Recently, MSCs are the subject of a wide variety of clinical studies including drug/gene delivery (
28), immune modulation (
29), tissue repair (
30), and diagnosis/treatment of cancer (
31,
32). There are various tissue sources to isolate these cells; most commonly is BMSCs.
Several studies show that hEnMSCs could enhance angiogenesis (
7,
9,
18,
33). Alcayaga-Miranda et al., reported that hEnMSCs exhibited superior angiogenetic properties compared to BMSCs (
23) and the beneficial effects of hEnMSCs therapeutic angiogenesis on heart failure and critical limb ischemia are confirmed by several preclinical studies (
24-
26). However, the underlying mechanisms of the proangiogenic effects of hEnMSCs remain unclear.
The results of the current study suggested that the angiogenic effects of hEnMSCs
in vitro can be partly due to hEnMSCs exosomes. Here, hEnMSCs were successfully isolated from endometrial tissue specimens. As shown in
Figure 1B, the cells positively expressed MSC markers such as CD90, CD105, and CD146by 98.4%, 76.7%, and 46.5%, respectively. The isolated cells were negative for expression of hematopoietic cell markers such as CD31 (1.97%), CD34 (3.02%), and CD45 (2.11%). Then exosomes were isolated from culture medium of hEnMSCs. Total yield of extracted exosomes was nearly 1 mg/mL. As shown in
Figures 2A and
C, exosomes isolated from hEnMSCs were heterogeneous in size, with approximate diameter of 30 to 150 nm. Immonobloting data showed that the exosomes were positive for the surface marker protein CD63. In addition, hEnMSC-derived exosomes could incorporate into the cytoplasm of endothelial cells (
Figure 3A) where they enhanced proliferation, migration, and proliferative gene expression (
Figure 4).
As shown in
Figure 3B, image analysis of fluorescence microscope indicated that more exosomes were internalized into endothelial cells by increasing incubation time and concentration of exosomes. Therefore, cell proliferation was investigated in the presence of increasing concentrations of hEnMSC-derived exosomes at different incubation time. It was observed that more cellular uptake of hEnMSC-derived exosomes led to more endothelial cell proliferation and higher expression levels of proliferative genes (PCNA and Ki-67). However, approximately equal cell proliferation and gene expression levels in HUVECs treated with 150 and 200 μg/mL hEnMSC-derived exosomes can be due to high cell confluence and contact inhibition (
Figure 4A and
B).
The MTT and scratch wound healing data showed that 150 and 200 μg/mL hEnMSC-derived exosomes increased endothelial cell proliferation much more than other concentrations, which led to much faster cell proliferation and migration; hence, the scratches were completely filled after 12 hours of treatment (
Figure 4C). After 24 hours of treatment, it was observed that cell wells were filled with cellular debris due to extremely large proliferation of cells and their multi-layered growth.
In addition, the ability of extremely increased cell proliferation in the presence of 150 and 200 μg/mL hEnMSC-derived exosomes resulted in the inhibition of endothelial cell angiogenesis onto Matrigel. Nevertheless, 100 μg/mL hEnMSC-derived exosomes was the optimal concentration that significantly increased endothelial cell proliferation as well as migration and angiogenic activity, as shown in
Figures 4D and
5A.
Moreover, hEnMSC-derived exosomes induced tube forming colonies and angiogenic gene expression, suggesting that hEnMSC-derived exosomes can be partly responsible for the angiogenic effects of hEnMSCs.
It was observed that hEnMSC-derived exosomes enhanced endothelial cell angiogenesis in a dose dependent manner. Endothelial cell colony score significantly increased only in the presence of 100 μg/mL hEnMSC-derived exosomes. Interestingly, it was observed that endothelial cells treated with 100 μg/mL hEnMSC-derived exosomes significantly increased the number of tube forming colonies, and also reduced the length of the tubes (
Figure 5A and
B).
The expression levels of angiogenic genes (Tie2, Ang1, Ang2, and VEGF) increased in endothelial cells treated with hEnMSC-derived exosomes compared to untreated cells (
Figure 5C). There is the possibility that the difference in the expression levels of these genes in endothelial cells in the presence of different concentrations of exosomes lead to differences in the angiogenic activity of cells.
Besides, analysis of tube formation images showed that hEnMSC-derived exosomes led to increased tubes branched out from each colony. However, the mechanisms by which hEnMSC-derived exosomes enhance these angiogenic activities of endothelial cells are studied continuously.
The components and hence the effects of exosomes on their recipient cells can vary depending on the tissue source and environmental context of MSCs. Exosomes can carry various molecules and exert their biological effects via transporting these molecules to recipient cells. Here, for the first time, it was demonstrated that in addition to growth and migration, hEnMSC-derived exosomes can enhance angiogenesis of endothelial cells. These results provide the first evidence for the potential of hEnMSC exosomes in wound healing. However, the discovery of the exosome components and exact molecular mechanisms responsible for these stimulatory effects of hEnMSC exosomes are suggested. The study on signaling pathways and key factors involved in angiogenesis after treatment of cells with these exosomes may be helpful.
5.1. Conclusions
In summary, the current study findings suggested that the hEnMSC-derived exosomes were the positive regulator of angiogenesis in a dose dependent manner and might be promising tools to apply in wound healing, and treatment of vascular disease.