脱细胞冻干羊膜移植通过调节结缔组织生长因子和基质金属蛋白酶-2组织抑制剂来抑制子宫内膜纤维化。
Transplantation of decellularized and lyophilized amniotic membrane inhibits endometrial fibrosis by regulating connective tissue growth factor and tissue inhibitor of matrix metalloproteinase-2.
作者信息
Chen Xing, Zhou Yan, Sun Ying, Ji Tonghui, Dai Huihua
机构信息
Department of Gynecology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 210036, P.R. China.
Department of Obstetrics, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu 210036, P.R. China.
出版信息
Exp Ther Med. 2021 Sep;22(3):968. doi: 10.3892/etm.2021.10400. Epub 2021 Jul 7.
Intrauterine adhesion (IUA) is a disease characterized by endometrial fibrosis caused by injury to the endometrium. In the present study, decellularized and lyophilized human amniotic membrane (DL-AM) material was transplanted in a rat model to explore the preventive effect against IUA. A total of 24 Sprague Dawley rats were randomly divided into an IUA (n=12) group and an IUA + DL-AM (n=12) group. To establish the model, the endometrium of the left uterus was scraped, while that of the right uterus was used as a control. In the IUA group, scraped uteri were sutured without any other treatment, whereas DL-AM was transplanted onto the scraped uteri in the IUA + DL-AM group. Uteri were resected for histological and immunohistochemical evaluation at 3, 7, 14 and 28 days after surgery. The results confirmed the development of IUA, which was accompanied by an increase in the rate of fibrotic area. Integral optical density (IOD) values of connective tissue growth factor (CTGF) were elevated in the IUA group, while matrix metalloproteinase-2 (MMP-2) decreased relative to the control group (P<0.05). After DL-AM transplantation, the IOD value of CTGF dropped, while MMP-2 increased compared with the IUA group (P<0.05). However, compared with that in the control group, the IOD value of CTGF was still higher, whereas MMP-2 was still lower in the IUA + DL-AM group (P<0.05). Furthermore, no evidence of endometrial regeneration was detected in both the IUA and IUA + DL-AM groups. Overall, these results indicated that in the rat model of IUA, transplantation of DL-AM had the potential to prevent the formation of fibrosis to a certain extent and may thus be an alternative strategy for managing the condition.
宫腔粘连(IUA)是一种因子宫内膜损伤导致子宫内膜纤维化的疾病。在本研究中,将脱细胞冻干人羊膜(DL-AM)材料移植到大鼠模型中,以探讨其对IUA的预防作用。总共24只Sprague Dawley大鼠被随机分为IUA组(n = 12)和IUA + DL-AM组(n = 12)。为建立模型,刮除左子宫的子宫内膜,而右子宫作为对照。在IUA组中,刮除后的子宫进行缝合,不进行任何其他处理,而在IUA + DL-AM组中,将DL-AM移植到刮除后的子宫上。术后3、7、14和28天切除子宫进行组织学和免疫组织化学评估。结果证实了IUA的发生,同时伴有纤维化面积率增加。IUA组中结缔组织生长因子(CTGF)的积分光密度(IOD)值升高,而基质金属蛋白酶-2(MMP-2)相对于对照组降低(P<0.05)。DL-AM移植后,与IUA组相比,CTGF的IOD值下降,而MMP-2升高(P<0.05)。然而,与对照组相比,IUA + DL-AM组中CTGF的IOD值仍然较高,而MMP-2仍然较低(P<0.05)。此外,在IUA组和IUA + DL-AM组中均未检测到子宫内膜再生的证据。总体而言,这些结果表明,在IUA大鼠模型中,DL-AM移植有一定潜力预防纤维化形成,因此可能是管理该病症的一种替代策略。