Single-cell analysis of the decidua unveils the mechanism of anti-inflammatory exosomes for chorioamnionitis in nonhuman primates

Sci Adv. 2025 Jul 4;11(27):eadp0467. doi: 10.1126/sciadv.adp0467. Epub 2025 Jul 2.

Abstract

The effectiveness of exosomes engineered to carry a dominantly active variant of inhibitor α of nuclear factor κB (NF-κB) (IκBα), super-repressor IκB (srIκB), that inhibits the expression of NF-κB in various animal models of inflammatory diseases has been demonstrated. In this study, we used a lipopolysaccharide (LPS)-induced chorioamnionitis model in pregnant nonhuman primates to explore the therapeutic potential and mode of action of srIκB-loaded exosomes (Exo-srIκBs). Intraamniotic injection of LPS induced infiltration of BCL2A1-positive neutrophils and CD68-positive macrophages in the extraplacental membranes, causing fetal lung injury. Conversely, administration of Exo-srIκB via intraamniotic and intravenous routes (6.9 × 1010 and 4 × 1011 particle numbers, respectively) ameliorated these effects. Single-cell RNA sequencing of the decidua and bulk RNA sequencing of the choriodecidua highlighted that Exo-srIκB treatment mitigated LPS-induced inflammatory pathways, particularly in macrophages, leading to a cascade effect on neutrophils through NF-κB signaling inhibition. These findings underscore the potential of Exo-srIκB as a therapeutic strategy for chorioamnionitis.

MeSH terms

  • Animals
  • Chorioamnionitis* / chemically induced
  • Chorioamnionitis* / metabolism
  • Chorioamnionitis* / pathology
  • Chorioamnionitis* / therapy
  • Decidua* / metabolism
  • Decidua* / pathology
  • Disease Models, Animal
  • Exosomes* / metabolism
  • Female
  • Lipopolysaccharides
  • Macrophages / metabolism
  • NF-KappaB Inhibitor alpha / genetics
  • NF-KappaB Inhibitor alpha / metabolism
  • NF-kappa B / metabolism
  • Neutrophils / metabolism
  • Pregnancy
  • Signal Transduction
  • Single-Cell Analysis* / methods

Substances

  • Lipopolysaccharides
  • NF-kappa B
  • NF-KappaB Inhibitor alpha