Department of Obstetrics and Gynecology, Ninth Clinical Medical College, Peking University, Beijing Shijitan Hospital, Beijing, China.
Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Front Endocrinol (Lausanne). 2023 Aug 8;14:1154958. doi: 10.3389/fendo.2023.1154958. eCollection 2023.
Intrauterine adhesion (IUA) is the most common cause of uterine infertility. This study aims to evaluate whether platelet-rich fibrin (PRF) treatment can stimulate damaged endometrium regeneration in rats.
First, hematoxylin and eosin (HE) staining, scanning and transmission electron microscopy, and ELISAs were used to evaluate the microstructure of PRF. Then, mechanical damage was used to establish an IUA rat model. A total of 40 SD female rats were randomized to three groups: PRF transplantation group, IUA group, and sham group. Rats were sacrificed at 3, 7, and 14 days and uteruses were obtained for further analysis. Finally, functional and histological recovery of the damaged endometrium was analyzed by pregnancy test, HE staining, Masson's staining, and immunohistochemistry.
PRF has two distinct zones, platelets and fibrin zone. Long and narrow fibrin fibers interconnected with each other and formed a three-dimensional, flexible, and elastic structure; platelet aggregates were trapped in fibrin fibers, and each platelet is associated with several fibrin fibers. PRF exudates promoted endometrial stromal cell proliferation and migration . PRF transplantation was beneficial for maintaining uterine structure, promoting endometrial luminal epithelium and endometrial gland regeneration, and decreasing fibrotic areas .
Intrauterine administration of PRF was demonstrated to be effective in preventing IUA and stimulating damaged endometrium regeneration in rats. This study not only provided a promising method for its potential in endometrial regeneration in women who suffer from uterine infertility but also may prevent IUA after intrauterine surgery in clinical cases.
宫腔粘连（IUA）是子宫性不孕的最常见原因。本研究旨在评估富血小板纤维蛋白（PRF）治疗是否能刺激大鼠受损子宫内膜的再生。
首先，通过苏木精-伊红（HE）染色、扫描和透射电子显微镜以及 ELISA 评估 PRF 的微观结构。然后，采用机械损伤法建立 IUA 大鼠模型。共 40 只 SD 雌性大鼠随机分为 PRF 移植组、IUA 组和假手术组。大鼠在 3、7 和 14 天处死，取子宫进行进一步分析。最后，通过妊娠试验、HE 染色、Masson 染色和免疫组织化学分析，评估受损子宫内膜的功能和组织学恢复情况。
PRF 有两个明显的区域，即血小板和纤维蛋白区。长而窄的纤维蛋白纤维相互交织，形成三维、柔韧、有弹性的结构；血小板聚集体被困在纤维蛋白纤维中，每个血小板与几条纤维蛋白纤维相关联。PRF 渗出物促进子宫内膜基质细胞的增殖和迁移。PRF 移植有利于维持子宫结构，促进子宫内膜腔上皮和子宫内膜腺的再生，减少纤维性区域。
宫腔内给予 PRF 被证明能有效预防大鼠的 IUA 并刺激受损子宫内膜的再生。本研究不仅为其在因子宫性不孕而遭受痛苦的女性子宫内膜再生中的潜在应用提供了有前景的方法，而且可能在临床情况下预防宫腔内手术后的 IUA。
