Effects of treatment with stem cell-derived extracellular vesicles in preclinical rodent models of intrauterine adhesion: A meta-analysis

Wei-Hong Chen; Shao-Rong Chen; Xin-Xin Hu; Qiao-Yi Huang; Jia-Ming Chen; Shu Lin; Qi-Yang Shi

doi:10.1016/j.heliyon.2023.e22902

Effects of treatment with stem cell-derived extracellular vesicles in preclinical rodent models of intrauterine adhesion: A meta-analysis

Heliyon. 2023 Dec 1;9(12):e22902. doi: 10.1016/j.heliyon.2023.e22902. eCollection 2023 Dec.

Authors

Wei-Hong Chen¹, Shao-Rong Chen¹, Xin-Xin Hu¹, Qiao-Yi Huang¹, Jia-Ming Chen¹, Shu Lin^{2

3}, Qi-Yang Shi¹

Affiliations

¹ Department of Gynaecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China.
² Centre of Neurological and Metabolic Research, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian Province, China.
³ Group of Neuroendocrinology, Garvan Institute of Medical Research, 384 Victoria St, Sydney, Australia.

Abstract

Background: Intrauterine adhesion (IUA) results from serious complications of intrauterine surgery or infection and mostly remains incurable. Small extracellular vesicles (sEVs) derived from mesenchymal stem cells (MSCs) have emerged as a potential new approach for the treatment of IUA; however, their impact is not fully understood. Here, we performed a meta-analysis summarizing the effects of sEVs on IUA in preclinical rodent models.

Methods: This meta-analysis included searches of PubMed, EMBASE, Cochrane, and the Web of Science databases from January 1, 1997, to April 1, 2022, to identify studies reporting the therapeutic effect of sEVs on rodent preclinical animal models of IUA. We compared improvements in endometrial thickness, endometrial gland number, fibrosis area, embryo number, vascular endothelial growth factor (VEGF), transforming growth factor β1 (TGFβ1), and leukemia inhibitory factor (LIF) levels after treatment.

Results: Our search included 100 citations, of which 7 met the inclusion criteria, representing 231 animals. Compared with that in the control group, the fibrosis area in the sEV-treated group was significantly reduced (standardized mean difference (SMD) = -6.87，95 % confidence interval (CI) = -9.67 to -4.07). The number of glands increased after the intervention (95 % CI, 3.72-7.68; P = 0.000). Endometrial thickness was significantly improved in the sEV-treated group (SMD = 2.57, 95 % CI, 1.62-3.52).

Conclusions: This meta-analysis is highlighting that sEV treatment can improve the area of endometrial fibrosis, as well as VEGF, and LIF level, in a mouse IUA model. This knowledge of these findings will provide new insights into future preclinical research.

Keywords: Animal models; Intrauterine adhesion; Meta-analysis; Small extracellular vesicles; Stem cell.

Publication types

Review