Zhu Honglei, Liu Fenghua, Liao Yuru, Li Huayan, Gao Kunjie, Liang Xiaomei, Jiang Haoyuan, Chen Feng, Wu Jianwei, Wang Qian, Wang Yifeng, Shuai Xintao, Yi Xiao
Department of Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, China.
Center for Reproductive Medicine, Guangdong Women and Children Hospital, Guangzhou, 511400, China.
Biomaterials. 2025 Jun;317:123081. doi: 10.1016/j.biomaterials.2024.123081. Epub 2025 Jan 1.
Cesarean section (CS) is highly prevalent surgery among females. However, current absorbable anti-adhesion membranes used clinically can partially prevent postoperative adhesions but show limited efficacy in tissue regeneration, leaving post-cesarean women at risk for severe complications including cesarean scar pregnancy, placenta previa, and uterine rupture. Herein, we designed a fully amniotic membrane (AM)-derived biomimetic nanostructural materials (AM-BNMs) as an anti-adhesion barrier, and validated its therapeutic efficacy in a rat CS model. The biomaterial consisted of AM-extracellular matrix (ECM) nanofibers, enriched with hemostatic proteins (collagen, S100A8, S100A9, etc.), carrying AM mesenchymal stem cells (MSCs)-secretome that exhibited significantly elevated levels of pro-regenerative factors (miR-302a-3p, angiogenin, VEGF, etc.) compared to endogenous secretion. The reconstituted AM-BNMs demonstrated synergistic effects at CS wounds, effectively preventing adhesion formation while promoting hemostasis and tissue regeneration. In summary, this readily accessible human-derived biomaterial shows promising potential in preventing adhesion-related complications and enhancing uterine wound healing, thereby promoting female reproductive health.
剖宫产术(CS)是女性中非常常见的手术。然而,目前临床上使用的可吸收抗粘连膜可以部分预防术后粘连,但在组织再生方面效果有限,使剖宫产术后的女性面临包括剖宫产瘢痕妊娠、前置胎盘和子宫破裂等严重并发症的风险。在此,我们设计了一种完全由羊膜(AM)衍生的仿生纳米结构材料(AM-BNMs)作为抗粘连屏障,并在大鼠剖宫产模型中验证了其治疗效果。该生物材料由富含止血蛋白(胶原蛋白、S100A8、S100A9等)的羊膜细胞外基质(ECM)纳米纤维组成,携带着羊膜间充质干细胞(MSCs)的分泌组,与内源性分泌相比,其促再生因子(miR-302a-3p、血管生成素、血管内皮生长因子等)水平显著升高。重组后的AM-BNMs在剖宫产伤口处显示出协同作用,有效防止粘连形成,同时促进止血和组织再生。总之,这种易于获取的人源生物材料在预防粘连相关并发症和促进子宫伤口愈合方面显示出有前景的潜力,从而促进女性生殖健康。