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Stem cell–secreted factor therapy regenerates the ovarian niche and rescues follicles

Published:February 01, 2021DOI:https://doi.org/10.1016/j.ajog.2021.01.023

      Background

      Ovarian senescence is a normal age-associated phenomenon, but increasingly younger women are affected by diminished ovarian reserves or premature ovarian insufficiency. There is an urgent need for developing therapies to improve ovarian function in these patients. In this context, previous studies suggest that stem cell–secreted factors could have regenerative properties in the ovaries.

      Objective

      This study aimed to test the ability of various human plasma sources, enriched in stem cell–secreted factors, and the mechanisms behind their regenerative properties, to repair ovarian damage and to promote follicular development.

      Study Design

      In the first phase, the effects of human plasma enriched in bone marrow stem cell soluble factors by granulocyte colony–stimulating factor mobilization, umbilical cord blood plasma, and their activated forms on ovarian niche, follicle development, and breeding performance were assessed in mouse models of chemotherapy-induced ovarian damage (n=7 per group). In addition, the proteomic profile of each plasma was analyzed to find putative proteins and mechanism involved in their regenerative properties in ovarian tissue. In the second phase, the most effective plasma treatment was validated in human ovarian cortex xenografted in immunodeficient mice (n=4 per group).

      Results

      Infusion of human plasma enriched bone marrow stem cell soluble factors by granulocyte colony–stimulating factor mobilization or of umbilical cord blood plasma–induced varying degrees of microvessel formation and cell proliferation and reduced apoptosis in ovarian tissue to rescue follicular development and fertility in mouse models of ovarian damage. Plasma activation enhanced these effects. Activated granulocyte colony–stimulating factor plasma was the most potent inducing ovarian rescue in both mice and human ovaries, and proteomic analysis indicated that its effects may be mediated by soluble factors related to cell cycle and apoptosis, gene expression, signal transduction, cell communication, response to stress, and DNA repair of double-strand breaks, the most common form of age-induced damage in oocytes.

      Conclusion

      Our findings suggested that stem cell–secreted factors present in both granulocyte colony–stimulating factor–mobilized and umbilical cord blood plasma could be an effective treatment for increasing the reproductive outcomes in women with impaired ovarian function owing to several causes. The activated granulocyte colony–stimulating factor plasma, which is already enriched in both stem cell–secreted factors and platelet-enclosed growth factors, seems to be the most promising treatment because of its most potent restorative effects on the ovary together with the autologous source.

      Key words

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