Protective effect of ketamine and bone marrow-derived mesenchymal stem cell on ovarian follicular depletion in a rat ischaemia/reperfusion model: An experimental study

This study investigated the therapeutic potential of bone marrow-derived mesenchymal stem cells (BM-MSCs) and ketamine in alleviating ovarian ischemia-reperfusion (I/R) injury in a rat model. Forty-nine female rats were randomly divided into seven groups, each consisting of seven animals: Control, MSC (1 x106 cells via tail vein), I/R, ketamine (10 mg/kg, i.p.), I/R + ketamine, I/R + MSC, and I/R + ketamine + MSC. Biochemical analyses were performed using ELISA to measure malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), total antioxidant status (TAS), and total oxidant status (TOS). Histological evaluation included histopathological assessment and follicle counting, while the expression levels of TNF-alpha, IL-6, VEGF, and estradiol receptor (ER) were examined using immunohistochemical staining. Apoptotic cell counts were determined by the TUNEL method.I/R injury caused significant follicular degeneration, vascular congestion, edema, hemorrhage, and leukocyte infiltration, which were markedly improved by both MSC and ketamine treatments. The most pronounced improvement was observed in the MSC group. MSC therapy demonstrated strong anti-inflammatory effects by modulating TNF-alpha and IL-6, enhanced antioxidant defense by reducing MDA levels and increasing SOD and CAT activity. It exerted anti-apoptotic properties by decreasing the number of TUNEL-positive cells. In conclusion, BM-MSCs exhibited superior and longer-lasting protective effects compared to ketamine in repairing ovarian tissue damage induced by I/R injury and preserving fertility.