MSC‐EXO and tempol ameliorate bronchopulmonary dysplasia in newborn rats by activating HIF‐1α

Abstract Background Bronchopulmonary dysplasia (BPD) is a major complication of premature infants and an important cause of morbidity and mortality. This study investigates the effect of the combination of mesenchymal stem cells‐derived exosomes (MSC‐EXO) and tempol on BPD and analyzes its mechanism. Methods MSC‐EXO was extracted by centrifugation and identified by transmission electron microscopy (TEM), nanoparticle tracking analysis, and western blot analysis (WB). Tidal volume (TV), minute ventilation (MV), peak inspiratory flow (PIF), and dynamic pulmonary compliance (Cdyn) of rats were measured by BuxCo pulmonary function experimental platform. Hematoxylin‐eosin staining was performed to observe the lung morphology and radical alveolar count (RAC) and mean linear intercept (MLI) were assessed. Immunofluorescence (IF) was conducted to detect the expression of CD31 and α‐SMA in pulmonary blood vessels. The kits were used to calculate malondialdehyde (MDA), superoxide dismutase (SOD), and total antioxidant capacity (TAOC) concentration in lung tissue. Enzyme linked immunosorbent assay was applied to detect the levels of IL‐1β, IL‐17, IL‐6, and IFN‐γ in bronchoalveolar lavage fluid. In addition, the expressions of HIF‐1α, vascular endothelial growth factor (VEGF), p‐PI3K, and p‐AKT were analyzed by WB and IF. Results We successfully extracted and identified MSC‐EXO. In BPD rats, TV, MV, PIF, and Cdyn decreased, alveoli were simplified, and the number of interalveoli small vessels, blood vessel density decreased. Moreover, RAC, CD31, TAOC, and SOD decreased, and MLI, α‐SMA, MDA, IL‐1β, IL‐17, IL‐6, and IFN‐γ increased, which was reversed by the combination of MSC‐EXO and tempol treatment after combined treatment. In addition, the expression levels of HIF‐1α, VEGF, p‐PI3K, and p‐AKT were increased after combined treatment. Conclusions Combined treatment could improve lung tissue injury, promote pulmonary vascular remodeling, restore lung function, and inhibit oxidative stress in BPD rats. These effects were achieved through activation of HIF‐1α.