.org/10.29188/2222-8543-2022-15-3-130-141 [Sivkov A.V., Romikh V.V., Kukushkina L.Yu., Panteleev V.V. Firsty experience with using the implantable bulking material Sphero®GEL for stress urinary incontinence in women. Experimental and Clinical Urology. 2022; 15(3): 130-41 (in Russian). https://dx.doi.org/10.29188/2222-8543-2022-15-3-130-141].
  15. Григорьев А.М., Басок Ю.Б., Кириллова А.Д., Кирсанова Л.А., Шмерко Н.П., Суббот А.М., Немец Е.А., Милосердов И.А., Шагидулин М.Ю., Севастьянов В.И. Экспериментальные подходы к созданию тканеспецифического матрикса для биоискусственной печени. Вестник трансплантологии и искусственных органов. 2020; 22(3): 123-33. https://dx.doi.org/10.15825/1995-1191-2020-3-123-133 [Grigoriev A.M., Basok Yu.B., Kirillova A.D., Kirsanova L.A., Shmerko N.P., Subbot A.M., Nemets E.A., Miloserdov I.A., Shagidulin M.Yu., Sevastyanov V.I. Experimental approaches to creating a tissue-specific matrix for a bioartificial liver. Russian Journal of Transplantology and Artificial Organs. 2020; 22(3): 123-33 (in Russian). https://dx.doi.org/10.15825/ 1995-1191-2020-3-123-133].

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