Apoptotic vesicles of mesenchymal stem cells promote M2 polarization and alleviate early-onset preeclampsia via miR-191-5p

Abstract Background Macrophages play a crucial role in the development of early-onset preeclampsia (EOPE), which may be closely associated with an imbalance in macrophage M1/M2 polarization. Mesenchymal stem cell (MSC)-derived apoptotic vesicles (apoVs) have anti-inflammatory, tissue repair, and imm...

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Main Authors: Ling Li, Xu Lu, Qinghai Lian, Xiaoyun Wang, Changchang Jia, Chengfang Xu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Stem Cell Research & Therapy
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Online Access:https://doi.org/10.1186/s13287-025-04546-5
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author Ling Li
Xu Lu
Qinghai Lian
Xiaoyun Wang
Changchang Jia
Chengfang Xu
author_facet Ling Li
Xu Lu
Qinghai Lian
Xiaoyun Wang
Changchang Jia
Chengfang Xu
author_sort Ling Li
collection DOAJ
description Abstract Background Macrophages play a crucial role in the development of early-onset preeclampsia (EOPE), which may be closely associated with an imbalance in macrophage M1/M2 polarization. Mesenchymal stem cell (MSC)-derived apoptotic vesicles (apoVs) have anti-inflammatory, tissue repair, and immunomodulatory functions. MSC-apoVs may ameliorate EOPE by regulating macrophage polarization, but the underlying mechanisms remain to be clarified. Methods Macrophage infiltration and M1/M2 polarization were first analyzed in the placentas of PE patients and normal pregancies to identify macrophage alterations in EOPE placentas. MSC-apoVs were extracted and characterized. The effects of MSC-apoVs on macrophage polarization and trophoblasts invasion were validated in vivo and in vitro. miRNA transcriptomic sequencing of MSC-apoVs was conducted to identify key miRNAs involved in macrophage M2 polarization and to investigate upstream and downstream regulation factors, which were further validated in vivo and in vitro. Results The proportion of M2 macrophages was significantly reduced in EOPE placentas. MSC-apoVs carrying high levels of miR-191-5p recruited macrophages, downregulated CDK6 protein expression, stabilized mitochondrial membrane potential (MMP), and promoted M2 polarization of macrophages. This enhanced the invasion of trophoblasts and improved EOPE pregnancy outcomes in mice, including reduced blood pressure, decreased urine protein, and improved embryo quality. Overexpression of miR-191-5p mimics in MSC-apoVs further alleviated EOPE-related symptoms, whereas inhibition of miR-191-5p reduced the therapeutic effect of MSC-apoVs. Further experiments confirmed that M2 macrophages polarized by MSC-apoVs promote trophoblasts invasion by secreting platelet-derived growth factor-AB (PDGF-AB), which binds to platelet-derived growth factor receptor-beta (PDGFR-β) on trophoblasts, directly activating the downstream PI3K-AKT-mTOR signaling pathway, thereby improving EOPE. Conclusion Our findings reveal the crucial role of M2 macrophages in the pathogenesis of EOPE. MSC-apoVs with high miR-191-5p recruit macrophages, downregulate CDK6, stabilize MMP, and promote M2 polarization, increasing PDGF-AB secretion, which enhances trophoblasts invasion and thereby treat EOPE. Therefore, MSC-apoVs therapy may serve as a promising strategy to improve the prognosis of EOPE.
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spelling doaj-art-e0a753f2944d4c4b91a3bcaed524f6362025-08-20T03:46:00ZengBMCStem Cell Research & Therapy1757-65122025-07-0116112110.1186/s13287-025-04546-5Apoptotic vesicles of mesenchymal stem cells promote M2 polarization and alleviate early-onset preeclampsia via miR-191-5pLing Li0Xu Lu1Qinghai Lian2Xiaoyun Wang3Changchang Jia4Chengfang Xu5Department of Obstetrics, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Hepatic Surgery, Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Cell-Gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Gynecology, The Second Affiliated Hospital of Zhejiang University School of MedicineDepartment of Cell-Gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Obstetrics, The Third Affiliated Hospital of Sun Yat-Sen UniversityAbstract Background Macrophages play a crucial role in the development of early-onset preeclampsia (EOPE), which may be closely associated with an imbalance in macrophage M1/M2 polarization. Mesenchymal stem cell (MSC)-derived apoptotic vesicles (apoVs) have anti-inflammatory, tissue repair, and immunomodulatory functions. MSC-apoVs may ameliorate EOPE by regulating macrophage polarization, but the underlying mechanisms remain to be clarified. Methods Macrophage infiltration and M1/M2 polarization were first analyzed in the placentas of PE patients and normal pregancies to identify macrophage alterations in EOPE placentas. MSC-apoVs were extracted and characterized. The effects of MSC-apoVs on macrophage polarization and trophoblasts invasion were validated in vivo and in vitro. miRNA transcriptomic sequencing of MSC-apoVs was conducted to identify key miRNAs involved in macrophage M2 polarization and to investigate upstream and downstream regulation factors, which were further validated in vivo and in vitro. Results The proportion of M2 macrophages was significantly reduced in EOPE placentas. MSC-apoVs carrying high levels of miR-191-5p recruited macrophages, downregulated CDK6 protein expression, stabilized mitochondrial membrane potential (MMP), and promoted M2 polarization of macrophages. This enhanced the invasion of trophoblasts and improved EOPE pregnancy outcomes in mice, including reduced blood pressure, decreased urine protein, and improved embryo quality. Overexpression of miR-191-5p mimics in MSC-apoVs further alleviated EOPE-related symptoms, whereas inhibition of miR-191-5p reduced the therapeutic effect of MSC-apoVs. Further experiments confirmed that M2 macrophages polarized by MSC-apoVs promote trophoblasts invasion by secreting platelet-derived growth factor-AB (PDGF-AB), which binds to platelet-derived growth factor receptor-beta (PDGFR-β) on trophoblasts, directly activating the downstream PI3K-AKT-mTOR signaling pathway, thereby improving EOPE. Conclusion Our findings reveal the crucial role of M2 macrophages in the pathogenesis of EOPE. MSC-apoVs with high miR-191-5p recruit macrophages, downregulate CDK6, stabilize MMP, and promote M2 polarization, increasing PDGF-AB secretion, which enhances trophoblasts invasion and thereby treat EOPE. Therefore, MSC-apoVs therapy may serve as a promising strategy to improve the prognosis of EOPE.https://doi.org/10.1186/s13287-025-04546-5Early-onset preeclampsiaMesenchymal stem cellsApoptotic vesiclesMacrophagesMiR-191-5pPDGF
spellingShingle Ling Li
Xu Lu
Qinghai Lian
Xiaoyun Wang
Changchang Jia
Chengfang Xu
Apoptotic vesicles of mesenchymal stem cells promote M2 polarization and alleviate early-onset preeclampsia via miR-191-5p
Stem Cell Research & Therapy
Early-onset preeclampsia
Mesenchymal stem cells
Apoptotic vesicles
Macrophages
MiR-191-5p
PDGF
title Apoptotic vesicles of mesenchymal stem cells promote M2 polarization and alleviate early-onset preeclampsia via miR-191-5p
title_full Apoptotic vesicles of mesenchymal stem cells promote M2 polarization and alleviate early-onset preeclampsia via miR-191-5p
title_fullStr Apoptotic vesicles of mesenchymal stem cells promote M2 polarization and alleviate early-onset preeclampsia via miR-191-5p
title_full_unstemmed Apoptotic vesicles of mesenchymal stem cells promote M2 polarization and alleviate early-onset preeclampsia via miR-191-5p
title_short Apoptotic vesicles of mesenchymal stem cells promote M2 polarization and alleviate early-onset preeclampsia via miR-191-5p
title_sort apoptotic vesicles of mesenchymal stem cells promote m2 polarization and alleviate early onset preeclampsia via mir 191 5p
topic Early-onset preeclampsia
Mesenchymal stem cells
Apoptotic vesicles
Macrophages
MiR-191-5p
PDGF
url https://doi.org/10.1186/s13287-025-04546-5
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