The Therapeutic Effects of Mesenchymal Stem Cells Derived Extracellular Vesicles on Intrauterine Adhesions

Intrauterine adhesions (IUAs), also known as Asherman syndrome, is a pathological condition characterized by the development of fibrous scar tissue within the uterine cavity, leading to menstrual abnormalities, infertility, and recurrent pregnancy loss. Current treatment options for IUAs are limited and often associated with suboptimal outcomes. In recent years, mesenchymal stem cells (MSCs) and their secreted extracellular vesicles (EVs) have emerged as potential therapeutic tools for various tissue injuries and disorders. MSCs play an important role in regeneration and repair and can differentiate into several lineages. These cells can be harvested from various sources, such as bone marrow, umbilical cord, adipose tissue, peripheral blood, and placenta. EVs are small membrane-bound vesicles containing a diverse cargo of proteins, lipids, and nucleic acids, which can be transferred to target cells to modulate their biological functions. Evidence suggests that EVs possess therapeutic properties similar to their parent cells but without the risks associated with cell-based therapies. Studies have demonstrated that EVs, by multiple pathways and mechanisms, can promote endometrial repair, reduce fibrosis, and restore normal uterine function in animal models of IUAs. Understanding the therapeutic effects of MSCs-derived EVs on IUAs could pave the way for developing novel and minimally invasive treatment options for this challenging condition. This review provides an overview of the current knowledge regarding the therapeutic potential of different sources of MSC-EVs in treating IUAs in preclinical and in vitro studies.