The application of stem cell biotechnology based therapeutic in Asherman Syndrome

Asherman syndrome (AS) is characterized by intrauterine adhesions (IUA) which associated with pregnancy complications and subsequent infertility disorder. Hormonal treatment and surgical operation used as traditional AS therapy. During surgery, deep damage of the basalis endometrium causes loss of stem/progenitor cells population which leading to amenorrhea, hypomenorrhea, dysmenorrhea and recurrent pregnancy loss (RPL). Nowadays, transplantation of mesenchymal stem/stromal cells (MSCs) due to their high proliferative activity, differentiation ability to various mesodermal cell lineages, immunomodulatory and secretion of the cytokines, chemokines and extracellular matrix (ECM) proteins to repair damaged tissues offer as suitable candidate to cure these patients.Human MSCs can be derived from various sources for endometrial regeneration including, bone marrow, adipose tissue, umbilical cord, menstrual blood, amniotic membrane, human embryonic stem cells (hESCs) and endometrium.Prianishnikov introduced endometrial stem cells (EnSCs) for the first time in 1978. Chan et al. isolated human EnSCs from endometrium in 2004. Later, in 2009 Gargett et al. extensively used the EnSCs in therapeutic applications. In our work, human endometrial tissue obtained following hysterectomy operation from a PCO woman after fully informed patient consent. Human EnMSCs were isolated, cultured and characterized, by immunofluorescence (IF) and flow cytometry techniques with CD105, CD90, CD73, CD44 and VIMENTIN as specific mesenchymal markers. Moreover, expression of CD166, CD10, CD105, VMENTIN, FIBRONECTIN, MHCI, CD14, MHCII genes was evaluated using RT-PCR. Our report confirms results of other studies regarding isolation, culture and characterization of human EnMSCs. In conclusion, endometrial tissue is a part of uterus with available source of MSCs with self-renewal and differentiation capacity that undergoes a cyclical regeneration every month in normal women’s life span. Therefore, human EnMSCs could be used for future novel therapeutic methods in regenerative medicine for treatment of uterine-factor infertile patients which can leads to RPL and finally resolve of surrogacy problems.