The Effects Of Stem Cell Applications On Internal Adhesions Created In Experimental Animal Models
Project no. 23335 · Status: Kapanmış (Yayın bekleniyor) · 2021
Summary
<p><strong>Aim:</strong> In this experimental animal model, it is aimed to compare the effectiveness of the applications of exosome originating from the mesenchymal stem cell and mesenchymal stem cell taken from the umbilical cord and adipose tissue in the treatment of intrauterine lesions secondary to surgical interventions in the intrauterine cavity.</p><p><strong>Material and Method:</strong> A total of 7 study groups, each consisting of 5 animals; negative control group, positive control group, human umbilical cord-derived exosome administered group intravenously, and locally adipose tissue-derived mesenchymal stem cell administered group, human umbilical cord-derived mesenchymal stem cell administered group, human umbilical cord-derived exosome administered group, human adipose tissue-derived exosome administered group. Adhesion training by applying ethanol to the intrauterine cavity in all groups. After 2 weeks, the control group was sacrificed after hysterectomy. Saline solution was applied locally to the intrauterine cavity of rats in the sham group. In other groups, mesenchymal stem cells and exosomes were applied locally and intravenously to the intrauterine cavity. After 2 weeks, these groups were sacrificed by performing hysterectomy.</p><p>Endometrial thickness, fibrosis, inflammation, vascular proliferation formation and by immunohistochemical staining with fibroblastic growth factor (FGF), vascular endothelial growth factor (VEGF), hypoxia inducible factor (HIF-1α) and anti-collagen1 antibodies wound healing, scar formation and angiogenesis were evaluated. Comparisons were made between the groups in terms of treatment efficacy.</p><p><strong>Results: </strong>Uterus of the rats with intrauterine adhesion model was examined histopathologically, it was found that the endometrial epithelial thickness and the uterine wall thickness decreased; it is seen that the incidence of inflammation, fibrosis and vascular proliferation in these tissues is significantly increased. In the treated groups, the thickness of the endometrium becomes thinner and the wall thickness increases compared to the group with adhesions; we see that inflammation, fibrosis and vascular proliferation are decreasing. In all criteria except uterine wall thickness, adipose tissue-derived mesenchymal stem cell exosomes reduce inflammation, fibrosis and vascular proliferation more than others and increasing the uterine wall thickness and endometrial epithelial thickness more than the others, we can say that it is the most successful among the treatments applied in this study. In addition, with a significant difference, less fibrosis, inflammation and vascular proliferation were observed in those administered umbilical cord-derived mesenchymal stem cell exosome systemically than those administered locally. However, no statistically significant difference was found between endometrial epithelial and uterine wall thicknesses.</p><p><strong>Conclusion: </strong>Removal of adhesion and fibrotic tissue formed in this area after intrauterine interventions such as pregnancy termination and regeneration of epithelial cells is the basic treatment procedure.<strong> </strong>In a limited number of studies, it has been shown that stem cell and exosome treatments can be clinically effective in the regeneration of the damaged endometrium. We have shown that intrauterine adhesion can be significantly treated with stem cell and exosome applications, and their effect levels are different from each other. We also compared with local and systemic administration by the systemic administration of the treatment in one group. However, we think that more evidence for clinical applications should be revealed by increasing the number of human studies in this field.</p><p><strong>Key words:</strong> intrauterine adhesion, animal model, stem cell, exosome</p>