骨髓间充质干细胞外泌体调控TLR4/NF-κB信号通路缓解小鼠子宫内膜异位症研究

doi:10.3877/cma.j.issn.2095-1221.2026.03.002

目的

探究骨髓间充质干细胞外泌体（BMSC-exo）影响小鼠子宫内膜异位症（EMS）的功能及机制。

方法

小鼠子宫内膜上皮细胞（mEECs）分为BMSC-exo组（25 μg/mL BMSC-exo共孵育）和磷酸盐缓冲溶液（PBS）组（等体积PBS共孵育），EdU法检测细胞增殖率；细胞划痕和Transwell法检测细胞迁移能力。RT-qPCR检测mEECs白细胞介素-1β （IL-1β）、白细胞介素-6 （IL-6）、C-C基序趋化因子配体2 （Ccl-2）和肿瘤坏死因子-α （TNF-α）相对表达量；BALB/c小鼠分为假手术组、EMS模型组和BMSC-exo组（n = 7），EMS组和BMSC-exo组小鼠构建EMS模型，BMSC-exo组小鼠以3 μg/g的剂量每周尾静脉注射1次BMSC-exo （治疗4周），苏木精-伊红染色法（HE）染色观察小鼠EMS病灶组织病理变化；酶联免疫吸附法（ELISA）检测血清和细胞上清中炎症因子IL-1β、IL-6、Ccl-2和TNF-α；Western blot检测小鼠子宫内膜组织TLR4和NF-κB p65表达。两组间比较采用独立样本t检验；多组间比较采用单因素方差分析，组间两两比较采用Dunnett-t检验；不符合正态分布的两组间比较采用Wilcoxon Signed Rank test法；两组间多个时间点同一指标比较采用两因素重复测量方差分析。

结果

与PBS组比较，BMSC-exo组mEECs增殖率[（41.00 ± 3.61）%比（59.67 ± 2.52）%]、细胞划痕愈合率[（22.00 ± 3.00）%比（65.33 ± 5.51）%]、细胞迁移数[（82.00 ± 19.31）比（145.00 ± 9.85）个]降低（P < 0.05），IL-1β （0.18 ± 0.05比1.00 ± 0.01）、IL-6 （0.30 ± 0.09比0.99 ± 0.01）、Ccl-2 （0.27 ± 0.08比1.00 ± 0.02）和TNF-α mRNA相对表达（0.33 ± 0.08比1.00 ± 0.06）均下调（P 均 < 0.01），细胞上清液中IL-1β [（1 083.00 ± 67.68）比（1 507.00 ± 131.10） pg/mL]、IL-6[（878.70 ± 19.50）比（1 127.00 ± 75.59）pg/mL]、Ccl-2[（1 046.00 ± 56.72）比（1 298.00 ± 52.52）pg/mL]和TNF-α浓度[（1 069.00 ± 114.80）比（1 470.00 ± 165.90）pg/mL]降低（P 均 < 0.05）。与假手术组比较，EMS组小鼠子宫内膜病理损伤显著，血清炎症因子IL-1β[（2 034.00 ± 165.50）比（1 083.00 ± 125.80） pg/mL]、IL-6[（3 292.00 ± 232.30）比（1 505.00 ± 126.20）pg/mL]、Ccl-2 [（1 300.00 ± 64.50）比（939.30 ± 56.45）pg/mL]和TNF-α浓度[（545.00 ± 34.70）比（344.00 ± 41.33） pg/mL]增加（P 均 < 0.01），TLR4 （1.44 ± 0.06比0.38 ± 0.06）和NF-κB p65表达（1.18 ± 0.03比0.29 ± 0.04）上调（P 均 < 0.001）。与EMS组比较，BMSC-exo组小鼠EMS组织病灶减少，血清炎症因子IL-1β[（1 488.00 ± 202.50）比（2 034.00 ± 165.50）pg/mL]、IL-6[（2 543.00 ± 317.20）比（3 292.00 ± 232.30）pg/mL]、Ccl-2[（1 058.00 ± 57.95）比（1 300.00 ± 64.50）pg/mL]和TNF-α浓度[（415.00 ± 13.00）比（545.00 ± 34.70）pg/mL]降低（P 均 < 0.05），TLR4 （0.81 ± 0.03比1.44 ± 0.06）和NF-κB p65表达（0.81 ± 0.06比1.18 ± 0.03）下调（P 均 < 0.001）。

结论

BMSC-exo抑制TLR4/NF-κB信号通路缓解小鼠EMS。

关键词: 骨髓间充质干细胞, 外泌体, 子宫内膜异位症, 小鼠, 炎症, TLR4, NF-κB

Objective

To explore the effects and mechanisms of bone marrow mesenchymal stem cell exosomes (BMSC-exo) on endometriosis (EMS) in mice.

Methods

Mouse endometrial epithelial cells (mEECs) were divided into the BMSC-exo group (co-cultured with 25 μg/mL) and phosphate buffer saline (PBS) group (co-cultured with equal volume of PBS) . The EdU method was used to detect cell proliferation rate. Cell scratch and Transwell assays were employed to assess cell migration ability. RT-qPCR was used to detect the relative expression levels of Interleukin-1β (IL-1β) , interleukin-6 (IL-6) , chemokine 2 (Ccl-2) , and tumor necrosis factor alpha (TNF-α) in mEECs. BALB/c mice were divided into sham-operated, EMS model, and BMSC-exo groups (n = 7) . EMS and BMSC-exo groups were used to construct EMS models. Mice in the BMSC-exo group received weekly tail vein injections of BMSC-exo at a dose of 3 μg/g for 4 weeks. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of EMS lesion tissue in mice. Enzyme-linked immunosorbent assay (ELISA) was used to detect inflammatory factors IL-1β, IL-6, Ccl-2, and TNF-α in serum and cell supernatants. Western blot was used to detect the expression of TLR4 and NF-κB p65 in endometrial tissue. Comparisons between two groups were performed using the independent sample t-test. Comparisons among multiple groups were performed using one-way analysis of variance (ANOVA) , with post-hoc pairwise comparisons conducted using Dunnett's t-test. For data not following a normal distribution, comparisons between two groups were performed using the Wilcoxon signed-rank test. For the analysis of repeated measures factors between two groups, the two-way repeated measures ANOVA was used.

Results

Compared with PBS group, the proliferation rates[ (41.00 ± 3.61) % vs (59.67 ± 2.52) %], cell scratch healing rates [ (22.00 ± 3.00) %vs (65.33 ± 5.51) %], the number of migration cells (82.00 ± 19.31 vs 145.00 ± 9.85) of mEECs, the expression of IL-1β mRNA (0.18 ± 0.05 vs 1.00 ± 0.01) , IL-6 mRNA (0.30 ± 0.09 vs 0.99 ± 0.01) , Ccl-2 mRNA (0.27 ± 0.08 vs 1.00 ± 0.02) , TNF-α mRNA (0.33 ± 0.08 vs 1.00 ± 0.06) and the concentrations of IL-1β[ (1 083.00 ± 67.68) vs (1 507.00 ± 131.10) pg/mL], IL-6[ (878.70 ± 19.50) vs (1 127.00 ± 75.59) pg/mL], Ccl-2 [ (1 046.00 ± 56.72) vs (1 298.00 ± 52.52) pg/mL] and TNF-α[ (1 069.00 ± 114.80) vs (1 470.00 ± 165.90) pg/mL] in cell supernatants in the BMSC-exo group were significantly decreased (P < 0.05) , were significantly decreased (all P < 0.05) . Compared with the sham-operated group, the pathological damageof endometrium in EMS group was significantly, with increased concentrations of serum inflammatory factors IL-1β [ (2 034.00 ± 165.50) vs (1 083.00 ± 125.80) pg/mL], IL-6 [ (3 292.00 ± 232.30) vs (1 505.00 ± 126.20) pg/mL], Ccl-2 [ (1 300.00 ± 64.50) vs (939.30 ± 56.45) pg/mL] and TNF-α [ (545.00 ± 34.70) vs (344.00 ± 41.33) pg/mL] (all P < 0.01) , as well as a significantly upregulated expression of TLR4 (1.44 ± 0.06 vs 0.38 ± 0.06) and NF-κB p65 (1.18 ± 0.03 vs 0.29 ± 0.04) (all P < 0.001) . Compared with the EMS group, the BMSC-exo group showed a reduction in EMS tissue lesions, with a decrease in the expression of serum inflammatory factors IL-1β [ (1 488.00 ± 202.50) vs (2 034.00 ± 165.50) pg/mL], IL-6 [ (2 543.00 ± 317.20) vs (3 292.00 ± 232.30) pg/mL], Ccl-2 [ (1 058.00 ± 57.95) vs (1 300.00 ± 64.50) pg/mL], TNF-α [ (415.00 ± 13.00) vs (545.00 ± 34.70) pg/mL] (all P < 0.05) , and TLR4 (0.81 ± 0.03 vs 1.44 ± 0.06) , NF-κB p65 (0.81 ± 0.06 vs 1.18 ± 0.03) expression (all P < 0.001) .

Conclusion

BMSC-exo inhibits TLR4/NF-κB signaling pathway to alleviate EMS in mice.

Key words: Bone marrow mesenchymal stem cell, Exosomes, Endometriosis, Mice, Inflammation, TLR4, NF-κB

表1 引物序列信息

基因	引物序列（5'→3'）	预期扩增长度
IL-1β	上游GCAACTGTTCCTGAACTCAACT	89 bp
	下游ATCTTTTGGGGTCCGTCAACT
IL-6	上游TACCACTCCCAACAGACCTG	135 bp
	下游CAAGTGCATCATCGTTGTTCA
Ccl-2	上游GCTACAAGAGGATCACCAGCAG	146 bp
	下游GTCTGGACCCATTCCTTCTTGG
TNF-α	上游AGGCACTCCCCCAAAAGATG	145 bp
	下游CAAAGCCATCAGTGACCTAATCA
GAPDH	上游TCTCTGTCCTTGGAACATAGTCT	142 bp
	下游CAAAGCCATCAGTGACCTAATCA

表1 引物序列信息

基因	引物序列（5'→3'）	预期扩增长度
IL-1β	上游GCAACTGTTCCTGAACTCAACT	89 bp
	下游ATCTTTTGGGGTCCGTCAACT
IL-6	上游TACCACTCCCAACAGACCTG	135 bp
	下游CAAGTGCATCATCGTTGTTCA
Ccl-2	上游GCTACAAGAGGATCACCAGCAG	146 bp
	下游GTCTGGACCCATTCCTTCTTGG
TNF-α	上游AGGCACTCCCCCAAAAGATG	145 bp
	下游CAAAGCCATCAGTGACCTAATCA
GAPDH	上游TCTCTGTCCTTGGAACATAGTCT	142 bp
	下游CAAAGCCATCAGTGACCTAATCA

图1 倒置相差显微镜下观察BMSC （×100）

图2 流式细胞术检测BMSC注：a ~ e图分别为CD105、CD73、CD90、CD45和CD34表达

图3 BMSC-exo鉴定结果注：a图为透射电镜观察BMSC-exo结构（×10 000）；b图为NTA检测BMSC-exo粒径结果；c图为Western blot鉴定BMSC-exo标志蛋白

图4 BMSC-exo对mEECs增殖和迁移能力的影响注：a图为CCK8法检测mEECs增殖能力；b图为荧光显微镜下观察各组细胞增殖率（绿色为EdU染色，蓝色为DAPI染色，×200）及定量比较；c 图为倒置相差显微镜下观察各组细胞划痕愈合率（×200）及定量比较；d图为光学显微镜下观察各组细胞迁移数（结晶紫染色，×200）及定量比较；^*P < 0.05，^**P < 0.01，^***P < 0.001；n = 3

表2 BMSC-exo对mEECs IL-1β、IL-6、Ccl-2和TNF-α mRNA相对表达量的影响（

± s）

分组	实验重复次数	IL-1β	IL-6	Ccl-2	TNF-α
PBS组	3	1.00 ± 0.01	0.99 ± 0.01	1.00 ± 0.02	1.00 ± 0.06
BMSC-exo组	3	0.18 ± 0.05	0.30 ± 0.09	0.27 ± 0.08	0.33 ± 0.08
t值		26.371	14.062	14.800	10.792
P值		0.001	0.004	0.003	0.006

表2 BMSC-exo对mEECs IL-1β、IL-6、Ccl-2和TNF-α mRNA相对表达量的影响（

± s）

分组	实验重复次数	IL-1β	IL-6	Ccl-2	TNF-α
PBS组	3	1.00 ± 0.01	0.99 ± 0.01	1.00 ± 0.02	1.00 ± 0.06
BMSC-exo组	3	0.18 ± 0.05	0.30 ± 0.09	0.27 ± 0.08	0.33 ± 0.08
t值		26.371	14.062	14.800	10.792
P值		0.001	0.004	0.003	0.006

表3 BMSC-exo对mEECs上清IL-1β、IL-6、Ccl-2和TNF-α分泌的影响（

± s，pg/mL）

分组	实验重复次数	IL-1β	IL-6	Ccl-2	TNF-α
PBS组	3	1 507.00 ± 131.10	1 127.00 ± 75.59	1 298.00 ± 52.52	1 470.00 ± 165.90
BMSC-exo组	3	1 083.00 ± 67.68	878.70 ± 19.50	1 046.00 ± 56.72	1 069.00 ± 114.80
t值		4.970	5.517	5.646	3.446
P值		0.025	0.015	0.012	0.032

表3 BMSC-exo对mEECs上清IL-1β、IL-6、Ccl-2和TNF-α分泌的影响（

± s，pg/mL）

分组	实验重复次数	IL-1β	IL-6	Ccl-2	TNF-α
PBS组	3	1 507.00 ± 131.10	1 127.00 ± 75.59	1 298.00 ± 52.52	1 470.00 ± 165.90
BMSC-exo组	3	1 083.00 ± 67.68	878.70 ± 19.50	1 046.00 ± 56.72	1 069.00 ± 114.80
t值		4.970	5.517	5.646	3.446
P值		0.025	0.015	0.012	0.032

图5 BMSC-exo对mEECs的TLR4和NF-κB p65表达的影响注：a图为各组细胞TLR4相对表达量比较；b图为各组细胞NF-κB p65相对表达量比较；^***P < 0.001；n = 3

图6 BMSC-exo在EMS小鼠体内分布结果注：Ⅰ、Ⅲ、Ⅴ为不接受DiR标记的BMSC-exo回输的EMS小鼠，作为对照调仪器背景；Ⅱ、Ⅳ、Ⅵ为3只接受DiR标记的BMSC-exo回输的EMS小鼠，观察BMSC-exo在病灶分布

图7 倒置相差显微镜下观察小鼠子宫内膜组织（HE染色，×200）注：a~c分别为假手术组、EMS组、BMSC-exo组；假手术组小鼠子宫内膜上皮细胞完整；EMS模型组小鼠子宫内腺体坏死，出现炎症细胞浸润；BMSC-exo组小鼠子宫内膜组织坏死缓解，病理症状减轻

图8 EMS组和BMSC-exo组小鼠EMS病变组织重量比较注：^**P < 0.01，n = 7

表4 各组小鼠血清IL-1β、IL-6、Ccl-2和TNF-α浓度比较（

± s，pg/mL）

分组	实验重复次数	IL-1β	IL-6	Ccl-2	TNF-α
假手术组	3	1 083.00 ± 125.80	1 505.00 ± 126.20	939.30 ± 56.45	344.00 ± 41.33
EMS组	3	2 034.00 ± 165.50^a	3 292.00 ± 232.30^a	1 300.00 ± 64.50^a	545.00 ± 34.70^a
BMSC-exo组	3	1 488.00 ± 202.50^b	2 543.00 ± 317.20^b	1 058.00 ± 57.95^b	415.00 ± 13.00^b
F值		24.333	42.491	28.454	30.350
P值		0.001	0.000 3	0.000 9	0.000 7

表4 各组小鼠血清IL-1β、IL-6、Ccl-2和TNF-α浓度比较（

± s，pg/mL）

分组	实验重复次数	IL-1β	IL-6	Ccl-2	TNF-α
假手术组	3	1 083.00 ± 125.80	1 505.00 ± 126.20	939.30 ± 56.45	344.00 ± 41.33
EMS组	3	2 034.00 ± 165.50^a	3 292.00 ± 232.30^a	1 300.00 ± 64.50^a	545.00 ± 34.70^a
BMSC-exo组	3	1 488.00 ± 202.50^b	2 543.00 ± 317.20^b	1 058.00 ± 57.95^b	415.00 ± 13.00^b
F值		24.333	42.491	28.454	30.350
P值		0.001	0.000 3	0.000 9	0.000 7

图9 各组小鼠子宫内膜组织TLR4和NF-κB相对表达量比较注：a图为各组细胞TLR4相对表达量比较；b图为各组细胞NF-κB p65相对表达量比较；^***P < 0.001，n = 3

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Bone marrow mesenchymal stem cell-derived exosomes alleviate endometriosis in mice by regulating the TLR4/NF-κB signaling pathway

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Bone marrow mesenchymal stem cell-derived exosomes alleviate endometriosis in mice by regulating the TLR4/NF-κB signaling pathway