# Suture-Mediated Delivery System Reduces the Incidence of Uterine Scarring Through the TGF-β Pathway

## TL;DR

A new suture system reduces uterine scarring by delivering TGF-β3 gene medicine during surgery.

## Contribution

A suture-based delivery system combining non-viral vectors and recombinant collagen to target uterine scarring.

## Key findings

- RhCol III and TGF-β3 were successfully loaded onto sutures and released in vitro.
- In vivo experiments showed a 39% increase in TGF-β3 and a 62.8% decrease in TGF-β1 expression in treated rats.
- The fibrosis rate decreased by 16.8%, indicating improved prevention of uterine scars.

## Abstract

In recent years, factors such as the postponement of childbearing and the relaxation of the childbearing policy have led to an increase in the proportion of cesarean sections and other intrauterine surgeries among pregnant women, further increasing the incidence of uterine scars. Currently, there is a lack of effective clinical treatment methods for uterine scars. In this study, a suture loaded with gene medicine was designed for the repair of uterine scars. Specifically, the non-viral vector Lipo8000 was first used to form a complex solution with the plasmid TGF-β3. Then, it was mixed and adsorbed with the surgical sutures pretreated with recombinant human type III collagen (RhCol III). In vitro experiments confirmed that RhCol III and the plasmid were successfully loaded onto the sutures and could be released and expressed. In vivo experiments were carried out using a rat model simulating uterine scars. The section results showed that compared with the scar model group, the expression level of TGF-β3 in the RhCol III+TGF-β3 group increased by 39%, the expression level of TGF-β1 decreased by 62.8%, and the fibrosis rate decreased by 16.8%, which has a positive effect on the prevention of uterine scars. This study integrates the therapeutic medicine into the sutures, ensuring that the medicine can come into contact with the wound site after suturing. Moreover, RhCol III and the gene medicine work synergistically to promote the repair of uterine wounds.