View an example
When you place an order, you can specify your field of study and we’ll match you with an editor who has familiarity with this area.
However, our editors are language specialists, not academic experts in your field. Your editor’s job is not to comment on the content of your dissertation, but to improve your language and help you express your ideas as clearly and fluently as possible.
This means that your editor will understand your text well enough to give feedback on its clarity, logic and structure, but not on the accuracy or originality of its content.
Good academic writing should be understandable to a non-expert reader, and we believe that academic editing is a discipline in itself. The research, ideas and arguments are all yours – we’re here to make sure they shine!
After your document has been edited, you will receive an email with a link to download the document.
The editor has made changes to your document using ‘Track Changes’ in Word. This means that you only have to accept or ignore the changes that are made in the text one by one.
It is also possible to accept all changes at once. However, we strongly advise you not to do so for the following reasons:
You choose the turnaround time when ordering. We can return your dissertation within 24 hours , 3 days or 1 week . These timescales include weekends and holidays. As soon as you’ve paid, the deadline is set, and we guarantee to meet it! We’ll notify you by text and email when your editor has completed the job.
Very large orders might not be possible to complete in 24 hours. On average, our editors can complete around 13,000 words in a day while maintaining our high quality standards. If your order is longer than this and urgent, contact us to discuss possibilities.
Always leave yourself enough time to check through the document and accept the changes before your submission deadline.
Scribbr is specialised in editing study related documents. We check:
Calculate the costs
The fastest turnaround time is 24 hours.
You can upload your document at any time and choose between four deadlines:
At Scribbr, we promise to make every customer 100% happy with the service we offer. Our philosophy: Your complaint is always justified – no denial, no doubts.
Our customer support team is here to find the solution that helps you the most, whether that’s a free new edit or a refund for the service.
Yes, in the order process you can indicate your preference for American, British, or Australian English .
If you don’t choose one, your editor will follow the style of English you currently use. If your editor has any questions about this, we will contact you.
✂️ The Future of Marketing Is Personal: Personalize Experiences at Scale with Ninetailed AI Platform Ninetailed AI →
What is a control group in an experiment.
A control group is a set of subjects in an experiment who are not exposed to the independent variable. The purpose of a control group is to serve as a baseline for comparison. By having a group that is not exposed to the treatment, researchers can compare the results of the experimental group and determine whether the independent variable had an impact.
In some cases, there may be more than one control group. This is often done when there are multiple treatments or when researchers want to compare different groups of subjects. Having multiple control groups allows researchers to isolate the effect of each treatment and better understand how each one works.
Control groups are an important part of any experiment, as they help ensure that the results are accurate and reliable. Without a control group, it would be difficult to determine whether the results of an experiment are due to the independent variable or other factors.
When designing an experiment, it is important to carefully consider what kind of control group you will need. There are many different ways to set up a control group, and the best approach will depend on the specific goals of your research.
A control group is a group in an experiment that does not receive the experimental treatment. The purpose of a control group is to provide a baseline against which to compare the experimental group results.
An experimental group is a group in an experiment that receives the experimental treatment. The purpose of an experimental group is to test whether or not the experimental treatment has an effect.
The differences between control and experimental groups are important to consider when designing an experiment. The most important difference is that the control group provides a comparison for the results of the experimental group. This comparison is essential in order to determine whether or not the experimental treatment had an effect. Without a control group, it would be impossible to know if the results of the experiment are due to the treatment or not.
Another important difference between a control group and an experimental group is that the experimental group is the only group that receives the experimental treatment. This is necessary in order to ensure that any results seen in the experimental group can be attributed to the treatment and not to other factors.
Control groups and experimental groups are both essential parts of experiments. Without a control group, it would be impossible to know if the results of an experiment are due to the treatment or not. Without an experimental group, it would be impossible to test whether or not a treatment has an effect.
The purpose of a control group is to serve as a baseline for comparison. By having a group that is not exposed to the treatment, researchers can compare the results of the experimental group and determine whether the independent variable had an impact.
A control group is an essential part of any experiment. It is a group of subjects who are not exposed to the independent variable being tested. The purpose of a control group is to provide a baseline against which the results from the treatment group can be compared.
Without a control group, it would be impossible to determine whether the results of an experiment are due to the treatment or some other factor. For example, imagine you are testing the effects of a new drug on patients with high blood pressure. If you did not have a control group, you would not know if the decrease in blood pressure was due to the drug or something else, such as the placebo effect.
A control group must be carefully designed to match the treatment group in all important respects, except for the one factor that is being tested. This ensures that any differences in the results can be attributed to the independent variable and not to other factors.
Get a weekly roundup of Ninetailed updates, curated posts, and helpful insights about the digital experience, MACH, composable, and more right into your inbox
Keep Reading on This Topic
In this blog post, we will explore nine of the most common personalization challenges and discuss how to overcome them.
In this post, we will discuss some of the best practices and tips for using website content personalization to delight your customers and enhance user experiences.
How science REALLY works...
The Understanding Science site is assembling an expanded list of FAQs for the site and you can contribute. Have a question about how science works, what science is, or what it’s like to be a scientist? Send it to [email protected] !
Expand the individual panels to reveal the answers or Expand all | Collapse all
The “scientific method” is traditionally presented in the first chapter of science textbooks as a simple, linear, five- or six-step procedure for performing scientific investigations. Although the Scientific Method captures the core logic of science (testing ideas with evidence), it misrepresents many other aspects of the true process of science — the dynamic, nonlinear, and creative ways in which science is actually done. In fact, the Scientific Method more accurately describes how science is summarized after the fact — in textbooks and journal articles — than how scientific research is actually performed. Teachers may ask that students use the format of the scientific method to write up the results of their investigations (e.g., by reporting their question, background information, hypothesis, study design, data analysis, and conclusion ), even though the process that students went through in their investigations may have involved many iterations of questioning, background research, data collection, and data analysis and even though the students’ “conclusions” will always be tentative ones. To learn more about how science really works and to see a more accurate representation of this process, visit The real process of science .
Scientists often seem tentative about their explanations because they are aware that those explanations could change if new evidence or perspectives come to light. When scientists write about their ideas in journal articles, they are expected to carefully analyze the evidence for and against their ideas and to be explicit about alternative explanations for what they are observing. Because they are trained to do this for their scientific writing, scientist often do the same thing when talking to the press or a broader audience about their ideas. Unfortunately, this means that they are sometimes misinterpreted as being wishy-washy or unsure of their ideas. Even worse, ideas supported by masses of evidence are sometimes discounted by the public or the press because scientists talk about those ideas in tentative terms. It’s important for the public to recognize that, while provisionality is a fundamental characteristic of scientific knowledge, scientific ideas supported by evidence are trustworthy. To learn more about provisionality in science, visit our page describing how science builds knowledge . To learn more about how this provisionality can be misinterpreted, visit a section of the Science toolkit .
Peer review helps assure the quality of published scientific work: that the authors haven’t ignored key ideas or lines of evidence, that the study was fairly-designed, that the authors were objective in their assessment of their results, etc. This means that even if you are unfamiliar with the research presented in a particular peer-reviewed study, you can trust it to meet certain standards of scientific quality. This also saves scientists time in keeping up-to-date with advances in their fields by weeding out untrustworthy studies. Peer-reviewed work isn’t necessarily correct or conclusive, but it does meet the standards of science. To learn more, visit Scrutinizing science .
In an experiment, the independent variables are the factors that the experimenter manipulates. The dependent variable is the outcome of interest—the outcome that depends on the experimental set-up. Experiments are set-up to learn more about how the independent variable does or does not affect the dependent variable. So, for example, if you were testing a new drug to treat Alzheimer’s disease, the independent variable might be whether or not the patient received the new drug, and the dependent variable might be how well participants perform on memory tests. On the other hand, to study how the temperature, volume, and pressure of a gas are related, you might set up an experiment in which you change the volume of a gas, while keeping the temperature constant, and see how this affects the gas’s pressure. In this case, the independent variable is the gas’s volume, and the dependent variable is the pressure of the gas. The temperature of the gas is a controlled variable. To learn more about experimental design, visit Fair tests: A do-it-yourself guide .
In scientific testing, a control group is a group of individuals or cases that is treated in the same way as the experimental group, but that is not exposed to the experimental treatment or factor. Results from the experimental group and control group can be compared. If the control group is treated very similarly to the experimental group, it increases our confidence that any difference in outcome is caused by the presence of the experimental treatment in the experimental group. For an example, visit our side trip Fair tests in the field of medicine .
A negative control group is a control group that is not exposed to the experimental treatment or to any other treatment that is expected to have an effect. A positive control group is a control group that is not exposed to the experimental treatment but that is exposed to some other treatment that is known to produce the expected effect. These sorts of controls are particularly useful for validating the experimental procedure. For example, imagine that you wanted to know if some lettuce carried bacteria. You set up an experiment in which you wipe lettuce leaves with a swab, wipe the swab on a bacterial growth plate, incubate the plate, and see what grows on the plate. As a negative control, you might just wipe a sterile swab on the growth plate. You would not expect to see any bacterial growth on this plate, and if you do, it is an indication that your swabs, plates, or incubator are contaminated with bacteria that could interfere with the results of the experiment. As a positive control, you might swab an existing colony of bacteria and wipe it on the growth plate. In this case, you would expect to see bacterial growth on the plate, and if you do not, it is an indication that something in your experimental set-up is preventing the growth of bacteria. Perhaps the growth plates contain an antibiotic or the incubator is set to too high a temperature. If either the positive or negative control does not produce the expected result, it indicates that the investigator should reconsider his or her experimental procedure. To learn more about experimental design, visit Fair tests: A do-it-yourself guide .
In a correlational study, a scientist looks for associations between variables (e.g., are people who eat lots of vegetables less likely to suffer heart attacks than others?) without manipulating any variables (e.g., without asking a group of people to eat more or fewer vegetables than they usually would). In a correlational study, researchers may be interested in any sort of statistical association — a positive relationship among variables, a negative relationship among variables, or a more complex one. Correlational studies are used in many fields (e.g., ecology, epidemiology, astronomy, etc.), but the term is frequently associated with psychology. Correlational studies are often discussed in contrast to experimental studies. In experimental studies, researchers do manipulate a variable (e.g., by asking one group of people to eat more vegetables and asking a second group of people to eat as they usually do) and investigate the effect of that change. If an experimental study is well-designed, it can tell a researcher more about the cause of an association than a correlational study of the same system can. Despite this difference, correlational studies still generate important lines of evidence for testing ideas and often serve as the inspiration for new hypotheses. Both types of study are very important in science and rely on the same logic to relate evidence to ideas. To learn more about the basic logic of scientific arguments, visit The core of science .
Deductive reasoning involves logically extrapolating from a set of premises or hypotheses. You can think of this as logical “if-then” reasoning. For example, IF an asteroid strikes Earth, and IF iridium is more prevalent in asteroids than in Earth’s crust, and IF nothing else happens to the asteroid iridium afterwards, THEN there will be a spike in iridium levels at Earth’s surface. The THEN statement is the logical consequence of the IF statements. Another case of deductive reasoning involves reasoning from a general premise or hypothesis to a specific instance. For example, based on the idea that all living things are built from cells, we might deduce that a jellyfish (a specific example of a living thing) has cells. Inductive reasoning, on the other hand, involves making a generalization based on many individual observations. For example, a scientist who samples rock layers from the Cretaceous-Tertiary (KT) boundary in many different places all over the world and always observes a spike in iridium may induce that all KT boundary layers display an iridium spike. The logical leap from many individual observations to one all-inclusive statement isn’t always warranted. For example, it’s possible that, somewhere in the world, there is a KT boundary layer without the iridium spike. Nevertheless, many individual observations often make a strong case for a more general pattern. Deductive, inductive, and other modes of reasoning are all useful in science. It’s more important to understand the logic behind these different ways of reasoning than to worry about what they are called.
Scientific theories are broad explanations for a wide range of phenomena, whereas hypotheses are proposed explanations for a fairly narrow set of phenomena. The difference between the two is largely one of breadth. Theories have broader explanatory power than hypotheses do and often integrate and generalize many hypotheses. To be accepted by the scientific community, both theories and hypotheses must be supported by many different lines of evidence. However, both theories and hypotheses may be modified or overturned if warranted by new evidence and perspectives.
A null hypothesis is usually a statement asserting that there is no difference or no association between variables. The null hypothesis is a tool that makes it possible to use certain statistical tests to figure out if another hypothesis of interest is likely to be accurate or not. For example, if you were testing the idea that sugar makes kids hyperactive, your null hypothesis might be that there is no difference in the amount of time that kids previously given a sugary drink and kids previously given a sugar-substitute drink are able to sit still. After making your observations, you would then perform a statistical test to determine whether or not there is a significant difference between the two groups of kids in time spent sitting still.
Ockham’s razor is an idea with a long philosophical history. Today, the term is frequently used to refer to the principle of parsimony — that, when two explanations fit the observations equally well, a simpler explanation should be preferred over a more convoluted and complex explanation. Stated another way, Ockham’s razor suggests that, all else being equal, a straightforward explanation should be preferred over an explanation requiring more assumptions and sub-hypotheses. Visit Competing ideas: Other considerations to read more about parsimony.
Rigorous and well controlled scientific investigations 1 have examined these topics and have found no evidence supporting their usual interpretations as natural phenomena (i.e., ghosts as apparitions of the dead, ESP as the ability to read minds, and astrology as the influence of celestial bodies on human personalities and affairs) — although, of course, different people interpret these topics in different ways. Science can investigate such phenomena and explanations only if they are thought to be part of the natural world. To learn more about the differences between science and astrology, visit Astrology: Is it scientific? To learn more about the natural world and the sorts of questions and phenomena that science can investigate, visit What’s natural ? To learn more about how science approaches the topic of ESP, visit ESP: What can science say?
Knowledge generated by science has had many effects that most would classify as positive (e.g., allowing humans to treat disease or communicate instantly with people half way around the world); it also has had some effects that are often considered negative (e.g., allowing humans to build nuclear weapons or pollute the environment with industrial processes). However, it’s important to remember that the process of science and scientific knowledge are distinct from the uses to which people put that knowledge. For example, through the process of science, we have learned a lot about deadly pathogens. That knowledge might be used to develop new medications for protecting people from those pathogens (which most would consider a positive outcome), or it might be used to build biological weapons (which many would consider a negative outcome). And sometimes, the same application of scientific knowledge can have effects that would be considered both positive and negative. For example, research in the first half of the 20th century allowed chemists to create pesticides and synthetic fertilizers. Supporters argue that the spread of these technologies prevented widespread famine. However, others argue that these technologies did more harm than good to global food security. Scientific knowledge itself is neither good nor bad; however, people can choose to use that knowledge in ways that have either positive or negative effects. Furthermore, different people may make different judgments about whether the overall impact of a particular piece of scientific knowledge is positive or negative. To learn more about the applications of scientific knowledge, visit What has science done for you lately?
1 For examples, see:
Subscribe to our newsletter
Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.
Scientific Reports volume 14 , Article number: 18463 ( 2024 ) Cite this article
125 Accesses
1 Altmetric
Metrics details
Cyclophosphamide (CTX) is the most commonly used effective alkylating drug in cancer treatment, but its use is restricted because its toxic side effect causes testicular toxicity. CTX disrupts the tissue redox and antioxidant balance and the resulting tissue damage causes oxidative stress. In our study based on this problem, kefir against CTX-induced oxidative stress and testicular toxicity were investigated. Rats were divided into 6 groups: control, 150 mg/kg CTX, 5 and 10 mg/kg kefir, 5 and 10 mg/kg kefir + 150 CTX. While the fermented kefirs were mixed and given to the rats for 12 days, CTX was given as a single dose on the 12th day of the experiment. Testis was scored according to spermatid density, giant cell formation, cells shed into tubules, maturation disorder, and atrophy. According to our biochemical findings, the high levels of total oxidant status (TOS), and the low levels of total antioxidant status (TAS) in the CTX group, which are oxidative stress markers, indicate the toxic effect of CTX, while the decrease in TOS levels and the increase in TAS levels in the kefir groups indicate the protective effect of kefir. In the CTX-administered group, tubules with impaired maturation and no spermatids were observed in the transverse section of the testicle, while in the kefir groups, the presence of near-normal tubule structures and tubule lumens despite CTX showed the protective effect of kefir. In our study, it was observed that kefir had a protective and curative effect on CTX-induced toxicity and oxidative stress and could be a strong protector.
Introduction.
Antineoplastic drugs may have gonadotoxic effects in varying amounts depending on factors such as the dose, type, and duration of the drug used. Cyclophosphamide (CTX), one of these cytotoxic agents, can cause infertility due to permanent and long-term gonadal toxicity 1 , 2 . Although the cytotoxic effects of CTX, which is widely used in cancer chemotherapy, limit the use of the drug, it also increases oxidative stress, which mediates the disruption of redox balance after exposure and causes many biochemical and physiological disorders 2 . In order for CTX to exert its potential coccoidal effect, it must first be metabolized and activated. CTX-induced immunosuppression occurs due to the release of its metabolites rather than the drug itself. The metabolism of CTX in the liver the formation of acrolein, a cytotoxic metabolite, and a simultaneous increase in reactive oxygen species (ROS) and lipid peroxidation are associated with oxidative stress 3 . The alkylating metabolite of CTX, phosphoramide mustard, is responsible for therapeutic activity and produces a wide range of adverse effects, such as testicular toxicity. Acrolein has also been reported to have adverse effects on fertility, including hemorrhagic cystitis and apoptotic changes in the testicles 4 . Furthermore, because the spermatozoa's mitochondrial membrane is rich in polyunsaturated fatty acids and deficient in antioxidants, it is more vulnerable to lipid peroxidation 5 . In the germinal epithelium, spermatogenesis is a vigorous meiotic division cycle that requires a lot of oxygen from the mitochondria. Nonetheless, low oxygen tension results from inadequate testicular vascularization. Because Leydig cells are sensitive to oxidative stress in both spermatogenesis and steroidogenesis, low oxygen levels may shield tissues from damage by free radicals 6 . These may explain how CTX causes toxicity in organs such as testicles, as CTX disrupts tissue redox balance, and tissue damage resulting from this disruption causes oxidative stress 7 . In many studies, It has been reported that CTX was histologically in testicular tubules may cause a decrease in germinal epithelium height and seminiferous tubule diameter, tubular atrophy, disruption of germinal epithelium and basement membrane integrity, edema in the interstitium, increase in collagen density and Leydig cell atrophy 8 . Normally, free radicals occur in the mitochondria of testicular cells but are scavenged by the antioxidant defense system 5 , 9 . Kefir, a natural antioxidant, is the most important prebiotic and probiotic fermented milk product needed to prevent oxidative damage and cytotoxicity caused by CTX. Fermented kefir slows the growth of cancer cells and accelerates apoptosis, with its immunotherapeutic, antioxidant, and antitumor properties 10 . Studies have shown that kefir exhibits activities such as antioxidative, antimicrobial, and anticarcinogenic properties, and protection against apoptosis 11 .
In this experimental study, the possible protective effect of kefir in the testicular damage model created with cyclophosphamide (CTX) was examined with biochemical and histopathological parameters, and the antioxidant and cytoprotective effects of kefir on testicular toxicity were compared. Since the kefir we used in our experimental study created microbial flora at different times, fermented kefirs on different days were tested. As a result of the test we conducted on the kefirs on different days, no significant change was observed between the kefirs of the 1st, 2nd, and 3rd days, so the kefirs of all days were mixed and used to be given to the rats. Kefir used in experimental studies was used in very different doses and durations. In our study, we gave kefir to rats by gavage method for 12 days.
As seen in Table 1 , our data were scored according to testicular spermatid density, giant cell formation, tubule-sloughed cells, maturation disorder, and atrophy. In the CTX-administered group, testicular spermatid density, giant cell formation, cells sloughed into tubules, maturation disorder, and atrophy levels were seen as moderate changes (score 2). In the groups given CTX + kefir, this moderate change decreased to a slight change (score 1) and approached the control group (Table 1 ).
Total oxidant status (TOS) level, one of the parameters we measured as an indicator of CTX-induced oxidative damage, was found to be very high in the group given a single dose of 150 mg/kg CTX. TOS levels decreased significantly in the groups given 5 and 10 mg/kg kefir along with CTX. As a matter of fact, our findings showed that the TOS level, which increases with oxidative stress caused by CTX, can mostly be eliminated by kefir (Fig. 1 ).
Comparison of TOS values of experimental groups administered Control, 150 mg/kg CTX, 5 mg/kg kefir, 5 mg/kg kefir + 150 mg/kg CTX, l0 mg/kg kefir, l0 mg/kg kefir + 150 mg/kg CTX. (*** p < 0.001 compared to control; ### p < 0.001 compared to CTX group).
Comparing the total antioxidant status (TAS) level, which is an important biomarker; In the second group, which was given only CTX, the TAS level decreased significantly. This shows that CTX causes an increase in oxidative stress and has a decreasing effect on antioxidant levels. In the groups given kefir along with CTX, the TAS level increased despite CTX and approached the control level, indicating that kefir has an antioxidative and protective effect (Fig. 2 ).
Comparison of TAS values of experimental groups administered Control, 150 mg/kg CTX, 5 mg/kg kefir, 5 mg/kg kefir + 150 mg/kg CTX, l0 mg/kg kefir, l0 mg/kg kefir + 150 mg/kg CTX. (*** p < 0.001 compared to control; ** p < 0.05 compared to control; * p < 0.01 compared to control; # p < 0.01 compared to CTX group).
According to testicular histopathology findings, normal tubule lumens (blue star) were seen in the transverse section of the testis of control group animals. In the transverse section of the testicles of the group given 150 mg/kg CTX, maturated tubules (yellow asterisks) with no spermatids were observed. Close to normal tubule structures and tubule lumens were observed in rats given 5 and 10 mg/kg kefir. In the group given CTX + 10 mg/kg kefir, a maturated tubule (yellow star) with no spermatids was observed in the transverse section of the testicle. The histopathological findings of the group given 150 mg/kg CTX + 10 mg/kg kefir were better than the group given 150 mg/kg CTX + 5 mg/kg kefir (Fig. 3 ).
( a ) Normal appearance tubule lumens in the transverse section of the testicle (blue star), ( b ) A tubule with impaired maturation, with no spermatids observed in the transverse section of the testicle (yellow star), ( c ) Close to normal tubule structures and tubule lumens, ( d ) A tubule with impaired maturation, with no spermatids observed in the transverse section of the testicle (yellow star), ( e ) Close to normal tubule structures and tubule lumens, ( f ) Close to normal tubule structures and tubule lumens (H&E; X200).
The most commonly used alkylating type antineoplastic drugs are used in chemotherapy to regress or stop tumor progression. Although chemotherapy basically aims to stop or destroy tumor growth without damaging healthy cells, antineoplastic drugs have low selective properties and although they destroy cancer cells, they can also cause undesirable toxicities on healthy cells. In order to enable Cyclophosphamide (CTX), an antineoplastic drug, to be used more effectively and safely in high doses, studies on the development of methods that prevent its toxic effects are important. Infertility is a major concern for patients receiving CTX therapy. In the testis, cells in the seminiferous tubules of the germinal epithelium are the most sensitive structures to the toxic effects of CTX because they have the highest mitotic and meiotic indices.
Cancer chemotherapy can cause many side effects such as infertility by causing temporary or long-term gonadal damage. According to our data, moderate changes were observed in testicular spermatid density, giant cell formation, shedding of cells into tubules, maturation disorder, and atrophy levels in the group given 150 mg/kg CTX (Table 1 ). In a study, it was reported that although there was no major distortion in the testicles in the CTX group, degeneration, bleeding, and cell loss were observed in the seminiferous tubules of the testicles 7 . Parallel with our study we also stated that CTX-induced reproductive damage can be attributed to oxidative stress and DNA damage 9 . Another factor that may cause oxidative stress in the testicles is defined as infection in the literature 12 . In their study, Kim et al. (2016) also determined shedding, vacuolization, decrease in the number of spermatocytes, and degeneration in the testicular germ cell epithelium of rats given CTX 13 . Likewise, in another study, significant damage such as hemorrhage between the seminiferous tubules, disorganization and separation of cells of the spermatogenic series, and vacuoles in germ cells were detected in the testicles of rats given CTX 14 . In the groups given kefir along with CTX, the moderate change seen in the CTX group decreased to a slight change and approached the control group (Table 1 ). In this sense, in addition to its antioxidant and antitumor properties, kefir also has an anti-inflammatory effect, suggesting that it can eliminate CTX-induced testicular damage due to oxidative stress.
Normally, the oxidative state is in balance with ROS production and ROS elimination in the cell, while disruption of this balance results in damage to the cell 15 . Some reports showed that CTX could disrupt the redox equilibrium of tissues, which suggests that the biochemical and physiological disturbances may result from oxidative stress 8 . In parallel with this information in our study, TOS level, which is an indicator of CTX-induced oxidative damage, was found to be quite high in the group given a single dose of 150 mg/kg CTX (Fig. 1 ). Studies showed that CTX had the lowest Johnsen score mean, consistent with its gonadotoxic effects 16 , 17 . Since both spermatogenesis and Leydig cell steroidogenesis are sensitive to oxidative stress, it is thought that the low oxygen tension that characterizes this tissue may be an important component of the testicles' protective mechanisms from damage caused by free radicals 6 . According to our findings, TOS levels decreased in the groups given 5 and 10 mg/kg kefir along with CTX (Fig. 1 ). Since these undesirable effects of CTX may be due to inducing oxidative stress in tissues and disrupting the oxidant-antioxidant balance 18 , and it has been reported that the expression of antioxidant enzymes is inhibited by CTX treatment, which reduces intratesticular testosterone concentration 19 , we aimed to use kefir, which has antioxidant properties. As a matter of fact, our results showed that kefir alleviated the oxidative damage caused by CTX by reducing the TOS level with its antioxidative properties (Fig. 1 ).
Disruption of the balance between antioxidant and oxidant systems causes toxicities and tissue damage. The toxic effect of CTX is related to its active metabolite, ACR. It has been stated that this toxic effect of CTX occurs by destroying the antioxidant defense systems of acrolein, which is formed as a result of its metabolism, and causes the formation of high amounts of free radicals. In our study, when we compared the TAS level, which is an important biomarker, it was seen that the TAS level decreased significantly in the only dose CTX-given group. Studies have shown that oxidative stress increases with a decrease in antioxidant enzymes 20 and an increase in lipid peroxidation in rats treated with CTX 21 . It is reported that deterioration of the balance between antioxidant and oxidant systems causes tissue damage 22 . Antioxidative biological compounds may protect cells and tissues from the harmful effects of ROS and other free radicals produced during CTX exposure. As a matter of fact, our results show that kefir has an antioxidative and protective effect by increasing the TAS level despite CTX and approaching the control level in the groups where kefir was given together with CTX (Fig. 2 ). In a study, it was found that the oxidative stress index (OSI) value, which shows the status of oxidative and antioxidative systems, was higher in the CTX group than in the control group 23 .
According to testicular histopathology findings, in the transverse section of the testicles of the group given 150 mg/kg CTX, maturated tubules with no spermatids were observed (Fig. 3 ) and this showed that CTX damaged testicular tissue. A study's histological analysis showed that the CTX-treated group's spermatogenetic cells were disorganized and their seminiferous tubules were irregular. Moreover, spermatogenetic cells were shown to pour into the tubular lumen in this investigation, resulting in a decrease in tubule diameter 23 . In accordance with similar studies 24 , 25 , signs of degeneration such as atrophy in seminiferous tubules and decrease in tubule diameter, and loss of spermatogenic cells were observed in our study. Also, a decrease in tubule thickness and loss at the spermatogenic level was reflected in the sperm count and morphology of our CTX-given group findings. In a study localization and morphology of telocytes have been demonstrated in the rat male reproductive system 25 . Moreover, studies have shown that CTX, which induces oxidative stress in testicular and epididymal tissues, can cause a decrease in sperm count and motility. Additionally, it has been shown that oxidative stress caused by CTX can lead to apoptosis and shrinkage in seminiferous tubules, thinned seminiferous epithelium, and a decrease in interstitial cells and spermatogenic cells, especially in post-meiotic stages 26 , 27 . Testis blood barrier damage and aberrant expression of functional proteins were seen in an animal experiment with CTX intervention, wherein Sertoli cells experienced morphological, and functional abnormalities 28 . Fermented kefir, which has antioxidant, anti-apoptotic, anti-lipid peroxidation and anti-inflammatory activities 11 , could alleviate or avoid this damage. In the group given CTX + 10 mg/kg kefir, a maturated tubule with no spermatids was observed in the transverse section of the testicle. The histopathological findings of the group given 150 mg/kg CTX + 10 mg/kg kefir were better than the group given 150 mg/kg CTX + 5 mg/kg kefir (Fig. 3 ). We have previously shown that immune activities have been observed in humans and various animals after ingestion of lactic acid bacteria found in kefir, and it has been observed that lactic acid bacteria increase non-specific resistance against tumors or infections in humans or animals or have a strengthening effect on specific immune reactions 11 . In other studies, it has been reported that kefir consumption has antioxidant, and anticarcinogenic effects 29 , 30 , 31 , in parallel with the results of our study. In this study, it was observed that kefir was histologically and biochemically effective against the toxic effects of CTX on the testicles when high doses were required. For this reason, it can be stated that kefir can be used as an alternative supplement when CTX is used in high doses.
The use of complementary and alternative treatments, which prevent the toxic effects of many antineoplastic chemical agents such as CTX and allow them to be used in higher or effective doses for a long time, has increased rapidly recently and has gained importance in many areas including the medical industry, the country's economy, and even social psychology. The most severe histopathological, and biochemical picture was seen in the group where high-dose CTX was used, confirming that CTX has a highly toxic effect on the testicles. An important way to ensure the effectiveness of cancer treatment is to regulate the microbiota through probiotic consumption. So, kefir is a very effective agent both in reducing the side effects of CTX and in providing cancer immunotherapy that uses the power of the patient's own immune system to destroy cancerous cells. In addition, we hope that our study will contribute to the literature for future scientific studies.
In our study, commercially supplied and freeze-dried kefir yeast and 1 L of cow’s milk were preferred for kefir fermentation. Three groups of kefirs were created, with fermentation at 24–26 °C temperature at intervals of 24, 48, and 72 h on days 1, 2, and 3. It was kept at + 4 °C ready for use. We gave kefir to rats by gavage method for 12 days. Kefirs from the 1st, 2nd, and 3rd days were mixed and given by gavage method for 12 days.
Cyclophosphamide (CTX) (Sigma-Aldrich) was commercially available. 500 mg CTX was dissolved in 25 ml bidistilled water to prepare for injection of 150 mg/kg CTX. The injection was performed as a single dose intraperitoneally (i.p.)/body-weight (b.w.) on the 12th day of the experiment, using sterile disposable syringes.
This experimental study was approved by the Ethics Committee of Eskisehir Osmangazi University Animal Experiments Local Ethics Committee (784-145 / 2020. And the entire study was conducted in accordance with the Animal Experiments Local Ethics Committee Directive.
In our experimental study, healthy, males, 200 ± 20 gr, about 3 months age Wistar albino rats were used. During the experiment, the animals were kept in rooms with 12;12 light/dark lighting, 45–50% humidity, and 22 ± 2 °C temperature. And were given tap water and normal pellet feed. The 42 rats used in this study were divided into 6 groups, each group including 7 rats. Group 1 (control), single dose of 150 mg/kg/b.w CTX to the 2nd group, 5 mg/kg/b.w kefir to the 3rd group, 5 mg/kg/b.w kefir + 150 mg/kg/b.w CTX to the 4th group, 10 mg/kg/b.w kefir was given to the 5th group, 10 mg/kg/b.w kefir + 150 mg/kg/b.w CTX was given to the 6th group. Kefir was given to rats by gavage method for 12 days. A single dose of CTX was given i.p. on the last day of the experiment, namely the 12th day. At the end of the experiment, biochemical parameters and testicular tissues were taken under anesthesia.
Total antioxidant status (tas) (mmol/l).
TAS levels were measured using commercially available kits (Relassay, Turkey). The novel automated method is based on the bleaching of the characteristic color of a more stable ABTS (2,2′-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)) radical cation by antioxidants. The assay has excellent precision values, which are lower than 3%. The results were expressed as mmol Trolox equivalent/L.
TOS levels were measured using commercially available kits (Relassay, Turkey). In the new method, oxidants present in the sample oxidized the ferrous ion-o-dianisidine complex to the ferric ion. The oxidation reaction was enhanced by glycerol molecules abundantly present in the reaction medium. The ferric ion produced a colored complex with xylenol orange in an acidic medium. The color intensity, which could be measured spectrophotometrically, was related to the total amount of oxidant molecules present in the sample. The assay was calibrated with hydrogen peroxide and the results were expressed in terms of micromolar hydrogen peroxide equivalent per liter (μmol H2O2 equivalent/L).
Before being examined under a light microscope, tissue samples were preserved in a 10% Neutral Buffer formaldehyde solution. Following identification, tissue samples were put into cassettes and given a two-hour rinse under running water. Tissues were run through a succession of increasing alcohol concentrations (60–100%) in order to extract water. The tissues were then polished by passing them through xylene before being implanted in melted paraffin. For each group, 4-micron-thick slices were cut from paraffin blocks and stained with hematoxylin–eosin stain. Using the Leica Q Vin 3 program on the Leica DCM 4000 computer-aided imaging system (Germany), the sections were assessed and captured on camera. A criteria table was created as a result of the evaluations made with Hematoxylin–Eosin (H&E) staining.
The quantitative values we obtained at the end of the study were evaluated by applying the Duncan test after one-way ANOVA, which is used in the statistical analysis of more than two independent groups, with the SPSS 26.00 statistical data program.
The authors declare that all data supporting the findings of this study are available within the paper. Moreover, the datasets used and/or analysed during the current study available from the corresponding author on reasonable request.
Vassilakopoulou, M. et al. Anticancer treatment and fertility: Effect of therapeutic modalities on reproductive system and functions. Crit. Rev. Oncol. Hematol. 97 , 328–334 (2016).
Article PubMed Google Scholar
Cengiz, M., Yeşildağ, Ö. & Ayhancı, A. Siklofosfamid Nedenli Hematoksisite Üzerine Karvakrolün Sitoprotektif Etkileri. Türkiye Tarımsal Araştırmalar Dergisi 5 (2), 125–130 (2018).
Article Google Scholar
Yildiz, S. C., Demir, C., Cengiz, M. & Ayhanci, A. Protective properties of kefir on burn wounds of mice that were infected with S. aureus , P. auroginasa and E. coli . Cell. Mol. Biol. 65 , 60–65 (2019).
Drumond, A. L. et al. Effects of multiple doses of cyclophosphamide on mouse testes: Accessing the germ cells lost, and the functional damage of stem cells. Reprod. Toxicol. 32 , 395–406 (2011).
Article PubMed PubMed Central Google Scholar
Agarwal, A., Makker, K. & Sharma, R. Clinical relevance of oxidative stress in male factor infertility: An update. Am. J Reprod. Immunol. 59 (1), 2–11 (2008).
Chen, H. et al. Vitamin E, aging and Leydig cell steroidogenesis. Exp. Gerontol. 40 (8–9), 728–736 (2005).
Can, S. et al. Investigation into the protective effects of Hypericum triquetrifolium Turra . seed against cyclophosphamide-induced testicular injury in Sprague Dawley rats. Drug Chem. Toxicol. 45 , 1679–1686 (2022).
Singh, S., Lata, S. & Tiwari, K. N. Antioxidant potential of phyllanthus fraternus webster on cyclophosphamide-induced changes in sperm characteristics and testicular oxidative damage in mice. Indian J Exp. Biol. 53 (10), 647–656 (2015).
PubMed Google Scholar
Cengiz, M. Boric acid protects against cyclophosphamide-induced oxidative stress and renal damage in rats. Cell. Mol. Biol. 64 (12), 11–14 (2018).
Gozuoglu, G. & Yildiz, S. C. Myeloprotective and hematoprotective role of kefir on cyclophosphamide toxicity in rats. Arch. Clin. Exp. Med. 6 (2), 77–82 (2021).
Hadisaputro, S. Effects of oral clear kefir probiotics on glycemic status, lipid peroxidation, antioxidative properties of streptozotocin induced hyperglycemia Wistar rats. Gizi Indonesia. 34 , 1–6 (2011).
Google Scholar
Reddy, M. M. et al. Bacterial lipopolysaccharide-induced oxidative stress in the impairment of steroidogenesis and spermatogenesis in rats. Reprod. Toxicol. 22 (3), 493–500 (2006).
Cengiz, M. Ratlarda siklofosfamid nedenli kardiyotoksisite üzerine borik asitin koruyucu etkileri. Bitlis Eren Üniv. Fen Bil. Derg. 7 (1), 113–118 (2018).
Mahmoud, A. M., Soilman, H. A. & El-hameed, A. Wheat germ oil attenuates cyclophosphamide induced testicilar injury in rats. WJPPS. 5 (5), 40–52 (2016).
Vladimir, S. K. et al. Acetylcholinesterase inhibitory, Antioxidant and phytochemical properties of selected medicinal plants of the Lamiaceae family. Molecules. 19 , 767–782 (2014).
Ramos, S. P. et al. Exercise protects rat testis from cyclophosphamide-induced damage. Acta Sci. Biol. Sci. 35 (1), 105–113 (2013).
Nie, Z. et al. The protective effects of pretreatment with resveratrol in cyclophosphamide-induced rat ovarian granulosa cell injury: In vitro study. Reprod. Toxicol. 95 , 66–74 (2020).
Hamzeh, M. et al. Cerium oxide nanoparticles protect cyclophosphamide-induced testicular toxicity in mice. Int. J Prev. Med. 10 (1), 5–14 (2019).
Zini, A. & Schlegel, P. N. Effect of hormonal manipulation on mRNA expression of antioxidant enzymes in the rat testis. J Urol. 169 (2), 767–771 (2003).
Motawi, T. M., Sadik, N. A. & Refaat, A. Cytoprotective effects of DL-alpha-lipoic acid or squalene on cyclophosphamide-induced oxidative injury: an experimental study on rat myocardium, testicles and urinary bladder. Food Chem. Toxicol. 48 , 2326–2336 (2010).
AbdEl, T. A. M., Shahin, N. N. & AbdEl Mohsen, M. M. Protective effect of Satureja montana extract on cyclophosphamide-induced testicular injury in rats. Chem. Biol. Interact. 224 (5), 1872–7786 (2014).
Nie, Z. et al. The protective effects of resveratrol pretreatment in cyclophosphamide-induced rat ovarian injury: an vivo study. Gynecol. Endocrinol. 37 (10), 914–919 (2021).
Altuntas, H., Ozdemir, M., Harmancı, N., Yigitaslan, S. & Sahinturk, V. The effect of berberine on the prevention and/or treatment on cyclophosphamide-ınduced testicular damage in rats. Osmangazi Tıp Derg. 45 (2), 161–167 (2023).
Hosseini, A., Zare, S., Borzouei, Z. & Ghaderi, P. F. Cyclophosphamide-induced testicular toxicity ameliorate by American ginseng treatment: An experimental study. Int. J Reprod. Bio. Med. 16 , 711–718 (2018).
Sirin, C. et al. Assessment of Resveratrol’s effects comparatively with zinc in experimental rat testicular damage induced by Cyclophosphamide. EJM. 62 (1), 18–29 (2023).
Tripathi, D. N. & Jena, G. B. Astaxanthin inhibits cytotoxic and genotoxic effects of cyclophosphamide in mice germ cells. Toxicol. 248 (2–3), 96–103 (2008).
Cengiz, M., Tekin, Y., İnal, B. & Ayhanci, A. Kekik bitkisinin temel bileşeni olan karvakrolün sıçanlarda siklofosfamid nedenli üreme sistemi hasarı üzerine koruyucu etkileri. Turk. J. Agric. Res 4 (2), 171–175 (2017).
Aghaie, S. et al. Protective effect of combined pumpkin seed and ginger extracts on sperm characteristics, biochemical parameters and epididymal histology in adult male rats treated with cyclophosphamide. Anat. Sci. Int. 91 , 382–390 (2015).
Arslan, S. A review: Chemical, microbiological and nutritional characteristics of kefir. CyTA-J Food. 13 , 340–345 (2015).
Rosa, D. D. et al. Milk kefir. Nutr. Res. Rev. 30 (1), 82–96 (2017).
Yildiz, S. C. et al. In vitro antitumor and antioxidant capacity as well as ameliorative effects of fermented kefir on cyclophosphamide-induced toxicity on cardiac and hepatic tissues in rats. Biomed. 12 (6), 1199 (2024).
Download references
This study was financed by Mardin Artuklu University BAP Coordination Office (MAU.BAP.20.SHMYO.004). Ethical statement: This exprimental study was approved by Ethics Committee of Eskisehir Osmangazi University Animal Experiments Local Ethics Committee (784-145 / 2020. And the entire study was conducted in accordance with the Animal Experiments Local Ethics Committee Directive. A part of this study was presented at IV. International Siirt Conference on Scientific Research Siirt University, November 17-18, 2023.
Authors and affiliations.
Department of Medical Services and Techniques, Health Services Vocational School, Mardin Artuklu University, Mardin Artuklu University Campus, 47200, Mardin, Turkey
Songul Cetik Yildiz & Cemil Demir
Department of Elementary Education, Faculty of Education, Siirt University, Siirt, Turkey
Mustafa Cengiz
Department of Computer Sciences, Mardin Artuklu University, Mardin, Turkey
Halit Irmak
Eskisehir Yunus Emre State Hospital, Eskisehir, Turkey
Betul Peker Cengiz
Department of Biology, Science Faculty, Eskisehir Osmangazi University, Eskişehir, Turkey
Adnan Ayhanci
You can also search for this author in PubMed Google Scholar
S.C.Y.: Writing – original draft, Review & editing, Methodology, Visualization. C.D.: Conceptualization, Methodology, Review & editing. M.C.: Visualization, Conceptualization, Review & editing. B.P.C.: Formal analysis, Methodology H.I.: Statistical analysis, Methodology A.A.: Conceptualization, Review & editing, All authors reviewed the results and approved the final version of the manuscript.
Correspondence to Songul Cetik Yildiz .
Competing interests.
The authors declare no competing interests.
Publisher's note.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ .
Reprints and permissions
Cite this article.
Cetik Yildiz, S., Demir, C., Cengiz, M. et al. The protection afforded by kefir against cyclophosphamide induced testicular toxicity in rats by oxidant antioxidant and histopathological evaluations. Sci Rep 14 , 18463 (2024). https://doi.org/10.1038/s41598-024-67982-y
Download citation
Received : 29 March 2024
Accepted : 18 July 2024
Published : 09 August 2024
DOI : https://doi.org/10.1038/s41598-024-67982-y
Anyone you share the following link with will be able to read this content:
Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative
By submitting a comment you agree to abide by our Terms and Community Guidelines . If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.
Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research, free to your inbox weekly.
Respiratory Research volume 25 , Article number: 303 ( 2024 ) Cite this article
110 Accesses
Metrics details
Acute lung injury (ALI) following pneumonia involves uncontrolled inflammation and tissue injury, leading to high mortality. We previously confirmed the significantly increased cargo content and extracellular vesicle (EV) production in thrombin-preconditioned human mesenchymal stromal cells (thMSCs) compared to those in naïve and other preconditioning methods. This study aimed to investigate the therapeutic efficacy of EVs derived from thMSCs in protecting against inflammation and tissue injury in an Escherichia coli (E. coli) -induced ALI mouse model.
In vitro, RAW 264.7 cells were stimulated with 0.1 µg/mL liposaccharides (LPS) for 1 h, then were treated with either PBS (LPS Ctrl) or 5 × 10 7 particles of thMSC-EVs (LPS + thMSC-EVs) for 24 h. Cells and media were harvested for flow cytometry and ELISA. In vivo, ICR mice were anesthetized, intubated, administered 2 × 10 7 CFU/100 µl of E. coli . 50 min after, mice were then either administered 50 µL saline (ECS) or 1 × 10 9 particles/50 µL of thMSC-EVs (EME). Three days later, the therapeutic efficacy of thMSC-EVs was assessed using extracted lung tissue, bronchoalveolar lavage fluid (BALF), and in vivo computed tomography scans. One-way analysis of variance with post-hoc TUKEY test was used to compare the experimental groups statistically.
In vitro, IL-1β, CCL-2, and MMP-9 levels were significantly lower in the LPS + thMSC-EVs group than in the LPS Ctrl group. The percentages of M1 macrophages in the normal control, LPS Ctrl, and LPS + thMSC-EV groups were 12.5, 98.4, and 65.9%, respectively. In vivo, the EME group exhibited significantly lower histological scores for alveolar congestion, hemorrhage, wall thickening, and leukocyte infiltration than the ECS group. The wet-dry ratio for the lungs was significantly lower in the EME group than in the ECS group. The BALF levels of CCL2, TNF-a, and IL-6 were significantly lower in the EME group than in the ECS group. In vivo CT analysis revealed a significantly lower percentage of damaged lungs in the EME group than in the ECS group.
Intratracheal thMSC-EVs administration significantly reduced E. coli -induced inflammation and lung tissue damage. Overall, these results suggest therapeutically enhanced thMSC-EVs as a novel promising therapeutic option for ARDS/ALI.
Acute respiratory distress syndrome (ARDS) and severe acute lung injury (ALI) are critical respiratory diseases characterized by uncontrolled inflammation, bilateral lung damage, fibrosis, and non-cardiogenic pulmonary edema [ 1 , 2 , 3 ]. ARDS/ALI develops by primary causes including bacterial or viral pneumonia, inhalation of toxic substances, or sepsis, and leads to poor prognosis and high mortality rates [ 2 , 4 , 5 ]. Treatment strategies for ARDS/ALI traditionally involve combinations of antibiotics and prone positioning to address individual symptoms without any definite treatment options. Considering the severity and diverse complications, such as inflammation, edema, and fibrosis, a comprehensive therapeutic approach to improve the overall pathophysiology of ALI is urgently needed [ 6 , 7 ].
Recently, new therapeutic modalities for ARDS/ALI are being explored using mesenchymal stromal cells (MSCs) or MSC-derived extracellular vehicles (EVs) [ 8 , 9 , 10 ]. The therapeutic efficacy of MSCs depends on paracrine signaling, with bioactive factors released into EVs [ 11 , 12 , 13 ]. Paracrine enhancement of MSCs through various priming methods has shown promise because EV cargo content is stimulus-dependent [ 14 , 15 ]. Our previous investigations revealed that EV production and cargo content significantly increase, primarily via proteinase-activated receptor (PAR)-1 and partly via a PAR3-dependent pathway, in thrombin-preconditioned human MSCs (thMSCs) compared to those in naïve and other preconditioning methods [ 16 , 17 ]. Furthermore, the transplantation of thMSCs in neonatal rat models of intraventricular hemorrhage and hypoxic-ischemic encephalopathy, as well as thMSC-derived EVs in neonatal meningitis, confirmed their significant therapeutic efficacy in attenuating inflammation, decreasing cell death, and reducing subsequent tissue injuries [ 18 , 19 , 20 ].
Among the pathophysiological processes of ALI, inflammation, leukocyte infiltration, impaired vascular permeability, edema, and fibrosis are closely associated with PAR signaling, a member of the G protein-coupled receptor family expressed in epithelial, endothelial, and immune cells [ 21 , 22 ]. On inflammation and tissue damage, increased thrombin production cleaves and activates PARs triggering a cascade of reactions, leading to the release of prothrombotic mediators, inflammatory cytokines, and chemokines IL-6, TNF-α, and CCL2 [ 22 ]. This cascade increases vascular permeability, endothelial activation, and edema, ultimately causing severe tissue injury [ 23 , 24 , 25 ] .
Thus, we hypothesized that EVs derived from MSCs with enhanced function via thrombin preconditioning-mediated PAR activation (thMSC-EVs) would provide substantial protection against ARDS/ALI [ 17 ]. This study aimed to assess the therapeutic efficacy of EVs from thrombin-preconditioned Warton jelly-derived MSCs (thWJ-MSCs) in an Escherichia coli (E. coli) -induced ALI mouse model. To our knowledge, this is the first investigation of thrombin-preconditioned MSC-derived EVs in an ARDS/ALI preclinical model.
Human WJ-MSCs were provided by the Good Manufacturing Practice Facility of Samsung Medical Center and expanded as previously described [ 20 ]; WJ-MSCs from passage 6 were used in this study and were characterized of its surface markers, proliferation rate, and differentiation potential according to the minimal MSC criteria set by the ISCT (Supplementary Figure S1 ). WJ-MSCs were cultured in minimum essential medium (MEM)-α (Gibco; Grand Island, NY, USA) with 10% fetal bovine serum (FBS. Gibco; Grand Island, NY, USA) and 0.1% gentamicin (Gibco; Grand Island, NY, USA) in a 5% CO 2 humidified incubator at 37 ℃. Thrombin preconditioning was done following the previously established method [ 20 ]. Briefly, At 90% confluency, the culture medium was washed three times with Dulbecco’s phosphate-buffered saline (Welgene; Daegu, South Korea) to remove residual FBS, and replaced with serum-free MEMα supplemented with 20 units/mL of thrombin (Reyon Pharmaceutical Co, Ltd; Seoul, South Korea) for 3 h. The levels of HGF and VEGF in thrombin-preconditioned WJ-MSCs measured from the conditioned medium are presented in Supplementary Figure S2 .
The thrombin preconditioned medium of WJ-MSCs was harvested and filtered using a 0.2 μm bottle top vacuum filtration system (Corning; Corning, NY, USA). EVs were then isolated and diafiltrated in DPBS using a tangential flow filtration system (KrosFlo ® KR2i, Repligen; Waltham, MA, USA) with pore size 300 kDa mPES membrane (S02-E300-05-N, Repligen; Waltham, MA, USA). Subsequently, the concentrated EVs were filtered via a 0.2 μm filter (S6534-FMOSK, Sartorius; Göttingen, Germany) and analyzed using Nanoparticle Tracking Analysis (NanoSight NS300; Malvern, Malvern, UK) (Fig. 1 ). thMSC-EVs were aliquoted and stored at -70 ℃ until subsequent experiments. thMSC-EVs were confirmed of markers GM130 (1:1000; Cell Signaling Technology, Danvers, MA, USA), TSG101 (1:1000; Abcam, Cambridge, UK), and flotillin-1 (1:1000; Cell Signaling Technology, Danvers, MA, USA) using western blot. The size of naïve MSC-EVs are presented in Supplementary Figure S3 .
Characterization of thrombin preconditioned WJ-MSCs-derived EVs. ( A ) Nanoparticle tracking analysis (NTA) evaluated protein concentration and size distribution. ( B ) EV-specific markers were analyzed using western blot. GM130, negative EV marker (Golgi membrane marker); TGS101, and Flotillin-1 are positive markers of EV surface. Full blot images can be found in Figure S9. GM130, Golgi matrix protein 130; TGS101, Tumor susceptibility gene 101; FLOT-1, Flotillin-1
Kanamycin-resistant E. coli strain E69 was kindly provided by Dr. Kwang Sik Kim from Johns Hopkins Hospital. The E. coli was cultured in suspension overnight in Brain-Heart-Infusion broth (BHI, BD Bioscience; Franklin Lakes, NJ, USA) with 53 µg/mL kanamycin (Sigma Aldrich; Burlington, Massachusetts, USA) at 37 °C and 200 rpm. 300 µL of cultured broth was freshly diluted in 7 mL BHI broth, further incubated for 2 h, and centrifuged for 7 min at 3500 rpm. Optical density (OD) was measured at 600 nm and diluted to an OD value of approximately 0.6 using a Multiskan Sky spectrophotometer (Thermo Fisher Scientific, Waltham, MA, USA). 100 µl of E. coli culture was then spread on BHI agar plates using a sterilized spreader (SPL Life Science, Pocheon-si, South Korea) and incubated the plates overnight at 37 °C. The final E. coli concentration in 50 µL normal saline was 10 7 colony-forming units (CFU).
Alveolar macrophage cell line, RAW 264.7 (Korean Cell Line Bank; Seoul, Republic of Korea), were maintained in Dulbecco’s Modified Eagle Medium (Gibco; Grand Island, NY, USA) supplemented with 10% FBS and 1% penicillin/streptomycin (Invitrogen, Carlsbad, California, USA) in a humidified chamber under 5% CO 2 at 37 ℃, as previously described [ 26 ]. At 80% confluence, RAW264.7 cells were stimulated with 0.1 µg/mL lipopolysaccharide (LPS O111:B4. Sigma Aldrich; Burlington, Massachusetts, USA) for 1 h in a 96-well plate. Then, equal volumes (5 µL) of PBS and thMSC-EVs (5 × 10 7 particles / 5 µL) were added as the LPS Ctrl and LPS + thMSC-EVs groups, respectively, and maintained for 24 h. Culture media were collected for Enzyme-linked immunosorbent assay (ELISA) of pro-inflammatory cytokines.
The extent of M1 activation and M2 activation in RAW 264.7 cells was assessed using flow cytometry. RAW 264.7 cells in the normal control (NC), LPS Ctrl, and LPS + thMSC-EV groups were collected and centrifuged at 450 × g at 4 °C for 10 min. Anti-CD86 antibody (BD Biosciences, Franklin Lakes, NJ, USA) and anti-CD206 antibody (BD Biosciences, Franklin Lakes, NJ, USA) were incubated for 20 min and FACS was performed as previously described [ 27 ]. Dead cells and doublets were excluded from the population.
All animal experimental protocols were reviewed and approved by the Institutional Animal Care and Use Committee (IACUC, Approval number: 20,230,126,004) of the Samsung Biomedical Research Institute, an AAALAC International (Association for Assessment and Accreditation of Laboratory Animal Care)-accredited facility, under the National Institutes of Health Guidelines for Laboratory Animal Care. A brief description of the experimental design is presented in Fig. 2 . 8 weeks old ICR male mice were purchased from Orient Co. (Seoul, Republic of Korea) and stabilized for 1 week. Experimental ALI induction was performed as shown in Fig. 2 . The mice were anesthetized using an intraperitoneal (IP) injection of 45 mg/kg ketamine and 8 mg/kg xylazine cocktail. The vocal cords of the mice were visualized using an otoscope by placing the animals in an inclined plane, as previously described [ 28 ]. Mice were endotracheally intubated using a catheter (introcan certo catheter 22G, 0.9 \(\:\times\:\) 25 mm, B/Braun, Melsungen, Germany). E. coli (2 × 10 7 CFU/100 µL) was administered into the lungs of mice via the catheter. 50 min after E. coli administration, the ALI control (ECS) and thMSC-EVs treated (EME) groups were administered equal volumes of saline (50 µL) and thMSC-EVs (1 × 10 9 particles/50 µL), respectively. The timing of administration was determined based on time-dependent cytokine and bacterial CFU measurements (Supplementary Figure S5 , Supplementary Table 1 ). The survival and body weight of the mice were monitored daily (Supplementary Figure S6 ). Ceftriaxone (100 mg/kg) was administered IP once daily. In vivo micro-computed tomography (micro-CT) scanning of the lungs was performed two days post-injury. On day 3, the mice were anesthetized with pentobarbital (60 mg/kg, IP) to collect the lung tissues and bronchoalveolar lavage fluid (BALF) for further analysis. Transcardial perfusion was performed prior to tissue excision. The excised lungs were then inflated with saline using a 3 mL syringe, fixed overnight in 4% paraformaldehyde, and embedded in a paraffin block. BALF was collected by irrigating twice with 1 mL of aseptic saline using a 22-gauge catheter, as previously described [ 26 ].
In vivo experimental design. ALI, acute lung injury; NC, normal control; E. coli , Escherichia coli; thMSC-EVs, EVs derived from thrombin-preconditioned Warton’s jelly MSCs; IP, intraperitoneal injection; IT, intratracheal injection; Micro CT, Micro-computed tomography
Micro CT scanning was performed using the Siemens Inveon Micro-PET/CT scanner (Siemens Medical Solutions, Knoxville, TN, USA). All micro CT analysis protocol and figures are presented in Table S2 , Figure S7 , and Figure F8 under the Supplementary File. The mice were anesthetized with 2–3% isoflurane in 100% oxygen during the scan. The CT images were obtained during the expiratory breathing phase. Briefly, each mouse was scanned for 20 min using a 1.5 mm-thick aluminum filter. For each scan, the Inveon Acquisition Workplace (IAW, Siemens Medical Solutions, Knoxville, TN, USA) software package was used to reconstruct the data into an effective pixel size with a downsampling factor of 2 using the Shepp and Logan filter back-projection algorithm. A phantom scan was conducted for Hounsfield unit (HU) calibration, establishing grayscale values for air and water (ranging from 0 to -1000 HU).
Ten axial micro-CT slices were selected for tissue analysis. The criteria for slide selection were strictly applied to all animals to reduce inter-animal variance. The first slide without a visible diaphragm was marked as the first slide. Every eighth image and ten consecutive images were selected. All images for analysis were matched for 24-bit and the same field of view was used to remove variance. The aerated regions of the lung were semi-automatically measured using the Inveon Research Workplace (IRW, Siemens Medical Solutions, Knoxville, TN, USA) software. The tissue regions of the lungs, excluding the heart, were manually outlined by the investigator using the ImageJ software (National Institutes of Health, Bethesda, MD, USA). The detailed methods are provided in the Supplementary Material. The percentage of damaged tissue was calculated using the following equation:
All analyses were performed blindly.
Paraffin-embedded lung tissues were sectioned into 5 μm-thick slices, deparaffinized, and stained using hematoxylin and eosin (H&E). Three slides per tissue representing the ventral, medial, and dorsal regions of the lungs were selected for analysis. Furthermore, a total of 24 serial images, 8 images from the left lobe and 16 images from the right lobe, were taken and scored. Histological lung injury scores were measured using the following four criteria specified in a previous study [ 28 ]: alveolar congestion, alveolar hemorrhage, infiltration of leukocytes, and thickening of the alveolar wall. Each category was scored on a five-point scale from 0 to 4 as follows: 0, no or minimal lung injury and 1, 2, 3, and 4 with lung injury in 25, 50, 75 and > 75% of the field, respectively. All data were analyzed blindly.
To assess pulmonary edema, the wet weight of the lungs was measured immediately after excision. Subsequently, the lungs were dried at 60 ℃ for 72 h to measure the dry weight. The wet/dry ratio for each lung was assessed by dividing the mass of the wet lung by that of the dry lung, as described previously [ 28 ].
To assess the levels of pro-inflammatory cytokines, such as CCL-2, IL-1α, IL-1β, IL-6, TNF-α, and Interferon Gamma (IFN-γ) in the lungs, commercial ELISA kits (R&D Systems, Minneapolis, MN, USA) were used following the manufacturer’s instructions.
All data were analyzed using GraphPad Prime 8 software (GraphPad, San Diego, CA, USA). Survival curves were assessed using the log-rank test. One-way analysis of variance with post-hoc Tukey’s test was used to statistically compare the experimental groups. Data in bar graphs are presented with mean ± standard error of mean (SEM). In the box and whisker plots, the first, median, and third quartiles are presented as boxes, and the minimum and maximum are presented as whiskers. Specific p values and sample populations are indicated in the figure legends. Statistical significance was set at p < 0.05.
LPS-induced mouse alveolar macrophage RAW 264.7 cells were treated with either thMSC-EVs or PBS after 1 h of LPS stimulation (Fig. 3 A). The levels of inflammatory cytokines (IL-1β, IL-6, and CCL-2) and MMP-9 and the extent of M1 macrophage polarization were measured 24 h after (Figs. 3 B and 4 ) using ELISA and flow cytometry, respectively. The levels of IL-1β, IL-6, CCL-2, and MMP-9 were significantly higher in the LPS Ctrl and LPS + thMSC-EVs groups than those in the NC group. LPS + thMSC-EVs group was significantly lower in the levels of IL-1β, CCL-2, and MMP-9 compared to the LPS Ctrl group, however, the level of IL-6 did not reach statistical significance. FACS confirmed that the percentages of M1 polarization in the normal control, LPS Ctrl, and LPS + thMSC-EV groups were 12.5, 98.4, and 65.9%, respectively (Fig. 4 ). The percentages of M2 polarization in the normal control, LPS Ctrl, and LPS + thMSC-EV groups were < 0.3%, 21.7%, and 29.7%, respectively. Dead cells and doublets were excluded from the population (Supplementary Figure S4 ).
Anti-inflammatory effect of thMSC-EVs in LPS-stimulated RAW 264.7 cells. ( A ) Study design of the LPS-stimulated RAW 264.7 cells ALI in vitro model. ( B ) The levels of pro-inflammatory cytokines IL-1β, IL-6, CCL-2, and MMP-9 were measured using ELISA. n = 4, 6, 6 in the NC, LPS Ctrl, and LPS + thMSC-EVs groups, respectively. Data are presented as box and whisker plot. whiskers represent the min and max. **, p < 0.01 vs. NC; ##, p < 0.01 vs. LPS Ctrl group. One-way analysis of variance (ANOVA) post hoc Tukey analysis was used. NC, normal control; LPS Ctrl, LPS control group; LPS + thMSC-EVs, thMSC-EVs treated group
Flow cytometric analysis of LPS-induced RAW 264.7 cells. Percent representation of CD86 (a marker of M1 macrophage) and CD206 (a marker of M2 macrophage) expressing RAW 264.7 cells. NC, normal control; LPS Ctrl, LPS control group; LPS + thMSC-EVs, thMSC-EVs treated group
The lungs of E. coli -induced ALI mice were excised, fixed, paraffin-embedded, and sectioned for histological evaluation. Figure 5 A shows the representative H&E-stained lung sections from each group. Histologic scores of ALI pathophysiology including alveolar congestions, hemorrhage, wall thickening, and leukocyte infiltration were higher in the E.coli- induced ALI lung tissues than in the NC group (Fig. 5 B). These elevated scores were significantly reduced after thMSC-EV administration, as evidenced by the significantly lower scores in the EME group than those in the ECS group.
Intratracheal administration of thMSC-EVs attenuated tissue injury in E. coli -induced ALI mice. ( A ) Representative microscopic images of lung tissues of each group. (Original magnification; \(\:\:\times\:\:\) 40, scale bars; 200 μm) ( B ) Scored histological grades of alveolar congestion, alveolar hemorrhage, leukocyte infiltration, and alveolar wall thickening in lung tissue. n = 10, 14, and 19 in NC, ECS, and EME groups, respectively. Data are presented as a box and whisker plot. Whiskers represent the min and max. **, p < 0.01 vs. NC; #, p < 0.05 vs. ECS; ##, p < 0.01 vs. ECS. One-way ANOVA post hoc Tukey was used. NC, normal control; ECS, E. coli -induced ALI control group; EME, thMSC-EVs treatment group after E. coli -induced ALI
The extent of E. coli -induced pulmonary edema was evaluated by measuring the tissue wet-dry mass ratio. Representative images of tissues are shown in Fig. 6 A. A higher wet-dry ratio indicates more fluid in the lung tissue. E. coli induction significantly increased the wet-dry ratio, in both the ECS and EME groups compared to that in the NC group (Fig. 6 B). However, this ratio was significantly lower in the EME group than in the ECS group.
Lung tissue and lung water content. ( A ) The lung tissue of NC, ECS, and EME groups. ( B ) Lung water content was measured as wet-dry lung ratio in normal control, ALI control, and treated with the thMSC-EVs group. n = 14, 19, and 23 in the NC, ECS, and EME groups, respectively. Data are presented as a box and whisker plot. Whiskers represent the min and max. **, p < 0.01 vs. NC; #, p < 0.05 vs. ECS. One-way ANOVA post hoc Tukey was used. NC, normal control; ECS, E. coli -induced ALI control group; EME, thMSC-EVs treatment group after E. coli -induced ALI
The obtained BALF samples were used for cytokine analysis. Levels of the pro-inflammatory cytokines, CCL-2, IL-1α, IL-1β, IL-6, TNF-α, and IFN-γ were measured (Fig. 7 ). These were significantly higher in the ECS group than in the NC group. Only IL-1α, IL-1β, and TNF-α levels were significantly increased in the thMSC-EVs-treated EME group compared to those in the NC group. The levels of CCL2, TNF-α, and IL-6 in the EME group were significantly lower than those in the ECS group. Moreover, the levels of CCL2, IFN-γ, and IL-6 were not significantly different from those in the NC group. The levels of IL-1α and IL-1β in the EME group were not significantly different from those in the ECS group, however, the mean value was lower in the EME group.
Intratracheal administration of thMSC-EVs attenuated inflammatory cytokine secretion in E. coli -induced ALI mice. The levels of pro-inflammatory cytokines such as CCL-2, IL-1α, IL-1β, INF-γ, TNF-α, and IL-6 were measured using ELISA. n = 18, 25, and 25 in the NC, ECS, and EME groups, respectively. Data are presented as a box and whisker plot. Whiskers represent the min and max. **, p < 0.01 vs. NC; *, p < 0.05 vs. NC; #, p < 0.05 vs. ECS. One-way ANOVA post hoc Tukey analysis was used. NC, normal control; ECS, E. coli -induced ALI control group; EME, thMSC-EVs treatment group after E. coli -induced ALI
In vivo, micro-CT was performed on each mouse to assess lung damage using the calculation of the percentage of damaged lung regions (Fig. 8 A). The HU setting allows air-exchanging lung parenchyma to be distinguished from denser tissue areas such as infected lesions and injured tissue areas. The aerated lung parenchyma appeared dark, whereas lesions appeared as white patches. These images were used to generate a 3D-rendered aerated parenchyma (Fig. 8 B) and calculate the percentage of damaged tissue (Fig. 8 C). In Fig. 8 B, only the aerated tissue regions appeared white, allowing visualization of the retained air-exchanging parenchyma. The percentage of damaged tissue in both E. coli -induced ECS and EME groups were significantly higher than that in the NC group. However, thMSC-EVs administration significantly reduced the percentage of damaged lungs in the EME group compared with that in the ECS group (Fig. 8 C).
Computerized tomography (CT) scans of mice lungs. ( A ) The air-filled areas in the mice lung CT scans appeared as dark backgrounds, while the lesions resulting from the E. coli administration were observed as hyperintense patches. ( B ) Semi-automated 3D rendered image of the mouse lung parenchyma and airways. The white region represents the aerated parenchyma, allowing visualization of retained parenchyma. ( C ) Calculated percent of damaged lung using CT images from Fig. 8 A. n = 4, 23, and 21 in the NC, ECS, and EME groups, respectively. Data are represented as a box and whisker plot. Whiskers represent the min and max. **, p < 0.01 vs. NC; ##, p < 0.01 vs. ECS. One-way ANOVA post hoc Tukey analysis was used. NC, normal control; ECS, E. coli -induced ALI control group; EME, thMSC-EVs treatment group after E. coli -induced ALI
In the present study, we have demonstrated that intratracheal thMSC-EVs administration significantly attenuated lung injury in E. coli -induced ALI mice, as evidenced by decreased lung edema and inflammatory cytokine levels in the BALF, as well as decreased histological lung injury scores and damaged regions observed in lung CT. Numerous studies have investigated the therapeutic effects of MSC-EVs in ALI animal models [ 8 , 9 , 10 ] and proposed MSC-EVs as promising therapeutic candidates for ALI owing to their cell-free nature and low immunogenicity [ 29 , 30 ]. However, enhancing the regenerative and protective potency of MSCs is critical, considering their severity, which leads to a high mortality rate. We have previously investigated the enhanced therapeutic efficacy of preconditioned MSCs, specifically with LPS and thrombin [ 26 , 27 , 31 ]. Preconditioning involves educating MSCs before transplantation to the injured area by pre-exposing them to specific stimuli, such as LPS or E. coli for inflammation and thrombin for hemorrhagic injury, allowing MSCs to readily exert therapeutic effects. E. coli -preconditioned MSCs exert anti-inflammatory and bactericidal effects by secreting defensin [ 31 ], whereas thrombin-preconditioned MSCs significantly increase angiogenic factors which improve vascular permeability and tissue injury through PAR1 and PAR3 signaling [ 17 ]. We have further confirmed the enhanced therapeutic efficacy of thMSCs compared to the naïve MSCs in neonatal IVH study, and further confirmed equivalent therapeutic efficacy of thMSCs and thMSC-EVs in neonatal meningitis study [ 18 , 32 ]. Building on our previous confirmation of antimicrobial, anti-inflammatory, and anti-apoptotic effects of LPS-preconditioned MSCs in an E. coli -induced ALI mouse model [ 26 , 31 ], this study aimed to further assess the therapeutic efficacy of thrombin-preconditioned MSCs derived EVs in tissue injuries using the same E. coli -induced ALI mouse model in the present study.
The interplay between inflammation and coagulation pathways mediating PAR activation in ARDS/ALI is well known to induce severe and diffuse lung tissue injury [ 2 , 22 , 23 , 25 , 33 , 34 ]. Among the four PAR subtypes, PAR1, PAR3, and PAR4 are activated by thrombin, a serine protease that regulates blood coagulation. Hemorrhage increases thrombin levels in the area, further activating PAR-expressing endothelial, epithelial, and immune cells. Upon infection, activated immune cells induce vascular permeability, recruiting immune cells and blood coagulation factors to the injury site. Hypercoagulability can increase circulatory levels of fibrinogen and d-dimer, not only within the blood but also in the lungs [ 35 ]. Fibrin formation, reflecting localized microthrombi and endothelial damage in the pulmonary microcirculation, leads to plasma exudation, tissue factor-mediated thrombin generation, and the development of fibrinous hyaline membranes, a characteristic of the inflammatory response in ARDS [ 24 ]. The interaction between inflammation and vascular activation cumulatively induces lung damage [ 36 ]. An increase in PAR signaling has been recapitulated in multiple experimental ALI animal models [ 25 , 37 ]. The present study observed that MSCs preconditioned with thrombin, a substance indicative of coagulative status, improved lung injury in E. coli-induced infectious ARDS via an anti-inflammatory response from EVs. We postulate that the protective factors secreted through EVs in PAR-activated thrombin-preconditioned MSCs may have been the mechanism of thMSC-EVs’ improvement of tissue injuries, which is known to be mediated by PAR. However, further study is needed to determine whether its efficacy varies according to the degree of hypercoagulable status in vivo, as evidenced by the variable level of hypercoagulability markers such as fibrinogen and d-dimer.
In this study, we histologically confirmed a significant reduction in leukocyte infiltration, pulmonary edema, and alveolar wall thickening after the intratracheal administration of thMSC-EVs. Our previous report demonstrated the thrombin-activated PARs in MSCs enhanced the secretion of the angiogenic cargo angiogenin, angiopoietin-1, and vascular endothelial growth factor (VEGF) in thrombin-preconditioned MSCs compared to those in LPS-preconditioned MSCs [ 17 ]. We have confirmed a significant increase in the secretion of HGF and VEGF in thrombin-preconditioned MSCs, in which the thMSC-EVs were isolated, compared to the naïve MSCs (Supplementary Figure S2 ). HGF, VEGF, angiogenin, and angiopoietin-1 are known to reduce inflammation, endothelial cell activation, apoptosis, and fibrosis [ 38 , 39 , 40 , 41 , 42 , 43 , 44 ], which presumably contributed to attenuating tissue injuries in the present study. Gupta et al. demonstrated the therapeutic effect of MSCs against bacterial pneumonia in a mouse model of PAR1-mutated mouse bone marrow-derived MSCs, suggesting that PAR signaling is critical for the survival and therapeutic efficacy of MSCs [ 45 ]. Our findings of reduced alveolar wall thickness, alveolar congestion, and leukocyte infiltration can be attributed to the protective cargo content of thMSC-EVs.
Upon thrombin activation, PAR-expressing epithelial, endothelial, and immune cells secrete significant levels of inflammatory cytokines and chemokines [ 22 ]. Classically activated M1 macrophages upregulate the production of pro-inflammatory cytokines, including IL-6, IL-1α, IL-1β, and TNF-α, which, under excessive secretion and accumulation, leads to increased vascular permeability and damaged alveolar epithelium and endothelium [ 2 , 22 , 26 , 46 , 47 ]. In this study, a significant reduction of pro-inflammatory cytokines IL-1β, CCL-2, and MMP-9 can be attributed to the suppression of M1 polarization, without meaningful modulation of M2 polarization, in LPS-induced RAW 264.7 cells (Fig. 4 ). Several studies have also reported a reduction of lung injury via M1 suppression, supporting the idea that macrophage polarization is a dynamic process rather than strictly dichotomous [ 48 , 49 , 50 , 51 ]. Decreased levels of the major neutrophil-recruiting factor, CCL-2, were also evident in BALF and tissue histology measurements. MMP-9, a proteinase secreted by macrophages and regulating extracellular matrix degradation, is associated with fibrosis, indicating the therapeutic efficacy of thMSC-EVs in fibrosis [ 52 , 53 ]. In vivo, thMSC-EVs significantly reduced the levels of TNF- 𝛼 , IL-6, and CCL-2 in E. coli -induced mice, with non-significant decreases in the mean of IL-1 𝛼 and IL-1β (Fig. 7 ). Statistical non-significance can be attributed to the lack of antimicrobial effects of thMSC-EVs, though not measured in this study. In our previous study using LPS-preconditioned MSCs, TLR4 signaling activation mediated immune modulation and bacterial clearance synergistically, resulting in a broader anti-inflammatory response [ 31 ]. However, thMSC-EVs administration to our previous E. coli -induced meningitis rat model study did not show bacterial clearance, similar to the present study. The stimuli-dependent modulation of cargo in MSCs-derived EVs is a highly advantageous approach for developing disease-specific therapeutics [ 18 ]. In summary, this study confirmed the protective therapeutic effect of thMSC-EVs by significantly reducing alveolar wall thickening, congestion, vascular permeability, and macrophage activation.
Challenges in the classical method of CT image analysis in small rodents include ambiguous air-surface contrast and complicated segmentation of the lung parenchymal regions because of intrathoracic structures, including the vasculature, heart, and airways [ 54 , 55 ]. Here, we present a more feasible and accurate method for quantitative CT image analysis of small rodents by manually but precisely segmenting the lungs using semi-automatically calculated aerated parenchymal volumes. The therapeutic effect of thMSC-EVs was further confirmed macroscopically using CT image analysis. Quantitative CT image analysis revealed reduced diffuse patchy regions after intratracheal thMSC-EVs administration. Thus, we present a reliable and reproducible CT image analysis method which allows the precise evaluation of lung tissue in small rodents.
Despite several recent studies, the demand for an effective treatment for ARDS/ALI remains unmet [ 56 , 57 , 58 ]. A pharmacological approach investigates the use of drugs like anticoagulants, utilizing the effective targeting of a specific signaling pathway. A study suggested that nebulized antithrombin effectively ameliorated acute lung injury by decreasing coagulation and inflammation without altering the systemic coagulation [ 59 ]. MSCs are another promising therapeutic approach for lung injury, considering their stable secretion and delivery of regenerative factors to neighboring cells via EVs [ 13 , 60 , 61 , 62 ]. WJ-MSCs are known for their higher proliferative capacity, non-tumorigenic properties, and rich secretome than those with other sources of MSCs [ 13 , 63 ]. Recently, MSCs-derived EVs have been clinically evaluated for treating ARDS. [ 64 , 65 , 66 , 67 , 68 ]. EVs are advanced stem cell therapeutics, characteristically cell-free, low in immunogenicity and tumorigenic potential, and are more feasible form as “off the shelf” therapeutics [ 69 , 70 , 71 ]. Studies on preconditioned MSCs or derived EVs in ARDS/ALI preclinical models are not frequently performed despite their significant advantage in enhancing therapeutic efficacy. Therefore, the significance of this study lies in its investigation of the therapeutic efficacy of cargo-enhanced, injury-preexposed MSCs in an ALI experimental model. Considering that the therapeutic effect of EVs depends on their cargo, strategies to modulate and enhance its cargo cannot be overemphasized as the power of EV therapeutics. In that sense, thMSC-EVs may offer a broader range of therapeutic effects than specific pathway-targeting therapeutics such as anticoagulants in ARDS, since its much-enhanced cargo and production amount secreted by the MSCs with thrombin preconditioning involve various pathways but not limited to anti-inflammation. During the isolation of thMSC-EVs using the TFF system, thrombin should have theoretically filtered out, leaving no significant leftovers to alter the study results. However for translational research, the confirmation of thrombin leftover levels will be included in future studies.
From gross to microscopic analysis, we have thoroughly evaluated the therapeutic effect of thMSC-EVs in reducing E.coli -induced acute lung injury. thMSC-EVs reduced tissue damage, pulmonary edema, inflammatory cytokine levels (CCL2, TNF-α, and IL-6), and damaged lung regions on CT image analysis, which are crucial therapeutic indicators of ARDS/ALI. There was no significant difference in body weight and mortality, which are indicators of animal well-being. However, we postulate that considering the severity of ALI-induction and intratracheal, not systemic, administration of thMSC-EVs, 3-day observation was too short to observe acute improvements in body weight and survival. A longer observation may help confirm the holistic animal improvements. Therefore, a long-term follow-up study will be needed. In conclusion, therapeutically enhanced MSC-EVs represent a novel potential therapeutic option for ARDS/ALI.
All data generated or analyzed during this study are included in this published article and its supplementary information files.
Matuschak GM, Lechner AJ. Acute lung injury and the acute respiratory distress syndrome: pathophysiology and treatment. Mo Med. 2010;107(4):252–8.
PubMed PubMed Central Google Scholar
Bos LDJ, Ware LB. Acute respiratory distress syndrome: causes, pathophysiology, and phenotypes. Lancet. 2022;400(10358):1145–56.
Article PubMed Google Scholar
Matthay MA, et al. Acute respiratory distress syndrome. Nat Reviews Disease Primers. 2019;5(1):18.
Lee KY, Pneumonia AR. Distress syndrome, and early Immune-Modulator Therapy. Int J Mol Sci, 2017. 18(2).
Lee JW, et al. Therapeutic effects of human mesenchymal stem cells in ex vivo human lungs injured with live bacteria. Am J Respir Crit Care Med. 2013;187(7):751–60.
Article CAS PubMed PubMed Central Google Scholar
Bellani G, et al. Epidemiology, patterns of Care, and mortality for patients with Acute Respiratory Distress Syndrome in Intensive Care Units in 50 countries. JAMA. 2016;315(8):788–800.
Article CAS PubMed Google Scholar
Lee JH, Park J, Lee JW. Therapeutic use of mesenchymal stem cell-derived extracellular vesicles in acute lung injury. Transfusion. 2019;59(S1):876–83.
Zhu YG, et al. Human mesenchymal stem cell microvesicles for treatment of Escherichia coli endotoxin-induced acute lung injury in mice. Stem Cells. 2014;32(1):116–25.
Monsel A, et al. Therapeutic effects of Human mesenchymal stem cell-derived microvesicles in severe pneumonia in mice. Am J Respir Crit Care Med. 2015;192(3):324–36.
Tang X-D, et al. Mesenchymal stem cell microvesicles attenuate Acute Lung Injury in mice partly mediated by Ang-1 mRNA. Stem Cells. 2017;35(7):1849–59.
Ha DH et al. Mesenchymal Stem/Stromal cell-derived exosomes for Immunomodulatory Therapeutics and skin regeneration. Cells, 2020. 9(5).
Manzoor T, et al. Extracellular vesicles derived from mesenchymal stem cells — a novel therapeutic tool in infectious diseases. Inflamm Regeneration. 2023;43(1):17.
Article CAS Google Scholar
Drobiova H, et al. Wharton’s jelly mesenchymal stem cells: a concise review of their secretome and prospective clinical applications. Front Cell Dev Biol. 2023;11:1211217.
Article PubMed PubMed Central Google Scholar
Hu C, Li L. Preconditioning influences mesenchymal stem cell properties in vitro and in vivo. J Cell Mol Med. 2018;22(3):1428–42.
Saparov A, et al. Preconditioning of human mesenchymal stem cells to Enhance their regulation of the Immune response. Stem Cells Int. 2016;2016:3924858.
Sung DK et al. Thrombin preconditioning of Extracellular vesicles derived from mesenchymal stem cells accelerates cutaneous Wound Healing by boosting their Biogenesis and enriching Cargo Content. J Clin Med, 2019. 8(4).
Sung DK et al. Thrombin Preconditioning boosts Biogenesis of Extracellular vesicles from mesenchymal stem cells and enriches their Cargo contents via protease-activated receptor-mediated signaling pathways. Int J Mol Sci, 2019. 20(12).
Kim YE et al. Mesenchymal-stem-cell-derived extracellular vesicles attenuate Brain Injury in Escherichia coli Meningitis in Newborn rats. Life (Basel), 2022. 12(7).
Ahn SY, et al. Mesenchymal stem cells transplantation attenuates brain injury and enhances bacterial clearance in Escherichia coli meningitis in newborn rats. Pediatr Res. 2018;84(5):778–85.
Kim YE et al. Thrombin Preconditioning Enhances Therapeutic Efficacy of Human Wharton’s Jelly-Derived Mesenchymal Stem Cells in Severe Neonatal Hypoxic Ischemic Encephalopathy. Int J Mol Sci, 2019. 20(10).
Bunnett NW. Protease-activated receptors: how Proteases Signal to cells to cause inflammation and Pain. Semin Thromb Hemost. 2006;32(1):039–48.
Chambers RC. Procoagulant signalling mechanisms in lung inflammation and fibrosis: novel opportunities for pharmacological intervention? Br J Pharmacol. 2008;153(Suppl 1):S367–78.
CAS PubMed PubMed Central Google Scholar
Shebuski RJ, Kilgore KS. Role of inflammatory mediators in thrombogenesis. J Pharmacol Exp Ther. 2002;300(3):729–35.
Frantzeskaki F, Armaganidis A, Orfanos SE. Immunothrombosis in Acute Respiratory Distress Syndrome: Cross talks between inflammation and coagulation. Respiration. 2017;93(3):212–25.
Lou J, et al. Endothelial cell-specific anticoagulation reduces inflammation in a mouse model of acute lung injury. Acta Pharmacol Sin. 2019;40(6):769–80.
Kim YE et al. SOCS3 protein mediates the therapeutic efficacy of mesenchymal stem cells against Acute Lung Injury. Int J Mol Sci, 2023. 24(9).
Hwang S et al. Mesenchymal stromal cells primed by toll-like receptors 3 and 4 enhanced anti-inflammatory effects against LPS-Induced macrophages via Extracellular vesicles. Int J Mol Sci, 2023. 24(22).
Kim ES, et al. Intratracheal transplantation of human umbilical cord blood-derived mesenchymal stem cells attenuates Escherichia coli-induced acute lung injury in mice. Respir Res. 2011;12(1):108.
Leavitt RJ, Limoli CL, Baulch JE. miRNA-based therapeutic potential of stem cell-derived extracellular vesicles: a safe cell-free treatment to ameliorate radiation-induced brain injury. Int J Radiat Biol. 2019;95(4):427–35.
Xu B, et al. Stem cell derived exosomes-based therapy for acute lung injury and acute respiratory distress syndrome: a novel therapeutic strategy. Life Sci. 2020;254:117766.
Sung DK, et al. Antibacterial effect of mesenchymal stem cells against Escherichia coli is mediated by secretion of beta- defensin- 2 via toll- like receptor 4 signalling. Cell Microbiol. 2016;18(3):424–36.
Jung SY et al. Thrombin Preconditioning improves the therapeutic efficacy of mesenchymal stem cells in severe Intraventricular Hemorrhage Induced neonatal rats. Int J Mol Sci, 2022. 23(8).
Mokra D. Acute lung injury - from pathophysiology to treatment. Physiol Res. 2020;69(Suppl 3):S353–66.
Shorr AF, et al. D-dimer correlates with proinflammatory cytokine levels and outcomes in critically ill patients. Chest. 2002;121(4):1262–8.
Bonaventura A, et al. Endothelial dysfunction and immunothrombosis as key pathogenic mechanisms in COVID-19. Nat Rev Immunol. 2021;21(5):319–29.
Sharp C, Millar AB, Medford AR. Advances in understanding of the pathogenesis of acute respiratory distress syndrome. Respiration. 2015;89(5):420–34.
Howell DC, et al. Absence of proteinase-activated receptor-1 signaling affords protection from bleomycin-induced lung inflammation and fibrosis. Am J Pathol. 2005;166(5):1353–65.
Murray LA et al. Antifibrotic role of vascular endothelial growth factor in pulmonary fibrosis. JCI Insight, 2017. 2(16).
Stockmann C, et al. Loss of myeloid cell-derived vascular endothelial growth factor accelerates fibrosis. Proc Natl Acad Sci U S A. 2010;107(9):4329–34.
Thurston G, et al. Angiopoietin-1 protects the adult vasculature against plasma leakage. Nat Med. 2000;6(4):460–3.
Kim I, et al. Angiopoietin-1 reduces VEGF-stimulated leukocyte adhesion to endothelial cells by reducing ICAM-1, VCAM-1, and E-selectin expression. Circ Res. 2001;89(6):477–9.
Ong T, et al. Ratio of angiopoietin-2 to angiopoietin-1 as a predictor of mortality in acute lung injury patients. Crit Care Med. 2010;38(9):1845–51.
Coudriet GM, et al. Hepatocyte growth factor modulates interleukin-6 production in bone marrow derived macrophages: implications for inflammatory mediated diseases. PLoS ONE. 2010;5(11):e15384.
Lee SH et al. Angiogenin reduces immune inflammation via inhibition of TANK-binding kinase 1 expression in human corneal fibroblast cells. Mediators Inflamm, 2014. 2014: p. 861435.
Gupta N, et al. The TLR4-PAR1 Axis regulates bone marrow mesenchymal stromal cell survival and therapeutic capacity in experimental bacterial pneumonia. Stem Cells. 2018;36(5):796–806.
Liu C, Xiao K, Xie L. Progress in preclinical studies of macrophage autophagy in the regulation of ALI/ARDS. Front Immunol. 2022;13:922702.
Yao Y, Xu XH, Jin L. Macrophage polarization in physiological and pathological pregnancy. Front Immunol. 2019;10:792.
Xu MM, et al. Melatonin improves influenza virus infection-induced acute exacerbation of COPD by suppressing macrophage M1 polarization and apoptosis. Respir Res. 2024;25(1):186.
Chang C, et al. Exogenous IL-25 ameliorates airway neutrophilia via suppressing macrophage M1 polarization and the expression of IL-12 and IL-23 in asthma. Respir Res. 2023;24(1):260.
Kim J, et al. Innate immune crosstalk in asthmatic airways: innate lymphoid cells coordinate polarization of lung macrophages. J Allergy Clin Immunol. 2019;143(5):1769–e178211.
Msheik Z, et al. The macrophage: a key player in the pathophysiology of peripheral neuropathies. J Neuroinflammation. 2022;19(1):97.
Craig VJ, et al. Matrix metalloproteinases as therapeutic targets for idiopathic pulmonary fibrosis. Am J Respir Cell Mol Biol. 2015;53(5):585–600.
Bergin PJ, et al. Secretion of matrix metalloproteinase-9 by macrophages, in vitro, in response to Helicobacter pylori. FEMS Immunol Med Microbiol. 2005;45(2):159–69.
Redente EF, et al. Application-specific approaches to MicroCT for evaluation of mouse models of pulmonary disease. PLoS ONE. 2023;18(2):e0281452.
Shofer S, et al. A micro-computed tomography-based method for the measurement of pulmonary compliance in healthy and bleomycin-exposed mice. Exp Lung Res. 2007;33(3–4):169–83.
Zhao J et al. NETs promote Inflammatory Injury by activating cGAS-STING pathway in Acute Lung Injury. Int J Mol Sci, 2023. 24(6).
Huang CY et al. Attenuation of Lipopolysaccharide-Induced Acute Lung Injury by Hispolon in mice, through regulating the TLR4/PI3K/Akt/mTOR and Keap1/Nrf2/HO-1 pathways, and suppressing oxidative stress-mediated ER stress-Induced apoptosis and autophagy. Nutrients, 2020. 12(6).
Gonzalez H, et al. Nebulised mesenchymal stem cell derived extracellular vesicles ameliorate E. Coli induced pneumonia in a rodent model. Stem Cell Res Ther. 2023;14(1):151.
Camprubí-Rimblas M, et al. Effects of nebulized antithrombin and heparin on inflammatory and coagulation alterations in an acute lung injury model in rats. J Thromb Haemost. 2020;18(3):571–83.
Baek G, et al. Mesenchymal stem cell-derived extracellular vesicles as therapeutics and as a drug delivery platform. Stem Cells Transl Med. 2019;8(9):880–6.
Guo H, Su Y, Deng F. Effects of Mesenchymal Stromal Cell-Derived Extracellular vesicles in Lung diseases: current status and future perspectives. Stem Cell Reviews Rep. 2021;17(2):440–58.
Article Google Scholar
Sharma M, et al. Mesenchymal stem cell-derived Extracellular vesicles prevent experimental Bronchopulmonary Dysplasia Complicated by Pulmonary Hypertension. Stem Cells Transl Med. 2022;11(8):828–40.
Watson N, et al. Discarded Wharton jelly of the human umbilical cord: a viable source for mesenchymal stromal cells. Cytotherapy. 2015;17(1):18–24.
Sengupta V, et al. Exosomes derived from bone marrow mesenchymal stem cells as treatment for severe COVID-19. Stem Cells Dev. 2020;29(12):747–54.
Zarrabi M, et al. Allogenic mesenchymal stromal cells and their extracellular vesicles in COVID-19 induced ARDS: a randomized controlled trial. Stem Cell Res Ther. 2023;14(1):169.
Chu M, et al. Nebulization therapy with umbilical cord mesenchymal stem cell-derived exosomes for COVID-19 Pneumonia. Stem Cell Reviews Rep. 2022;18(6):2152–63.
Lightner AL et al. Bone Marrow Mesenchymal Stem Cell-Derived Extracellular Vesicle Infusion for the Treatment of Respiratory Failure From COVID-19: A Randomized, Placebo-Controlled Dosing Clinical Trial. Chest, 2023.
Zhuang X, et al. Advances of mesenchymal stem cells and their derived extracellular vesicles as a promising therapy for acute respiratory distress syndrome: from bench to clinic. Front Immunol. 2023;14:1244930.
Su Y, Guo H, Liu Q. Effects of mesenchymal stromal cell-derived extracellular vesicles in acute respiratory distress syndrome (ARDS): current understanding and future perspectives. J Leukoc Biol. 2021;110(1):27–38.
Yi X, et al. Exosomes derived from microRNA-30b-3p-overexpressing mesenchymal stem cells protect against lipopolysaccharide-induced acute lung injury by inhibiting SAA3. Exp Cell Res. 2019;383(2):111454.
Abas BI, Demirbolat GM, Cevik O. Wharton jelly-derived mesenchymal stem cell exosomes induce apoptosis and suppress EMT signaling in cervical cancer cells as an effective drug carrier system of paclitaxel. PLoS ONE. 2022;17(9):e0274607.
Download references
We thank Donglim Kang for EV production and Yea Jin Lee for technical assistance in animal study.
This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HR22C1363); by the Korean Fund for Regenerative Medicine (KFRM) grant funded by the Korean government (Ministry of Science and ICT, Ministry of Health & Welfare) (23C0119L1); and the Future Medicine 2030 Project from Samsung Medical Center (SMX1240621).
Yuna Bang and Sein Hwang contributed equally to this work.
Cell and Gene Therapy Institute, Samsung Medical Center, Seoul, 06351, Republic of Korea
Yuna Bang, Sein Hwang, Young Eun Kim, Dong Kyung Sung, Misun Yang, So Yoon Ahn, Se In Sung & Yun Sil Chang
Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, 06351, Republic of Korea
Sein Hwang, Kyeung Min Joo & Yun Sil Chang
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
Young Eun Kim, Misun Yang, So Yoon Ahn, Se In Sung & Yun Sil Chang
Department of Anatomy & Cell Biology, Sungkyunkwan University School of Medicine, Suwon, 16419, Republic of Korea
Yuna Bang & Kyeung Min Joo
You can also search for this author in PubMed Google Scholar
Conceptualization, Y.S.C.; methodology, Y.B., S.H. and Y.E.K.; formal analysis, Y.B., S.H. and Y.E.K.; investigation, Y.B., S.H.,Y.E.K, D.K.S., M.Y.,S.Y.A., S.I.S.,K.M.J.,Y.S.C.; writing-original draft, Y.B.,S.H.; writing-review and editing, Y.S.C.; supervision, Y.S.C.; funding acquisition, S.Y.A., and Y.S.C. All authors have read and agreed to the published version of the manuscript.
Correspondence to Yun Sil Chang .
Ethics approval and consent to participate.
All animal experimental protocols were reviewed and approved by the Institutional Animal Care and Use Committee (IACUC, Approval number: 20230126004) of the Samsung Biomedical Research Institute, an AAALAC International (Association for Assessment and Accreditation of Laboratory Animal Care)-accredited facility, under the National Institutes of Health Guidelines for Laboratory Animal Care.
Not applicable.
The funders had no role in the design of this study, in the collection, analyses, or interpretation of data, in the writing of the manuscript, or in the decision to publish the results. Yun Sil Chang, So Yoon Ahn, and Dong Kyung Sung declare potential conflicts of interest arising from a filed or issued patent titled “Composition for treating infectious diseases comprising exosomes derived from thrombin-treated stem cells. (10-2020-0161582) (18/036,474) (2023-528342) (202180077317.3) (21898556.2)” and “Method for promoting generation of stem cell-derived exosome by using thrombin (10-1643825) (03081223) (6343671) (09982233)” as co-inventors, not as patentees.
Publisher’s note.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Below is the link to the electronic supplementary material.
Supplementary material 2, supplementary material 3, rights and permissions.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Reprints and permissions
Cite this article.
Bang, Y., Hwang, S., Kim, Y.E. et al. Therapeutic efficacy of thrombin-preconditioned mesenchymal stromal cell-derived extracellular vesicles on Escherichia coli -induced acute lung injury in mice. Respir Res 25 , 303 (2024). https://doi.org/10.1186/s12931-024-02908-w
Download citation
Received : 16 April 2024
Accepted : 07 July 2024
Published : 07 August 2024
DOI : https://doi.org/10.1186/s12931-024-02908-w
Anyone you share the following link with will be able to read this content:
Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative
ISSN: 1465-993X
Hiya Images/Corbis/VCG/Getty Images
In experiments, controls are factors that you hold constant or don't expose to the condition you are testing. By creating a control, you make it possible to determine whether the variables alone are responsible for an outcome. Although control variables and the control group serve the same purpose, the terms refer to two different types of controls which are used for different kinds of experiments.
A student places a seedling in a dark closet, and the seedling dies. The student now knows what happened to the seedling, but he doesn't know why. Perhaps the seedling died from lack of light, but it might also have died because it was already sickly, or because of a chemical kept in the closet, or for any number of other reasons.
In order to determine why the seedling died, it is necessary to compare that seedling's outcomes to another identical seedling outside the closet. If the closeted seedling died while the seedling kept in sunshine stayed alive, it's reasonable to hypothesize that darkness killed the closeted seedling.
Even if the closeted seedling died while the seedling placed in sunshine lived, the student would still have unresolved questions about her experiment. Might there be something about the particular seedlings that caused the results she saw? For example, might one seedling have been healthier than the other to start with?
To answer all of her questions, the student might choose to put several identical seedlings in a closet and several in the sunshine. If at the end of a week, all of the closeted seedlings are dead while all of the seedlings kept in the sunshine are alive, it is reasonable to conclude that the darkness killed the seedlings.
A control variable is any factor you control or hold constant during an experiment. A control variable is also called a controlled variable or constant variable.
If you are studying the effect of the amount of water on seed germination, control variables might include temperature, light, and type of seed. In contrast, there may be variables you can't easily control, such as humidity, noise, vibration, and magnetic fields.
Ideally, a researcher wants to control every variable, but this isn't always possible. It's a good idea to note all recognizable variables in a lab notebook for reference.
A control group is a set of experimental samples or subjects that are kept separate and aren't exposed to the independent variable .
In an experiment to determine whether zinc helps people recover faster from a cold, the experimental group would be people taking zinc, while the control group would be people taking a placebo (not exposed to extra zinc, the independent variable).
A controlled experiment is one in which every parameter is held constant except for the experimental (independent) variable. Usually, controlled experiments have control groups. Sometimes a controlled experiment compares a variable against a standard.
You are accessing a machine-readable page. In order to be human-readable, please install an RSS reader.
All articles published by MDPI are made immediately available worldwide under an open access license. No special permission is required to reuse all or part of the article published by MDPI, including figures and tables. For articles published under an open access Creative Common CC BY license, any part of the article may be reused without permission provided that the original article is clearly cited. For more information, please refer to https://www.mdpi.com/openaccess .
Feature papers represent the most advanced research with significant potential for high impact in the field. A Feature Paper should be a substantial original Article that involves several techniques or approaches, provides an outlook for future research directions and describes possible research applications.
Feature papers are submitted upon individual invitation or recommendation by the scientific editors and must receive positive feedback from the reviewers.
Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.
Original Submission Date Received: .
Find support for a specific problem in the support section of our website.
Please let us know what you think of our products and services.
Visit our dedicated information section to learn more about MDPI.
Intestinal microbiome profiles in broiler chickens raised with different probiotic strains.
Silva, J.M.S.d.; Almeida, A.M.D.S.; Borsanelli, A.C.; Athayde, F.R.F.d.; Nascente, E.d.P.; Batista, J.M.M.; Gouveia, A.B.V.S.; Stringhini, J.H.; Leandro, N.S.M.; Café, M.B. Intestinal Microbiome Profiles in Broiler Chickens Raised with Different Probiotic Strains. Microorganisms 2024 , 12 , 1639. https://doi.org/10.3390/microorganisms12081639
Silva JMSd, Almeida AMDS, Borsanelli AC, Athayde FRFd, Nascente EdP, Batista JMM, Gouveia ABVS, Stringhini JH, Leandro NSM, Café MB. Intestinal Microbiome Profiles in Broiler Chickens Raised with Different Probiotic Strains. Microorganisms . 2024; 12(8):1639. https://doi.org/10.3390/microorganisms12081639
Silva, Julia Marixara Sousa da, Ana Maria De Souza Almeida, Ana Carolina Borsanelli, Flávia Regina Florencio de Athayde, Eduardo de Paula Nascente, João Marcos Monteiro Batista, Alison Batista Vieira Silva Gouveia, José Henrique Stringhini, Nadja Susana Mogyca Leandro, and Marcos Barcellos Café. 2024. "Intestinal Microbiome Profiles in Broiler Chickens Raised with Different Probiotic Strains" Microorganisms 12, no. 8: 1639. https://doi.org/10.3390/microorganisms12081639
Article access statistics, further information, mdpi initiatives, follow mdpi.
Subscribe to receive issue release notifications and newsletters from MDPI journals
IMAGES
COMMENTS
In a controlled experiment, scientists compare a control group, and an experimental group is identical in all respects except for one difference - experimental manipulation.. Differences. Unlike the experimental group, the control group is not exposed to the independent variable under investigation. So, it provides a baseline against which any changes in the experimental group can be compared.
The control group and experimental group are compared against each other in an experiment. The only difference between the two groups is that the independent variable is changed in the experimental group. The independent variable is "controlled", or held constant, in the control group. A single experiment may include multiple experimental ...
A true experiment (a.k.a. a controlled experiment) always includes at least one control group that doesn't receive the experimental treatment.. However, some experiments use a within-subjects design to test treatments without a control group. In these designs, you usually compare one group's outcomes before and after a treatment (instead of comparing outcomes between different groups).
An experimental group is the group that receives the variable being tested in an experiment. The control group is the group in an experiment that does not receive the variable you are testing. For ...
There are two groups in the experiment, and they are identical except that one receives a treatment (water) while the other does not. The group that receives the treatment in an experiment (here, the watered pot) is called the experimental group, while the group that does not receive the treatment (here, the dry pot) is called the control group.The control group provides a baseline that lets ...
This group typically receives no treatment. These experiments compare the effectiveness of the experimental treatment to no treatment. For example, in a vaccine study, a negative control group does not get the vaccine. Positive Control Group. Positive control groups typically receive a standard treatment that science has already proven effective.
Three types of experimental designs are commonly used: 1. Independent Measures. Independent measures design, also known as between-groups, is an experimental design where different participants are used in each condition of the independent variable. This means that each condition of the experiment includes a different group of participants.
In an experiment, the control is a standard or baseline group not exposed to the experimental treatment or manipulation.It serves as a comparison group to the experimental group, which does receive the treatment or manipulation. The control group helps to account for other variables that might influence the outcome, allowing researchers to attribute differences in results more confidently to ...
control group, the standard to which comparisons are made in an experiment. Many experiments are designed to include a control group and one or more experimental groups; in fact, some scholars reserve the term experiment for study designs that include a control group. Ideally, the control group and the experimental groups are identical in every ...
The types of groups and method of assigning participants to groups will help you implement control in your experiment. Control groups. Controlled experiments require control groups ... You use a computer program to randomly place each number into either a control group or an experimental group. Because of random assignment, the two groups have ...
Experiments play an important role in the research process and allow psychologists to investigate cause-and-effect relationships between different variables. Having one or more experimental groups allows researchers to vary different levels or types of the experimental variable and then compare the effects of these changes against a control group.
A control group is not the same thing as a control variable. A control variableor controlled variable is any factor that is held constant during an experiment. Examples of common control variables include temperature, duration, and sample size. The control variables are the same for both the control and experimental groups.
In a properly designed experiment, the control group and the experimental group should be identical in every way except for the variable being tested. Thus, the control group serves to isolate and affirm the effects of the variable, ensuring that the observed changes in the experimental group are genuinely due to the manipulated variable and ...
A true experiment (aka a controlled experiment) always includes at least one control group that doesn't receive the experimental treatment.. However, some experiments use a within-subjects design to test treatments without a control group. In these designs, you usually compare one group's outcomes before and after a treatment (instead of comparing outcomes between different groups).
A control group in a scientific experiment is a group separated from the rest of the experiment, where the independent variable being tested cannot influence the results. This isolates the independent variable's effects on the experiment and can help rule out alternative explanations of the experimental results. Control groups can also be separated into two other types: positive or negative.
Experiments that look at the effects of medications on certain conditions are also examples of how a control group can be used in research. For example, researchers looking at the effectiveness of a new antidepressant might use a control group that receives a placebo and an experimental group that receives the new medication.
A control group is a group in an experiment that does not receive the experimental treatment and is used as a comparison for the group that does receive the treatment. It is a critical aspect of experimental research to determine whether the treatment caused the outcome rather than another factor.
An experimental group in a scientific experiment is the group on which the experimental procedure is performed. The independent variable is changed for the group and the response or change in the dependent variable is recorded. In contrast, the group that does not receive the treatment or in which the independent variable is held constant is ...
A true experiment (a.k.a. a controlled experiment) always includes at least one control group that doesn't receive the experimental treatment. However, some experiments use a within-subjects design to test treatments without a control group.
Experimental and control groups. In a true experiment, the effect of an intervention is tested by comparing two groups: one that is exposed to the intervention (the experimental group, also known as the treatment group) and another that does not receive the intervention (the control group). Importantly, participants in a true experiment need to ...
Experimental Group Definition. In a comparative experiment, the experimental group (aka the treatment group) is the group being tested for a reaction to a change in the variable. There may be experimental groups in a study, each testing a different level or amount of the variable. The other type of group, the control group, can show the effects ...
Treatment and control groups. In the design of experiments, hypotheses are applied to experimental units in a treatment group. [ 1] In comparative experiments, members of a control group receive a standard treatment, a placebo, or no treatment at all. [ 2] There may be more than one treatment group, more than one control group, or both.
Random assignment is used in experiments with a between-groups or independent measures design. In this research design, there's usually a control group and one or more experimental groups. Random assignment helps ensure that the groups are comparable.
What Is a Control Group in an Experiment. A control group is a set of subjects in an experiment who are not exposed to the independent variable. The purpose of a control group is to serve as a baseline for comparison. By having a group that is not exposed to the treatment, researchers can compare the results of the experimental group and determine whether the independent variable had an impact.
The dependent variable is the outcome of interest—the outcome that depends on the experimental set-up. Experiments are set-up to learn more about how the independent variable does or does not affect the dependent variable. ... a control group is a group of individuals or cases that is treated in the same way as the experimental group, but ...
In the groups given kefir along with CTX, the moderate change seen in the CTX group decreased to a slight change and approached the control group (Table 1). In this sense, in addition to its ...
Background Acute lung injury (ALI) following pneumonia involves uncontrolled inflammation and tissue injury, leading to high mortality. We previously confirmed the significantly increased cargo content and extracellular vesicle (EV) production in thrombin-preconditioned human mesenchymal stromal cells (thMSCs) compared to those in naïve and other preconditioning methods. This study aimed to ...
A scientific control is an experiment or observation designed to minimize the effects of variables other than the independent variable ... if the treatment group and the negative control both produce a negative result, it can be inferred that the treatment had no effect. ... the groups that receive different experimental treatments are ...
A control group is a set of experimental samples or subjects that are kept separate and aren't exposed to the independent variable . In an experiment to determine whether zinc helps people recover faster from a cold, the experimental group would be people taking zinc, while the control group would be people taking a placebo (not exposed to ...
The composition of the intestinal microbiota can influence the metabolism and overall functioning of avian organisms. Therefore, the objective of this study was to evaluate the effect of three different probiotics and an antibiotic on the microbiomes of 1.400 male Cobb® broiler raised for 42 days. The experiment was conducted with the following treatments: positive control diet (basal diet ...