Effect of Zhuyun I Recipe Capsule Enema on the Immune Microenvironment of the Endometrium during Implantation Window in Rats

Abstract

Background. Preterm birth is the leading cause of neonatal death, and there are no effective clinical means for the prevention and treatment of spontaneous preterm birth, mainly because the mechanism for labor initiation has not been fully elucidated. Objective. The effect of enucleation with Zhuyun I Recipe Capsule enema (ZRC) on the maternal-fetal interface microenvironment in SD rats with kidney deficiency and blood stasis. Methods. In this study, poor endometrial tolerance was induced by hydroxyurea and epinephrine in SD rats with kidney deficiency and blood stasis type of endometrium, and gavage with norethindrone (estradiol) or Bamboo Rhythm No.1 formula. HOXA10 mRNA levels were measured by qPCR. In addition, the expression of IL-6, VEGF, TGF–β, and IGFBP-1 in the uterus was detected by IHC and ELISA. Results. Hydroxyurea- and epinephrine-induced PER was associated with low levels of HOXA10 in the endometrium and reduced levels of IL-6, TGF-β, VEGF, and IGFBP-1 in the endometrium. These were abolished by ZRC and Progynova treatment compared to PER rats, resulting in a dramatic increase in the levels of HOXA10 mRNA, IL-6, TGF-β, VEGF, and IGFBP-1 proteins. Conclusions. ZRC improves metaplasticization of endometrial stromal cells and promotes angiogenesis in rats with kidney deficiency and blood stasis. The moderate dose of kidney tonic to promote blood circulation method is superior in promoting angiogenesis, facilitating the establishment and maintenance of pregnancy, limiting trophoblast invasion of metaplasia, reducing miscarriage, and improving pregnancy rate.