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Efficacy of Mesenchymal Stem Cell-Derived Extracellular Vesicles in the Animal Model of Female Reproductive Diseases: A Meta-Analysis

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A Correction to this article was published on 07 October 2023

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Abstract

Background

Female reproductive disorders, such as premature ovarian insufficiency (POI), intrauterine adhesion (IUA) or thin endometrium, and polycystic ovary syndrome (PCOS), are the main factors affecting fertility. Mesenchymal stem cells derived–extracellular vesicles (MSC-EVs) have gained traction as a new potential treatment and were widely studied in these diseases. However, their impact is still not fully clear.

Methods

A systematic search of PubMed, Web of Science, EMBASE, the Chinese National Knowledge of Infrastructure, and WanFang online databases was performed up to September 27th, 2022, and the studies of MSC-EVs-based therapy on the animal models of female reproductive diseases were included. The primary outcomes were anti-Müllerian hormone (AMH) in POI and endometrial thickness in IUA, respectively.

Results

28 studies (POI, N = 15; IUA, N = 13) were included. For POI, MSC-EVs improved AMH at 2 weeks (SMD 3.40, 95% CI 2.02 to 4.77) and 4 weeks (SMD 5.39, 95% CI 3.43 to 7.36) compared with placebo, and no difference was found when compared with MSCs in AMH (SMD -2.03, 95% CI -4.25 to 0.18). For IUA, MSC-EVs treatment could increase the endometrial thickness at 2 weeks (WMD 132.36, 95% CI 118.99 to 145.74), but no improvement was found at 4 weeks (WMD 166.18, 95% CI -21.44 to 353.79). The combination of MSC-EVs with hyaluronic acid or collagen had a better effect on the endometrial thickness (WMD 105.31, 95% CI 85.49 to 125.13) and glands (WMD 8.74, 95% CI 1.34 to 16.15) than MSC-EVs alone. The medium dose of EVs may allow for great benefits in both POI and IUA.

Conclusions

MSC-EVs treatment could improve the functional and structural outcomes in female reproductive disorders. The combination of MSC-EVs with HA or collagen may enhance the effect. These findings can accelerate the translation of MSC-EVs treatment to human clinical trials

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Data Availability

The datasets used or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This study was supported by Kuanren Talents Program of The Second Affiliated Hospital of Chongqing Medical University (to F. H.), and Program for Youth Innovation in Future Medicine, Chongqing Medical University (to F. H.).

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  1. Yuanyang Zhou and Qu Li contributed equally to this work.

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Chongqing, 400010, China

    Yuanyang Zhou, Shuang You, Huanhuan Jiang & Linying Jiang

  2. Department of Obstetrics and Gynaecology, Jinjiang Maternity Hospital, No. 22 Huangshan Road, Deyang, Sichuan Province, China

    Yuanyang Zhou & Qu Li

  3. The Center for Reproductive Medicine, Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Chongqing, 400010, China

    Fan He & Lina Hu

  4. Joint International Research Lab for Reproduction and Development, Ministry of Education of the People’s Republic of China, Chongqing, China

    Fan He & Lina Hu

  5. Reproduction and Stem Cell Therapy Research Center of Chongqing, Chongqing, China

    Fan He & Lina Hu

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Contributions

Y.-Y. Z. and L.Q. are responsible for the research, acquisition and data analysis. Y.-Y.Z, F. H. and L.-N.H were in charge of the study design, manuscript writing and revision. S.Y., H.-H.J and L.-Y.J. participated in the data research, analysis, and the interpretation. All authors read and approved the final manuscript.

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Correspondence to Fan He or Lina Hu.

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Zhou, Y., Li, Q., You, S. et al. Efficacy of Mesenchymal Stem Cell-Derived Extracellular Vesicles in the Animal Model of Female Reproductive Diseases: A Meta-Analysis. Stem Cell Rev and Rep 19, 2299–2310 (2023). https://doi.org/10.1007/s12015-023-10576-4

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