Purpose

Cell therapy is a promising strategy for the treatment of Asherman’s syndrome (AS), but the origin of these cells and injection route influence the therapeutic effect and complications of cell therapy. Herein, we compared the effects of systemic or local intrauterine injection of bone marrow or adipose-derived mesenchymal stem cells (BMSCs/AMSCs) on the endometrium in a rat model of AS.

Methods

After induction of AS in adult Wistar rats, the CM-Dil-positive BMSCs or AMSCs were injected either locally or intravenously. After 3 weeks, endometrial thickness, collagen deposition, cell migration, and VEGF expression were evaluated using histochemistry/immunofluorescence studies.

Results

In all stem cell-treated groups, an ameliorative effect on the damaged endometrium was noted. Collagen deposition diminished in both groups (IV and local injection) compared to the AS model. In rats injected locally with MSC, fibrosis decreased compared to the other groups. Moreover, endometrial thickness increased in the groups that received local injection of BMSCs and AMSCs more than the IV-transplanted AMSCs group. Immunofluorescent staining demonstrated that although the systemic transplantation of BMSCs was more effective than the other groups on VEGF expression, it led to the lowest number of CM-Dil+ stem cells in the damaged endometrium.

Conclusion

Stem cell transplantation may reconstruct the damaged endometrium, but it is recommended to select the most effective stem cells and injection route. Because the removal of the fibrosis and the replacement of the epithelia cells is an effective therapeutic strategy for AS, in this study, we conclude that the local injection of AMSCs is more appropriate than BMSCs to treat AS.

中文翻译：

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局部或全身给药后，Asherman 模型中骨髓/脂肪干细胞再生效果的比较。

目的

细胞疗法是治疗阿什曼综合征（AS）的一种很有前景的策略，但这些细胞的来源和注射途径会影响细胞疗法的治疗效果和并发症。在此，我们比较了全身或局部宫内注射骨髓或脂肪间充质干细胞 (BMSCs/AMSCs) 对 AS 大鼠模型子宫内膜的影响。

方法

在成年 Wistar 大鼠中诱导 AS 后，局部或静脉注射 CM-Dil 阳性 BMSCs 或 AMSCs。3 周后，使用组织化学/免疫荧光研究评估子宫内膜厚度、胶原沉积、细胞迁移和 VEGF 表达。

结果

在所有干细胞治疗组中，都注意到对受损子宫内膜的改善作用。与 AS 模型相比，两组（IV 和局部注射）的胶原沉积均减少。在局部注射 MSC 的大鼠中，与其他组相比，纤维化减少。此外，接受局部注射 BMSCs 和 AMSCs 的组的子宫内膜厚度比 IV 移植 AMSCs 组增加更多。免疫荧光染色表明，尽管 BMSCs 的全身移植在 VEGF 表达方面比其他组更有效，但它导致受损子宫内膜中 CM-Dil+ 干细胞的数量最少。

结论

干细胞移植可以重建受损的子宫内膜，但建议选择最有效的干细胞和注射途径。由于去除纤维化和更换上皮细胞是 AS 的有效治疗策略，因此在本研究中，我们得出结论，局部注射 AMSCs 比 BMSCs 更适合治疗 AS。