Interplay Between Macrophages and Endometrial Stem/Stromal Cells on Mesh Performance in Animal Models

Pelvic Organ Prolapse (POP) is the downward descent of pelvic organs into the vagina and affects more than 25% of all women. Despite the broad acceptance of synthetic mesh surgery for treating POP, complications led to FDA warnings. Tissue engineering using mesenchymal stem cells to modulate the tissue response could reduce these complications. I assessed the immunomodulatory effect of human endometrial mesenchymal stem cells (eMSC) on the macrophage response to polyamide/gelatin composite mesh in immunocompetent and immunocompromised mice. eMSC dampen the macrophage-mediated inflammatory response against implanted mesh. eMSC exerted their modulatory effects via paracrine factor secretion influencing all types of innate and adaptive immune cells in immunocompetent mice and only macrophages in immunocompromised mice.