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Neural injury in SBA occurs in two stages involving failed neural tube closure and progressive degeneration through contact with the amniotic fluid. We previously suggested that intra\u2010amniotic bone marrow\u2010derived mesenchymal stem cell (BMSC) therapy for fetal rat SBA could achieve beneficial functional recovery through lesion\u2010specific differentiation. The aim of this study is to examine whether the amniotic fluid microenvironment can be improved by intra\u2010amniotic BMSC transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The intra\u2010amniotic BMSC injection was performed using in vivo rat fetal SBA models. The various cytokine expressions in rat amniotic fluid were screened by protein microassays. Intervention experiments were used to study the function of differentially expressed cytokines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 32 cytokines showed significant upregulated expression in the BMSC\u2010injected amniotic fluid. We focused on Activin A, NGF, BDNF, CNTF, and CXCR4. Intervention experiments showed that the upregulated Activin A, NGF, BDNF, and CNTF could inhibit apoptosis and promote synaptic development in fetal spinal cords. Inhibiting the activity of these factors weakened the anti\u2010apoptotic and pro\u2010differentiation effects of transplanted BMSCs. Inhibition of CXCR4 activity reduced the engraftment rate of BMSCs in SBA fetuses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>BMSC transplantation can improve the amniotic fluid environment, and this is beneficial for SBA repair.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cpr.13354","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T03:04:11Z","timestamp":1666321451000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Intra\u2010amniotic mesenchymal stem cell therapy improves the amniotic fluid microenvironment in rat spina bifida aperta fetuses"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2320-8982","authenticated-orcid":false,"given":"Xiaowei","family":"Wei","sequence":"first","affiliation":[{"name":"Key Laboratory of Health Ministry for Congenital Malformation, Department of Pediatric Surgery, Shengjing 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