Premature ovarian failure (POF) is a significant reproductive disorder characterized by the loss of ovarian function, leading to infertility and endocrine disruption. Hormone replacement therapy (HRT) remains the most commonly used clinical treatment for POF. However, in patients with a history of ovarian or breast cancer, HRT poses significant risks, necessitating the development of alternative approaches. Stem cell-based therapy has emerged as a promising option for treating female infertility disorders such as POF. This study aimed to evaluate the therapeutic effects of ovarian granulosa-like cells (OGLCs) derived from Wharton's jelly-mesenchymal stem cells (WJ-MSCs) in a POF mouse model. WJ-MSCs were successfully differentiated into OGLCs using combination with a growth factor cocktails, as confirmed by the significant upregulation of granulosa cell-specific markers (P < 0.01). To assess their therapeutic potential, POF was induced in female mice using cyclophosphamide and busulfan, and OGLCs were injected into the ovaries. After 3 weeks, vaginal smear analysis revealed restoration of estrus cycle in OGLC-treated mice. Enzyme-linked immunosorbent assay analysis demonstrated the recovery of serum 17β-estradiol and follicle-stimulating hormone levels (P < 0.05), while histological staining confirmed increased follicular development and restoration of ovarian structure. Furthermore, real-time quantitative polymerase chain reaction analysis showed a significant upregulation of genes related to follicular development and primordial follicle activation, including downstream molecules of the mTOR/PI3K pathway, following OGLCs treatment. These findings suggest that OGLCs possess a strong potential for restoring ovarian function in POF. This study provides evidence supporting the use of OGLCs as a novel cell-based therapeutic approach for female reproductive diseases.
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