Extracorporeal Shock Wave Therapy Combined with Platelet‐Rich Plasma during Preventive and Therapeutic Stages of Intrauterine Adhesion in a Rat Model

Yin Hua Cheng, Ni Chin Tsai, Yun Ju Chen, Pei Ling Weng, Yun Chiao Chang, Jai Hong Cheng, Jih Yang Ko, Hong Yo Kang, Kuo Chung Lan*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

8 Scopus citations

Abstract

Intrauterine adhesion (IUA) is caused by artificial endometrial damage during intrauterine cavity surgery. The typical phenotype involves loss of spontaneous endometrium recovery and angiogenesis. Undesirable symptoms include abnormal menstruation and infertility; therefore, prevention and early treatment of IUA remain crucial issues. Extracorporeal shockwave therapy (ESWT) major proposed therapeutic mechanisms include neovascularization, tissue regeneration, and fibrosis. We examined the effects of ESWT and/or platelet‐rich plasma (PRP) during preventive and therapeutic stages of IUA by inducing intrauterine mechanical injury in rats. PRP alone, or combined with ESWT, were detected an increased number of endometrial glands, elevated vascular endothelial growth factor protein expression (hematoxylin‐eosin staining and immunohistochemistry), and reduced fibrosis rate (Masson trichrome staining). mRNA expression levels of nuclear factor‐kappa B, tumor necrosis factor‐α, transforming growth factor‐β, interleukin (IL)‐6, collagen type I alpha 1, and fibronectin were reduced during two stages. However, PRP alone, or ESWT combined with PRP transplantation, not only increased the mRNA levels of vascular endothelial growth factor (VEGF) and progesterone receptor (PR) during the preventive stage but also increased PR, insulin‐like growth factor 1 (IGF‐1), and IL‐4 during the therapeutic stage. These findings revealed that these two treatments inhibited endometrial fibrosis and inflammatory markers, thereby inhibiting the occurrence and development of intrauterine adhesions.

Original languageEnglish
Article number476
JournalBiomedicines
Volume10
Issue number2
DOIs
StatePublished - 02 2022

Bibliographical note

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • EWST
  • Endometrium
  • Intrauterine adhesion
  • PRP
  • VEGF

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