Department of Biomedical Science, Graduate School of Medicine, Korea University, Seoul, Republic of Korea.
Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Republic of Korea.
Gynecol Obstet Invest. 2022;87(6):333-343. doi: 10.1159/000527514. Epub 2022 Oct 20.
OBJECTIVES: The objective of this study was to evaluate the efficacy of cell therapy using human amniotic epithelial stem cells (hAESCs) for the treatment of premature rupture of membranes (PROM) in vitro. DESIGN: Using the amniotic pore culture technique (APCT), we mimicked the environment of PROM in vitro, thus enabling the observation of the healing process of hAESC-treated amniotic membranes. MATERIALS: Amniotic membrane samples were collected from placentas of pregnant women who underwent elective cesarean sections. APCT model and isolated hAESCs were used in this study. All patients who participated in this study provided their written informed consent prior to the commencement of the study. SETTINGS: To create the APCT model in vitro, isolated amniotic membranes were punched to create 5 mm diameter circles and re-punched to form a 1-mm pore at the center. Membranes were cultured in α-minimal essential medium, and the hAESCs were collected and cultured as well. Subsequently, the APCT models were divided into two groups: hAESC treated and control. METHODS: Within the culture period, pore sizes were calculated to evaluate the degree of tissue regeneration in both groups. We then evaluated the histology, cell density, and epithelial thickness of the regenerated tissues. Statistical analyses were performed using SPSS software ver. 20.0 (IBM, Armonk, NY, USA) with repeated-measures one-way analysis of variance or paired samples t test. The significance level was set at p < 0.05. RESULTS: As per the evaluation of the APCT model in vitro, the pore size in the hAESC-treated group reduced by 62.2% on day 6 (62.2 ± 0.19, n = 24), whereas in the control group, it shrank by only 36.8% (p < 0.05) (36.8 ± 0.19, n = 24). Furthermore, the epithelial thickness in the amniotic epithelial stem cell-treated group (10.08 ± 1.26 μm, n = 8) was significantly higher than that in the control group (5.87 ± 0.94 μm, n = 8). Cell density in the regenerated tissue in the amniotic epithelial stem cell-treated group (57 ± 2.77, n = 8) was significantly higher than that in the control group (49 ± 2.23, n = 8). LIMITATIONS: In this study, we did not explore the molecular mechanisms by which hAESCs participate in membrane healing in the APCT model. Although our results showed a significant difference, this difference was not too obvious. Therefore, further research on the mechanisms of hAESCs is needed, with more amniotic tissues and APCT samples being tested. CONCLUSIONS: We developed an APCT model to investigate the PROM conditions in vitro. By implanting donor hAESCs in the pores of the APCT model, we observed that hAESCs seeding accelerated pore healing in vitro. Thus, hAESCs may be a valuable source of cells for cell therapies in regenerative medicine.
目的:本研究旨在评估人羊膜上皮干细胞(hAESCs)用于体外治疗胎膜早破(PROM)的疗效。
设计:采用羊膜孔培养技术(APCT),我们在体外模拟 PROM 环境,从而观察 hAESC 处理的羊膜的愈合过程。
材料:从行择期剖宫产术的孕妇胎盘采集羊膜样本。本研究使用了 APCT 模型和分离的 hAESCs。所有参与本研究的患者在研究开始前均签署了书面知情同意书。
地点:为了在体外建立 APCT 模型,分离的羊膜被打孔以形成 5 毫米直径的圆圈,并在中心重新打孔形成 1 毫米的孔。将膜培养在α-最小必需培养基中,并收集和培养 hAESCs。随后,将 APCT 模型分为 hAESC 处理组和对照组两组。
方法:在培养期间,计算孔径以评估两组组织再生的程度。然后,我们评估了再生组织的组织学、细胞密度和上皮厚度。使用 SPSS 软件 ver. 20.0(IBM,Armonk,NY,USA)进行统计分析,采用重复测量单因素方差分析或配对样本 t 检验。显著性水平设为 p < 0.05。
结果:根据体外 APCT 模型的评估,hAESC 处理组第 6 天的孔径缩小了 62.2%(62.2±0.19,n=24),而对照组仅缩小了 36.8%(p<0.05)(36.8±0.19,n=24)。此外,hAESC 处理组的羊膜上皮干细胞治疗组的上皮厚度(10.08±1.26μm,n=8)明显高于对照组(5.87±0.94μm,n=8)。再生组织中的细胞密度在 hAESC 处理组(57±2.77,n=8)明显高于对照组(49±2.23,n=8)。
局限性:在这项研究中,我们没有探讨 hAESCs 如何参与 APCT 模型中膜愈合的分子机制。尽管我们的结果显示出显著差异,但这种差异并不太明显。因此,需要进一步研究 hAESCs 的机制,使用更多的羊膜组织和 APCT 样本进行测试。
结论:我们开发了一种 APCT 模型来研究体外 PROM 条件。通过将供体 hAESCs 植入 APCT 模型的孔中,我们观察到 hAESC 接种加速了体外孔的愈合。因此,hAESCs 可能是再生医学中细胞治疗的有价值的细胞来源。
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