Setyaningrum Trisniartami, Listiawan M Yulianto, Santoso Budi, Prakoeswa Cita Rosita Sigit, Widjiati Widjiati, Tjokroprawiro Brahmana Askandar
Department of Dermatology and Venereology, Faculty of Medicine, Airlangga University, Dr. Soetomo General Hospital Surabaya, Surabaya, East Java, Indonesia.
Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
J Lasers Med Sci. 2023 Jan 30;14:e2. doi: 10.34172/jlms.2023.02. eCollection 2023.
Vaginal laxity, a symptom of pelvic floor dysfunction observed in women, has many negative biological and psychological impacts. Laser treatments and stem cell-based therapies are emerging therapeutic methods for treating this condition. This study aimed to determine changes in vaginal laxity in model rats using a combination therapy of erbium-doped yttrium aluminium garnet (Er:YAG) fractional lasers and topical treatment with amniotic membrane stem cell metabolite products (AMSC-MP). The experimental animal population comprised 36 female white rats (; 2-day-post-vaginal-delivery rats) allocated into the following four groups (n=9): K1, untreated two-day-post-vaginal-delivery rats; K2, two-day-post-vaginal-delivery rats treated with topical gel without AMSC-MP; P1, two-day-post-vaginal-delivery rats treated with Er:YAG fractional lasers and topical gel without AMSC-MP; P2, two-day-post-vaginal-delivery rats treated with Er: YAG fractional lasers and topical gel containing AMSC-MP. Immunohistochemical (IHC) examination was carried out for the expression and activity of heat shock protein 70 (HSP-70), collagen-1, tissue inhibitors of metalloproteinase 1 (TIMP-1) and matrix metalloproteinase 1 (MMP-1), as well as vaginal mucosal thickness. There was a significant difference (<0.05) in the expression of HSP-70 among all groups except K2 and P1 (>0.05); there was no significant difference in type I collagen and TIMP-1 expression between the groups (>0.05); there was a significant difference (<0.05) in MMP-1 activity, with the activity in the K2 group (5.79±0.83) being higher than that in the P1 group (4.44±1.82) and that in the K1 group (5.74±1.03) being higher than that in the P2 group (4.24±1.55). Also, there was a significant difference in the thickness of the vaginal mucosa in all groups except K2 and P1 (>0.05). Er:YAG fractional laser and AMSC-MP combination therapy improved vaginal laxity in model rats by increasing Hsp70 expression and vaginal mucosal thickness and decreasing MMP-1 activity.
阴道松弛是女性盆底功能障碍的一种症状，会对生理和心理产生诸多负面影响。激光治疗和基于干细胞的疗法是治疗该病症的新兴治疗方法。本研究旨在通过掺铒钇铝石榴石（Er:YAG）分次激光与羊膜干细胞代谢产物（AMSC-MP）局部治疗相结合的方法，确定模型大鼠阴道松弛情况的变化。实验动物群体包括36只雌性白鼠（产后2天的大鼠），分为以下四组（n = 9）：K1组，未治疗的产后2天大鼠；K2组，用不含AMSC-MP的局部凝胶治疗的产后2天大鼠；P1组，用Er:YAG分次激光和不含AMSC-MP的局部凝胶治疗的产后2天大鼠；P2组，用Er:YAG分次激光和含AMSC-MP的局部凝胶治疗的产后2天大鼠。对热休克蛋白70（HSP-70）、胶原蛋白-1、基质金属蛋白酶组织抑制剂1（TIMP-1）和基质金属蛋白酶1（MMP-1）的表达及活性以及阴道黏膜厚度进行免疫组织化学（IHC）检测。除K2组和P1组之间HSP-70表达无显著差异（>0.05）外，所有组之间HSP-70表达均有显著差异（<0.05）；各组之间I型胶原蛋白和TIMP-1表达无显著差异（>0.05）；MMP-1活性有显著差异（<0.05），K2组活性（5.79±0.83）高于P1组（4.44±1.82），K1组活性（5.74±1.03）高于P2组（4.24±1.55）。此外，除K2组和P1组之间阴道黏膜厚度无显著差异（>0.05）外，所有组之间阴道黏膜厚度均有显著差异。Er:YAG分次激光和AMSC-MP联合治疗可通过增加Hsp70表达和阴道黏膜厚度以及降低MMP-1活性来改善模型大鼠的阴道松弛情况。
