Endometrial regeneration with mesenchymal stem cells and exosomes: an experimental rat model of intrauterine adhesions.

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Intrauterine adhesions (IUA) arise from inflammation-driven fibrotic remodeling that limits endometrial repair. Mesenchymal stem cells (MSCs) and MSC-derived exosomes are promising, but direct comparisons by tissue source and delivery route are limited. To compare umbilical cord (UC) and adipose-derived MSCs versus their exosomes and to assess local intrauterine versus intravenous (IV) UC-exosome delivery in a rat IUA model. Thirty-five female Sprague-Dawley rats were randomized (n = 5/group) to negative control, positive control (ethanol-IUA), and five treatment arms (local UC-MSC, UC-Exo, Adipose-MSC, Adipose-Exo, and IV UC-Exo). IUA was induced with 0.3 mL 95% ethanol; treatments were administered 2 weeks later. Two weeks after treatment, uterine tissues underwent H&E/Masson's trichrome evaluation, epithelial and wall thickness measurements, and blinded 0-3 scoring of inflammation, vascular proliferation, and fibrosis. Positive controls showed severe fibrosis and luminal narrowing. All treated groups demonstrated improved architecture and reduced collagen deposition versus positive controls. Epithelial thickness was higher in treated groups but did not differentiate treatment arms; only negative vs. positive controls differed (p < 0.001). Uterine wall thickness increased in all treatment groups versus positive controls (overall p < 0.006), and local and IV UC-Exo groups were

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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