Objectives: To investigate the thermo-chemical effects of nonablative Er:YAG laser on human endometrial stromal cells (hESCs).

Materials and methods: In this laboratory based study, for the hESCs cultures, endometrial tissue biopsy samples were obtained from three fertile women in the late proliferative phase. In this laboratory-based study, seven experimental groups were created: Estradiol (E₂) group, E₂ + Sham (S) group, E₂ + P₄ group, E₂ + Laser (L) group, E₂ + P₄ + L group, hESC group and hESC+L group. Cell cultures reaching confluence on the matrigel-coated petri dishes in all groups were incubated for 12, 24, 48, and 72 h after laser irradiation, respectively. Nonablative Er:YAG laser irradiation was performed to the hESCs culture. The main outcome of this study involves assessing the alterations in MMP-2, TNF-α, IL-6, VEGF-A, and IGFBP-1 levels within conditioned media of hESC cultures subsequent to the Er:YAG laser irradiation.

Results: Median MMP-2 levels significantly differed between groups at the 12th, 24th, 48th, and 72nd hour (p = 0.012, p = 0.045, p = 0.021, and p = 0.032, respectively). All media of hESCs irradiated with Er-YAG laser had higher median MMP-2 values. At the 48th hour, the groups showed significant differences in terms of median TNF-α levels (p = 0.029), which were lower in the groups that received Er-YAG laser. At the 12th hour, median IL-6 levels differed significantly between the groups (p = 0.011), being higher in the groups that received Er-YAG laser. At the 72nd hour, lower median VEGF-A values were observed for the groups that received Er-YAG laser (p = 0.021). A statistically significant difference existed in terms of median IGFBP-1 levels between the groups at the 24th hour, with higher levels in the groups which received Er-YAG laser (p = 0.041).

Conclusion: Our findings demonstrated that the non-ablative Er-YAG laser induces tissue remodeling, modulates immune responses by favoring Th2 cell activity and suppresses Th1 cell activity in hESCs. Additionally, it exerts favorable impact on decidualization.

Keywords: decidualization; human endometrial stromal cells; immunomodulation; nonablative Er‐YAG laser; tissue remodeling.

© 2025 The Author(s). Lasers in Surgery and Medicine published by Wiley Periodicals LLC.

目的： 探讨非剥脱Er:YAG激光对人类子宫内膜基质细胞（hESCs）的热化学效应。

材料和方法： 在这项实验室研究中，为了培养hESCs，从三名处于增殖期晚期的生育女性处获取了子宫内膜组织活检样本。在本实验室内研究中，创建了七个实验组：雌二醇（E₂）组、E₂+假处理(S)组、E₂+孕酮(P₄)组、E₂+激光(L)组、E₂+P₄+L组、hESC组和hESC+L组。所有组的细胞培养在Matrigel涂覆的培养皿上达到汇合后，分别在激光照射后的12小时、24小时、48小时和72小时进行孵育。对hESCs培养物进行了非剥脱Er:YAG激光照射。本研究的主要结果是评估Er:YAG激光照射之后hESC培养基中MMP-2、TNF-α、IL-6、VEGF-A和IGFBP-1水平的变化。

结果： 在第12小时、第24小时、第48小时和第72小时，各组之间MMP-2中位数水平存在显著差异（p = 0.012, p = 0.045, p = 0.021, 和 p = 0.032 分别）。所有经Er-YAG激光照射的hESCs培养基中的MMP-2中位数值更高。在第48小时，各组之间TNF-α中位数水平存在显著差异（p = 0.029），接受Er-YAG激光照射的组显示较低水平。在第12小时，各组之间的IL-6中位数水平显著不同（p = 0.011），接受Er-YAG激光照射的组显示较高水平。在第72小时，接受Er-YAG激光照射的组观察到VEGF-A中位数值较低（p = 0.021）。各组之间IGFBP-1中位数水平在第24小时存在统计学显著差异（p = 0.041），接受Er-YAG激光照射的组显示较高水平。

结论： 我们的研究结果表明，非剥脱Er-YAG激光可以诱导组织重塑，通过促进Th2细胞活性来调节免疫反应并抑制Th1细胞活性。此外，它对蜕膜化也有积极影响。

关键词： 蜕膜化；人类子宫内膜基质细胞；免疫调节；非剥脱Er-YAG激光；组织重塑。

© 2025 The Author(s). Lasers in Surgery and Medicine published by Wiley Periodicals LLC.