1
|
Zaninović L, Bašković M, Ježek D, Habek D, Pogorelić Z, Katušić Bojanac A, Elveđi Gašparović V, Škrgatić L. Enhancement of Vascularization and Ovarian Follicle Survival Using Stem Cells in Cryopreserved Ovarian Tissue Transplantation-A Systematic Review. BIOLOGY 2024; 13:342. [PMID: 38785824 PMCID: PMC11117700 DOI: 10.3390/biology13050342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/12/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
The increase in cancer survival rates has put a focus on ensuring fertility preservation procedures for cancer patients. Ovarian tissue cryopreservation presents the only option for prepubertal girls and patients who require immediate start of treatment and, therefore, cannot undergo controlled ovarian stimulation. We aimed to provide an assessment of stem cells' impact on cryopreserved ovarian tissue grafts in regard to the expression of growth factors, angiogenesis promotion, tissue oxygenation, ovarian follicle survival and restoration of endocrine function. For this systematic review, we searched the Scopus and PubMed databases and included reports of trials using murine and/or human cryopreserved ovarian tissue for transplantation or in vitro culture in combination with mesenchymal stem cell administration to the grafting site. Of the 1201 articles identified, 10 met the criteria. The application of stem cells to the grafting site has been proven to support vascular promotion and thereby shorten the period of tissue hypoxia, which is reflected in the increased number of remaining viable follicles and faster recovery of ovarian endocrine function. Further research is needed before implementing the use of stem cells in OT cryopreservation and transplantation procedures in clinical practice. Complex ethical dilemmas make this process more difficult.
Collapse
Affiliation(s)
- Luca Zaninović
- Scientific Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
- Department of Obstetrics and Gynecology, University Hospital Centre Zagreb, Petrova ulica 13, 10 000 Zagreb, Croatia
- School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
| | - Marko Bašković
- Scientific Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
- School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
- Department of Pediatric Surgery, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10 000 Zagreb, Croatia
- Croatian Academy of Medical Sciences, Kaptol 15, 10 000 Zagreb, Croatia
| | - Davor Ježek
- Scientific Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
- School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
- Department of Histology and Embryology, School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
- Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Kišpatićeva ulica 12, 10 000 Zagreb, Croatia
| | - Dubravko Habek
- School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
- Croatian Academy of Medical Sciences, Kaptol 15, 10 000 Zagreb, Croatia
- Department of Obstetrics and Gynecology, Clinical Hospital Merkur, Zajčeva ulica 19, 10 000 Zagreb, Croatia
- School of Medicine, Catholic University of Croatia, Ilica 242, 10 000 Zagreb, Croatia
| | - Zenon Pogorelić
- Department of Pediatric Surgery, University Hospital of Split, Spinčićeva ulica 1, 21 000 Split, Croatia;
- School of Medicine, University of Split, Šoltanska ulica 2a, 21 000 Split, Croatia
| | - Ana Katušić Bojanac
- Scientific Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
- School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
- Department of Medical Biology, School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
| | - Vesna Elveđi Gašparović
- Department of Obstetrics and Gynecology, University Hospital Centre Zagreb, Petrova ulica 13, 10 000 Zagreb, Croatia
- School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
| | - Lana Škrgatić
- Scientific Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
- Department of Obstetrics and Gynecology, University Hospital Centre Zagreb, Petrova ulica 13, 10 000 Zagreb, Croatia
- School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
| |
Collapse
|
2
|
Cheng J, Ruan X, Li Y, Du J, Jin F, Gu M, Zhou Q, Xu X, Yang Y, Wang H, Mueck AO. Effects of hypoxia-preconditioned HucMSCs on neovascularization and follicle survival in frozen/thawed human ovarian cortex transplanted to immunodeficient mice. Stem Cell Res Ther 2022; 13:474. [PMID: 36104746 PMCID: PMC9476266 DOI: 10.1186/s13287-022-03167-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background The massive loss of follicles in the early stage of ovarian tissue transplantation is considered a significant restriction to the efficacy of ovarian tissue cryopreservation (OTC) and transplantation (OT). The use of mesenchymal stem cells (MSCs) before transplantation of ovarian fragments shortened the hypoxic period and boosted neovascularization. Hypoxia-preconditioned MSCs can enhance the potential of angiogenesis. Can hypoxia-preconditioned human umbilical cord mesenchymal stem cell (HucMSCs) and ovarian tissue co-xenotransplantation improve more neovascularization and subsequently more follicle survival in human ovarian tissue? Methods Frozen-thawed cortical pieces from 4 patients were transplanted into the bilateral renal capsule of immune-deficient nude mice without HucMSCs or normoxia/hypoxia-preconditioned HucMSCs. Sixty-four mice were randomly distributed into 4 groups. In each group, the mice were euthanized for blood and/or graft retrieval on post-transplantation days 3 (n = 8) and 7 (n = 8), respectively. Non-grafted frozen-thawed ovarian fragment was taken for non-grafted control. Grafts were histologically processed and analysed for follicle density and atretic follicles by HE, neovascularization by CD34 and CD31 immunohistochemical staining, primordial follicle growth by Ki67 staining, and apoptosis of stromal cell and follicles by immunofluorescence using TUNEL. The ROS and TAC levels of grafted and non-grafted tissue were assessed. We evaluated the protein expression of HIF1α, VEGFA, pAkt, Akt, and GDF9 in grafted and non-grafted ovarian tissue. E2, Prog, AMH, and FSH levels in the plasma of mice were measured after 3 and 7 days of OT. Results Hypoxia-preconditioned HucMSCs positively protect the grafted ovarian tissue by significantly decreasing the apoptosis and increasing higher expression of CD31, CD34, and VEGFA for earlier angiogenesis. They are crucial to preserving the resting primordial follicle pool by modulation of follicle death. Conclusion This is the first study to demonstrate that co-transplantation of hypoxia-preconditioned HucMSC with ovarian tissue improved earlier vascularization of ovarian grafts in the early post-grafting period, which correlates with increased follicle survival and reduced apoptosis. The HIF1α/VEGFA signal pathways may play an important role in elucidating the mechanisms of action of hypoxia-preconditioned HucMSCs with regard to OT and clinical implementation.
Collapse
|
3
|
Damous LL, Shiroma ME, Carvalho AETSD, Soares-Jr JM, Krieger JE, Baracat EC. Gene expression profile in experimental frozen-thawed ovarian grafts treated with scaffold-base delivery of adipose tissue-derived stem cells. Clinics (Sao Paulo) 2022; 77:100066. [PMID: 35777300 PMCID: PMC9253596 DOI: 10.1016/j.clinsp.2022.100066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Gelfoam scaffold is a feasible and safe non-invasive technique for Adipose tissue-derived Stem Cell (ASC)-delivery in the treatment of frozen-thawed ovarian autografts. This study seeks to analyze the genes expression profile of rat frozen-thawed ovarian autografts treated with scaffold-based delivery of adipose tissue-derived stem cells. METHODS Eighteen adult Wistar rats were distributed into three groups: Control (frozen-thawed only); Group 1 (G1) and Group 2 (G2) (frozen-thawed ovaries treated with culture medium or ASC, respectively). Both treatments were performed immediately after autologous retroperitoneal transplant with scaffold-based delivery. The ovarian grafts were retrieved 30 days after transplantation. Quantitative gene expression (qPCR) for apoptosis, angiogenesis, and inflammatory cytokines (84 genes in each pathway) were evaluated by RT-PCR. Graft morphology (HE), apoptosis (cleaved-caspase-3), neoangiogenesis (VEGF), and cellular proliferation (Ki-67) were assessed. RESULTS In grafts treated with ASC, the apoptosis pathway showed the highest number of genes over-regulated - 49 genes - compared to inflammation cytokines and angiogenesis pathway - 36 and 23 genes respectively, compared to grafts treated with culture medium. Serpinb5 family was highlighted in the angiogenesis pathway and Cxcl6 in the inflammation cytokines pathway. In the apoptosis pathway, the most over-regulated gene was Capsase14. ASC treatment promoted the reduction of cleaved caspase-3 in the theca internal layer and increased cell proliferation by Ki-67 in the granulosa layer without altering VEGF. A mild inflammatory infiltrate was observed in both groups. CONCLUSION ASC therapy in rat frozen-thawed ovarian autografts promoted an abundance of genes involved with apoptosis and inflammatory cytokines without compromising the ovary graft morphology and viability for short time. Further studies are necessary to evaluate the repercussion of apoptosis and inflammation on the graft in the long term.
Collapse
Affiliation(s)
- Luciana Lamarão Damous
- Laboratório de Ginecologia Estrutural e Molecular (LIM-58), Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Marcos Eiji Shiroma
- Laboratório de Ginecologia Estrutural e Molecular (LIM-58), Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ana Elisa Teófilo Saturi de Carvalho
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (Incor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - José Maria Soares-Jr
- Laboratório de Ginecologia Estrutural e Molecular (LIM-58), Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - José Eduardo Krieger
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração (Incor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Edmund C Baracat
- Laboratório de Ginecologia Estrutural e Molecular (LIM-58), Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
4
|
Role of Stem Cells in the Ovarian Tissue Cryopreservation and Transplantation for Fertility Preservation. Int J Mol Sci 2021; 22:ijms222212482. [PMID: 34830363 PMCID: PMC8620430 DOI: 10.3390/ijms222212482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022] Open
Abstract
Although the cancer survival rate has increased, cancer treatments, including chemotherapy and radiotherapy, can cause ovarian failure and infertility in women of reproductive age. Preserving fertility throughout cancer treatment is critical for maintaining quality of life. Fertility experts should propose individualized fertility preservation methods based on the patient’s marital status, pubertal status, partner status, and the urgency of treatment. Widely practiced fertility preservation methods, including ovarian transposition and embryo and oocyte cryopreservation, are inappropriate for prepubertal girls or those needing urgent initiation of cancer treatment. Ovarian tissue cryopreservation and transplantation, an emerging new technology, may be a solution for these cancer patients. The use of stem cells in ovarian tissue cryopreservation and transplantation increases oxygenation, angiogenesis, and follicle survival rates. This review discusses the recent advances in ovarian tissue cryopreservation and transplantation with special focus on the use of stem cells to improve fertilization techniques.
Collapse
|
5
|
Lee S, Ozkavukcu S, Ku SY. Current and Future Perspectives for Improving Ovarian Tissue Cryopreservation and Transplantation Outcomes for Cancer Patients. Reprod Sci 2021; 28:1746-1758. [PMID: 33791995 PMCID: PMC8144135 DOI: 10.1007/s43032-021-00517-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/21/2021] [Indexed: 02/06/2023]
Abstract
Although advances in cancer treatment and early diagnosis have significantly improved cancer survival rates, cancer therapies can cause serious side effects, including ovarian failure and infertility, in women of reproductive age. Infertility following cancer treatment can have significant adverse effects on the quality of life. However, established methods for fertility preservation, including embryo or oocyte cryopreservation, are not always suitable for female cancer patients because of complicated individual conditions and treatment methods. Ovarian tissue cryopreservation and transplantation is a promising option for fertility preservation in pre-pubertal girls and adult patients with cancer who require immediate treatment, or who are not eligible to undergo ovarian stimulation. This review introduces various methods and strategies to improve ovarian tissue cryopreservation and transplantation outcomes, to help patients and clinicians choose the best option when considering the potential complexity of a patient's situation. Effective multidisciplinary oncofertility strategies, involving the inclusion of a highly skilled and experienced oncofertility team that considers cryopreservation methods, thawing processes and devices, surgical procedures for transplantation, and advances in technologies, are necessary to provide high-quality care to a cancer patient.
Collapse
Affiliation(s)
- Sanghoon Lee
- Moores Cancer Center, University of California San Diego, San Diego, CA, USA.
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
| | - Sinan Ozkavukcu
- Center for Assisted Reproduction, Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Seung-Yup Ku
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
6
|
Shiroma ME, Damous LL, Cotrim FP, Roa CL, Cipolla-Neto J, Reiter RJ, Baracat EC, Soares JM. Pretreatment with melatonin improves ovarian tissue cryopreservation for transplantation. Reprod Biol Endocrinol 2021; 19:17. [PMID: 33536029 PMCID: PMC7856714 DOI: 10.1186/s12958-021-00705-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/28/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUD Melatonin has anti-inflammatory and antioxidative actions at the mitochondrial level. This indole-containing molecule may protect ovarian grafts during the process of cryopreservation. Therefore, we aimed to determine whether melatonin pretreatment improves rat ovarian graft quality. METHODS Twenty-six female rats were allocated to two study groups of thirteen animals each: 1) control group: ovaries cryopreserved using the standard protocol; and 2) melatonin group: ovaries cryopreserved in a medium with melatonin. Ten rats of each group were submitted to 24-h freezing, and whole ovaries autologous and avascular transplantation with retroperitoneal placement. After postoperative (PO) day 15, daily vaginal smears were obtained for estrous cycle characterization. Between PO days 30 and 35, the animals were euthanized and ovarian grafts were recovered for histological and immunohistochemical (Ki-67, cleaved caspase-3, TUNEL, von Willebrand factor, estrogen, and progesterone receptors) analyses. The ovaries of the three remaining rats from each group were studied immediately after thawing to assess the effects of cryopreservation. ANOVA and Tukey's tests were used and the rejection level of the null hypothesis was set at 0.05 or 5% (p < 0.05). RESULTS Melatonin promoted faster restart of the estrous cycle and increased the expression of mature follicles, collagen type I, von Willebrand factor, Ki-67, and cleaved caspase-3 on corpora lutea and estrogen receptors in the ovaries as compared to control. There was a reduction in apoptosis by TUNEL on follicles, corpora lutea, and collagen type III. CONCLUSION Based on the evaluated parameters, melatonin may promote the quality of ovarian grafts. Reproductive function enhancement should be further studied.
Collapse
Affiliation(s)
- Marcos Eiji Shiroma
- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, CEP 01246-903, Brazil.
| | - Luciana Lamarão Damous
- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, CEP 01246-903, Brazil
| | - Fernanda Pereira Cotrim
- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, CEP 01246-903, Brazil
| | - Cristiane Lima Roa
- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, CEP 01246-903, Brazil
| | - José Cipolla-Neto
- Instituto de Ciencias Biomedicas ICB, Universidade de Sao Paulo, Av. Prof. Lineu Prestes, 1374 - Butantã, São Paulo, SP, CEP 05508-000, Brazil
| | - Russel Joseph Reiter
- University of Texas, Health Sciences Center, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA
| | - Edmund Chada Baracat
- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, CEP 01246-903, Brazil
| | - José Maria Soares
- Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455 - Cerqueira César, São Paulo, SP, CEP 01246-903, Brazil
| |
Collapse
|
7
|
Restoration of estrous cycles by co-transplantation of mouse ovarian tissue with MSCs. Cell Tissue Res 2020; 381:509-525. [PMID: 32424509 DOI: 10.1007/s00441-020-03204-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 03/12/2020] [Indexed: 12/13/2022]
Abstract
This study investigates the effect of bone marrow (BM-MSCs) and visceral peritoneum (VP-MSCs)-derived mesenchymal stem cells on the transplanted ovary. VP-MSCs and BM-MSCs were obtained from green fluorescent protein-expressing mice (GFP+). Six- to eight-week-old female NMRI mice were divided into four experimental groups, autograft ovarian tissue fragments (AO), autograft ovarian tissue fragments encapsulated in fibrin-collagen hydrogel (AO-H), autograft ovarian tissue fragments encapsulated in fibrin-collagen hydrogel containing BM-MSCs (AO-HB) and autograft ovarian tissue fragments encapsulated in fibrin-collagen hydrogel containing VP-MSCs (AO-HP). Intact ovary (IO) was the control group. The estrous cycles resumption time was monitored and at the third estrous cycle, the blood samples and grafted ovaries were evaluated using hormonal, histological and gene expression analysis. Onset of estrous cycles, especially at the second cycle, was earlier in AO-HB and AO-HP groups than in the AO-H group (P < 0.05). Moreover, E2 and FSH levels in AO-HB and AO-HP groups were returned to those of the intact group. However, folliculogenesis was still retarded as compared with the IO group. The gene expression of theca (Lhcgr, Cyp17a1, Gli2, Gli3 and Ptch1), granulosa (Amh and Fshr), oocyte (Zp3 and Gdf9), germ cells (Stella and Prdm1), angiogenesis (VEGF and bFGF) and apoptosis (Bax/Bcl2 and Caspase3) markers was similar in both AO-HB and AO-HP groups. Expression of Amh, Fshr, Gdf9 and VEGF increased only in the AO-HP group whereas expression of Ptch1 increased only in the AO-HB group, as compared with the AO group (P < 0.05). In conclusion, BM-MSCs or VP-MSCs can improve ovarian autotransplantation in mice with no superiority over each other.
Collapse
|
8
|
Alemzadeh E, Oryan A, Mohammadi AA. Hyaluronic acid hydrogel loaded by adipose stem cells enhances wound healing by modulating IL-1β, TGF-β1, and bFGF in burn wound model in rat. J Biomed Mater Res B Appl Biomater 2019; 108:555-567. [PMID: 31081996 DOI: 10.1002/jbm.b.34411] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 03/17/2019] [Accepted: 04/25/2019] [Indexed: 01/21/2023]
Abstract
Application of hydrogels can be an effective technique in transferring the adipose-derived stem cells (ASCs) to injured tissue and their protection from further complications. Besides, acellular dermal matrix (ADM) has successfully been used in treatment of wounds. In this study, a combination of hylauronic acid (HA) and ASCs (HA/ASCs) was applied on burn wounds and the injured area was then covered by an ADM dressing in a rat model (ADM-HA/ASCs). Wound healing was evaluated by histopathological, histomorphometrical, molecular, biochemical, and scanning electron microscopy assessments on days 7, 14, and 28 post-wounding. ADM-HA/ASCs stimulated healing significantly more than the ADM-HA and ADM treated wounds, as it led to reduced inflammation, and improved angiogenesis and enhanced granulation tissue formation. Expression of interleukin-1β (IL-1β) and transforming growth factor-β1 (TGF-β1) was lower in the ADM-HA/ASCs treated wounds than the ADM-HA and ADM groups, at the seventh post-wounding day. ADM-HA/ASCs also enhanced the expression level of TGF-β1 mRNA at 14 day post-wounding that was parallel to the experimental data from histological and biochemical assessments and confirmed the positive role of ASCs in repair of burn wounds. Additionally, increase in basic fibroblast growth factor (bFGF) expression and decreased TGF-β1 level on the 28th post-wounding day indicated the anti-scarring activity of ASCs. HA loaded by adipose stem cells can represent a promising strategy in accelerating burn wound healing.
Collapse
Affiliation(s)
- Esmat Alemzadeh
- Department of Biotechnology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Ahmad Oryan
- Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Ali A Mohammadi
- Burn and Wound Healing Research Center, Plastic and Reconstructive Ward, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
9
|
Dolmans M, Cacciottola L, Amorim CA, Manavella D. Translational research aiming to improve survival of ovarian tissue transplants using adipose tissue‐derived stem cells. Acta Obstet Gynecol Scand 2019; 98:665-671. [DOI: 10.1111/aogs.13610] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/12/2019] [Indexed: 01/28/2023]
Affiliation(s)
- Marie‐Madeleine Dolmans
- Research Center in Gynecology Institute of Experimental and Clinical Research Université Catholique de Louvain Brussels Belgium
- Gynecology Department Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Luciana Cacciottola
- Research Center in Gynecology Institute of Experimental and Clinical Research Université Catholique de Louvain Brussels Belgium
| | - Christiani A. Amorim
- Research Center in Gynecology Institute of Experimental and Clinical Research Université Catholique de Louvain Brussels Belgium
| | - Diego Manavella
- Research Center in Gynecology Institute of Experimental and Clinical Research Université Catholique de Louvain Brussels Belgium
| |
Collapse
|
10
|
Adipose derived mesenchymal stem cells improve the structure and function of autografted mice ovaries through reducing oxidative stress and inflammation: A stereological and biochemical analysis. Tissue Cell 2019; 56:23-30. [DOI: 10.1016/j.tice.2018.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/12/2018] [Accepted: 11/28/2018] [Indexed: 12/19/2022]
|
11
|
Damous LL, de Carvalho AETS, Nakamuta JS, Shiroma ME, Louzada ACS, Soares-Jr JM, Krieger JE, Baracat EC. Cell-free therapy with the secretome of adipose tissue-derived stem cells in rats' frozen-thawed ovarian grafts. Stem Cell Res Ther 2018; 9:323. [PMID: 30463630 PMCID: PMC6249760 DOI: 10.1186/s13287-018-1054-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/29/2018] [Accepted: 10/18/2018] [Indexed: 02/06/2023] Open
Abstract
The use of secretome may be a new strand of cell therapy, which is equal to or even superior to the injection of live cells, called cell-free therapy. In ovarian transplantation, this approach may be a therapeutic possibility for the ovarian graft in hypoxia. We designed the present study to evaluate whether the cell-free therapy with the secretome of adipose tissue-derived stem cells (ASCs) in rat frozen-thawed ovarian grafts could protect a graft against ischemic injury. A single dose of rat ASCs secretome or vehicle was injected into the bilateral frozen-thawed ovaries of 18 adult female rats immediately after an autologous transplant. Nine animals were used to control the cryopreservation protocol and were evaluated before and after the cryopreservation process. Daily vaginal smears were performed for estrous cycle evaluation until euthanasia on postoperative day 30. Follicle viability by trypan blue, graft morphology by HE, and apoptosis by TUNEL and cleaved-caspase-3 were assessed. No differences were found with respect to estrous cycle resumption and follicle viability (p > 0.05). However, compared with the vehicle-treated grafts, the morphology of the secretome-treated grafts was impaired, showing reduced follicular population and increased apoptosis (p < 0.05). ASC secretome impaired the rat frozen-thawed ovarian graft from ischemic injury. However, more studies are needed to evaluate the factors involved and the possibility of applying the secretome in scaffolds to optimize its use.
Collapse
Affiliation(s)
- Luciana Lamarão Damous
- Disciplina de Ginecologia, Laboratório de Biologia Estrutural e Molecular (LIM58), Faculdade de Medicina da Universidade de São Paulo, Dr Arnaldo av 455, 4nf floor, room 4119, Pacaembu, São Paulo, 01246-903, Brazil. .,Baturite St, 120. Ap 91., Aclimação, São Paulo, 01530-030, Brazil.
| | - Ana Elisa Teófilo Saturi de Carvalho
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (Incor), Faculdade de Medicina da Universidade de São Paulo, Dr Enéas de Carvalho Aguiar Av 44, 10th floor, Cerqueira Cesar, São Paulo, 05403-000, Brazil
| | - Juliana Sanajotti Nakamuta
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (Incor), Faculdade de Medicina da Universidade de São Paulo, Dr Enéas de Carvalho Aguiar Av 44, 10th floor, Cerqueira Cesar, São Paulo, 05403-000, Brazil
| | - Marcos Eiji Shiroma
- Disciplina de Ginecologia, Laboratório de Biologia Estrutural e Molecular (LIM58), Faculdade de Medicina da Universidade de São Paulo, Dr Arnaldo av 455, 4nf floor, room 4119, Pacaembu, São Paulo, 01246-903, Brazil
| | - Andressa Cristina Sposato Louzada
- Disciplina de Ginecologia, Laboratório de Biologia Estrutural e Molecular (LIM58), Faculdade de Medicina da Universidade de São Paulo, Dr Arnaldo av 455, 4nf floor, room 4119, Pacaembu, São Paulo, 01246-903, Brazil
| | - José Maria Soares-Jr
- Disciplina de Ginecologia, Laboratório de Biologia Estrutural e Molecular (LIM58), Faculdade de Medicina da Universidade de São Paulo, Dr Arnaldo av 455, 4nf floor, room 4119, Pacaembu, São Paulo, 01246-903, Brazil
| | - José Eduardo Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (Incor), Faculdade de Medicina da Universidade de São Paulo, Dr Enéas de Carvalho Aguiar Av 44, 10th floor, Cerqueira Cesar, São Paulo, 05403-000, Brazil
| | - Edmund C Baracat
- Disciplina de Ginecologia, Laboratório de Biologia Estrutural e Molecular (LIM58), Faculdade de Medicina da Universidade de São Paulo, Dr Arnaldo av 455, 4nf floor, room 4119, Pacaembu, São Paulo, 01246-903, Brazil
| |
Collapse
|
12
|
Adipose-derived mesenchymal stromal cell transplantation at the graft site improves the structure and function of autografted mice ovaries: a stereological and biochemical analysis. Cytotherapy 2018; 20:1324-1336. [DOI: 10.1016/j.jcyt.2018.09.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/15/2018] [Accepted: 09/19/2018] [Indexed: 12/26/2022]
|
13
|
Praxedes ÉCG, Lima GL, Bezerra LGP, Santos FA, Bezerra MB, Guerreiro DD, Rodrigues APR, Domingues SFS, Silva AR. Development of fresh and vitrified agouti ovarian tissue after xenografting to ovariectomised severe combined immunodeficiency (SCID) mice. Reprod Fertil Dev 2018; 30:459-468. [PMID: 28784201 DOI: 10.1071/rd17051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 07/12/2017] [Indexed: 11/23/2022] Open
Abstract
The aim of the present study was to evaluate the development of fresh and vitrified agouti ovarian tissue after xenografting to C57Bl/6 severe combined immunodeficiency (SCID) female mice. Ovaries were obtained from five female agoutis and divided into 16 fragments. Five fragments were transplanted immediately to ovariectomised SCID mice and the others were vitrified, stored for 2 weeks and transplanted only after rewarming. Tissue fragments were transplanted under the kidney capsule in recipients. The return of ovarian activity in recipients was monitored by the observation of external signs of oestrus and vaginal cytology over a period of 40 days after transplantation, after which the grafts were removed and evaluated for morphology, cell proliferation and the occurrence of DNA fragmentation. Ovarian activity returned in four of five mice that received fresh ovarian tissue from agoutis and in one of six mice that had received vitrified tissue a mean (±s.e.m.) 20.6±8.6 days after xenotransplantation. After graft removal, a predominance of primordial and primary follicles was observed in all grafts. Vitrification reduced cell proliferation and increased the occurrence of DNA fragmentation in grafted agouti ovarian tissue. In conclusion, the present study demonstrates that xenografted agouti ovarian tissue, fresh or vitrified, is able to promote the return of ovarian activity in ovariectomised SCID C57B1/6 mice. However, improvements to vitrification protocols for agouti ovarian tissue are necessary.
Collapse
Affiliation(s)
- Érica C G Praxedes
- Laboratory of Animal Germplasm Conservation, Universidade Federal Rural do Semi-Árido, BR 110, Km 47, Costa e Silva, 59625-900, Mossoró, RN, Brazil
| | - Gabriela L Lima
- Department of Animal Sciences, Instituto Federal de Educação, Ciência e Tecnologia do Ceará (IFCE), CE-292, KM 15, Gisélia Pinheiro, 63115-500, Crato-CE, Brazil
| | - Luana G P Bezerra
- Laboratory of Animal Germplasm Conservation, Universidade Federal Rural do Semi-Árido, BR 110, Km 47, Costa e Silva, 59625-900, Mossoró, RN, Brazil
| | - Fernanda A Santos
- Laboratory of Gonadal Transplantation and Embryo Production, Universidade Federal Rural do Semi-Árido, BR 110, Km 47, Costa e Silva, 59625-900, Mossoró, RN, Brazil
| | - Marcelo B Bezerra
- Laboratory of Gonadal Transplantation and Embryo Production, Universidade Federal Rural do Semi-Árido, BR 110, Km 47, Costa e Silva, 59625-900, Mossoró, RN, Brazil
| | - Denise D Guerreiro
- Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), Faculdade de Veterinária, Universidade do Ceará, Av. Paranjana 1700, Campus do Itaperi, 60714-903, Fortaleza, CE, Brazil
| | - Ana P R Rodrigues
- Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), Faculdade de Veterinária, Universidade do Ceará, Av. Paranjana 1700, Campus do Itaperi, 60714-903, Fortaleza, CE, Brazil
| | - Sheyla F S Domingues
- Laboratory of Amazon Wild Animals Biology and Medicine, Universidade Federal do Pará, Jaderlândia, 68746-360,Castanhal, PA, Brazil
| | - Alexandre R Silva
- Laboratory of Animal Germplasm Conservation, Universidade Federal Rural do Semi-Árido, BR 110, Km 47, Costa e Silva, 59625-900, Mossoró, RN, Brazil
| |
Collapse
|
14
|
|
15
|
Tavana S, Valojerdi MR, Azarnia M, Shahverdi A. Restoration of ovarian tissue function and estrous cycle in rat after autotransplantation using hyaluronic acid hydrogel scaffold containing VEGF and bFGF. Growth Factors 2016; 34:97-106. [PMID: 27362476 DOI: 10.1080/08977194.2016.1194835] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This study investigates the effect of hyaluronic acid (HA) containing VEGF and bFGF on restoration of ovarian function after ovarian autotransplantation. Twenty-four rats were randomly divided into three groups for ovarian autotransplantation: group A (ovaries without HA, VEGF and bFGF), group B (ovaries encapsulated with HA) and group C (ovaries encapsulated with HA containing VEGF and bFGF). The grafts were assessed using vaginal smears, histological, hormonal, and the genes expression analysis. The duration of first estrous cycle was shorter in group C than in group A (p < 0.01). The mean number of primordial follicles was protected in group C. The level of estradiol was higher in group A than in group C (p < 0.01). The expression level of Cellular-Myelocytomatosis (C-Myc) in group C was lower than in group B (p < 0.05). HA containing VEGF and bFGF can ensure follicular survival, decrease apoptosis and recover ovarian function after auto-transplantation.
Collapse
Affiliation(s)
- Somayeh Tavana
- a Department of Embryology , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
- b Department of Animal Biology , Faculty of Biological Sciences, Kharazmi University , Tehran , Iran , and
| | - Mojtaba Rezazadeh Valojerdi
- a Department of Embryology , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
- c Department of Anatomy , Faculty of Medical Sciences, Tarbiat Modares University , Tehran , Iran
| | - Mahnaz Azarnia
- b Department of Animal Biology , Faculty of Biological Sciences, Kharazmi University , Tehran , Iran , and
| | - Abdolhossein Shahverdi
- a Department of Embryology , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
| |
Collapse
|
16
|
Ejzenberg D, Soares Júnior JM, Baracat EC. Uterus transplant: Are we close to this reality? Rev Assoc Med Bras (1992) 2016; 62:295-6. [DOI: 10.1590/1806-9282.62.04.295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
|
17
|
San-Marina S, Voss S, Crespo-Diaz R, Wyles C, Behfar A, Stalboeger P, Janus JR. Adipose-Derived Mesenchymal Stem Cell Features in Patients with a History of Head and Neck Radiation. Laryngoscope Investig Otolaryngol 2016; 1:36-41. [PMID: 28894802 PMCID: PMC5510263 DOI: 10.1002/lio2.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 05/05/2016] [Indexed: 12/30/2022] Open
Abstract
Objectives/Hypothesis Radiation plays a prominent role in advanced stage head and neck tumors. Often, the radiated area includes adjacent nonmalignant mesenchymal tissue, which contains a mixture of cells that has been shown to accelerate wound healing. The purpose of this study is to determine the long‐term effect of radiation on the expansion potential of adipose‐derived stromal/stem cell (ADSC) tissue and on the ability of resident stem cells in this fraction to undergo phenotypic differentiation. Study Design/Methods: After institutional review board approval, 12 patients with a history of head and neck radiation and pending surgery were enrolled. Adipose tissue was collected from irradiated tissue (XRT) and nonirradiated tissue (NRT) sites. Mesenchymal stem cells were isolated from these populations, with subsequent assessment of cellular kinetics and differentiation potential between harvest sites. Results Adipose‐derived stromal/stem cells could not be isolated from XRT in six patients due to lack of in vitro cell proliferation. For the remaining six patients, overall cumulative population‐doubling time was longer for XRT relative to NRT (29.3 vs. 11.5 days; P = 0.02). However, no significant differences were observed in cell generation time or viability. When XRT and NRT ADSC fractions were grown to standardized concentrations and incubated under conditions that induce phenotypic differentiation of resident stem cells, no significant changes in chondrogenic, adipogenic, or osteogenic differentiation were observed. Conclusion These preliminary observations suggest that irradiated ADSCs close to the surgical site undergo long‐term changes in proliferative capacity. The potential for phenotypic differentiation is retained, however, in ADSCs that survive the irradiation process. Level of Evidence 2b.
Collapse
Affiliation(s)
- Serban San-Marina
- Department of Otolaryngology, Head and Neck Surgery (s.s-m., s.v., j.r.j.) Mayo Clinic Rochester Minnesota U.S.A
| | - Steve Voss
- Department of Otolaryngology, Head and Neck Surgery (s.s-m., s.v., j.r.j.) Mayo Clinic Rochester Minnesota U.S.A
| | - Ruben Crespo-Diaz
- Department of Cardiology (r.c-d., a.b., p.s.) Mayo Clinic Rochester Minnesota U.S.A
| | - Cody Wyles
- Mayo Medical School (c.w.); Mayo Clinic Rochester Minnesota U.S.A
| | - Atta Behfar
- Department of Cardiology (r.c-d., a.b., p.s.) Mayo Clinic Rochester Minnesota U.S.A
| | - Paul Stalboeger
- Department of Cardiology (r.c-d., a.b., p.s.) Mayo Clinic Rochester Minnesota U.S.A
| | - Jeffrey R Janus
- Department of Otolaryngology, Head and Neck Surgery (s.s-m., s.v., j.r.j.) Mayo Clinic Rochester Minnesota U.S.A
| |
Collapse
|
18
|
Fettback PBT, Pereira RMA, Rocha AM, Soares JM, Smith GD, Baracat EC, Serafini PC. Expression of stem cell-related genes in the endometrium and endometriotic lesions: a pilot study. Gynecol Endocrinol 2016; 32:82-6. [PMID: 26426155 DOI: 10.3109/09513590.2015.1092135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To compare the expression of stem cell-related genes in the endometrium (END), superficial endometriosis (SE), and deep infiltrating endometriosis (DIE). STUDY DESIGN We performed a prospective pilot study of six women suffering from SE and DIE who gave consent for laparoscopy surgery, endometrial biopsies, and participation in this study. Quantitative RT-PCR analysis of 84 stem cell-related genes was performed in 18 biopsy samples. RESULTS A total of 40 of 84 genes were expressed in SE and DIE, but were different from END as follows. Seven genes were over-expressed in SE and 33 genes were under-expressed in DIE compared with END. Two genes were only over-expressed in SE and three genes were only over-expressed in DIE. Six under-expressed genes were exclusively located in SE and one was only located in DIE. The remaining 31 genes were not different among the groups. There was no significant difference in gene expression between SE and DIE samples. CONCLUSION Tissue of DIE and SE appears to have similar stem cell-related genes. Nevertheless, there are differences in gene expression between SE and DIE.
Collapse
Affiliation(s)
- Paula B T Fettback
- a Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina da Universidade de São Paulo, Hospital das Clínicas , São Paulo , Brazil
| | | | - André M Rocha
- c Departments of Obstetrics and Gynecology , Urology, and Physiology, University of Michigan Medical School , Ann Arbor , MI , USA
| | - José Maria Soares
- a Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina da Universidade de São Paulo, Hospital das Clínicas , São Paulo , Brazil
| | - Gary D Smith
- c Departments of Obstetrics and Gynecology , Urology, and Physiology, University of Michigan Medical School , Ann Arbor , MI , USA
| | - Edmund C Baracat
- a Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina da Universidade de São Paulo, Hospital das Clínicas , São Paulo , Brazil
| | - Paulo C Serafini
- a Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina da Universidade de São Paulo, Hospital das Clínicas , São Paulo , Brazil
- b Huntington Centro de Medicina Reprodutiva , São Paulo , Brazil , and
| |
Collapse
|
19
|
Damous LL, Nakamuta JS, Saturi de Carvalho AET, Carvalho KC, Soares-Jr JM, Simões MDJ, Krieger JE, Baracat EC. Scaffold-based delivery of adipose tissue-derived stem cells in rat frozen-thawed ovarian autografts: preliminary studies in a rat model. J Assist Reprod Genet 2015; 32:1285-94. [PMID: 26206456 PMCID: PMC4554376 DOI: 10.1007/s10815-015-0527-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 06/30/2015] [Indexed: 12/24/2022] Open
Abstract
PURPOSE This study aimed to evaluate whether a gelatin-based Gelfoam sponge is feasible as a scaffold for adipose tissue-derived stem cell (ASC) therapy in rat frozen-thawed ovarian autografts. METHODS Two sets of studies were performed. The in vitro set evaluated ASCs' viability in the Gelfoam scaffold at different times of co-culturing (after 24, 48, 72, 96, and 120 h). The in vivo set used 20 12-week-old adult female Wistar rats. Frozen-thawed ovarian grafts were treated with ASCs delivered in Gelfoam scaffolds immediately after an autologous retroperitoneal transplant (ASCs-GS, n = 10). The controls received Gelfoam with a culture medium (GS, n = 10). Assessment of graft quality was conducted by vaginal smears (until euthanasia on the 30th postoperative day), histological analyses, follicular density, and viability and fibrosis. Immunohistochemical staining for VEGF-A expression, vascular network (vWF), apoptosis (caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL)), cell proliferation (Ki-67), and hormone receptors (estrogen and progesterone) were performed. RESULTS The cells remained viable in Gelfoam for up to 120 h of co-culturing. The graft morphology was similar among the groups. ASC therapy promoted the earlier resumption of the estrous phase (GS 16.6 ± 3 vs. ASCs-GS 12.8 ± 1.3 days) and enhanced estrogen receptors compared with the controls (p < 0.05) without interfering with the quantity and viability of the ovarian follicles, fibrosis, endothelial cells, VEGF immunoexpression, apoptosis, or cell proliferation (p > 0.05). CONCLUSION The Gelfoam scaffold could be a feasible and safe non-invasive technique for ASC delivery in the treatment of frozen-thawed ovarian autografts. Future studies should evaluate the real benefit of this treatment on the survival and endocrine activity of the graft.
Collapse
Affiliation(s)
- Luciana Lamarão Damous
- />Gynecology Discipline, Laboratory of Structural and Molecular Gynecology (LIM-58), Faculdade de Medicina da Universidade de São Paulo, Dr Arnaldo av 455, 2nd floor, room 2113, Pacaembu, São Paulo Brazil 01246-903
- />Galvão Bueno St, 499. Bloco A. Apto31, Liberdade, São Paulo Brazil 01506-000
| | - Juliana Sanajotti Nakamuta
- />Laboratory of Genetics and Molecular Cardiology, Heart Institute (Incor), Faculdade de Medicina da Universidade de São Paulo, Dr Enéas de Carvalho Aguiar Av 44, 10th floor, Cerqueira Cesar, São Paulo Brazil 05403-000
| | - Ana Elisa Teofilo Saturi de Carvalho
- />Laboratory of Genetics and Molecular Cardiology, Heart Institute (Incor), Faculdade de Medicina da Universidade de São Paulo, Dr Enéas de Carvalho Aguiar Av 44, 10th floor, Cerqueira Cesar, São Paulo Brazil 05403-000
| | - Kátia Cândido Carvalho
- />Gynecology Discipline, Laboratory of Structural and Molecular Gynecology (LIM-58), Faculdade de Medicina da Universidade de São Paulo, Dr Arnaldo av 455, 2nd floor, room 2113, Pacaembu, São Paulo Brazil 01246-903
| | - José Maria Soares-Jr
- />Gynecology Discipline, Laboratory of Structural and Molecular Gynecology (LIM-58), Faculdade de Medicina da Universidade de São Paulo, Dr Arnaldo av 455, 2nd floor, room 2113, Pacaembu, São Paulo Brazil 01246-903
| | - Manuel de Jesus Simões
- />Department of Morphology and Genetics, Universidade Federal de São Paulo (UNIFESP), Botucatu St 740. Ed. Lemos Torres, 2nd floor, Vila Clementino, São Paulo, Brazil 04023-009
| | - José Eduardo Krieger
- />Laboratory of Genetics and Molecular Cardiology, Heart Institute (Incor), Faculdade de Medicina da Universidade de São Paulo, Dr Enéas de Carvalho Aguiar Av 44, 10th floor, Cerqueira Cesar, São Paulo Brazil 05403-000
| | - Edmund C. Baracat
- />Gynecology Discipline, Laboratory of Structural and Molecular Gynecology (LIM-58), Faculdade de Medicina da Universidade de São Paulo, Dr Arnaldo av 455, 2nd floor, room 2113, Pacaembu, São Paulo Brazil 01246-903
| |
Collapse
|