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Cited by 21Gynecological conditions and treatmentsTissue Engineering and Regenerative MedicineIntestinal and Peritoneal Adhesions

Transplantation of decellularized and lyophilized amniotic membrane inhibits endometrial fibrosis by regulating connective tissue growth factor and tissue inhibitor of matrix metalloproteinase-2

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Chen, Xing, Zhou, Yan, Sun, Ying, Ji, Tonghui, Dai, Huihua·2021·Experimental and Therapeutic Medicine
DOI 10.3892/etm.2021.10400PMC PMC8290472
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Abstract

Intrauterine adhesion (IUA) is a disease characterized by endometrial fibrosis caused by injury to the endometrium. In the present study, decellularized and lyophilized human amniotic membrane (DL-AM) material was transplanted in a rat model to explore the preventive effect against IUA. A total of 24 Sprague Dawley rats were randomly divided into an IUA (n=12) group and an IUA + DL-AM (n=12) group. To establish the model, the endometrium of the left uterus was scraped, while that of the right uterus was used as a control. In the IUA group, scraped uteri were sutured without any other treatment, whereas DL-AM was transplanted onto the scraped uteri in the IUA + DL-AM group. Uteri were resected for histological and immunohistochemical evaluation at 3, 7, 14 and 28 days after surgery. The results confirmed the development of IUA, which was accompanied by an increase in the rate of fibrotic area. Integral optical density (IOD) values of connective tissue growth factor (CTGF) were elevated in the IUA group, while matrix metalloproteinase-2 (MMP-2) decreased relative to the control group (P<0.05). After DL-AM transplantation, the IOD value of CTGF dropped, while MMP-2 increased compared with the IUA group (P<0.05). However, compared with that in the control group, the IOD value of CTGF was still higher, whereas MMP-2 was still lower in the IUA + DL-AM group (P<0.05). Furthermore, no evidence of endometrial regeneration was detected in both the IUA and IUA + DL-AM groups. Overall, these results indicated that in the rat model of IUA, transplantation of DL-AM had the potential to prevent the formation of fibrosis to a certain extent and may thus be an alternative strategy for managing the condition.

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  • The amnion graft partially inhibited fibrous adhesion band formation.

    “This indicates that the amnion graft partially inhibited fibrous adhesion band formation.”

    From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [103]

  • In a 2021 rodent study, rats treated with a decellularized, lyophilized human amnion patch showed attenuated fibrosis, with significantly lower connective tissue growth factor levels and higher MMP-2 levels in scarred uteri than untreated injured uteri.

    “Rats treated with the DL-AM showed attenuated fibrosis: connective tissue growth factor (CTGF) levels in scarred uteri were significantly lower, and MMP-2 (matrix-degrading enzyme) higher, than in untreated injured uteri.”

    From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [103]

  • DL-AM alone did not fully restore normal endometrium; fibrotic markers remained above baseline and there was no significant regeneration of endometrial glands by 4 weeks.

    “However, DL-AM alone did not fully restore normal endometrium—fibrotic markers remained above baseline and there was no significant regeneration of endometrial glands by 4 weeks [103].”

    From Biomaterials in Postoperative Adhesion Barriers and Uterine Tissue Engineering (2025) · cites this paper as [103]

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Cited by

Sorted by citations

Authors
Chen, X., Zhou, Y., Sun, Y., Ji, T., & Dai, H.
Affiliations
Jiangsu Province Hospital (CN)
Corresponding author
Dai, Huihua
ORCID
Venue
Experimental and Therapeutic Medicine
Publisher
Spandidos Publications
Published
2021-07-07
Volume
22
Issue
3
Pages
968-968
ISSN
  • 1792-0981 (ISSN-L)
  • 1792-1015
DOI
10.3892/etm.2021.10400
PMC
PMC8290472
OpenAlex
W3182915660
Cited by
21
References
0
Citations by year
2026: 5 · 2025: 8 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 1
FWCI
1.76
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Experimental and Therapeutic Medicine (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
Jiangsu Commission of Health
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
  • Health Sciences › Medicine › Surgery › Tissue Engineering and Regenerative Medicine
  • Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
Keywords
intrauterine adhesions, endometrial fibrosis, decellularized amniotic membrane, lyophilized amniotic membrane, connective tissue growth factor, MMP-2, endometrial regeneration, rat model

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