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Exosomes Derived by SIRT1-Overexpressing Bone Marrow Mesenchymal Stem Cells Improve Pubococcygeus Muscle Injury in Rats
International Journal of Stem Cells
Published online October 31, 2021;  
© 2021 Korean Society for Stem Cell Research.

Qing Li1,*, Jinzhong Song2,*, Tingting Liu1, Zhong Niu1, Xiufang Lu1, Junhong Jia1, Bingjie Wang1, Binghui Hu1, Wanli Ma1, Xiangsheng Wang1, Dongfeng Han1, Hua Li3, Dan Su4

1Department of Anorectal Surgery, Xingtai People’s Hospital, Xingtai, China
2Department of Colorectal Medicine, Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang, China
3Department of Gastrointestinal Oncology, Xingtai People’s Hospital, Xingtai, China
4Pelvic Floor Center, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Correspondence to: Dan Su
Pelvic Floor Center, the Sixth Affiliated Hospital of Sun Yat-sen University, No. 26, Erheng Road, Yuancun, Tianhe District, Guangzhou 510080, China
Tel: +86-020-38601831, Fax: +86-020-38254020, E-mail:
Hua Li
Department of Gastrointestinal Oncology, Xingtai People’s Hospital, 16 Hongxing Road, Xingtai 054031, China
Tel: +86-020-3220-6519, Fax: +86-020-3220-6519, E-mail:
*These authors contributed equally to this work and should be considered co-first authors.
Received April 3, 2021; Revised June 6, 2021; Accepted July 20, 2021.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background and Objectives: To evaluate the effect of exosomes (Exos) derived from silent mating type information regulation 2 homolog 1 (SIRT1)-overexpressing human bone marrow mesenchymal stem cells (BMSCs) on the recovery of pubococcygeus muscle Injury.
Methods and Results: Exos isolated from SIRT1-overexpressing BMSCs (SIRT1/exos) were injected into a vaginal dilation-induced rat model of Stress urinary incontinence (SUI). The efficacy of Exos treatment on SUI was evaluated by determining the values of urodynamic parameters. The proliferation and differentiation of satellite cells (SCs) were examined by CCK-8 assay, Western blotting, and immunofluorescence staining. The mRNA and protein expression of molecules related to SC differentiation were detected by RT-qPCR and Western blotting, respectively. Treatment with SIRT1/exos significantly improved the values of abdominal leak point pressure (ALPP), maximum bladder volume (MBV), and estimated marginal mean in rats of SUI. Exposure of SIRT1/exos enhanced the proliferation, differentiation, and activation of SCs. Moreover, SIRT1/exos exhibited their positive effect on BMSCs by activating the ERK signaling.
Conclusions: Our findings demonstrated that SIRT1/exos meliorated pubococcygeus muscle injury in rats by promoting ERK pathway, which may provide a novel cell-free therapeutic strategy for SUI.
Keywords : Exosomes, SIRT1, Bone marrow mesenchymal stem cells, Pubococcygeus muscle injury