关键词: 羊膜细胞外基质, 膀胱细胞外基质, 子宫内膜损伤, 宫腔粘连, 骨髓间充质干细胞

Abstract: BACKGROUND: A large number of studies have confirmed that both amniotic extracellular matrix materials and bladder extracellular matrix materials can be used as stem cell carriers for the treatment of endometrial injury, but the difference in effect between the two materials is relatively rare.
OBJECTIVE: To compare the difference of amniotic extracellular matrix materials and bladder extracellular matrix materials as stem cell carrier in the treatment of endometrial injury.
METHODS: Whole bone marrow adhesion method was used to isolate and purify bone marrow mesenchymal stem cells from SD rats. SD-rat amniotic extracellular matrix materials and bladder extracellular matrix materials were prepared respectively, and then bone marrow mesenchymal stem cells were inoculated on the surface of the two materials to detect cell proliferation and adhesion. Forty SD rats were randomly divided into four groups (n=10 per group). Except the sham operation group, the endometrial injury group, the amniotic extracellular matrix group, and the bladder extracellular matrix group were all established by mechanical intervention. The amniotic extracellular matrix/bone marrow mesenchymal stem cell complex and bladder stromal extracellular matrix/bone marrow mesenchymal stem cell complex were transplanted into the injured endometrial site in the amniotic extracellular matrix group and the bladder extracellular matrix group. Samples were collected and detected 14 and 28 days after transplantation. The morphology of rat endometrial tissue was observed by hematoxylin-eosin staining. The levels of basic fibroblast growth factor, insulin-like growth factor 1, and vascular endothelial growth factor in endometrial tissues were analyzed by enzyme-linked immunosorbent assay. The expression levels of vimentin and CD34 in endometrial tissues were analyzed by immunohistochemical staining.
RESULTS AND CONCLUSION: (1) Both kinds of extracellular matrix materials were beneficial to the proliferation of bone marrow mesenchymal stem cells. Compared with bladder extracellular matrix materials, amniotic extracellular matrix materials could promote the adhesion of bone marrow mesenchymal stem cells. (2) Compared with the sham operation group, the levels of basic fibroblast growth factor, insulin-like growth factor 1, and vascular endothelial growth factor were significantly decreased (P < 0.01), endometrial tissue was dysplastic, endometrial thickness and number of glands were significantly decreased, and vimentin and CD34 positive expression levels were significantly decreased (P < 0.01) in the endometrial injury group. Compared with the endometrial injury group, the levels of basic fibroblast growth factor, insulin-like growth factor 1, and vascular endothelial growth factor were increased (P < 0.05 or P < 0.01), the endometrial tissue morphology was significantly improved, and the endometrial thickness and the number of glands were significantly increased; the positive expressions of vimentin and CD34 were significantly increased (P < 0.05 or P < 0.01) in the amniotic extracellular matrix group and the bladder extracellular matrix group, and the improvement of amniotic extracellular matrix group was better than that of bladder extracellular matrix group (P < 0.05). (3) The results show that compared with bladder extracellular matrix materials, amniotic extracellular matrix material as a carrier of bone marrow mesenchymal stem cells can further promote the repair of damaged endometrium.

Key words: amniotic extracellular matrix, bladder extracellular matrix, endometrial injury, intrauterine adhesion, bone marrow mesenchymal stem cell