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. 2021 Sep 21;9:760943. doi: 10.3389/fbioe.2021.760943

TABLE 2.

Summary of bioactive hydrogels in cell therapy in IUA.

Cell Biomaterial Model Molecule/pathway Strength References
- Chitosan-heparin hydrogels Sprague-Dawley rats Downregulated expression of TGF-β SDF-1α/CXCR4 axle secreted cytokine to regulate the tissue regeneration Wenbo et al. (2020)
Upregulated expression of VEGF
- E2@uECMNPs/AP hydrogel Sprague-Dawley rats Upregulated Ki67, cytokeratin, and ER-β Increased morphological recovery and decreased uterine fibrosis rate Yao et al. (2020)
Decreased TGF-β1 and TNF-α
- E2-Heparin-Poloxamer Hydrogel Sprague-Dawley rats Kisspeptin; ERK1/2 and MAPKs p38 pathways Facilitate the regeneration Zhang et al. (2020b)
Inhibiting the cell apoptosis in IUA model
dEMSCs Hyaluronic acid fibrinogen/thrombin hydrogel (HA + F + T50 gel) Sprague-Dawley rats Increased expression of PECAM and IGF-1 Expression and secretion of molecules essential for embryonic implantation Kim et al. (2019)
VEGF and LIF expression are also increased Shortens time window between cell transplantation and embryo transfer
MSC-Sec Crosslinked hyaluronic acid gel Sprague-Dawley rats - Creates a sustained release system Liu et al. (2019)
Thicker endometrium and more glands were observed after treatment
BMSCs Pluronic F-127-vitminC hydrogel Sprague-Dawley rats Restored cytokeratin, von Willebrand Factor (vWF) Vc promoted the survival and health of PF-127-encapsulated BMSCs in vitro Yang et al. (2017)
Decreased interleukin-1β (IL-1β) Thicker endometrium membrane
More glands and fewer areas of fibrosis
Oral mucosal epithelial cells Lyophilized amniotic membrane Sprague-Dawley rats VEGF expression is increased Effective in preventing fibrosis with improved regeneration of endometrium and endometrial glands in the rat model of IUA Chen et al. (2019)
OMECs
hUCMSC Collagen Sprague-Dawley rats Increased the expression of HuNu and vimentin in a IUA-induced rat model Increased number of endometrial glands and reduced area of fibrosis Liu et al. (2020b)
Protein levels of the p-transcriptional co-activator with PDZ-binding motif, stromal cell-derived factor-1, and C-X-C chemokine receptor type 4 were upregulated
UC-MSCs Collagen Human - 38.4% participants had a successful pregnancy Cao et al. (2018)
UC-MSC-derived exosomes Collagen Sprague-Dawley rats Increased the expression of the estrogen receptor α/progesterone receptor Endometrium regeneration Xin et al. (2020)
Collagen remodeling
Increased the expression of the estrogen receptor α/progesterone receptor
Restored fertility
Reduced inflammation, and increased anti-inflammatory responses
hiMSCs Alginate and gelatin Sprague-Dawley rats Integrin αv β3 and LIF were significantly higher in the cell-loaded scaffold group Promoted the recovery of the endometrial histomorphology (endometrial tissue and gland regeneration) and the regeneration of endometrial cells (stromal cells and epithelial cells) and endothelial cells Ji et al. (2020)
Improved endometrial receptivity functional indicators
ADSCs-derived exosomes PEG Sprague-Dawley rats Significant increases in VEGF, LIF, avβ3, and IGF-1 expression Promote HUVEC proliferation, migration, and tube formation in vitro Pan et al. (2020)
Exhibited a robust ability to induce neovascularization and tissue regeneration while suppressing localized fibrosis in vivo
Regenerated endometrial tissue was more receptive to embryos, leading to higher rates of pregnancy

hAECs: human amnion epithelial cells; bFGF: basic fibroblast growth factor; VEGF: vascular endothelial growth factor; IGF-1: insulin-like growth factor-1; COL1A1: collagen type I alpha 1; TIMP-1: tissue inhibitor of metalloproteinase-1; TGF-β: transforming growth factor-β; PDGF-C: platelet-derived growth factor-C; THBS1: thrombospondin-1; CTGF: connective tissue growth factor; ER-β: estrogen receptor β; E2@uECMNPs/AP hydrogel: nanoparticulate decellularized uterus (uECMNPs) encapsulated β-estradiol thermosensitive aloe-poloxamer hydrogel; MenSCs: menstrual blood stem cells; BMSCs: bone marrow-derived stem cells; dEMSCs: decidualized endometrial stromal cells; MSC-Sec: mesenchymal stem cell-secretome; UC-MSCs: umbilical cord-derived mesenchymal stromal cells; ADSCs: adipose stem cells.