Tissue integrity and healing response in hypoestrogenic animal model treated by mesh implantation with addition of mesenchymal stem cell secretome.

Abstract

<h4>Background</h4>Pelvic organ prolapse increases in prevalence and incidence in older women and hypoestrogenic conditions. Treatment with native tissue surgery has a fairly high recurrence rate. Mesh-augmented surgery is one of the most promising treatments for pelvic organ prolapse, with high effectiveness and low recurrence. Mesh-augmented surgery has a side effect of tissue erosion. The addition of secretome is expected to improve tissue integrity and reduce tissue erosion.<h4>Aim</h4>This study aimed to investigate the effect of adding the umbilical cord mesenchymal stem cell (UC-MSC) secretome on preventing tissue inflammatory responses, improving tissue integrity, and accelerating wound healing.<h4>Methods</h4>A total of 32 female New Zealand white rabbit hypoestrogenic models were divided into two groups: the control group with normal mesh and the secretome group with artificial mesh. Hypoestrogenic models were created using the bilateral ovariectomy method. Mesh implantation was performed using a surgical method on hypoestrogenic rabbits. The animals were euthanized on days 7, 14, 28, and 90 after mesh implantation. Histopathology parameters included angiogenesis formation, fibroblast number, and collagen deposition area.<h4>Result</h4>The results of this study showed that the number of angiogenesis, fibroblast, and collagen deposition data in the secretome group showed higher significantly <i>(p</i> < 0.05) than those in the control group on days 7, 14, 28, and 90 post mesh implantation. The formation of new blood vessels (angiogenesis) in the secretome group demonstrated a mean value of 9.81 ± 2.2 compared to 0.37 ± 0.03 in the control. The number of fibroblasts in the secretome group averaged 151.00 ± 8.14, in contrast to 34.00 ± 13.37 in the control group. Collagen formation in the secretome group was also higher, with a mean value of 80.02 ± 6.71 compared to 59.49 ± 4.61 in the control group over 90 days of observation.<h4>Conclusion</h4>The administration of secretomes from UC-MSC improved tissue integrity and accelerated wound healing.