Wang Zhuomin, Gu Ying, Qu Yiyuan, Huang Xujia, Sun Tao, Wu Wei, Hu Qianyu, Chen Xiao, Li Yu, Zhao Huafei, Hu Yingying, Wu Bingbing, Xu Jian
Department of Obstetrics and Gynecology, Center for Reproductive Medicine, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, China.
Department of Assisted Reproduction, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, 310006, China.
Adv Biol (Weinh). 2025 Feb;9(2):e2400336. doi: 10.1002/adbi.202400336. Epub 2024 Dec 14.
Intrauterine adhesion (IUA) can negatively impact on pregnancy outcomes, leading to reduced pregnancy rates, secondary infertility, and an increased risk of pregnancy complications. Studies have shown that the application of platelet-rich plasma (PRP) in IUA patients is effective. However, the clinical readhesive rate of IUA after treatment is still high, especially in severe cases. Platelet-rich plasma double-network hydrogel (DN gel) is an engineered PRP double network hydrogel, which is a sodium alginate (SA) based PRP hydrogel with egg carton ion cross-linking and fibrin double network. The results of this study show that intrauterine injection of DN gel has a better effect on promoting endometrial regeneration and enhancing endometrial receptivity than PRP gel. The mechanism is analyzed through single-cell sequencing, which may be achieved by increasing the expression of neutrophils (Neut), natural killer cells (NK), and type I classical dendritic cells (cDC1) in the endometrium and inhibiting the infiltration of M2 macrophages. Overall, based on the good healing efficiency and good biocompatibility of DN gel, it is expected to become a method of treating IUA with better efficacy and faster clinical translation.
宫腔粘连(IUA)会对妊娠结局产生负面影响,导致妊娠率降低、继发性不孕以及妊娠并发症风险增加。研究表明,在IUA患者中应用富血小板血浆(PRP)是有效的。然而,IUA治疗后的临床再粘连率仍然很高,尤其是在严重病例中。富血小板血浆双网络水凝胶(DN凝胶)是一种工程化的PRP双网络水凝胶,它是以海藻酸钠(SA)为基础的PRP水凝胶,具有蛋盒离子交联和纤维蛋白双网络结构。本研究结果表明,与PRP凝胶相比,宫腔内注射DN凝胶在促进子宫内膜再生和增强子宫内膜容受性方面具有更好的效果。通过单细胞测序分析其机制,这可能是通过增加子宫内膜中中性粒细胞(Neut)、自然杀伤细胞(NK)和I型经典树突状细胞(cDC1)的表达,并抑制M2巨噬细胞的浸润来实现的。总体而言,基于DN凝胶良好的愈合效率和生物相容性,有望成为一种疗效更好、临床转化更快的IUA治疗方法。