Background. Abnormal endometrial repair after injury results in the formation of intrauterine adhesions (IUA) and a thin endometrium, which are key causes for implantation failure and infertility. Stem cell transplantation offers a potential alternative for some cases of severe Asherman’s syndrome that cannot be treated with surgery or hormonal therapy. Umbilical cord-derived mesenchymal stem cells (UCMSCs) have been reported to repair the damaged endometrium. However, there is no report on the effects of UCMSCs previously seeded on human acellular amniotic matrix (AAM) on endometrial injury. Methods. Absolute ethanol was injected into rat uteri to damage the endometrium. UCMSCs previously seeded on AAM were surgically transplanted. Using a variety of methods, the treatment response was assessed by endometrial thickness, endometrial biomarker expression, endometrial receptivity, cell proliferation, and inflammatory factors. Results. Endometrial thickness was markedly improved after UCMSC-AAM transplantation. The expression of endometrial biomarkers, namely, vimentin, cytokeratin, and integrin β3, in treated rats increased compared with untreated rats. In the UCMSC-AAM group, the VEGF expression decreased, whereas that of MMP9 increased compared with the injury group. Moreover, in the AAM group, the MMP9 expression increased. The expression of proinflammatory factors (IL-2, TNFα, and IFN-γ) in the UCMSC-AAM group decreased compared with the untreated group, whereas the expression of anti-inflammatory factors (IL-4, IL-10) increased significantly. Conclusions. UCMSC transplantation using AAM as the carrier can be applied to treat endometrial injury in rats. The successful preparation of lyophilized AAM provides the possibility of secondary infectious disease screening and amniotic matrix quality detection, followed by retrospective analysis. The UCMSC-AAM complex may promote the better application of UCMSCs on the treatment of injured endometrium.

中文翻译：

---

具有先前接种的脐带间充质干细胞的人脱细胞羊膜基质在大鼠损伤模型中恢复子宫内膜功能

背景。损伤后的子宫内膜修复异常会导致宫腔粘连（IUA）和子宫内膜变薄，这是导致植入失败和不孕的关键原因。干细胞移植为某些无法通过手术或激素疗法治疗的严重 Asherman 综合征病例提供了一种潜在的替代方案。据报道，脐带来源的间充质干细胞 (UCMSCs) 可修复受损的子宫内膜。然而，尚无关于先前接种在人无细胞羊膜基质 (AAM) 上的 UCMSCs 对子宫内膜损伤的影响的报道。方法. 将无水乙醇注入大鼠子宫以损伤子宫内膜。通过手术移植先前在 AAM 上播种的 UCMSC。使用多种方法，通过子宫内膜厚度、子宫内膜生物标志物表达、子宫内膜容受性、细胞增殖和炎症因子评估治疗反应。结果。UCMSC-AAM 移植后子宫内膜厚度明显改善。与未治疗的大鼠相比，治疗大鼠的子宫内膜生物标志物，即波形蛋白、细胞角蛋白和整合素β 3 的表达增加。与损伤组相比，UCMSC-AAM组VEGF表达降低，而MMP9表达升高。此外，在 AAM 组中，MMP9 表达增加。促炎因子（IL-2、TNF与未治疗组相比，UCMSC-AAM 组的α和 IFN- γ降低，而抗炎因子（IL-4、IL-10）的表达显着增加。结论。以AAM为载体的UCMSC移植可用于治疗大鼠子宫内膜损伤。冻干AAM的成功制备为二次传染病筛查和羊膜基质质量检测提供了可能，随后进行回顾性分析。UCMSC-AAM复合物可能促进UCMSCs更好地应用于损伤子宫内膜的治疗。