Observation on the Effect of Mesenchymal Stem Cell-derived Extracellular Vesicles in the Prevention and Treatment of Oral Ulcers after Kidney Transplantation

WU Zhengmin; ZHENG Chunyan; XU Yilian

doi:10.3969/j.issn.1002-3429.2024.03.026

Abstract：Objective To observe the effectiveness of mesenchymal stem cell-derived extracellular vesicles(MSC-EVs)in the prevention and treatment of oral ulcers after kidney transplantation.Methods A total of 100 patients ad-mitted from October 2021 to April 2022 and underwent kidney transplantation were selected to analyze the incidence of oral ul-cers.Patients with oral ulcers were divided into the observation group(n =20)and the control group(n =20)based on dif-ferent intervention methods.The control group was given normal saline for oral care,and the observation group was given mes-enchymal stem cell exocrine spray after regular care for 7 consecutive days.The treatment effectiveness,oral ulcer and recov-ery status of the two groups(recovery time of food intake,pain disappearance time,ulcer healing time)were compared be-tween the two groups.The oral pH value,saliva immunoglobulin[secretory immunoglobulin A(sIgA),lysozyme(Lys),im-munoglobulin G(IgG)],serum inflammatory factors[interleukin-6(IL-6),transforming growth factor-β(TGF-β)],pros-taglandin E2(PGE2),tumor necrosis factor-α(TNF-α)],oral ulcer Visual Analog Scale(VAS)pain score,Oral Assess-ment Guidelines(OAG)score,and Oral Health Profile-14(OHIP-14)Scale score of the two groups before treatment and at 3 and 7 days after treatment were compared.Results Among the 100 patients who underwent kidney transplantation,40 de-veloped oral ulcers.The total effective rate of the observation group was 95.00%(19/20),which was higher than that[65.00%(13/20)]of the control group(P<0.05).The observation group had shorter recovery time of food intake,pain disappearance time,and ulcer healing time than the control group(P<0.05,P<0.01).At 3 and 7 days after treatment,the pH value and saliva sIgA levels in the observation group were higher than those in the control group,while the saliva Lys and IgG levels were lower than those in the control group(P<0.05,P<0.01).The levels of serum IL-6,TGF-β,PGE2,and TNF-α in the observation group were lower than those of the control group at 3 and 7 days after treatment(P<0.01).At 3 and 7 days after treatment,the OAG score,VAS score,and OHIP-14 score of the saliva sIgA group were lower than those of the control group(P<0.05,P<0.01).Conclusion The incidence of oral ulcers after kidney transplantation is relatively high,and the application of MSC-EVs is effective in the treatment of oral ulcers after kidney transplantation.It can shorten the duration of pain and ulcer healing time,alleviate inflammatory reactions,and improve the oral health status of patients.