Administration of injectable platelet-rich fibrin improved repair of thin endometrium via mitochondria in a rat model.
6 affiliations
- 1Reproductive Medicine Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China. [email protected].
- 2First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
- 3Reproductive Medicine Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
- 4Department of Joint Surgery, Shanghai East Hospital, Shanghai Institute of Stem Cell Research and Clinical Translation & Institute for Regenerative Medicine, Tongji University School of Medicine, Shanghai, China.
- 5School of Medicine, Jianghan University, Wuhan, Hubei, China.
- 6Medical Center of Diagnosis and Treatment for Cervical Disease, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China. [email protected].
Abstract
Background
Thin endometrium(TE) has been widely recognized as a critical factor contributing to reduced success rates of assisted reproductive technology (ART). In recent years, platelet-rich plasma (PRP) has been extensively employed in the treatment of thin endometrium; however, its underlying mechanisms remain poorly understood, and its clinical efficacy remains controversial. Given the superior therapeutic outcomes demonstrated by platelet concentrates (PCs) in regenerative medicine, the present study aimed to investigate the therapeutic potential and mechanistic basis of injectable platelet-rich fibrin (i-PRF) in an ethanol‑induced rat model of thin endometrium.Methods
i-PRF was prepared from human blood and characterized for growth factor release and microstructure. Rats were divided into control, Model, Ethanol + NS, and Ethanol+i-PRF groups.Endometrial morphology was assessed by H&E and immunohistochemistry. Receptivity was evaluated by LIF/VEGF expression and embryo implantation counts. In vitro, endometrial stromal cells (ESCs) were co-cultured with platelets, and mitochondrial transfer was tracked using MitoTracker®. Platelet mitochondrial respiration was inhibited with oligomycin/FCCP to assess functional contribution.Results
i-PRF released VEGF-A, TGF-β1, and PDGF-AB for up to 15 days (peak at 7 days), with a dense fibrin network entrapping abundant platelets. Ethanol injection significantly reduced endometrial thickness from 409.27 ± 55.86 μm to 104.48 ± 57.03 μm and decreased gland number from 22.4 ± 4.34 to 9.2 ± 3.77 (both p < 0.05).Administration of i-PRF reversed these pathological changes, restoring endometrial thickness to 464.11 ± 27.1 μm and gland count to 29.0 ± 9.41 (*p* < 0.05 vs. model). Immunohistochemical analysis revealed that i-PRF treatment increased the abundance of vimentin⁺,cytokeratin 18⁺ (CK-18⁺) and ki-67⁺ cells and enhanced the expression of leukemia inhibitory factor (LIF) and vascular endothelial growth factor (VEGF). Compared with the model group, the Ethanol + i‑PRF group exhibited a markedly higher embryo number (3.88 ± 3.91, P < 0.001); although this value was lower than that of the control group (5.00 ± 3.46), the difference did not reach statistical significance (P > 0.05). In vitro co-culture of endometrial stromal cells (ESCs) with platelets promoted ESC proliferation and VEGF secretion. Confocal microscopy confirmed the direct transfer of platelet mitochondria to ESCs. Inhibition of platelet mitochondrial respiration did not block ESC proliferation but significantly suppressed VEGF and vimentin expression (p < 0.05).Conclusions
i-PRF effectively repairs thin endometrium in a rat model, and mitochondrial transfer from platelets to ESCs plays a key role in promoting endometrial regeneration. These findings support i-PRF as a promising therapy for TE.
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BibTeX
@article{tian2026administration,
title = {{Administration of injectable platelet-rich fibrin improved repair of thin endometrium via mitochondria in a rat model.}},
author = {Haiqing Tian and Yixuan Zhu and Haozhe Ma and Nan Su and Manli Zhang and Xiaolin La and Lei Cui and Zijian Zhang and Jing Dong and Mengjie Zhang},
journal = {Stem cell research \& therapy},
year = {2026},
month = jul,
doi = {10.1186/s13287-026-05181-4},
url = {https://europepmc.org/article/MED/42897588},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Administration of injectable platelet-rich fibrin improved repair of thin endometrium via mitochondria in a rat model.
AU - Haiqing Tian
AU - Yixuan Zhu
AU - Haozhe Ma
AU - Nan Su
AU - Manli Zhang
AU - Xiaolin La
AU - Lei Cui
AU - Zijian Zhang
AU - Jing Dong
AU - Mengjie Zhang
PY - 2026
DA - 2026/07/01
JO - Stem cell research & therapy
DO - 10.1186/s13287-026-05181-4
UR - https://europepmc.org/article/MED/42897588
AB - Background Thin endometrium(TE) has been widely recognized as a critical factor contributing to reduced success rates of assisted reproductive technology (ART). In recent years, platelet-rich plasma (PRP) has been extensively employed in the treatment of thin endometrium; however, its underlying mechanisms remain poorly understood, and its clinical efficacy remains controversial. Given the superior therapeutic outcomes demonstrated by platelet concentrates (PCs) in regenerative medicine, the present study aimed to investigate the therapeutic potential and mechanistic basis of injectable platelet-rich fibrin (i-PRF) in an ethanol‑induced rat model of thin endometrium.Methods i-PRF was prepared from human blood and characterized for growth factor release and microstructure. Rats were divided into control, Model, Ethanol + NS, and Ethanol+i-PRF groups.Endometrial morphology was assessed by H&E and immunohistochemistry. Receptivity was evaluated by LIF/VEGF expression and embryo implantation counts. In vitro, endometrial stromal cells (ESCs) were co-cultured with platelets, and mitochondrial transfer was tracked using MitoTracker®. Platelet mitochondrial respiration was inhibited with oligomycin/FCCP to assess functional contribution.Results i-PRF released VEGF-A, TGF-β1, and PDGF-AB for up to 15 days (peak at 7 days), with a dense fibrin network entrapping abundant platelets. Ethanol injection significantly reduced endometrial thickness from 409.27 ± 55.86 μm to 104.48 ± 57.03 μm and decreased gland number from 22.4 ± 4.34 to 9.2 ± 3.77 (both p < 0.05).Administration of i-PRF reversed these pathological changes, restoring endometrial thickness to 464.11 ± 27.1 μm and gland count to 29.0 ± 9.41 (*p* < 0.05 vs. model). Immunohistochemical analysis revealed that i-PRF treatment increased the abundance of vimentin⁺,cytokeratin 18⁺ (CK-18⁺) and ki-67⁺ cells and enhanced the expression of leukemia inhibitory factor (LIF) and vascular endothelial growth factor (VEGF). Compared with the model group, the Ethanol + i‑PRF group exhibited a markedly higher embryo number (3.88 ± 3.91, P < 0.001); although this value was lower than that of the control group (5.00 ± 3.46), the difference did not reach statistical significance (P > 0.05). In vitro co-culture of endometrial stromal cells (ESCs) with platelets promoted ESC proliferation and VEGF secretion. Confocal microscopy confirmed the direct transfer of platelet mitochondria to ESCs. Inhibition of platelet mitochondrial respiration did not block ESC proliferation but significantly suppressed VEGF and vimentin expression (p < 0.05).Conclusions i-PRF effectively repairs thin endometrium in a rat model, and mitochondrial transfer from platelets to ESCs plays a key role in promoting endometrial regeneration. These findings support i-PRF as a promising therapy for TE.
SN - 1757-6512
ER -