Intrauterine adhesion (IUA) can occur after trauma to the basal layer of the endometrium, contributing to severe complications in females, such as infertility and amenorrhea. To date, the proposed therapeutic strategies are targeted to relieve IUA, such as hysteroscopic adhesiolysis, Foley catheter balloon, and hyaluronic acid injection have been applied in the clinic. However, these approaches showed limited effects in alleviating endometrial fibrosis and thin endometrium. Mesenchymal stem cells (MSCs) can offer the potential for endometrium regeneration owing to reduce inflammation and release growth factors. On this basis, MSCs have been proposed as promising methods to treat intrauterine adhesion. However, due to the drawbacks of cell therapy, the possible therapeutic use of extracellular vesicles released by stem cells is raising increasing interest. The paracrine effect, mediated by MSCs derived extracellular vehicles (MSC-EVs), has recently been suggested as a mechanism for their therapeutic properties. Here, we summarizes the main pathological mechanisms involved in intrauterine adhesion, the biogenesis and characteristics of extracellular vesicles, explaining how these vesicles could provide new opportunities for MSCs.

中文翻译：

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间充质干细胞衍生的细胞外囊泡作为宫内粘连的无细胞疗法。

子宫内膜基底层创伤后可能会发生宫腔粘连（IUA），导致女性严重并发症，例如不孕和闭经。迄今为止，针对缓解IUA提出的治疗策略，如宫腔镜粘连松解术、Foley导管球囊、透明质酸注射等已应用于临床。然而，这些方法在缓解子宫内膜纤维化和子宫内膜薄方面效果有限。由于减少炎症和释放生长因子，间充质干细胞（MSC）可以提供子宫内膜再生的潜力。在此基础上，间充质干细胞被认为是治疗宫腔粘连的有前景的方法。然而，由于细胞疗法的缺点，干细胞释放的细胞外囊泡的潜在治疗用途引起了越来越多的兴趣。最近有人提出，由 MSC 衍生的细胞外载体 (MSC-EV) 介导的旁分泌效应是其治疗特性的一种机制。在这里，我们总结了宫腔粘连的主要病理机制、细胞外囊泡的生物发生和特征，解释了这些囊泡如何为间充质干细胞提供新的机会。