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Park HS, Chugh RM, Seok J, Cetin E, Mohammed H, Siblini H, Liakath Ali F, Ghasroldasht MM, Alkelani H, Elsharoud A, Ulin M, Esfandyari S, Al-Hendy A. Comparison of the therapeutic effects between stem cells and exosomes in primary ovarian insufficiency: as promising as cells but different persistency and dosage. Stem Cell Res Ther 2023; 14:165. [PMID: 37340468 DOI: 10.1186/s13287-023-03397-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/05/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Primary ovarian insufficiency (POI) refers to the loss of ovarian function under the age of 40 and results in amenorrhea and infertility. Our previous studies have shown that transplantation of mesenchymal stem cells (MSCs) and MSC-derived exosomes in chemotherapy-induced POI mouse ovaries can reverse the POI and eventually achieve pregnancy. Based on our recent studies, MSC-derived exosomes have almost equal therapeutic potentials as transplanted MSCs. However, it is still unclear whether exosomes can completely replace MSCs in POI treatment. For the reliable application of cell-free treatment for POI patients using exosomes, there is a need to understand whether there is any outcome and effectiveness difference between MSC and MSC-derived exosome treatment. METHODS Comparing the therapeutic effect of intravenous injection using MSCs and equal amounts of exosomes in a POI mouse model will reveal the difference between the two therapeutic resources. In this study, we induced POI in C57/BL6 mice by chemotherapy (CXT) using a standard protocol. We then injected four different doses of MSCs or equal amounts of commercialized MSC-derived exosomes by retro-orbital injection post-CXT. RESULT After MSC/exosome treatment, tissue and serum samples were harvested to analyze molecular changes after treatment, while other mice in parallel experiments underwent breeding experiments to compare the restoration of fertility. Both the MSC- and exosome-treated groups had a restored estrous cycle and serum hormone levels compared to untreated POI mice. The pregnancy rate in the MSC-treated group was 60-100% after treatment, while the pregnancy rate in the exosome-treated group was 30-50% after treatment. Interestingly, in terms of long-term effects, MSC-treated mice still showed a 60-80% pregnancy rate in the second round of breeding, while the exosome-treated group became infertile again in the second round of breeding. CONCLUSIONS Although there were some differences in the efficacy between MSC treatment and exosome treatment, both treatments were able to achieve pregnancy in the POI mouse model. In conclusion, we report that MSC-derived exosomes are a promising therapeutic option to restore ovarian function in POI conditions similar to treatment with MSCs.
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Affiliation(s)
- Hang-Soo Park
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA
| | - Rishi Man Chugh
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, 60612, USA
- Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Jin Seok
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA
| | - Esra Cetin
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA
| | - Hanaa Mohammed
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA
- Human Anatomy and Embryology Department, Faculty of Medicine, Sohag University, Sohag, 82524, Egypt
| | - Hiba Siblini
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA
| | - Farzana Liakath Ali
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA
| | | | - Hiba Alkelani
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA
| | - Amro Elsharoud
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Mara Ulin
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Sahar Esfandyari
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, 60612, USA
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave., Chicago, IL, 60637, USA.
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, 60612, USA.
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Chugh RM, Park HS, El Andaloussi A, Elsharoud A, Esfandyari S, Ulin M, Bakir L, Aboalsoud A, Ali M, Ashour D, Igboeli P, Ismail N, McAllister J, Al-Hendy A. Mesenchymal stem cell therapy ameliorates metabolic dysfunction and restores fertility in a PCOS mouse model through interleukin-10. Stem Cell Res Ther 2021; 12:388. [PMID: 34233746 PMCID: PMC8261924 DOI: 10.1186/s13287-021-02472-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/21/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder in reproductive-age women. Excessive inflammation and elevated androgen production from ovarian theca cells are key features of PCOS. Human bone marrow mesenchymal stem cells (BM-hMSC) and their secreted factors (secretome) exhibit robust anti-inflammatory capabilities in various biological systems. We evaluated the therapeutic efficacy of BM-hMSC and its secretome in both in vitro and in vivo PCOS models. METHODS For in vitro experiment, we treated conditioned media from BM-hMSC to androgen-producing H293R cells and analyzed androgen-producing gene expression. For in vivo experiment, BM-hMSC were implanted into letrozole (LTZ)-induced PCOS mouse model. BM-hMSC effect in androgen-producing cells or PCOS model mice was assessed by monitoring cell proliferation (immunohistochemistry), steroidogenic gene expression (quantitative real-time polymerase chain reaction [qRT-PCR] and Western blot, animal tissue assay (H&E staining), and fertility by pup delivery. RESULTS BM-hMSC significantly downregulate steroidogenic gene expression, curb inflammation, and restore fertility in treated PCOS animals. The anti-inflammatory cytokine interleukin-10 (IL-10) played a key role in mediating the effects of BM-hMSC in our PCOS models. We demonstrated that BM-hMSC treatment was improved in metabolic and reproductive markers in our PCOS model and able to restore fertility. CONCLUSION Our study demonstrates for the first time the efficacy of intra-ovarian injection of BM-hMSC or its secretome to treat PCOS-related phenotypes, including both metabolic and reproductive dysfunction. This approach may represent a novel therapeutic option for women with PCOS. Our results suggest that BM-hMSC can reverse PCOS-induced inflammation through IL-10 secretion. BM-hMSC might be a novel and robust therapeutic approach for PCOS treatment.
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Affiliation(s)
- Rishi Man Chugh
- Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
- Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Hang-Soo Park
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL, 60637, USA
| | - Abdeljabar El Andaloussi
- Department of Pathology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Amro Elsharoud
- Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Sahar Esfandyari
- Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Mara Ulin
- Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Lale Bakir
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Alshimaa Aboalsoud
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
- Department of pharmacology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohamed Ali
- Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
- Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Dalia Ashour
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Prosper Igboeli
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Nahed Ismail
- Department of Pathology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA
| | - Jan McAllister
- Department of Pathology, Penn State Hershey College of Medicine, Hershey, PA, USA
| | - Ayman Al-Hendy
- Department of Surgery, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA.
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL, 60637, USA.
- Department of Obstetrics and Gynecology, University of Illinois at Chicago, 820 South Wood Street, Chicago, IL, 60612, USA.
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Park HS, Chugh RM, Elsharoud A, Ulin M, Esfandyari S, Aboalsoud A, Bakir L, Al-Hendy A. Safety of Intraovarian Injection of Human Mesenchymal Stem Cells in a Premature Ovarian Insufficiency Mouse Model. Cell Transplant 2021; 30:963689720988502. [PMID: 33593078 PMCID: PMC7894598 DOI: 10.1177/0963689720988502] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Primary ovarian insufficiency (POI), a condition in which there is a loss of ovarian function before the age of 40 years, leads to amenorrhea and infertility. In our previously published studies, we demonstrated recovery of POI, correction of serum sex hormone levels, increase in the granulosa cell population, and restoration of fertility in a chemotherapy-induced POI mouse model after intraovarian transplantation of human bone marrow-derived mesenchymal stem cells (hBM-MSCs). While hBM-MSC may be a promising cell source for treatment of POI, there are few reports on the safety of stem cell-based therapy for POI. For future clinical applications, the safety of allogenic hBM-MSCs for the treatment of POI through intraovarian engraftment needs to be addressed and verified in appropriate preclinical models. In this study, we induced POI in C57/BL6 mice using chemotherapy, then treated the mice with hBM-MSCs (500,000 cells/ovary) by intraovarian injection. After hBM-MSC treatment, we analyzed the migration of engrafted cells by genomic DNA polymerase chain reaction (PCR) using a human-specific ALU repeat and by whole-body sectioning on a cryo-imaging system. We examined the possibility of transfer of human DNA from the hBM-MSCs to the resulting offspring, and compared the growth rate of offspring to that of normal mice and hBM-MSC-treated mice. We found that engrafted hBM-MSCs were detected only in mouse ovaries and did not migrate into any other major organs including the heart, lungs, and liver. Further, we found that no human DNA was transferred into the fetus. Interestingly, the engrafted cells gradually decreased in number and had mostly disappeared after 4 weeks. Our study demonstrates that intraovarian transplantation of hBM-MSCs could be a safe stem cell-based therapy to restore fertility in POI patients.
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Affiliation(s)
- Hang-Soo Park
- Department of Obstetrics and Gynecology, University of Chicago, IL, USA
| | - Rishi Man Chugh
- Department of Surgery, College of Medicine, University of Illinois at Chicago, IL, USA
| | - Amro Elsharoud
- Department of Surgery, College of Medicine, University of Illinois at Chicago, IL, USA
| | - Mara Ulin
- Department of Surgery, College of Medicine, University of Illinois at Chicago, IL, USA
| | - Sahar Esfandyari
- Department of Surgery, College of Medicine, University of Illinois at Chicago, IL, USA
| | - Alshimaa Aboalsoud
- Department of Surgery, College of Medicine, University of Illinois at Chicago, IL, USA.,Faculty of Medicine, Department of Pharmacology, Tanta University, Egypt
| | - Lale Bakir
- Department of Surgery, College of Medicine, University of Illinois at Chicago, IL, USA
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, IL, USA
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Elsharoud A, Brakta S, Elhusseini H, Al-Hendy A. A presentation of ovarian fibrothecoma in a middle-aged female with recurrent massive ascites and postmenopausal bleeding: A case report. SAGE Open Med Case Rep 2020; 8:2050313X20974222. [PMID: 33425356 PMCID: PMC7758649 DOI: 10.1177/2050313x20974222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 10/26/2020] [Indexed: 11/19/2022] Open
Abstract
Fibrothecomas are mostly benign ovarian tumors. We describe a rare case of fibrothecoma in a 59-year-old woman with a history of recurrent massive ascites and postmenopausal bleeding. Over 2 years she has undergone more than 50 paracenteses with 8–11 L withdrawn each time. She presented with a newly diagnosed pelvic mass and bilateral hydrosalpinges demonstrated on ultrasound and were confirmed with computed tomography. The pelvic magnetic resonance imaging showed a large complex cystic mass arising from the left ovary measuring 16.6 × 12.1 × 8.6 cm3 with an area of irregular mural enhancement. The patient underwent left salpingo-oophorectomy with benign frozen section results. The final pathology was consistent with cystic degeneration of fibrothecoma
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Affiliation(s)
- Amro Elsharoud
- Department of Family Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Soumia Brakta
- Department of Obstetrics and Gynecology, Section of Reproductive Endocrine, Infertility & Genetics, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Heba Elhusseini
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA
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Park HS, Chugh RM, Elsharoud A, Ulin M, Esfandyari S, Bakir L, Aboalsoud A, Al-Hendy A. SAFETY AND TOXICOLOGY STUDY AFTER INTRA-OVARIAN ENGRAFTMENT OF HUMAN BONE MARROW MESENCHYMAL STEM CELL IN CHEMOTHERAPY INDUCED POI MOUSE MODEL. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chugh RM, Park HS, Esfandyari S, Elsharoud A, Ulin M, Al-Hendy A. MESENCHYMAL STEM CELLS SECRETOME REGULATES STEROIDOGENESIS AND DECREASES ANDROGEN PRODUCTION IN PCOS CELL MODEL VIA SECRETING BMP-2. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.1182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Park HS, Ashour D, Elsharoud A, Chugh RM, Ismail N, El Andaloussi A, Al-Hendy A. Towards Cell free Therapy of Premature Ovarian Insufficiency: Human Bone Marrow Mesenchymal Stem Cells Secretome Enhances Angiogenesis in Human Ovarian Microvascular Endothelial Cells. ACTA ACUST UNITED AC 2019; 5. [PMID: 32494757 PMCID: PMC7269190 DOI: 10.24966/srdt-2060/100019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Primary Ovarian Insufficiency (POI) refers to an ovarian loss of function in women under the age of 40. Unfortunately, currently, there is no effective treatment available for POI-related infertility. Alternatives such as the use of egg donations are culturally and ethically unacceptable to many couples. Human Bone marrow-derived Mesenchymal Stem Cells (MSCs) are known for their ability to differentiate into other cell types, once primed by the organ microenvironment. Importantly MSCs produce a vast array of bioactive factors many of them have been shown to enhance neovascularization in various tissues. Recently, preliminary data from our ongoing clinical trial revealed encouraging preliminary data after autologous MSC engraftment into the ovaries of 2 POI patients with durable elevation in serum estrogen levels and increase in size of treated ovaries sustained up to one-year post cell therapy. In this study, we investigated the action of the mechanisms of MSCs treatment on a POI ovary. We designed an in vitro study using MSC secretome and Human Ovarian Endothelial Cells (HOVECs) to understand the molecular mechanisms by which MSC mediates their angiogenic properties and regenerative effects. Human primary HOVECs were treatment with MSC secretome and examined by FACS for the expression of angiogenesis markers such as Endoglin, Tie-2, and VEGF. The formation of vessels was evaluated by using a 3D Matrigel tubulogenesis assay. We observed that the expression of proliferation marker Ki67 was significantly increased under treatment with MSC secretome in HOVEC cells (P4). MSCs secretome treatment also induced significantly higher expression of several angiogenic markers such as VEGFR2, Tie2/Tek, VE-Cadherin, Endoglin, and VEGF compared to matched control (P4). Furthermore, MSC secretome significantly increased the number of branching points in tubulogenesis assay (P4). Our study suggests that MSC secretome likely contains bioactive factors that can enhance ovarian angiogenesis. Further characterization of these factors can lead to novel therapeutic options for women with premature ovarian insufficiency and other related causes of female infertility.
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Affiliation(s)
- Hang-Soo Park
- Department of Surgery, University at Illinois at Chicago, Medical College, Chicago, USA
| | - Dalia Ashour
- Department of Surgery, University at Illinois at Chicago, Medical College, Chicago, USA.,Department of Pathology, University at Illinois at Chicago, Medical College, Chicago, USA
| | - Amro Elsharoud
- Department of Surgery, University at Illinois at Chicago, Medical College, Chicago, USA
| | - Rishi Man Chugh
- Department of Surgery, University at Illinois at Chicago, Medical College, Chicago, USA
| | - Nahed Ismail
- Department of Pathology, University at Illinois at Chicago, Medical College, Chicago, USA
| | | | - Ayman Al-Hendy
- Department of Surgery, University at Illinois at Chicago, Medical College, Chicago, USA
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Chugh RM, Park HS, Elsharoud A, Ulin M, Takala H, Al-Hendy A. Bone morphogenetic protein suppresses the androgen production in PCOS theca in-vitro cell model. Fertil Steril 2019. [DOI: 10.1016/j.fertnstert.2019.07.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Park H, Ashour D, Elsharoud A, Chugh R, Al-Hendy A, El Andaloussi A. towards stem cell therapy of polycystic ovary syndrome (PCOS): therapeutic effect of human mesenchymal stem cells transplantation in pcos mouse model by regulating ovarian vascularization. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Elsharoud A, Ali M, Al-Hendy A. Relugolix. GnRH (LHRH) receptor antagonist, Treatment of uterine fibroids, Treatment of endometriosis-related pain, Treatment of prostate cancer. DRUG FUTURE 2019. [DOI: 10.1358/dof.2019.44.2.2927590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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