Objective To investigate the therapeutic effect of different doses of exosomes derived from bone marrow mesenchymal stem cells (BMSCs) on peritoneal fibrosis, and to find out the optimal therapeutic dose and timing of BMSCs exosome therapy. Methods A mouse model of peritoneal fibrosis induced by high concentration of glucose in peritoneal dialysate was established and divided into the normal control group, exosome group, peritoneal fibrosis group and peritoneal fibrosis + exosome group. The exosome group was treated by giving exosomes at 6 time points and 4 different exosome doses to determine the optimal therapeutic dose and timing. Results Pathological changes of peritoneal fibrosis in the mouse model induced by high concentration of glucose in peritoneal dialysate were observed at the 28th day and became worse with prolongation of the treatment, suggesting that the BMSCs exosome therapy may be preferable from the 28th day. Administration of the exomes at the 28th day, peritoneal thickness and collagen I expression had no differences between the exomes 50 μg/kg and 100 μg/kg groups (t=0.540, P=0.705; t=1.031, P=0.360) but peritoneal fibrosis alleviated significantly in exomes 200 μg/kg and 400 μg/kg groups (t=5.071, P=0.005; t=5.226, P=0.005), as compared with those in the peritoneal fibrosis group. However, there was no significant difference in improvement of peritoneal fibrosis between exomes 200 μg/kg group and 400 μg/kg group (t=1.540, P=0.280). These results suggested that exomes 200 μg/kg may be the optimal dosage of peritoneal fibrosis therapy. Further exploration of the timing of exosome therapy showed that peritoneal thickening could be significantly reduced by the exosome therapy at the 28th day or at the 35th day (t=4.608, P=0.007; t=4.608, P=0.007), and exosome therapy at the 28th day plus at the 35th day was more effective than the single treatment at the 28th day or at the 35th day (t=5.730, P=0.003; t=5.730, P=0.003). These results suggested that the optimal exosome therapy was given at the 28th day plus at the 35th day for mouse peritoneal fibrosis model. Conclusion This study showed that the optimal treatment time of BMSCs exosomes for peritoneal fibrosis mice model was preferable at the 28th day plus at the 35th day, and the optimal dose was 200 μg/kg.
WANG Xiao-Yue
,
YU Fang
,
CAI Qing-Li
,
LUO Jia
,
CHEN Juan
,
BAI Li-Hua
,
CHEN Jia
,
HE Ya-Ni
,
CHEN Ke-Hong
. Timeliness and dose-effectiveness of exosomes in the treatment of peritoneal dialysis-associated peritoneal fibrosis in mice [J]. Chinese Journal of Blood Purification, 2023
, 22(07)
: 516
-521
.
DOI: 10.3969/j.issn.1671-4091.2023.07.009
1 Morelle J, Devuyst O. Water and solute transport across the peritoneal membrane. Curr Opin Nephrol Hypertens. 2015 Sep;24(5):434-43.
2 Devuyst O, Margetts PJ, Topley N. The pathophysiology of the peritoneal membrane. J Am Soc Nephrol. 2010 Jul;21(7):1077-85.
3 Ma X, Shi Y, Tao M, Jiang X, Wang Y, Zang X, Fang L, Jiang W, Du L, Jin D, Zhuang S, Liu N. Analysis of risk factors and outcome in peritoneal dialysis patients with early-onset peritonitis: a multicentre, retrospective cohort study. BMJ Open. 2020 Feb 13;10(2):e029949.
4 Wang Y, Shi Y, Tao M, Zhuang S, Liu N. Peritoneal fibrosis and epigenetic modulation.Perit Dial Int.2021Mar;41(2):168-178.
5 Samsonraj RM, Raghunath M, Nurcombe V, Hui JH, van Wijnen AJ, Cool SM. Concise Review: Multifaceted Characterization of Human Mesenchymal Stem Cells for Use in Regenerative Medicine. Stem Cells Transl Med. 2017 Dec;6(12):2173-2185.
6 Sid-Otmane C, Perrault LP, Ly HQ. Mesenchymal stem cell mediates cardiac repair through autocrine, paracrine and endocrine axes. J Transl Med. 2020 Sep 1;18(1):336.
7 Thongboonkerd V. Roles for Exosome in Various Kidney Diseases and Disorders. Front Pharmacol. 2020 Jan 31;10:1655.
8 Trohatou O, Roubelakis MG. Mesenchymal Stem/Stromal Cells in Regenerative Medicine: Past, Present, and Future. Cell Reprogram. 2017 Aug;19(4):217-224.
9 Zou XY, Yu Y, Lin S, Zhong L, Sun J, Zhang G, Zhu Y. Comprehensive miRNA Analysis of Human Umbilical Cord-Derived Mesenchymal Stromal Cells and Extracellular Vesicles. Kidney Blood Press Res. 2018;43(1):152-161.
10 Alatab S, Najafi I, Atlasi R, Pourmand G, Tabatabaei-Malazy O, Ahmadbeigi N. A systematic review of preclinical studies on therapeutic potential of stem cells or stem cells products in peritoneal fibrosis. Minerva Urol Nefrol. 2018 Apr;70(2):162-178.
11汪晓月, 蔡青利,喻芳,罗佳,王梨名,陈佳,陈客宏,何娅妮. 骨髓间充质干细胞外泌体治疗改善高糖腹透液引起的小鼠腹膜纤维化[J].陆军军医大学学报,2022,44(22) (in Chinese).
12 Yu M, Shi J, Sheng M. Exosomes: The New Mediator of Peritoneal Membrane Function. Kidney Blood Press Res. 2018;43(3):1010-1022.
13 Terri M, Trionfetti F, Montaldo C, Cordani M, Tripodi M, Lopez-Cabrera M, Strippoli R. Mechanisms of Peritoneal Fibrosis: Focus on Immune Cells-Peritoneal Stroma Interactions. Front Immunol. 2021 Mar 29;12:607204.
14 Zhou Q, Bajo MA, Del Peso G, Yu X, Selgas R. Preventing peritoneal membrane fibrosis in peritoneal dialysis patients. Kidney Int. 2016 Sep;90(3):515-24.
15 Kalluri R, LeBleu VS. The biology, function, and biomedical applications of exosomes. Science. 2020 Feb 7;367(6478):eaau6977.
16 Roy S, Hochberg FH, Jones PS. Extracellular vesicles: the growth as diagnostics and therapeutics; a survey. J Extracell Vesicles. 2018 Feb 26;7(1):1438720.
17 Yeagy BA, Cherqui S. Kidney repair and stem cells: a complex and controversial process. Pediatr Nephrol. 2011 Sep;26(9):1427-34.
18 Yang J, Liu XX, Fan H, Tang Q, Shou ZX, Zuo DM, Zou Z, Xu M, Chen QY, Peng Y, Deng SJ, Liu YJ. Extracellular Vesicles Derived from Bone Marrow Mesenchymal Stem Cells Protect against Experimental Colitis via Attenuating Colon Inflammation, Oxidative Stress and Apoptosis. PLoS One. 2015 Oct 15;10(10):e0140551.
19 Keshtkar S, Azarpira N, Ghahremani MH. Mesenchymal stem cell-derived extracellular vesicles: novel frontiers in regenerative medicine. Stem Cell Res Ther. 2018 Mar 9;9(1):63.
20 Ebrahim N, Ahmed IA, Hussien NI, Dessouky AA, Farid AS, Elshazly AM, Mostafa O, Gazzar WBE, Sorour SM, Seleem Y, Hussein AM, Sabry D. Mesenchymal Stem Cell-Derived Exosomes Ameliorated Diabetic Nephropathy by Autophagy Induction through the mTOR Signaling Pathway. Cells. 2018 Nov 22;7(12):226.
21 Wang J, Wu H, Peng Y, Zhao Y, Qin Y, Zhang Y, Xiao Z. Hypoxia adipose stem cell-derived exosomes promote high-quality healing of diabetic wound involves activation of PI3K/Akt pathways. J Nanobiotechnology. 2021 Jul 7;19(1):202.
22 Hu Y, Tao R, Chen L, Xiong Y, Xue H, Hu L, Yan C, Xie X, Lin Z, Panayi AC, Mi B, Liu G. Exosomes derived from pioglitazone-pretreated MSCs accelerate diabetic wound healing through enhancing angiogenesis. J Nanobiotechnology. 2021 May 21;19(1):150.