Cell-Free Regenerative Therapy for Pulmonary Hypertension: Human Breastmilk Stem Cell Secretome Restores Endothelial Barrier Integrity and BMPR2 Signaling Under Hypoxic Stress

Authors

  • Sri Lilijanti Widjaja Department of Pediatrics, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
  • Mylco Trisaputa Ahmadwirawan Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
  • Dina Luthfiyah Specialized Residency Training Student, Department of Pediatrics, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

DOI:

https://doi.org/10.37275/bsm.v10i5.1582

Keywords:

BMPR2, Breast milk stem cell, Pulmonary hypertension, VE-cadherin, Secretome

Abstract

Background: Pulmonary hypertension (PH) is a severe vascular disorder characterized by chronic hypoxia-induced endothelial dysfunction, leading to aberrant remodeling and right ventricular failure. The human breastmilk-derived stem cell (hBSC) secretome contains bioactive factors that may promote endothelial regeneration. However, the temporal dynamics of secretome-mediated repair on critical structural and signaling molecules remain poorly understood.

Methods: An in vitro experimental study was conducted using human umbilical vein endothelial cells (HUVECs) exposed to severe hypoxia (1% O₂, 10% CO₂, 37°C) to replicate PH-associated endothelial dysfunction. Cells were divided into four groups: normoxia control, hypoxia control, and hypoxia treated with hBSC secretome for 24 and 72 hours. Expression of bone morphogenetic protein receptor type 2 (BMPR2) and vascular endothelial cadherin (VE-cadherin) was quantified via ELISA. CCK-8 assays evaluated cellular viability. Data were analyzed using one-way ANOVA and least significant difference (LSD) post-hoc tests. 

Results: Hypoxia significantly diminished cell viability and reduced BMPR2 and VE-cadherin expression compared to normoxia (p<0.001). Administration of hBSC secretome significantly restored BMPR2 and VE-cadherin levels at both 24 and 72 hours (p<0.001), surpassing normoxic baselines. BMPR2 expression plateaued between 24 and 72 hours, while VE-cadherin expression demonstrated sustained functional recovery. 

Conclusion: The hBSC secretome actively reverses hypoxia-induced endothelial injury through rapid, time-dependent modulation of BMPR2 signaling and VE-cadherin junctional integrity, presenting a viable cell-free therapeutic target for PH. 

Authors

  • Sri Lilijanti Widjaja1
  • Mylco Trisaputa Ahmadwirawan2
  • Dina Luthfiyah3*
  1. 1Department of Pediatrics, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
  2. 2Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
  3. 3Specialized Residency Training Student, Department of Pediatrics, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

Corresponding author Dina Luthfiyah — luthfiyahdina@gmail.com

Article history

  1. Submitted
  2. Accepted
  3. Published

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Published

2026-03-09

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How to Cite

1.
Sri Lilijanti Widjaja, Mylco Trisaputa Ahmadwirawan, Dina Luthfiyah. Cell-Free Regenerative Therapy for Pulmonary Hypertension: Human Breastmilk Stem Cell Secretome Restores Endothelial Barrier Integrity and BMPR2 Signaling Under Hypoxic Stress. Bioscmed [Internet]. 2026 Mar. 9 [cited 2026 Aug. 4];10(5):1798-811. Available from: https://bioscmed.com/index.php/bsm/article/view/1582