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. 2023 Jul 5;16(7):964.
doi: 10.3390/ph16070964.

Dulaglutide Ameliorates Intrauterine Adhesion by Suppressing Inflammation and Epithelial-Mesenchymal Transition via Inhibiting the TGF-β/Smad2 Signaling Pathway

Affiliations

Dulaglutide Ameliorates Intrauterine Adhesion by Suppressing Inflammation and Epithelial-Mesenchymal Transition via Inhibiting the TGF-β/Smad2 Signaling Pathway

Yifan Wang et al. Pharmaceuticals (Basel). .

Abstract

Intrauterine adhesion (IUA) is a common gynecological disease with limited therapeutic options. Dulaglutide is a long-acting glucagon-like peptide-1 (GLP-1) analog with some anti-fibrotic and anti-inflammatory properties; however, its action on IUA remains uncertain. The purpose of the experiments in this study was to explore the effect of dulaglutide on IUA and to elucidate its mechanism to provide new ideas for the clinical treatment of IUA. An IUA mouse model was established via mechanical curettage and inflammation induction; mice received subcutaneous injection with three doses of dulaglutide once a day for two weeks (treatment) or equal amounts of sterile ddH2O (control), and sham-operated mice were treated similarly to the control mice. Mice were sacrificed, and uterine tissues were subjected to hematoxylin and eosin (H&E) and Masson's trichrome staining for histomorphological and pathological analyses and real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting (WB) for gene and protein expression analyses. Dulaglutide improved the shape of the uterine cavity, increased endometrial thickness and the number of glands, and significantly reduced the area of collagen fiber deposition in the endometrium. It significantly reduced collagen type I A 1 (COL1A1), interleukin-1beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), C-C motif chemokine ligand 2 (CCL2), F4/80 (macrophage), vimentin and transforming growth factor-beta (TGF-β) mRNA levels and COL1A1, IL-1β, IL-6, TNF-α, F4/80, vimentin, E-cadherin, TGF-β, and p-Smad2 protein expression levels. This study demonstrates that dulaglutide reduces inflammatory responses by inhibiting M1 macrophage polarization and inflammatory factor release and may ameliorate fibrosis by inhibiting epithelial-mesenchymal transition (EMT) via TGF-β/Smad2 signaling.

Keywords: TGF-β/Smad2; dulaglutide; endometrial fibrosis; epithelial–mesenchymal transition; inflammation; intrauterine adhesion.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Histological structures of the uterus in the six experimental groups (H&E and Masson’s trichrome staining). (B) Analysis of the fibrotic area in the endometrium in each group at 14 days after IUA model establishment. (C) RT-qPCR analysis of the relative mRNA expression levels of COL1A1 in each group. (D,E) Western blot analysis of the protein expression levels of COL1A1 in the uteri of mice in each group. Data are expressed as mean ± SD. ## p < 0.01, ### p < 0.001 vs. normal group; * p < 0.05, ** p < 0.01, and *** p < 0.001 vs. model group.
Figure 2
Figure 2
(AC) mRNA expression of IL-1β, IL-6, and TNF-α in each experimental group according to RT-qPCR analysis. (DG) Western blot analysis of the expression of IL-1β, IL-6, and TNF-α in the uteri of mice in each group. Data are expressed as the mean ± SD. ### p < 0.001 vs. normal group; * p < 0.05, ** p < 0.01, and *** p < 0.001 vs. model group.
Figure 3
Figure 3
(A,B) RT-qPCR analysis of the relative mRNA expression levels of CCL2 and ADGRE1 in each experimental group. (C,D) Western blot analysis of the protein expression level of F4/80 in the uteri of the mice in each group. Data are expressed as mean ± SD. ### p < 0.001 vs. normal group; ** p < 0.01, and *** p < 0.001 vs. model group.
Figure 4
Figure 4
(A) RT-qPCR analysis of the relative mRNA expression level of VIM in each experimental group. (BD) Western blot analysis of the protein expression levels of vimentin and E-cadherin in the uteri of the mice in each group. Data are expressed as mean ± SD. # p < 0.05, ### p < 0.001 vs. normal group; ** p < 0.01, and *** p < 0.001 vs. model group.
Figure 5
Figure 5
(A) RT-qPCR analysis of the relative mRNA expression level of TGF-β in each experimental group. (BD) Western blot analysis of the protein expression levels of TGF-β and p-Smad2 in the uteri of the mice in each group. Data are expressed as mean ± SD. ## p < 0.01, ### p < 0.001 vs. normal group. * p < 0.05, ** p < 0.01, and *** p < 0.001 vs. model group.

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References

    1. Li X., Lv H.F., Zhao R., Ying M.F., Samuriwo A.T., Zhao Y.Z. Recent developments in bio-scaffold materials as delivery strategies for therapeutics for endometrium regeneration. Mater. Today Bio. 2021;11:100101. doi: 10.1016/j.mtbio.2021.100101. - DOI - PMC - PubMed
    1. Lee W.L., Liu C.H., Cheng M., Chang W.H., Liu W.M., Wang P.H. Focus on the primary prevention of intrauterine adhesions: Current concept and vision. Int. J. Mol. Sci. 2021;22:5175. doi: 10.3390/ijms22105175. - DOI - PMC - PubMed
    1. Rout-Pitt N., Farrow N., Parsons D., Donnelley M. Epithelial mesenchymal transition (EMT): A universal process in lung diseases with implications for cystic fibrosis pathophysiology. Respir. Res. 2018;19:136. doi: 10.1186/s12931-018-0834-8. - DOI - PMC - PubMed
    1. Hu L., Ding M., He W. Emerging therapeutic strategies for attenuating tubular EMT and kidney fibrosis by targeting Wnt/β-catenin signaling. Front. Pharmacol. 2021;12:830340. doi: 10.3389/fphar.2021.830340. - DOI - PMC - PubMed
    1. Lovisa S., Genovese G., Danese S. Role of epithelial-to-mesenchymal transition in inflammatory bowel disease. J. Crohns. Colitis. 2019;13:659–668. doi: 10.1093/ecco-jcc/jjy201. - DOI - PubMed