Advances in molecular signaling pathways related to endometrial adhesions treated by stem cells related molecular signaling pathways
MA Guohui1 HUANG Yanhong2▲
1.Department of Clinical Medicine of Chinese and Western Medicine, the First Clinical Medical College of Shaanxi University of Chinese Medicine, Shaanxi Province, Xianyang 712046, China;
2.Department of Reproductive Endocrinology, Xi’an International Medical Center Hospital, Shaanxi Province, Xi’an 710100, China
Abstract:Intrauterine adhesion (IUA) is an important cause of infertility due to endometrial injury and abnormal adhesion caused by infection, abortion and repeated intrauterine operations. At present, for the treatment of IUA, mild to moderate patients can still achieve a certain effect through traditional treatment, but for patients with severe or extensive endometrial injury, endometrial regeneration and functional recovery has become a clinical thorny problem. With the extensive research of stem cells, stem cells with low immunogenicity, proliferation and differentiation advantages are considered to be one of the most potential methods in the treatment of intrauterine adhesions. Previous studies have shown that the paracrine effect of stem cells can promote the formation of new blood vessels and improve intrauterine fibrosis by secreting growth factors and inhibiting inflammation in the lesion area. In this paper, we review the existing molecular mechanisms of stem cell therapy for intrauterine adhesions in order to provide guidance for future research.
[1] Dreisler E,Kjer JJ. Asherman’s syndrome:current perspectives on diagnosis and management [J]. Int J Womens Health,2019,11:191-198.
[2] Ma J,Zhan H,Li W,et al. Recent trends in therapeutic str- ategies for repairing endometrial tissue in intrauterine adhesion [J]. Biomater Res,2021,25(1):40.
[3] Li J,Du S,Sheng X,et al. MicroRNA-29b Inhibits Endom- etrial Fibrosis by Regulating the Sp1-TGF-beta1/Smad-CTGF Axis in a Rat Model [J]. Reprod Sci,2016,23(3):386-394.
[4] Liu X,Duan H,Zhang HH,et al. Integrated Data Set of microRNAs and mRNAs Involved in Severe Intrauterine Adhesion [J]. Reprod Sci,2016,23(10):1340-1347.
[5] Zhao G,Li R,Cao Y,et al. DeltaNp63alpha-induced DUSP4/ GSK3beta/SNAI1 pathway in epithelial cells drives endometrial fibrosis [J]. Cell Death Dis,2020,11(6):449.
[6] Feng Q,Gao B,Zhao X,et al. Establishment of an animal model of intrauterine adhesions after surgical abortion and curettage in pregnant rats [J]. Ann Transl Med,2020,8(4):56.
[7] 蒲雯婕,朱天垣,孙琳,等.探讨IGF-1、TGF-β1在宫腔粘连子宫内膜组织中的临床表达及意义[J].实用妇科内分泌杂志(电子版),2018,5(32):1-2.
[8] Zhao J,Chen Q,Cai D,et al. Dominant factors affecting reproductive outcomes of fertility-desiring young women with intrauterine adhesions [J]. Arch Gynecol Obstet,2017,295(4): 923-927.
[9] Zhu H,Pan Y,Jiang Y,et al. Activation of the Hippo/TAZ pa- thway is required for menstrual stem cells to suppress myofibroblast and inhibit transforming growth factor beta signaling in human endometrial stromal cells [J]. Hum Reprod,2019, 34(4):635-645.
[10] Xin L,Lin X,Pan Y,et al. A collagen scaffold loaded with human umbilical cord-derived mesenchymal stem cells facilitates endometrial regeneration and restores fertility [J]. Acta Biomater,2019,92:160-171.
[11] Zhao S,Qi W,Zheng J,et al. Exosomes Derived from Adipose Mesenchymal Stem Cells Restore Functional Endometrium in a Rat Model of Intrauterine Adhesions [J]. Reproductive sciences(Thousand Oaks,Calif.),2020,27(6):1266-1275.
[12] Li B,Zhang Q,Sun J,et al. Human amniotic epithelial cells improve fertility in an intrauterine adhesion mouse model [J]. Stem cell Res Ther,2019,10(1):257.
[13] Guo YE,Li Y,Cai B,et al. Phenotyping of immune and endometrial epithelial cells in endometrial carcinomas revealed by single-cell RNA sequencing [J]. Aging(Albany NY), 2021,13(5):6565-6591.
[14] Li MY,Fan LN,Han DH,et al. Ribosomal S6 protein kinase 4 promotes radioresistance in esophageal squamous cell carcinoma [J]. J Clin Invest,2020,130(8):4301-4319.
[15] Zhao G,Li R,Cao Y,et al. DeltaNp63alpha-induced DUSP4/GSK3beta/SNAI1 pathway in epithelial cells drives endometrial fibrosis [J]. Cell Death Dis,2020,11(6):449.
[16] Zhao G,Cao Y,Zhu X,et al. Transplantation of collagen scaffold with autologous bone marrow mononuclear cells promotes functional endometrium reconstruction via dow- nregulating Delta Np63 expression in Asherman’s syndro-me [J]. Sci China Life Sci,2017,60(4):404-416.
[17] Rockey DC,Bell PD,Hill JA. Fibrosis--a common pathway to organ injury and failure [J]. N Engl J Med,2015,372(12):1138-1149.
[18] Yu B,Zhang X,Li X. Exosomes derived from mesenchymal stem cells [J]. Int J Mol Sci,2014,15(3):4142-4157.
[19] Liu F,Zhu ZJ,Li P,et al. Creation of a female rabbit model for intrauterine adhesions using mechanical and infectious injury [J]. J Surg Res,2013,183(1):296-303.
[20] Zhang L,Li Y,Guan CY,et al. Therapeutic effect of human umbilical cord-derived mesenchymal stem cells on injured rat endometrium during its chronic phase [J]. Stem Cell Res Ther,2018,9(1):36.
[21] Gaafar T,Osman O,Osman A,et al. Gene expression profiling of endometrium versus bone marrow-derived mesenchymal stem cells:upregulation of cytokine genes [J]. Mol Cell Biochem,2014,395(1/2):29-43.
[22] Chen Y,Chang Y,Yao S. Role of angiogenesis in endometrial repair of patients with severe intrauterine adhesion [J]. Int J Clin Exp Pathol,2013,6(7):1343-1350.
[23] Zhang Y,Lin X,Dai Y,et al. Endometrial stem cells repair injured endometrium and induce angiogenesis via AKT and ERK pathways [J]. Reproduction,2016,152(5):389-402.
[24] Ding DC,Shyu WC,Lin SZ. Mesenchymal stem cells [J]. Cell Transplant,2011,20(1):5-14.
[25] Walter J,Ware LB,Matthay MA. Mesenchymal stem cells:mechanisms of potential therapeutic benefit in ARDS and sepsis [J]. Lancet Respir Med,2014,2(12):1016-1026.
[26] Krampera M. Mesenchymal stromal cell‘licensing’:a multistep process [J]. Leukemia,2011,25(9):1408-1414.
[27] Muller L,Tunger A,Wobus M,et al. Immunomodulatory Properties of Mesenchymal Stromal Cells:An Update [J]. Front Cell Dev Biol,2021,9:637725.
[28] Luz-Crawford P,Kurte M,Bravo-Alegria J,et al. Mesenchymal stem cells generate a CD4+CD25+Foxp3+ regulatory T cell population during the differentiation process of Th1 and Th17 cells [J]. Stem Cell Res Ther,2013,4(3):65.
[29] Jiang Y,Zhang P,Zhang X,et al. Advances in mesenchymal stem cell transplantation for the treatment of osteoporosis [J]. Cell Prolif,2021,54(1):e12956.
[30] Guo L,Lai P,Wang Y,et al. Extracellular vesicles from mes- enchymal stem cells prevent contact hypersensitivity through the suppression of Tc1 and Th1 cells and expansion of regulatory T cells [J]. Int Immunopharmacol,2019,74:105663.
[31] Dong L,Chen X,Shao H,et al. Mesenchymal Stem Cells Inh- ibited Dendritic Cells Via the Regulation of STAT1 and STAT6 Phosphorylation in Experimental Autoimmune Uveitis [J]. Curr Mol Med,2018,17(7):478-487.
[32] Lu Z,Meng S,Chang W,et al. Mesenchymal stem cells activate Notch signaling to induce regulatory dendritic cells in LPS-induced acute lung injury [J]. J Transl Med,2020,18(1):241.
[33] Shahir M,Mahmoud HS,Asadirad A,et al. Effect of mesenchymal stem cell-derived exosomes on the induction of mouse tolerogenic dendritic cells [J]. J Cell Physiol,2020, 235(10):7043-7055.
[34] Chen L,Heikkinen L,Wang C,et al. Trends in the development of miRNA bioinformatics tools [J]. Brief Bioinform,2019,20(5):1836-1852.
[35] Tan Q,Xia D,Ying X. miR-29a in Exosomes from Bone Marrow Mesenchymal Stem Cells Inhibit Fibrosis during Endometrial Repair of Intrauterine Adhesion [J]. Int J Stem Cells,2020,13(3):414-423.
[36] Xiao B,Zhu Y,Huang J,et al. Exosomal transfer of bone marrow mesenchymal stem cell-derived miR-340 attenuates endometrial fibrosis [J]. Biol Open,2019,8(5):bio039958.