Zhang Yue, Li Yaqin, Wu Xiaotong, Wang Shiyan, Wei Xiaoting, Sun Xiuli
Department of Obstetrics and Gynecology, Peking University People's Hospital, No.11, Xi-Zhi-Men South Street, Xicheng District, Beijing, 100044, China.
Pelvic Floor Disorders Research Center of Peking University Health Science Center, Beijing, 100044, China.
Int Urogynecol J. 2025 Apr;36(4):881-893. doi: 10.1007/s00192-025-06117-x. Epub 2025 Mar 21.
The treatment of pelvic organ prolapse (POP) presents significant challenges. It is important to explore safer and more effective treatment modalities. Recombinant humanized collagen (rhCol) is a promising biomaterial with excellent biocompatibility and pro-regenerative properties. Therefore, this study aims to evaluate the potential applications of rhCol in POP treatment.
Vaginal wall tissues were collected from three non-POP and five POP patients to analyze extracellular matrix (ECM) changes via histological staining. Primary fibroblasts isolated from POP vaginal tissues were treated with rhCol III. Cell proliferation, migration, senescence, and ECM synthesis were assessed. A simulated birth injury (SBI) rat model was used to evaluate ECM remodeling following rhCol injection into the vaginal wall. Additionally, the angiogenic potential of rhCol III was examined in vivo and in vitro.
POP patient tissues and fibroblasts exhibited lower expression levels of type I and III collagen compared to non-POP samples. At a 1 mg/ml concentration, rhCol III promoted fibroblast proliferation and migration, reduced cellular senescence, and enhanced ECM synthesis. In the vaginal wall, the expression of COL1A1 and COL3A1 in the rhCol group was significantly higher than that in the SBI group, with a marked increase in the levels of CD31, CD34, and VEGFA. Furthermore, rhCol III improved the proliferation, migration, and tubule formation capacities of HUVECs.
rhCol III may promote ECM remodeling in an injured vaginal wall by restoring fibroblast function and stimulating angiogenesis, offering a novel biomaterial-based strategy for POP treatment.
盆腔器官脱垂（POP）的治疗面临重大挑战。探索更安全、更有效的治疗方式非常重要。重组人源化胶原蛋白（rhCol）是一种具有出色生物相容性和促再生特性的有前景的生物材料。因此，本研究旨在评估rhCol在POP治疗中的潜在应用。
从三名非POP患者和五名POP患者收集阴道壁组织，通过组织学染色分析细胞外基质（ECM）变化。用rhCol III处理从POP阴道组织分离的原代成纤维细胞。评估细胞增殖、迁移、衰老和ECM合成。使用模拟分娩损伤（SBI）大鼠模型评估rhCol注入阴道壁后ECM重塑情况。此外，在体内和体外检测rhCol III的血管生成潜力。
与非POP样本相比，POP患者组织和成纤维细胞中I型和III型胶原蛋白表达水平较低。在1mg/ml浓度下，rhCol III促进成纤维细胞增殖和迁移，减少细胞衰老，并增强ECM合成。在阴道壁中，rhCol组中COL1A1和COL3A1的表达明显高于SBI组，CD31、CD34和VEGFA水平显著增加。此外，rhCol III改善了人脐静脉内皮细胞（HUVECs）的增殖、迁移和小管形成能力。
rhCol III可能通过恢复成纤维细胞功能和刺激血管生成来促进受损阴道壁中的ECM重塑，为POP治疗提供一种基于新型生物材料的策略。
