Mesenchymal stem cell transplantation improves biomechanical properties of vaginal tissue following full-thickness incision in aged rats

Pelvic organ prolapse (POP) is common among post-menopausal women and is associated with bladder, bowel, and sexual dysfunction. Surgical repair with the patients’ native tissues is sub-optimal with high reoperation rates, potentially due to diminished age-related healing. We demonstrate that systemic transplantation of mesenchymal stem cells (MSCs) improves healing of full-thickness vaginal incision in the vaginal wall of old rats, as suggested by both histological and functional analysis. Transplanted MSCs homed and survived at the surgical vaginal site. Attenuation of the injury-induced inflammatory response, increased angiogenesis, and reduced matrix metalloproteinase 9 expression were observed at the surgical site of transplanted rats. Most importantly, the functional biomechanical properties of the healed vagina, at day 30 post-injury, were improved in MSC-transplanted, compared with sham-operated non-transplanted, old rats. These results may pave the way to further translational studies toward clinical transplantation of MSCs adjuvant to POP repair for the improvement of surgical outcome. •Systemically transplanted MSCs homed to full-thickness vaginal injury in old rats•MSC transplantation attenuated the inflammatory response and increased angiogenesis•MSC transplantation attenuated MMP9 immunolocalization at the injury site•MSC transplantation improved the healed vaginal tissue biomechanical properties In this article, Reubinoff and colleagues show that systemic transplantation of MSCs after vaginal full-thickness incision in old rats was associated with homing and survival of the MSCs at the injury site. MSC transplantation attenuated the inflammatory response, increased angiogenesis, attenuated MMP9 immunolocalization at the injury site, and improved the biomechanical properties of the healed vaginal tissue.