Sıçanlarda Trikloroasetik Asit ile İndüklenen Deneysel İntrauterin Adezyonlarda Kök Hücre Tedavisi

Yıl 2022, Cilt: 2 Sayı: 1, 40 - 49, 29.04.2022

Şamil Öztürk Serap Mutlu Özçelik Otcu İlhan Özdemir Latife Ceyda İrkin

Öz

Kemik iliğinden elde edilen kök hücrelerin, sıçanlarda kimyasal kullanılarak oluşturulan intrauterin adezyon modellemesinde rahim içi yapışıklıkların giderilmesinde ve blastosistin endometriuma implantasyonunun yeniden sağlanmasında etkinliği ve rolü araştırıldı.
Deney modeli, trikloroasetik asit kullanılarak tek uterin hornda meydana gelen hasara karşı, yalnızca kültür besiyeri (CM), kök hücre ve 48 saatlik Niş kullanılarak farklı grup ve iki alt grup oluşturulmuştur. Çalışmada toplam 30 dişi ve 3 erkek rat kullanıldı. Akut fazda model oluşumundan hemen sonra tedaviye başlandı ve 10 gün sonra denekler gebe kalmaları için erkek sıçanlarla aynı kafese yerleştirildi. Daha sonra gebelik durumu ve doğan yavru sayısı değerlendirildi. Histolojik değerlendirme hematoksilen-eozin boyaması ile yapıldı. Yenidoğan sayısına göre hem histolojik hem de morfolojik değerlendirmelerde kök hücre uygulanan gruplarda diğer gruplara göre istatistiksel olarak anlamlı fark (p<0.05) bulundu. Akut dönemde bölgesel kök hücre uygulamasının rahim içi yapışıklıkları ortadan kaldırabileceği ve endometriyumu implantasyona daha uygun hale getirebileceği belirlendi. Sonuç olarak tedavi gruplarında endometrial kalınlık, bez sayısı ve damarlanmanın artması, fibröz alanların azalması ve adeziv alanların gerilemesi sonucu yenidoğan sayısındaki artış deneysel intrauterin çalışmaların kliniğe uyarlanması açısından umut verici olmuştur.

Anahtar Kelimeler

Kök hücre, İntrauterin adezyon, rat, histoloji

Stem Cell Therapy in Rats with Experimental Intrauterine Adhesions Induced by Trichloroacetic Acid

Öz

The effectiveness and role of stem cells obtained from bone marrow in removing the adhesion formed in intrauterine adhesion modeling using chemicals in rats and restoring the implantation of the blastocyst to the endometrium were investigated.
The experimental model was created in a single horn using trichloroacetic acid. Three different groups and two subgroups were formed as only culture medium (CM), stem cell and 48-hour medium (Niche). A total of 30 female and 3 male rats were used in the study. Treatment was started immediately after model formation in the acute phase, and 10 days later, the subjects were placed in the same cage with male rats for conception. Then, the pregnancy status and the number of puppies born were evaluated. Histological evaluation was performed with hematoxylin-eosin staining.A statistically significant difference (p<0.05) was found in the stem cell applied groups compared to the other groups in both histological and morphological evaluations according to the number of newborns. It has been determined that regional stem cell application in the acute period can remove adhesions in uterine adhesions and make the endometrium more suitable for implantation. As a result, the increase in the number of newborns as a result of the increase in endometrial thickness, number of glands and vascularization, decrease in fibrous areas and regression of adhesive areas in the treatment groups is promising in terms of carrying experimental intrauterine studies to the clinic.

Anahtar Kelimeler

Stem cell, intrauterine adhesion, rat, histology

Kaynakça

• 1. W. Jiang, A. Ma, T. Wang, K. Han, Y. Liu and Y. Zhang. “Homing and differentiation of mesenchymal stem cells delivered intravenously to ischemic myocardium in vivo: a time-series study,” Pflugers Archive, vol. 453, pp. 43-52, 2006.
• 2. K. Kollar, M.M. Cook, K. Atkinson, and G. Brooke. “Molecular mechanisms involved in mesenchymal stem cell migration to the site of acute myocardial infarction,” International Journal of Cell Biology, vol. 904682, 2009.
• 3. S.L. Hu, H.S. Luo, J.T. Li, Y.Z. Xia and L. Li. “Functional recovery in acute traumatic spinal cord injury after transplantation of human umbilical cord mesenchymal stem cells,” Criteria Care Medicine, vol. 38, p.p. 2181-2189, 2010.
• 4. J.A. Asherman. “Amenorrhea traumatica (atretica),” An International Journal of Obstetrics and Gynaecology, vol. 55, pp.22-30, 1948.
• 5. C.M. March. “Management of Asherman’s syndrome,” Reproductive BioMedicine Online, vol. 23, pp. 63-76, 2010.
• 6. T. Oikawa. “Cancer Stem Cells and Their Cellular Origins in Primary Liver and Biliary Tract Cancers,” Hepatology, 2016;doi: 10.1002/hep.28485.
• 7. S. Kilic, B. Yuksel, F. Pinarli, A. Albayrak and B. Boztok. “Effect of stem cell application on Asherman syndrome, an experimental rat model,” Journal of Assist Reproduction Genetics, vol. 31(8), pp. 975-982, 2014.
• 8. L. Gan, H. Duan, Q. Xu, Y.Q. Tang and J.J. Li. “Human amniotic mesenchymal stromal cell transplantation improves endometrial regeneration in rodent models of intrauterine adhesions,” Cytotherapy, vol. 19, pp. 603-616, 2017.
• 9. J.K. Robinson, L.M. Colimon and K.B. Isaacson. “Postoperative adhesiolysis therapy for intrauterine adhesions (Asherman’s syndrome),” Fertility and Sterility, vol. 90(2), pp. 409-14, 2008.
• 10. J. Abbott, A. Thomson andT. Vancaillie. “SprayGel following surgery for Asherman’s syndrome may improve pregnancy outcome,” Journal of Obstetrics and Gynaecology, vol. 24(6), pp. 710-11, 2004.
• 11. V.S. Tsapanos, L.P. Stathopoulou, V.S. Papathanassopoulou and V.A. Tzingounis. “The role of Seprafilm bioresorbable membrane in the prevention and therapy of endometrial synechiae,” Journal of Biomedical Materials Research Part A, vol. 63, pp. 10-14, 2002.
• 12. X. Lin, M. Wei, T.C. Li, Q. Huang and D. Huang. “A comparison of intrauterine balloon, intrauterine contraceptive device and hyaluronic acid gel in the prevention of adhesion reformation following hysteroscopic surgery for Asherman syndrome: a cohort study,” European Journal of Obstetrics & Gynecology and Reproductive Biology, vol. S0301-2115(13), pp. 00325-4, 2013.
• 13. Y. Chen, Y. Chang and S. Yao. “Role of angiogenesis in endometrial repair of patients with severe intrauterine adhesion,” International Journal of Clinical and Experimental Pathology, vol. 6, pp. 1343-1350, 2013.
• 14. C.B. Nagori, S.Y. Panchal and H. Patel. “Endometrial regeneration using autologous adult stem cells followed by conception by in vitro fertilization in a patient of severe Asherman’s syndrome,” Journal of Human Reproductive Sciences, vol. 4, 43-8. 2011.
• 15. F. Alawadhi, H. Du, H. Cakmak and H.S. Taylor. “Bone marrow- derived stem cell (BMDSC) tranplantation improves fertility in murine model of Asherman’s syndrome,” PLoS One., vol. 9(5), pp. e96662, 2014.
• 16. C.E. Gargett, Masuda H. Adult stem cells in the endometrium. Mol Hum Reprod. 2010;16(11):818–34.
• 17. C.E. Gargett, K.E. Schwab and J.A. Deane. “Endometrial stem/progenitor cells: the first 10 years,” Human Reproduction, vol. 22, pp. 137-63, 2016.
• 18. J. Tan, P. Li, Q. Wang, Y. Li and D. Zhao. “Autologous menstrual blood-derived stromal cells transplantation for severe Asherman’s syndrome,” Human Reproduction, vol. 31, pp. 2723-9, 2016.
• 19. F. Chen, H. Duan, Y. Zhang and Y.H Wu. “Effect and mechanism of formation of intrauterine adhesion at different dose of estrogen,” Zhonghua Fu Chan Ke Za Zhi., vol. 45, 917-20, 2010.
• 20. F. Liu, Z.J. Zhu, P. Li and Y.L. He. “Creation of a female rabbit model for intrauterine adhesions using mechanical and infectious injury,” Journal of Surgical Research, vol. 183, pp. 183, 2013.