Extracellular vesicles derived from multipotent mesenchymal stromal cells: pathogenetic rationale for therapeutic use

Martirosyan Ya.O., Kadaeva A.I., Silachev D.N., Nazarenko T.A., Matveeva P.V.

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia

The article presents a review of scientific studies of modern views on folliculogenesis and its regulation. The review covers the possibilities and prospects for the use of cell therapy in reproductive medicine, as well as possible mechanisms of influence of stem cells and their extracellular vesicles on the mechanisms of follicle recruitment. The prospects of using targeted agents in the treatment of primary ovarian insufficiency are explained by the fact that most of the ovarian primordial follicles remain dormant and inactive throughout a woman’s life. The experimental studies made it possible to identify the main signaling pathways involved in the regulation of early folliculogenesis and oogenesis. After studying the regulation of the activity of the key signaling pathways, it will be possible to develop targets in order to influence the gonadotropin-independent phase of follicle growth and to prevent such disorders of the reproductive system as primary ovarian insufficiency and age-associated decrease in the quality and quantity of oocytes. 
The article presents the analysis of the literature data and describes the possible mechanisms of the effect of cell therapy on the ovarian reserve. The review includes the data of foreign articles published in databases eLibrary.ru and PubMed on this issue.  
Conclusion: The presented information on the ways of influence of extracellular vesicles shows the prospects for the treatment of infertility in the complex patient population. It is necessary to continue research into the mechanisms of functioning and application of extracellular vesicles for expanding therapeutic options. 

Authors’ contributions: Martirosyan Ya.O., Kadaeva A.I., Silachev D.N., Nazarenko T.A., Matveeva P.V. – developing the design of the study, obtaining data for analysis, review of publications on the issue of the article, analysis of the obtained data, writing the text of the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was carried out within the framework of state assignment “Solving the problem of infertility in modern conditions by developing a clinical and diagnostic model of infertile marriage and using innovative technologies in assisted reproduction programs”.
For citation: Martirosyan Ya.O., Kadaeva A.I., Silachev D.N., Nazarenko T.A., Matveeva P.V.  Extracellular vesicles derived from multipotent mesenchymal stromal cells: pathogenetic rationale for therapeutic use.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (1): 26-33 (in Russian)


decreased ovarian reserve
primary ovarian insufficiency
extracellular vesicles
intraovarian injection
multipotent mesenchymal stromal cells


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Received 16.10.2023

Accepted 09.01.2024

About the Authors

Yana O. Martirosyan, PhD, obstetrician-gynecologist at Scientific and Clinical Department named after F. Paulsen, V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, +7(925) 124-99-99, marti-yana@yandex.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Albina I. Kadaeva, postgraduate student in obstetrics and gynecology, V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology,
Ministry of Health of the Russian Federation, +7(917)762-82-11, albina.karimovai@mail.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Denis N. Silachev, Dr. Bio. Sci., Head of the Laboratory of Cell Technologies, V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, silachevdn@genebee.msu.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Tatiana A. Nazarenko, Professor, Dr. Med. Sci., Director of the Institute of Reproductive Medicine, V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, +7(495)531-44-44, t_nazarenko@oparina4.ru, 17997, Russia, Moscow, Ac. Oparin str., 4.
Polina V. Matveeva, student, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, +7(985)974-74-51,
polina.matveeva00@gmail.ru, 119048, Russia, Moscow, Trubetskaya str., 8/2.

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