Promotion of uterine reconstruction by a tissue-engineered uterus with biomimetic structure and extracellular matrix microenvironment

Abstract

The recurrence rate for severe intrauterine adhesions is as high as 60%, and there is still lack of effective prevention and treatment. Inspired by the nature of uterus, we have developed a bilayer scaffold (ECM-SPS) with biomimetic heterogeneous features and extracellular matrix (ECM) microenvironment of the uterus. As proved by subtotal uterine reconstruction experiments, the mechanical and antiadhesion properties of the bilayer scaffold could meet the requirement for uterine repair. With the modification with tissue-specific cell–derived ECM, the ECM-SPS had the ECM microenvironment signatures of both the endometrium and myometrium and exhibited the property of inducing stem cell–directed differentiation. Furthermore, the ECM-SPS has recruited more endogenous stem cells to promote endometrial regeneration at the initial stage of repair, which was accompanied by more smooth muscle regeneration and a higher pregnancy rate. The reconstructed uterus could also sustain normal pregnancy and live birth. The ECM-SPS may thereby provide a potential treatment for women with severe intrauterine adhesions.

Bioactive microgel-coated electrospun membrane with cell-instructive interfaces and topology for abdominal wall defect repair

“…Moreover, haphazard red myofibril formation was observed in the regenerated tissues of the AM@PLCL group, which could be attributed to the introduction of dECM, which elicited the differentiation and maturation of muscle cell. 48–50 At day 28, more collagen was deposited in the control and PLCL groups, but few myofibrils were observed, indicating a relatively lower regeneration level. In comparison, a larger amount of regenerated muscle was observed in both the AM@PLCL and ADM@PLCL groups, with a more homogeneous and orderly distribution of muscle cells in the ADM@PLCL group.…”