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Deguchi K, Zambaiti E, De Coppi P. Regenerative medicine: current research and perspective in pediatric surgery. Pediatr Surg Int 2023; 39:167. [PMID: 37014468 PMCID: PMC10073065 DOI: 10.1007/s00383-023-05438-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 04/05/2023]
Abstract
The field of regenerative medicine, encompassing several disciplines including stem cell biology and tissue engineering, continues to advance with the accumulating research on cell manipulation technologies, gene therapy and new materials. Recent progress in preclinical and clinical studies may transcend the boundaries of regenerative medicine from laboratory research towards clinical reality. However, for the ultimate goal to construct bioengineered transplantable organs, a number of issues still need to be addressed. In particular, engineering of elaborate tissues and organs requires a fine combination of different relevant aspects; not only the repopulation of multiple cell phenotypes in an appropriate distribution but also the adjustment of the host environmental factors such as vascularisation, innervation and immunomodulation. The aim of this review article is to provide an overview of the recent discoveries and development in stem cells and tissue engineering, which are inseparably interconnected. The current status of research on tissue stem cells and bioengineering, and the possibilities for application in specific organs relevant to paediatric surgery have been specifically focused and outlined.
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Affiliation(s)
- Koichi Deguchi
- Stem Cells and Regenerative Medicine Section, University College London Great Ormond Street Institute of Child Health, London, UK
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Elisa Zambaiti
- Stem Cells and Regenerative Medicine Section, University College London Great Ormond Street Institute of Child Health, London, UK
- UOC Chirurgia Pediatrica, Ospedale Infantile Regina Margherita, Turin, Italy
| | - Paolo De Coppi
- Stem Cells and Regenerative Medicine Section, University College London Great Ormond Street Institute of Child Health, London, UK.
- NIHR BRC SNAPS Great Ormond Street Hospitals, London, UK.
- Stem Cells and Regenerative Medicine Section, Faculty of Population Health Sciences, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
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2
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Morris TA, Eldeen S, Tran RDH, Grosberg A. A comprehensive review of computational and image analysis techniques for quantitative evaluation of striated muscle tissue architecture. BIOPHYSICS REVIEWS 2022; 3:041302. [PMID: 36407035 PMCID: PMC9667907 DOI: 10.1063/5.0057434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Unbiased evaluation of morphology is crucial to understanding development, mechanics, and pathology of striated muscle tissues. Indeed, the ability of striated muscles to contract and the strength of their contraction is dependent on their tissue-, cellular-, and cytoskeletal-level organization. Accordingly, the study of striated muscles often requires imaging and assessing aspects of their architecture at multiple different spatial scales. While an expert may be able to qualitatively appraise tissues, it is imperative to have robust, repeatable tools to quantify striated myocyte morphology and behavior that can be used to compare across different labs and experiments. There has been a recent effort to define the criteria used by experts to evaluate striated myocyte architecture. In this review, we will describe metrics that have been developed to summarize distinct aspects of striated muscle architecture in multiple different tissues, imaged with various modalities. Additionally, we will provide an overview of metrics and image processing software that needs to be developed. Importantly to any lab working on striated muscle platforms, characterization of striated myocyte morphology using the image processing pipelines discussed in this review can be used to quantitatively evaluate striated muscle tissues and contribute to a robust understanding of the development and mechanics of striated muscles.
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Affiliation(s)
| | - Sarah Eldeen
- Center for Complex Biological Systems, University of California, Irvine, California 92697-2700, USA
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3
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Barbon S, Biccari A, Stocco E, Capovilla G, D’Angelo E, Todesco M, Sandrin D, Bagno A, Romanato F, Macchi V, De Caro R, Agostini M, Merigliano S, Valmasoni M, Porzionato A. Bio-Engineered Scaffolds Derived from Decellularized Human Esophagus for Functional Organ Reconstruction. Cells 2022; 11:cells11192945. [PMID: 36230907 PMCID: PMC9563623 DOI: 10.3390/cells11192945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Esophageal reconstruction through bio-engineered allografts that highly resemble the peculiar properties of the tissue extracellular matrix (ECM) is a prospective strategy to overcome the limitations of current surgical approaches. In this work, human esophagus was decellularized for the first time in the literature by comparing three detergent-enzymatic protocols. After decellularization, residual DNA quantification and histological analyses showed that all protocols efficiently removed cells, DNA (<50 ng/mg of tissue) and muscle fibers, preserving collagen/elastin components. The glycosaminoglycan fraction was maintained (70–98%) in the decellularized versus native tissues, while immunohistochemistry showed unchanged expression of specific ECM markers (collagen IV, laminin). The proteomic signature of acellular esophagi corroborated the retention of structural collagens, basement membrane and matrix–cell interaction proteins. Conversely, decellularization led to the loss of HLA-DR expression, producing non-immunogenic allografts. According to hydroxyproline quantification, matrix collagen was preserved (2–6 µg/mg of tissue) after decellularization, while Second-Harmonic Generation imaging highlighted a decrease in collagen intensity. Based on uniaxial tensile tests, decellularization affected tissue stiffness, but sample integrity/manipulability was still maintained. Finally, the cytotoxicity test revealed that no harmful remnants/contaminants were present on acellular esophageal matrices, suggesting allograft biosafety. Despite the different outcomes showed by the three decellularization methods (regarding, for example, tissue manipulability, DNA removal, and glycosaminoglycans/hydroxyproline contents) the ultimate validation should be provided by future repopulation tests and in vivo orthotopic implant of esophageal scaffolds.
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Affiliation(s)
- Silvia Barbon
- Section of Human Anatomy, Department of Neuroscience, University of Padova, 35121 Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling—TES, Onlus, 35136 Padova, Italy
| | - Andrea Biccari
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Department of Surgical Oncological and Gastroenterological Sciences, University of Padova, 35128 Padova, Italy
| | - Elena Stocco
- Section of Human Anatomy, Department of Neuroscience, University of Padova, 35121 Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling—TES, Onlus, 35136 Padova, Italy
| | - Giovanni Capovilla
- Department of Surgical Oncological and Gastroenterological Sciences, University of Padova, 35128 Padova, Italy
| | - Edoardo D’Angelo
- Department of Surgical Oncological and Gastroenterological Sciences, University of Padova, 35128 Padova, Italy
| | - Martina Todesco
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Department of Industrial Engineering, University of Padova, 35131 Padova, Italy
| | - Deborah Sandrin
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Department of Physics and Astronomy “G. Galilei”, University of Padova, 35131 Padova, Italy
| | - Andrea Bagno
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Department of Industrial Engineering, University of Padova, 35131 Padova, Italy
| | - Filippo Romanato
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Department of Physics and Astronomy “G. Galilei”, University of Padova, 35131 Padova, Italy
| | - Veronica Macchi
- Section of Human Anatomy, Department of Neuroscience, University of Padova, 35121 Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
| | - Raffaele De Caro
- Section of Human Anatomy, Department of Neuroscience, University of Padova, 35121 Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling—TES, Onlus, 35136 Padova, Italy
| | - Marco Agostini
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Department of Surgical Oncological and Gastroenterological Sciences, University of Padova, 35128 Padova, Italy
- Correspondence: ; Tel.: +39-049-96-40-160
| | - Stefano Merigliano
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Department of Surgical Oncological and Gastroenterological Sciences, University of Padova, 35128 Padova, Italy
| | - Michele Valmasoni
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Department of Surgical Oncological and Gastroenterological Sciences, University of Padova, 35128 Padova, Italy
| | - Andrea Porzionato
- Section of Human Anatomy, Department of Neuroscience, University of Padova, 35121 Padova, Italy
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria, 35128 Padova, Italy
- Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling—TES, Onlus, 35136 Padova, Italy
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4
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Ozcakir E, Celik F, Guler S, Avci Z, Kaya M. The Use of Acellular Matrices Obtained by the Esophagus, Intestine, and Trachea for Esophageal Wall Repair: an Experimental Study on a Rat Model. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03542-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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5
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Ramaraju H, Sferra SR, Kunisaki SM, Hollister SJ. Finite element analysis of esophageal atresia repair with biodegradable polymer sleeves. J Mech Behav Biomed Mater 2022; 133:105349. [DOI: 10.1016/j.jmbbm.2022.105349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 10/17/2022]
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6
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Meng L, Frohbergh M, Villarraga M, Sundaram S, Roffidal T, Fodor W. Biomechanics of Regenerated Esophageal Tissue following the implantation of a Tissue Engineered CellspanTM Esophageal Implant. J Biomech 2022; 140:111162. [DOI: 10.1016/j.jbiomech.2022.111162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/29/2022] [Accepted: 05/23/2022] [Indexed: 11/16/2022]
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7
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Schizas D, Frountzas M, Sgouromallis E, Spartalis E, Mylonas KS, Papaioannou TG, Dimitroulis D, Nikiteas N. Esophageal defect repair by artificial scaffolds: a systematic review of experimental studies and proportional meta-analysis. Dis Esophagus 2021; 34:5917398. [PMID: 33016317 DOI: 10.1093/dote/doaa104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/26/2020] [Accepted: 08/21/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The traditional technique of gastrointestinal reconstruction of the esophagus after esophagectomy presents plenty of complications. Hence, tissue engineering has been introduced as an effective artificial alternative with potentially fewer complications. Three types of esophageal scaffolds have been used in experimental studies so far. The aim of our meta-analysis is to present the postoperative outcomes after esophageal replacement with artificial scaffolds and the investigation of possible factors that affect these outcomes. METHODS The present proportional meta-analysis was designed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and A MeaSurement Tool to Assess systematic Reviews guidelines. We searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL, and Google Scholar databases from inception until February 2020. RESULTS Overall, 32 studies were included that recruited 587 animals. The pooled morbidity after esophageal scaffold implantation was 53.4% (95% CI = 36.6-70.0%). The pooled survival interval was 111.1 days (95% CI = 65.5-156.8 days). Graft stenosis (46%), postoperative dysphagia (15%), and anastomotic leak (12%) were the most common complications after esophageal scaffold implantation. Animals that underwent an implantation of an artificial scaffold in the thoracic part of their esophagus presented higher survival rates than animals that underwent scaffold implantation in the cervical or abdominal part of their esophagus (P < 0.001 and P = 0.011, respectively). CONCLUSION Tissue engineering seems to offer an effective alternative for the repair of esophageal defects in animal models. Nevertheless, issues like graft stenosis and lack of motility of the esophageal scaffolds need to be addressed in future experimental studies before scaffolds can be tested in human trials.
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Affiliation(s)
- Dimitrios Schizas
- First Department of Surgery, Medical School, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.,Hellenic Minimally Invasive and Robotic Surgery Study Group, Athens, Greece
| | - Maximos Frountzas
- First Propaedeutic Department of Surgery, Medical School, National and Kapodistrian University of Athens, Hippocration General Hospital, Athens, Greece.,Hellenic Minimally Invasive and Robotic Surgery Study Group, Athens, Greece
| | - Emmanouil Sgouromallis
- Third Department of Surgery, Athens General Hospital "Georgios Gennimatas", Athens, Greece.,Hellenic Minimally Invasive and Robotic Surgery Study Group, Athens, Greece
| | | | - Konstantinos S Mylonas
- First Department of Surgery, Medical School, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Theodore G Papaioannou
- First Department of Cardiology, Biomedical Engineering Unit, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Dimitroulis
- Hellenic Minimally Invasive and Robotic Surgery Study Group, Athens, Greece.,Second Propedeutic Department of Surgery, Medical School, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Nikolaos Nikiteas
- Hellenic Minimally Invasive and Robotic Surgery Study Group, Athens, Greece.,Second Propedeutic Department of Surgery, Medical School, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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8
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Park H, Kim IG, Wu Y, Cho H, Shin J, Park SA, Chung E. Experimental investigation of esophageal reconstruction with electrospun polyurethane nanofiber and
3D
printing polycaprolactone scaffolds using a rat model. Head Neck 2020; 43:833-848. [DOI: 10.1002/hed.26540] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 10/01/2020] [Accepted: 10/30/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- Hanaro Park
- Department of Otorhinolaryngology‐Head & Neck Surgery Samsung Changwon Hospital, Sungkyunkwan University School of Medicine Changwon South Korea
| | - In Gul Kim
- Department of Otorhinolaryngology‐Head and Neck Surgery Seoul National University Hospital Seoul South Korea
| | - Yanru Wu
- Department of Biomedical Engineering Inje University Gimhae, Gyeongnam South Korea
| | - Hana Cho
- Department of Otorhinolaryngology‐Head and Neck Surgery Seoul National University Hospital Seoul South Korea
| | - Jung‐Woog Shin
- Department of Biomedical Engineering Inje University Gimhae, Gyeongnam South Korea
| | - Su A Park
- Department of Nature‐Inspired Nanoconvergence Systems Korea Institute of Machinery and Materials Daejeon Republic of Korea
| | - Eun‐Jae Chung
- Department of Otorhinolaryngology‐Head and Neck Surgery Seoul National University Hospital Seoul South Korea
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9
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Vogt CD, Panoskaltsis-Mortari A. Tissue engineering of the gastroesophageal junction. J Tissue Eng Regen Med 2020; 14:855-868. [PMID: 32304170 DOI: 10.1002/term.3045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 04/03/2020] [Indexed: 12/12/2022]
Abstract
The gastroesophageal junction has been of clinical interest for some time due to its important role in preventing reflux of caustic stomach contents upward into the esophagus. Failure of this role has been identified as a key driver in gastroesophageal reflux disease, cancer of the lower esophagus, and aspiration-induced lung complications. Due to the large population burden and significant morbidity and mortality related to reflux barrier dysfunction, there is a pressing need to develop tissue engineering solutions which can replace diseased junctions. While good progress has been made in engineering the bodies of the esophagus and stomach, little has been done for the junction between the two. In this review, we discuss pertinent topics which should be considered as tissue engineers begin to address this anatomical region. The embryological development and adult anatomy and histology are discussed to provide context about the native structures which must be replicated. The roles of smooth muscle structures in the esophagus and stomach, as well as the contribution of the diaphragm to normal anti-reflux function are then examined. Finally, engineering considerations including mechanics and current progress in the field of tissue engineering are presented.
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Affiliation(s)
- Caleb D Vogt
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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10
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Syed O, Kim JH, Keskin-Erdogan Z, Day RM, El-Fiqi A, Kim HW, Knowles JC. SIS/aligned fibre scaffold designed to meet layered oesophageal tissue complexity and properties. Acta Biomater 2019; 99:181-195. [PMID: 31446049 DOI: 10.1016/j.actbio.2019.08.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/17/2019] [Accepted: 08/08/2019] [Indexed: 12/27/2022]
Abstract
With donor organs not readily available, the need for a tissue-engineered oesophagus remains high, particularly for congenital childhood conditions such as atresia. Previous attempts have not been successful, and challenges remain. Small intestine submucosa (SIS) is an acellular matrix material with good biological properties; however, as is common with these types of materials, they demonstrate poor mechanical properties. In this work, electrospinning was performed to mechanically reinforce tubular SIS with polylactic-co-glycolic acid (PLGA) nanofibres. It was hypothesised that if attachment could be achieved between the two materials, then this would (i) improve the SIS mechanical properties, (ii) facilitate smooth muscle cell alignment to support directional growth of muscle cells and (iii) allow for the delivery of bioactive molecules (VEGF in this instance). Through a relatively simple multistage process, adhesion between the layers was achieved without chemically altering the SIS. It was also found that altering mandrel rotation speed affected the alignment of the PLGA nanofibres. SIS-PLGA scaffolds performed mechanically better than SIS alone; yield stress improvement was 200% and 400% along the longitudinal and circumferential directions, respectively. Smooth muscle cells cultured on the aligned fibres showed resultant unidirectional alignment. In vivo the SIS-PLGA scaffolds demonstrated limited foreign body reaction judged by the type and proportion of immune cells present and lack of fibrous encapsulation. The scaffolds remained intact at 4 weeks in vivo, and good cellular infiltration was observed. The incorporation of VEGF within SIS-PLGA scaffolds increased the blood vessel density of the surrounding tissues, highlighting the possible stimulation of endothelialisation by angiogenic factor delivery. Overall, the designed SIS-PLGA-VEGF hybrid scaffolds might be used as a potential matrix platform for oesophageal tissue engineering. In addition to this, achieving improved attachment between layers of acellular matrix materials and electrospun fibre layers offers the potential utility in other applications. STATEMENT OF SIGNIFICANCE: Because of its multi-layered nature and complex structure, the oesophagus tissue poses several challenges for successful clinical grafting. Therefore, it is promising to utilise tissue engineering strategies to mimic and form structural compartments for its recovery. In this context, we investigated the use of tubular small intestine submucosa (SIS) reinforced with polylactic-co-glycolic acid (PLGA) nanofibres by using electrospinning and also, amongst other parameters, the integrity of the bilayered structure created. This was carried out to facilitate smooth muscle cell alignment, support directional growth of muscle cells and allow the delivery of bioactive molecules (VEGF in this study). We evaluated this approach by using in vitro and in vivo models to determine the efficacy of this new system.
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11
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Wu Y, Kang YG, Kim IG, Kim JE, Lee EJ, Chung EJ, Shin JW. Mechanical stimuli enhance simultaneous differentiation into oesophageal cell lineages in a double-layered tubular scaffold. J Tissue Eng Regen Med 2019; 13:1394-1405. [PMID: 31066514 DOI: 10.1002/term.2881] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/13/2019] [Accepted: 04/29/2019] [Indexed: 01/02/2023]
Abstract
The tissue-engineered oesophagus serves as an alternative and promising therapeutic approach for long-gap oesophageal replacement. This study proposes an advanced in vitro culture platform focused on construction of the oesophagus by combining an electrospun double-layered tubular scaffold, stem cells, biochemical reagents, and biomechanical factors. Human mesenchymal stem cells were seeded onto the inner and outer surfaces of the scaffold. Mechanical stimuli were applied with a hollow organ bioreactor along with different biochemical reagents inside and outside of the scaffold. Electrospun fibres in a tubular scaffold were found to be randomly and circumferentially oriented for the inner and outer surfaces, respectively. Amongst the two types of mechanical stimuli, the intermittent shear flow that can simultaneously cause circumferential stretching due to hydrostatic pressure, and shear stress caused by flow on the inner surface, was found to be more effective for simultaneous differentiation into epithelial and muscle lineage than steady shear flow. Under these conditions, the expression of epithelial markers on the inner surface was significantly observed, although it was minimal on the outer surface. Muscle differentiation showed the opposite expression pattern. Meanwhile, the mechanical tests showed that the strength of the scaffold was improved after incubation for 14 days. We have developed a potential platform for tissue-engineered oesophagus construction. Specifically, simultaneous differentiation into epithelial and muscle lineages can be achieved by utilizing the double-layered scaffold and appropriate mechanical stimulation.
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Affiliation(s)
- Yanru Wu
- Department of Health Science and Technology, Inje University, Gimhae, Republic of Korea
| | - Yun Gyeong Kang
- Department of Biomedical Engineering, Inje University, Gimhae, Republic of Korea
| | - In Gul Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ji Eun Kim
- Department of Biomedical Engineering, Inje University, Gimhae, Republic of Korea
| | - Eun Jin Lee
- Department of Biomedical Engineering, Inje University, Gimhae, Republic of Korea
| | - Eun-Jae Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung-Woog Shin
- Department of Health Science and Technology, Inje University, Gimhae, Republic of Korea.,Department of Biomedical Engineering, Inje University, Gimhae, Republic of Korea.,Cardiovascular and Metabolic Disease Center/Institute of Aged Life Redesign/UHARC, Inje University, Gimhae, Republic of Korea
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12
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Wu B, Li S, Shi J, Vijayavenkataraman S, Lu WF, Trau D, Fuh JYH. Homogeneous cell printing on porous PCL/F127 tissue engineering scaffolds. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.bprint.2018.e00030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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13
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Multi-stage bioengineering of a layered oesophagus with in vitro expanded muscle and epithelial adult progenitors. Nat Commun 2018; 9:4286. [PMID: 30327457 PMCID: PMC6191423 DOI: 10.1038/s41467-018-06385-w] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/19/2018] [Indexed: 12/21/2022] Open
Abstract
A tissue engineered oesophagus could overcome limitations associated with oesophageal substitution. Combining decellularized scaffolds with patient-derived cells shows promise for regeneration of tissue defects. In this proof-of-principle study, a two-stage approach for generation of a bio-artificial oesophageal graft addresses some major challenges in organ engineering, namely: (i) development of multi-strata tubular structures, (ii) appropriate re-population/maturation of constructs before transplantation, (iii) cryopreservation of bio-engineered organs and (iv) in vivo pre-vascularization. The graft comprises decellularized rat oesophagus homogeneously re-populated with mesoangioblasts and fibroblasts for the muscle layer. The oesophageal muscle reaches organised maturation after dynamic culture in a bioreactor and functional integration with neural crest stem cells. Grafts are pre-vascularised in vivo in the omentum prior to mucosa reconstitution with expanded epithelial progenitors. Overall, our optimised two-stage approach produces a fully re-populated, structurally organized and pre-vascularized oesophageal substitute, which could become an alternative to current oesophageal substitutes. Combining decellularised scaffolds with patient-derived cells holds promise for bioengineering of functional tissues. Here the authors develop a two-stage approach to engineer an oesophageal graft that retains the structural organisation of native oesophagus.
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14
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Wu B, Takeshita N, Wu Y, Vijayavenkataraman S, Ho KY, Lu WF, Fuh JYH. Pluronic F127 blended polycaprolactone scaffolds via e-jetting for esophageal tissue engineering. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:140. [PMID: 30120625 DOI: 10.1007/s10856-018-6148-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 08/05/2018] [Indexed: 06/08/2023]
Abstract
Several attempts have been made to fabricate esophageal tissue engineering scaffolds. However, most of these scaffolds possess randomly oriented fibres and uncontrollable pore sizes. In order to mimic the native esophageal tissue structure, electro-hydrodynamic jetting (e-jetting) was used in this study to fabricate scaffolds with aligned fibres and controlled pore size. A hydrophilic additive, Pluronic F127 (F127), was blended with polycaprolactone (PCL) to improve the wettability of the scaffolds and hence the cell adhesion. PCL/F127 composite scaffolds with different weight ratios (0-12%) were fabricated. The wettability, phase composition, and the mechanical properties of the fabricated scaffolds were investigated. The results show that the e-jetted scaffolds have controllable fibres orientated in two perpendicular directions, which are similar to the human esophagus structure and suitable pore size for cell infiltration. In addition, the scaffolds with 8% F127 exhibited better wettability (contact angle of 14°) and an ultimate tensile strength (1.2 MPa) that mimics the native esophageal tissue. Furthermore, primary human esophageal fibroblasts were seeded on the e-jetted scaffolds. PCL/F127 scaffolds showed enhanced cell proliferation and expression of the vascular endothelial growth factor (VEGF) compared to pristine PCL scaffolds (1.5- and 25.8- fold increase, respectively; P < 0.001). An in vitro wound model made using the PCL/F127 scaffolds showed better cell migration than the PCL scaffolds. In summary, the PCL/F127 e-jetted scaffolds offer a promising strategy for the esophagus tissue repair.
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Affiliation(s)
- Bin Wu
- Department of Mechanical Engineering, National University of Singapore, Singapore, 117576, Singapore
| | - Nobuyoshi Takeshita
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Division of Gastroenterology and Hepatology, National University Health System, Singapore, 119228, Singapore
| | - Yang Wu
- Engineering Science and Mechanics Department, Penn State University, University Park, PA, 16802, USA
- The Huck Institutes of the Life Sciences, Penn State University, University Park, PA, 16802, USA
| | | | - Khek Yu Ho
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
- Division of Gastroenterology and Hepatology, National University Health System, Singapore, 119228, Singapore
| | - Wen Feng Lu
- Department of Mechanical Engineering, National University of Singapore, Singapore, 117576, Singapore
| | - Jerry Ying Hsi Fuh
- Department of Mechanical Engineering, National University of Singapore, Singapore, 117576, Singapore.
- National University of Singapore (Suzhou) Research Institute, Suzhou Industrial Park, Suzhou, 215123, People's Republic of China.
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15
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Luc G, Charles G, Gronnier C, Cabau M, Kalisky C, Meulle M, Bareille R, Roques S, Couraud L, Rannou J, Bordenave L, Collet D, Durand M. Decellularized and matured esophageal scaffold for circumferential esophagus replacement: Proof of concept in a pig model. Biomaterials 2018; 175:1-18. [PMID: 29793088 DOI: 10.1016/j.biomaterials.2018.05.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
Surgical resection of the esophagus requires sacrificing a long portion of it. Its replacement by the demanding gastric pull-up or colonic interposition techniques may be avoided by using short biologic scaffolds composed of decellularized matrix (DM). The aim of this study was to prepare, characterize, and assess the in vivo remodeling of DM and its clinical impact in a preclinical model. A dynamic chemical and enzymatic decellularization protocol of porcine esophagus was set up and optimized. The resulting DM was mechanically and biologically characterized by DNA quantification, histology, and histomorphometry techniques. Then, in vitro and in vivo tests were performed, such as DM recellularization with human or porcine adipose-derived stem cells, or porcine stromal vascular fraction, and maturation in rat omentum. Finally, the DM, matured or not, was implanted as a 5-cm-long esophagus substitute in an esophagectomized pig model. The developed protocol for esophageal DM fulfilled previously established criteria of decellularization and resulted in a scaffold that maintained important biologic components and an ultrastructure consistent with a basement membrane complex. In vivo implantation was compatible with life without major clinical complications. The DM's scaffold in vitro characteristics and in vivo implantation showed a pattern of constructive remodeling mimicking major native esophageal characteristics.
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Affiliation(s)
- Guillaume Luc
- CHU Bordeaux, CIC1401, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France; Inserm, Bioingénierie tissulaire, U1026, F-33000, Bordeaux, France; CHU Bordeaux, Department of Digestive Surgery, F-33000, Bordeaux, France
| | - Guillaume Charles
- CHU Bordeaux, CIC1401, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France
| | - Caroline Gronnier
- Univ. Bordeaux, F-33000, Bordeaux, France; CHU Bordeaux, Department of Digestive Surgery, F-33000, Bordeaux, France
| | - Magali Cabau
- CHU Bordeaux, CIC1401, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France; CHU Bordeaux, Department of Digestive Surgery, F-33000, Bordeaux, France
| | - Charlotte Kalisky
- CHU Bordeaux, CIC1401, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France
| | - Mallory Meulle
- CHU Bordeaux, CIC1401, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France
| | - Reine Bareille
- Univ. Bordeaux, F-33000, Bordeaux, France; Inserm, Bioingénierie tissulaire, U1026, F-33000, Bordeaux, France
| | - Samantha Roques
- CHU Bordeaux, CIC1401, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France
| | - Lionel Couraud
- CHU Bordeaux, CIC1401, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France; LAPVSO, F-31201, Toulouse Cedex 2, France
| | - Johanna Rannou
- CHU Bordeaux, CIC1401, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France
| | - Laurence Bordenave
- CHU Bordeaux, CIC1401, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France; Inserm, Bioingénierie tissulaire, U1026, F-33000, Bordeaux, France
| | - Denis Collet
- CHU Bordeaux, Department of Digestive Surgery, F-33000, Bordeaux, France
| | - Marlène Durand
- CHU Bordeaux, CIC1401, F-33000, Bordeaux, France; Univ. Bordeaux, F-33000, Bordeaux, France; Inserm, Bioingénierie tissulaire, U1026, F-33000, Bordeaux, France.
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16
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Chung EJ, Ju HW, Yeon YK, Lee JS, Lee YJ, Seo YB, Chan Hum P. Development of an omentum-cultured oesophageal scaffold reinforced by a 3D-printed ring: feasibility of an in vivo bioreactor. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2018; 46:885-895. [PMID: 29446982 DOI: 10.1080/21691401.2018.1439039] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Current treatments of oesophageal diseases, such as carcinoma, congenital abnormality or trauma, require surgical intervention and oesophageal reconstruction with the stomach, jejunum or colon. However, serious side effects are possible with each treatment option. Despite tissue engineering promising to be an effective regenerative strategy, no functional solution currently exists for oesophageal reconstruction. Here, we developed an omentum-cultured oesophageal scaffold reinforced by a 3D-printed ring. The nano-structured scaffolds were wrapped into the omentum of rats and orthotopically transplanted for the repair of circumferential oesophageal defects two weeks later. The artificial oesophagus exhibited complete healing of the surgically created circumferential defects by the second week. The integration of the omentum-cultured oesophageal scaffold and the regenerative tissue remained intact. Macroscopically, there was no evidence of a fistula, perforation, abscess formation or surrounding soft-tissue necrosis. The omentum-cultured nano-structure scaffold reinforced by a 3D-printed ring is a more practical model with better vascularization for artificial neo-oesophagus reconstruction in a rat model.
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Affiliation(s)
- Eun-Jae Chung
- a Department of Otorhinolaryngology-Head and Neck Surgery , College of Medicine, Seoul National University , Korea
| | - Hyung Woo Ju
- b Nano-Bio Regenerative Medical Institute , Collage of Medicine, Hallym University , Chuncheon , Korea
| | - Yeung Kyu Yeon
- b Nano-Bio Regenerative Medical Institute , Collage of Medicine, Hallym University , Chuncheon , Korea
| | - Ji Seung Lee
- b Nano-Bio Regenerative Medical Institute , Collage of Medicine, Hallym University , Chuncheon , Korea
| | - Young Jin Lee
- b Nano-Bio Regenerative Medical Institute , Collage of Medicine, Hallym University , Chuncheon , Korea
| | - Ye Been Seo
- b Nano-Bio Regenerative Medical Institute , Collage of Medicine, Hallym University , Chuncheon , Korea
| | - Park Chan Hum
- b Nano-Bio Regenerative Medical Institute , Collage of Medicine, Hallym University , Chuncheon , Korea.,c Department of Otorhinolaryngology-Head and Neck Surgery , Collage of Medicine, Hallym University , Chuncheon , Korea
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17
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Chung EJ. Bioartificial Esophagus: Where Are We Now? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1064:313-332. [DOI: 10.1007/978-981-13-0445-3_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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18
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Algarrahi K, Franck D, Cristofaro V, Yang X, Savarino A, Affas S, Schäfer FM, Ghezzi C, Jennings R, Nedder A, Kaplan DL, Sullivan MP, Estrada CR, Mauney JR. Bi-layer silk fibroin grafts support functional tissue regeneration in a porcine model of onlay esophagoplasty. J Tissue Eng Regen Med 2017; 12:e894-e904. [PMID: 28084044 DOI: 10.1002/term.2402] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 11/17/2016] [Accepted: 01/09/2017] [Indexed: 12/27/2022]
Abstract
Partial circumferential, full thickness defects of the esophagus can occur as a result of organ perforation or tumour resection, or during surgical reconstruction of strictured segments. Complications associated with autologous tissue flaps conventionally utilized for defect repair necessitate the development of new graft options. In this study, bi-layer silk fibroin (BLSF) scaffolds were investigated for their potential to support functional restoration of partial circumferential defects in a porcine model of esophageal repair. Onlay thoracic esophagoplasty with BLSF matrices (~3 x 1.5 cm) was performed in adult swine (N = 6) for 3 months of implantation. All animals receiving BLSF grafts survived with no complications and were capable of solid food consumption. Radiographic esophagrams revealed preservation of organ continuity with no evidence of contrast extravasation or strictures. Fluoroscopic analysis demonstrated peristaltic contractions. Ex vivo tissue bath studies displayed contractile responses to carbachol, electric field stimulation, and KCl while isoproterenol produced tissue relaxation. Histological and immunohistochemical evaluations of neotissues showed a stratified, squamous epithelium, a muscularis mucosa composed of smooth muscle bundles, and a muscularis externa organized into circular and longitudinal layers, with a mix of striated skeletal muscle fascicles interspersed with smooth muscle. De novo innervation and vascularization were observed throughout the graft sites and consisted of synaptophysin-positive neuronal boutons and vessels lined with CD31-positive endothelial cells. The results of this study demonstrate that BLSF scaffolds can facilitate constructive remodeling of partial circumferential, full thickness esophageal defects in a large animal model. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Khalid Algarrahi
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA.,Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Debra Franck
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
| | - Vivian Cristofaro
- Department of Surgery, Harvard Medical School, Boston, MA, USA.,Division of Urology, Veterans Affairs Boston Healthcare System, West Roxbury, MA, USA.,Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Xuehui Yang
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
| | - Alyssa Savarino
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
| | - Saif Affas
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA.,Department of Surgery, Harvard Medical School, Boston, MA, USA
| | | | - Chiara Ghezzi
- Department of Biomedical Engineering, Tufts University, Medford, MA, USA
| | | | - Arthur Nedder
- Animal Resource at Children's Hospital, Boston Children's Hospital, Boston, MA, USA
| | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, MA, USA
| | - Maryrose P Sullivan
- Department of Surgery, Harvard Medical School, Boston, MA, USA.,Division of Urology, Veterans Affairs Boston Healthcare System, West Roxbury, MA, USA.,Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Carlos R Estrada
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA.,Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Joshua R Mauney
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA.,Department of Surgery, Harvard Medical School, Boston, MA, USA
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19
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Alternating air-medium exposure in rotating bioreactors optimizes cell metabolism in 3D novel tubular scaffold polyurethane foams. J Appl Biomater Funct Mater 2017; 15:e122-e132. [PMID: 28362040 PMCID: PMC6379885 DOI: 10.5301/jabfm.5000334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2016] [Indexed: 01/15/2023] Open
Abstract
Background In vitro dynamic culture conditions play a pivotal role in developing
engineered tissue grafts, where the supply of oxygen and nutrients, and
waste removal must be permitted within construct thickness. For tubular
scaffolds, mass transfer is enhanced by introducing a convective flow
through rotating bioreactors with positive effects on cell proliferation,
scaffold colonization and extracellular matrix deposition. We characterized
a novel polyurethane-based tubular scaffold and investigated the impact of 3
different culture configurations over cell behavior: dynamic (i)
single-phase (medium) rotation and (ii) double-phase exposure (medium-air)
rotation; static (iii) single-phase static culture as control. Methods A new mixture of polyol was tested to create polyurethane foams (PUFs) as 3D
scaffold for tissue engineering. The structure obtained was morphologically
and mechanically analyzed tested. Murine fibroblasts were externally seeded
on the novel porous PUF scaffold, and cultured under different dynamic
conditions. Viability assay, DNA quantification, SEM and histological
analyses were performed at different time points. Results The PUF scaffold presented interesting mechanical properties and morphology
adequate to promote cell adhesion, highlighting its potential for tissue
engineering purposes. Results showed that constructs under dynamic
conditions contain enhanced viability and cell number, exponentially
increased for double-phase rotation; under this last configuration, cells
uniformly covered both the external surface and the lumen. Conclusions The developed 3D structure combined with the alternated exposure to air and
medium provided the optimal in vitro biochemical conditioning with adequate
nutrient supply for cells. The results highlight a valuable combination of
material and dynamic culture for tissue engineering applications.
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20
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Zhang B, Yan X, He HW, Yu M, Ning X, Long YZ. Solvent-free electrospinning: opportunities and challenges. Polym Chem 2017. [DOI: 10.1039/c6py01898j] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Electrospinning (e-spinning) has attracted tremendous attention because this technology provides a simple and versatile method for fabricating ultrafine fibers from a rich variety of materials including polymers, composites, and ceramics.
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Affiliation(s)
- Bin Zhang
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
| | - Xu Yan
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
| | - Hong-Wei He
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
| | - Miao Yu
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
| | - Xin Ning
- Industrial Research Institute of Nonwovens & Technical Textiles
- Qingdao University
- Qingdao 266071
- China
| | - Yun-Ze Long
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
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21
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Synthesis of polylactide acrylate derivatives for the preparation of 3D structures by photo-curing. MENDELEEV COMMUNICATIONS 2016. [DOI: 10.1016/j.mencom.2016.09.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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22
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Abstract
Functions of the gastrointestinal tract include motility, digestion and absorption of nutrients. These functions are mediated by several specialized cell types including smooth muscle cells, neurons, interstitial cells and epithelial cells. In gastrointestinal diseases, some of the cells become degenerated or fail to accomplish their normal functions. Surgical resection of the diseased segments of the gastrointestinal tract is considered the gold-standard treatment in many cases, but patients might have surgical complications and quality of life can remain low. Tissue engineering and regenerative medicine aim to restore, repair, or regenerate the function of the tissues. Gastrointestinal tissue engineering is a challenging process given the specific phenotype and alignment of each cell type that colonizes the tract - these properties are critical for proper functionality. In this Review, we summarize advances in the field of gastrointestinal tissue engineering and regenerative medicine. Although the findings are promising, additional studies and optimizations are needed for translational purposes.
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Affiliation(s)
- Khalil N Bitar
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, 391 Technology Way NE, Winston Salem, North Carolina 27101, USA.,Department of Molecular Medicine and Translational Sciences, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston Salem, North Carolina 27157, USA.,Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, 391 Technology Way NE, Winston Salem, North Carolina 27101, USA
| | - Elie Zakhem
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, 391 Technology Way NE, Winston Salem, North Carolina 27101, USA.,Department of Molecular Medicine and Translational Sciences, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston Salem, North Carolina 27157, USA
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23
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Tan YJ, Yeong WY, Tan X, An J, Chian KS, Leong KF. Characterization, mechanical behavior and in vitro evaluation of a melt-drawn scaffold for esophageal tissue engineering. J Mech Behav Biomed Mater 2016; 57:246-59. [DOI: 10.1016/j.jmbbm.2015.12.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 12/10/2015] [Accepted: 12/14/2015] [Indexed: 12/28/2022]
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24
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He HW, Zhang B, Yan X, Dong RH, Jia XS, Yu GF, Ning X, Xia LH, Long YZ. Solvent-free thermocuring electrospinning to fabricate ultrathin polyurethane fibers with high conductivity by in situ polymerization of polyaniline. RSC Adv 2016. [DOI: 10.1039/c6ra21882b] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Solidification mechanism of PU microfibers fabricated by solvent-free e-spinning under thermal radiation.
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Affiliation(s)
- Hong-Wei He
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
| | - Bin Zhang
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
| | - Xu Yan
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
| | - Rui-Hua Dong
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
| | - Xian-Sheng Jia
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
| | - Gui-Feng Yu
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
| | - Xin Ning
- Industrial Research Institute of Nonwovens & Technical Textiles
- College of Textiles & Clothing
- Qingdao University
- Qingdao 266071
- China
| | - Lin-Hua Xia
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
| | - Yun-Ze Long
- Collaborative Innovation Center for Nanomaterials & Devices
- College of Physics
- Qingdao University
- Qingdao 266071
- China
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25
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Algarrahi K, Franck D, Ghezzi CE, Cristofaro V, Yang X, Sullivan MP, Chung YG, Affas S, Jennings R, Kaplan DL, Estrada CR, Mauney JR. Acellular bi-layer silk fibroin scaffolds support functional tissue regeneration in a rat model of onlay esophagoplasty. Biomaterials 2015; 53:149-59. [PMID: 25890715 DOI: 10.1016/j.biomaterials.2015.02.092] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 02/18/2015] [Accepted: 02/21/2015] [Indexed: 02/07/2023]
Abstract
Surgical management of long-gap esophageal defects with autologous gastrointestinal tissues is frequently associated with adverse complications including organ dysmotility, dysphagia, and donor site morbidity. In order to develop alternative graft options, bi-layer silk fibroin (SF) scaffolds were investigated for their potential to support functional tissue regeneration in a rodent model of esophageal repair. Onlay esophagoplasty was performed with SF matrices (N = 40) in adult rats for up to 2 m of implantation. Parallel groups consisted of animals implanted with small intestinal submucosa (SIS) scaffolds (N = 22) or sham controls receiving esophagotomy alone (N = 20). Sham controls exhibited a 100% survival rate while rats implanted with SF and SIS scaffolds displayed respective survival rates of 93% and 91% prior to scheduled euthanasia. Animals in each experimental group were capable of solid food consumption following a 3 d post-op liquid diet and demonstrated similar degrees of weight gain throughout the study period. End-point μ-computed tomography at 2 m post-op revealed no evidence of contrast extravasation, fistulas, strictures, or diverticula in any of the implant groups. Ex vivo tissue bath studies demonstrated that reconstructed esophageal conduits supported by both SF and SIS scaffolds displayed contractile responses to carbachol, KCl and electrical field stimulation while isoproterenol produced tissue relaxation. Histological (Masson's trichrome and hematoxylin and eosin) and immunohistochemical (IHC) evaluations demonstrated both implant groups produced de novo formation of skeletal and smooth muscle bundles positive for contractile protein expression [fast myosin heavy chain (MY32) and α-smooth muscle actin (α-SMA)] within the graft site. However, SF matrices promoted a significant 4-fold increase in MY32+ skeletal muscle and a 2-fold gain in α-SMA+ smooth muscle in comparison to the SIS cohort as determined by histomorphometric analyses. A stratified squamous, keratinized epithelium expressing cytokeratin 5 and involucrin proteins was also present at 2 m post-op in all experimental groups. De novo innervation and vascularization were evident in all regenerated tissues indicated by the presence of synaptophysin (SYP38)+ boutons and vessels lined with CD31 expressing endothelial cells. In respect to SIS, the SF group supported a significant 4-fold increase in the density of SYP38+ boutons within the implant region. Evaluation of host tissue responses revealed that SIS matrices elicited chronic inflammatory reactions and severe fibrosis throughout the neotissues, in contrast to SF scaffolds. The results of this study demonstrate that bi-layer SF scaffolds represent promising biomaterials for onlay esophagoplasty, capable of producing superior regenerative outcomes in comparison to conventional SIS scaffolds.
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Affiliation(s)
- Khalid Algarrahi
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Surgery, Harvard Medical School, Boston, MA 02115, USA
| | - Debra Franck
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA 02115, USA
| | - Chiara E Ghezzi
- Department of Biomedical Engineering, Tufts University, Medford, MA 02155, USA
| | - Vivian Cristofaro
- Department of Surgery, Harvard Medical School, Boston, MA 02115, USA; Division of Urology, Veterans Administration Boston Healthcare System, West Roxbury, MA 02132, USA; Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Xuehui Yang
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA 02115, USA
| | - Maryrose P Sullivan
- Department of Surgery, Harvard Medical School, Boston, MA 02115, USA; Division of Urology, Veterans Administration Boston Healthcare System, West Roxbury, MA 02132, USA; Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Yeun Goo Chung
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Surgery, Harvard Medical School, Boston, MA 02115, USA
| | - Saif Affas
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Surgery, Harvard Medical School, Boston, MA 02115, USA
| | - Russell Jennings
- Department of Surgery, Harvard Medical School, Boston, MA 02115, USA
| | - David L Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, MA 02155, USA
| | - Carlos R Estrada
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Surgery, Harvard Medical School, Boston, MA 02115, USA.
| | - Joshua R Mauney
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA 02115, USA; Department of Surgery, Harvard Medical School, Boston, MA 02115, USA.
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26
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Hosseini V, Kollmannsberger P, Ahadian S, Ostrovidov S, Kaji H, Vogel V, Khademhosseini A. Fiber-assisted molding (FAM) of surfaces with tunable curvature to guide cell alignment and complex tissue architecture. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2014; 10:4851-4857. [PMID: 25070416 DOI: 10.1002/smll.201400263] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 05/22/2014] [Indexed: 06/03/2023]
Abstract
A simple and robust method termed "fiber-assisted molding (FAM)" is presented to create biomimetic three-dimensional surfaces with controllable curvature and helical twist. The alignment of muscle fibrils and the assembly of helically patterned extracellular matrix by cells demonstrate the potential of this method for tissue engineering and other materials science applications.
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Affiliation(s)
- Vahid Hosseini
- Laboratory of Applied Mechanobiology, Department of Health Sciences and Technology, ETH Zurich, Vladimir-Prelog-Weg 1-5/10, CH-8093, Zurich, Switzerland
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27
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Syed O, Walters NJ, Day RM, Kim HW, Knowles JC. Evaluation of decellularization protocols for production of tubular small intestine submucosa scaffolds for use in oesophageal tissue engineering. Acta Biomater 2014; 10:5043-5054. [PMID: 25173840 DOI: 10.1016/j.actbio.2014.08.024] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 07/24/2014] [Accepted: 08/22/2014] [Indexed: 12/11/2022]
Abstract
Small intestine submucosa (SIS) has emerged as one of a number of naturally derived extracellular matrix (ECM) biomaterials currently in clinical use. In addition to clinical applications, ECM materials form the basis for a variety of approaches within tissue engineering research. In our preliminary work it was found that SIS can be consistently and reliably made into tubular scaffolds which confer certain potential advantages. Given that decellularization protocols for SIS are applied to sheet-form SIS, it was hypothesized that a tubular-form SIS would behave differently to pre-existing protocols. In this work, tubular SIS was produced and decellularized by the conventional peracetic acid-agitation method, peracetic acid under perfusion along with two commonly used detergent-perfusion protocols. The aim of this was to produce a tubular SIS that was both adequately decellularized and possessing the mechanical properties which would make it a suitable scaffold for oesophageal tissue engineering, which was one of the goals of this work. Analysis was carried out via mechanical tensile testing, DNA quantification, scanning electron and light microscopy, and a metabolic assay, which was used to give an indication of the biocompatibility of each decellularization method. Both peracetic acid protocols were shown to be unsuitable methods with the agitation-protocol-produced SIS, which was poorly decellularized, and the perfusion protocol resulted in poor mechanical properties. Both detergent-based protocols produced well-decellularized SIS, with no adverse mechanical effects; however, one protocol emerged, SDS/Triton X-100, which proved superior in both respects. However, this SIS showed reduced metabolic activity, and this cytotoxic effect was attributed to residual reagents. Consequently, the use of SIS produced using the detergent SD as the decellularization agent was deemed to be the most suitable, although the elimination of the DNase enzyme would give further improvement.
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28
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Tessier W, Mariette C, Copin MC, Robb WB, Jashari R, Hubert T, Wurtz A. Replacement of the esophagus with fascial flap-wrapped allogenic aorta. J Surg Res 2014; 193:176-83. [PMID: 25145905 DOI: 10.1016/j.jss.2014.07.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 05/28/2014] [Accepted: 07/16/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Segmental replacement of the esophagus (SRE) is challenging. Allogenic aorta (AA) has shown promising remodeling abilities when used as an esophageal substitute. The aim of this study was to evaluate the feasibility and results of esophageal replacement with fascial flap-wrapped AA segments in a novel rabbit model. MATERIALS AND METHODS Seven Geant des Flandres rabbits and one New Zealand rabbit served as thoracic aorta donors, and 25 New Zealand rabbits were used as recipients. One to 3 wk before esophageal replacement either cryopreserved or fresh thoracic aortic segments were wrapped in thoracic wall fascia to generate revascularization. In an attempt to optimize the model, step-by-step modifications concerning perioperative and postoperative management of the recipients were made as results accumulated. Microscopic evaluation was focused on the viability of aortic segments and neoangiogenesis originating from the fascia. RESULTS Survival after SRE was poor. Most recipients died within 1 wk, mainly from upper digestive tract hypomotility. Microscopically, AAs were severely necrosed. In one recipient sacrificed on day 16, the edges of the graft became evanescent. In these areas, esophageal reepithelialization directly covered the fascia, in which unexpected smooth muscle cells were found, suggestive of the first stages of esophageal remodeling of the graft. CONCLUSIONS Results for SRE using fascial-wrapped AAs in rabbits were disappointing. The transposition of this approach to larger animals might result in longer survival, increasing the possibility for more complete graft remodeling.
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Affiliation(s)
- Williams Tessier
- Inserm UMR 837, Lille University Medical School, UDSL, University Lille Nord de France, Lille, France; Department of Digestive and Oncological Surgery, Lille University Teaching Hospital, CHULille, Lille, France
| | - Christophe Mariette
- Inserm UMR 837, Lille University Medical School, UDSL, University Lille Nord de France, Lille, France; Department of Digestive and Oncological Surgery, Lille University Teaching Hospital, CHULille, Lille, France
| | | | - William B Robb
- Department of Digestive and Oncological Surgery, Lille University Teaching Hospital, CHULille, Lille, France
| | | | - Thomas Hubert
- IMPRT-IFR 114, EA 2693, Lille University Medical School, UDSL, University Lille Nord de France, Lille, France
| | - Alain Wurtz
- IMPRT-IFR 114, EA 2693, Lille University Medical School, UDSL, University Lille Nord de France, Lille, France; Cardiac and Thoracic Surgery Division, Lille University Teaching Hospital, CHULille, Lille, France.
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29
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Sjöqvist S, Jungebluth P, Lim ML, Haag JC, Gustafsson Y, Lemon G, Baiguera S, Burguillos MA, Del Gaudio C, Rodríguez AB, Sotnichenko A, Kublickiene K, Ullman H, Kielstein H, Damberg P, Bianco A, Heuchel R, Zhao Y, Ribatti D, Ibarra C, Joseph B, Taylor DA, Macchiarini P. Experimental orthotopic transplantation of a tissue-engineered oesophagus in rats. Nat Commun 2014; 5:3562. [PMID: 24736316 PMCID: PMC4354271 DOI: 10.1038/ncomms4562] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 03/05/2014] [Indexed: 12/22/2022] Open
Abstract
A tissue-engineered oesophageal scaffold could be very useful for the treatment of pediatric and adult patients with benign or malignant diseases such as carcinomas, trauma or congenital malformations. Here we decellularize rat oesophagi inside a perfusion bioreactor to create biocompatible biological rat scaffolds that mimic native architecture, resist mechanical stress and induce angiogenesis. Seeded allogeneic mesenchymal stromal cells spontaneously differentiate (proven by gene-, protein and functional evaluations) into epithelial- and muscle-like cells. The reseeded scaffolds are used to orthotopically replace the entire cervical oesophagus in immunocompetent rats. All animals survive the 14-day study period, with patent and functional grafts, and gain significantly more weight than sham-operated animals. Explanted grafts show regeneration of all the major cell and tissue components of the oesophagus including functional epithelium, muscle fibres, nerves and vasculature. We consider the presented tissue-engineered oesophageal scaffolds a significant step towards the clinical application of bioengineered oesophagi.
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Affiliation(s)
- Sebastian Sjöqvist
- 1] Advanced Center for Translational Regenerative Medicine (ACTREM), Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86, Stockholm, Sweden [2] Division of Ear, Nose and Throat, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Philipp Jungebluth
- 1] Advanced Center for Translational Regenerative Medicine (ACTREM), Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86, Stockholm, Sweden [2] Division of Ear, Nose and Throat, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Mei Ling Lim
- 1] Advanced Center for Translational Regenerative Medicine (ACTREM), Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86, Stockholm, Sweden [2] Division of Ear, Nose and Throat, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Johannes C Haag
- 1] Advanced Center for Translational Regenerative Medicine (ACTREM), Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86, Stockholm, Sweden [2] Division of Ear, Nose and Throat, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Ylva Gustafsson
- 1] Advanced Center for Translational Regenerative Medicine (ACTREM), Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86, Stockholm, Sweden [2] Division of Ear, Nose and Throat, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Greg Lemon
- Advanced Center for Translational Regenerative Medicine (ACTREM), Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86, Stockholm, Sweden
| | - Silvia Baiguera
- Advanced Center for Translational Regenerative Medicine (ACTREM), Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86, Stockholm, Sweden
| | | | - Costantino Del Gaudio
- Department of Industrial Engineering, Intrauniversitary Consortium for Material Science and Technology (INSTM) Research Unit Tor Vergata, University of Rome, Rome 00133, Italy
| | - Antonio Beltrán Rodríguez
- 1] Advanced Center for Translational Regenerative Medicine (ACTREM), Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86, Stockholm, Sweden [2] Division of Ear, Nose and Throat, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Alexander Sotnichenko
- International Scientific-Research Clinical and Educational Center of Regenerative Medicine, Kuban State Medical University, Krasnodar 350040, Russian Federation
| | - Karolina Kublickiene
- 1] Center for Gender Medicine, Karolinska Institutet, SE-141 86 Stockholm, Sweden [2] Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86 Stockholm, Sweden
| | - Henrik Ullman
- Department of Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Heike Kielstein
- Department of Anatomy and Cell Biology, Faculty of Medicine, Martin Luther University Halle-Wittenberg, 06108 Halle (Saale), Germany
| | - Peter Damberg
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC) Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Alessandra Bianco
- Department of Industrial Engineering, Intrauniversitary Consortium for Material Science and Technology (INSTM) Research Unit Tor Vergata, University of Rome, Rome 00133, Italy
| | - Rainer Heuchel
- 1] Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86 Stockholm, Sweden [2] Center of Biosciences, Karolinska Institutet, SE-141 86 Stockholm, Sweden
| | - Ying Zhao
- 1] Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86 Stockholm, Sweden [2] Center of Biosciences, Karolinska Institutet, SE-141 86 Stockholm, Sweden
| | - Domenico Ribatti
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, National Cancer Institute 'Giovanni Paolo II', Bari 70121, Italy
| | - Cristián Ibarra
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Bertrand Joseph
- Cancer Centrum Karolinska, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Doris A Taylor
- Texas Heart Institute, Center for Regenerative Medicine, Houston, Texas 770-30, USA
| | - Paolo Macchiarini
- 1] Advanced Center for Translational Regenerative Medicine (ACTREM), Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-141 86, Stockholm, Sweden [2] Division of Ear, Nose and Throat, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
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Tuomi J, Paloheimo KS, Vehviläinen J, Björkstrand R, Salmi M, Huotilainen E, Kontio R, Rouse S, Gibson I, Mäkitie AA. A Novel Classification and Online Platform for Planning and Documentation of Medical Applications of Additive Manufacturing. Surg Innov 2014; 21:553-9. [DOI: 10.1177/1553350614524838] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Additive manufacturing technologies are widely used in industrial settings and now increasingly also in several areas of medicine. Various techniques and numerous types of materials are used for these applications. There is a clear need to unify and harmonize the patterns of their use worldwide. We present a 5-class system to aid planning of these applications and related scientific work as well as communication between various actors involved in this field. An online, matrix-based platform and a database were developed for planning and documentation of various solutions. This platform will help the medical community to structurally develop both research innovations and clinical applications of additive manufacturing. The online platform can be accessed through http://www.medicalam.info .
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Affiliation(s)
- Jukka Tuomi
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Kaija-Stiina Paloheimo
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Juho Vehviläinen
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Roy Björkstrand
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Mika Salmi
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Eero Huotilainen
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
| | - Risto Kontio
- Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | | | - Ian Gibson
- National University of Singapore, Singapore
| | - Antti A. Mäkitie
- Aalto University, Department of Engineering Design and Production, School of Engineering, Aalto, Espoo, Finland
- Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
- Karolinska Institutet, Division of ENT Diseases, CLINTEC, Stockholm, Sweden
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31
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Hoogenkamp HR, Koens MJW, Geutjes PJ, Ainoedhofer H, Wanten G, Tiemessen DM, Hilborn J, Gupta B, Feitz WFJ, Daamen WF, Saxena AK, Oosterwijk E, van Kuppevelt TH. Seamless vascularized large-diameter tubular collagen scaffolds reinforced with polymer knittings for esophageal regenerative medicine. Tissue Eng Part C Methods 2014; 20:423-30. [PMID: 24099067 DOI: 10.1089/ten.tec.2013.0485] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A clinical demand exists for alternatives to repair the esophagus in case of congenital defects, cancer, or trauma. A seamless biocompatible off-the-shelf large-diameter tubular scaffold, which is accessible for vascularization, could set the stage for regenerative medicine of the esophagus. The use of seamless scaffolds eliminates the error-prone tubularization step, which is necessary when emanating from flat scaffolds. In this study, we developed and characterized three different types of seamless tubular scaffolds, and evaluated in vivo tissue compatibility, including vascularization by omental wrapping. Scaffolds (luminal Ø ∼ 1.5 cm) were constructed using freezing, lyophilizing, and cross-linking techniques and included (1) single-layered porous collagen scaffold, (2) dual-layered (porous+dense) collagen scaffold, and (3) hybrid scaffold (collagen+incorporated polycaprolacton knitting). The latter had an ultimate tensile strength comparable to a porcine esophagus. To induce rapid vascularization, scaffolds were implanted in the omentum of sheep using a wrapping technique. After 6 weeks of biocompatibility, vascularization, calcification, and hypoxia were evaluated using immunohistochemistry. Scaffolds were biocompatible, and cellular influx and ingrowth of blood vessels were observed throughout the whole scaffold. No calcification was observed, and slight hypoxic conditions were detected only in the direct vicinity of the polymer knitting. It is concluded that seamless large-diameter tubular collagen-based scaffolds can be constructed and vascularized in vivo. Such scaffolds provide novel tools for esophageal reconstruction.
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Affiliation(s)
- Henk R Hoogenkamp
- 1 Department of Biochemistry 280, RIMLS, Radboud University Medical Center , Nijmegen, The Netherlands
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32
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Fan MR, Gong M, Da LC, Bai L, Li XQ, Chen KF, Li-Ling J, Yang ZM, Xie HQ. Tissue engineered esophagus scaffold constructed with porcine small intestinal submucosa and synthetic polymers. Biomed Mater 2014; 9:015012. [DOI: 10.1088/1748-6041/9/1/015012] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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33
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Luc G, Durand M, Collet D, Guillemot F, Bordenave L. Esophageal tissue engineering. Expert Rev Med Devices 2014; 11:225-41. [PMID: 24387697 DOI: 10.1586/17434440.2014.870470] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Esophageal tissue engineering is still in an early state, and ideal methods have not been developed. Since the beginning of the 20th century, advances have been made in the materials that can be used to produce an esophageal substitute. Three approaches to scaffold-based tissue engineering have yielded good results. The first development concerned non-absorbable constructs based on silicone and collagen. The need to remove the silicone tube is the main disadvantage of this material. Polymeric absorbable scaffolds have been used since the 1990s. The main polymeric material used is poly (glycolic) acid combined with collagen. The problem of stenosis remains prevalent in most studies using an absorbable construct. Finally, decellularized scaffolds have been used since 2000. The promises of this new approach are unfulfilled. Indeed, stenosis occurs when the esophageal defect is circumferential regardless of the scaffold materials. Cell supplementation can decrease the rate of stenosis, but the type(s) of cells and their roles have not been defined. Finally, esophageal tissue engineering cannot provide a functional esophageal substitute, and further development is necessary prior to conducting human clinical studies.
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Affiliation(s)
- Guillaume Luc
- Department of Digestive Surgery, University Hospital Haut-Lévêque, Av de Magellan, 33604 Pessac cedex, France
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34
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Tan B, Wei RQ, Tan MY, Luo JC, Deng L, Chen XH, Hou JL, Li XQ, Yang ZM, Xie HQ. Tissue engineered esophagus by mesenchymal stem cell seeding for esophageal repair in a canine model. J Surg Res 2013; 182:40-8. [PMID: 22925499 DOI: 10.1016/j.jss.2012.07.054] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 06/20/2012] [Accepted: 07/20/2012] [Indexed: 02/05/2023]
Abstract
PURPOSE Acellular porcine small intestinal submucosa (SIS) has been successfully used for esophagoplasty in dogs. However, this has not led to complete epithelialization and muscular regeneration. We undertook the present study to assess the effect of tissue-engineered esophagus generated by seeding bone marrow mesenchymal stem cells (BMSCs) onto an SIS scaffold (BMSCs-SIS) in a canine model. METHODS We cultured, passaged, and measured autologous BMSCs and myoblasts with cell proliferation and immunohistochemical assays. We labeled the third passage of BMSCs with PKH-26, a fluorescent dye, before seeded it onto the SIS. We resected canine cervical esophagus to generate a defect 5 cm in length and 50% in circumference, which we repaired with BMSCs-SIS or SIS alone. RESULTS Four weeks later, barium esophagram demonstrated that esophageal lumen surface of the patch graft was smoother in the BMSCs-SIS group compared with the SIS group. Histological examination suggested a strong similarity between BMSCs and esophageal myoblasts in terms of morphology and function. Although both BMSCs-SIS and SIS repaired the esophageal defects, we noted complete re-epithelialization with almost no inflammation only in the former group. By 12 wk after the surgery, we observed long bundles of skeletal muscles only in the BMSCs-SIS group, where the microvessel density was also much greater. CONCLUSIONS Bone marrow mesenchymal stem cells on an SIS scaffold can promote re-epithelialization, revascularization, and muscular regeneration. This approach may provide an attractive option for esophageal regeneration.
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Affiliation(s)
- Bo Tan
- Laboratory of Stem Cell and Tissue Engineering, Regenerative Medicine Research Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, PR China
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Totonelli G, Maghsoudlou P, Fishman JM, Orlando G, Ansari T, Sibbons P, Birchall MA, Pierro A, Eaton S, De Coppi P. Esophageal tissue engineering: A new approach for esophageal replacement. World J Gastroenterol 2012; 18:6900-7. [PMID: 23322987 PMCID: PMC3531673 DOI: 10.3748/wjg.v18.i47.6900] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 06/14/2012] [Accepted: 06/28/2012] [Indexed: 02/06/2023] Open
Abstract
A number of congenital and acquired disorders require esophageal tissue replacement. Various surgical techniques, such as gastric and colonic interposition, are standards of treatment, but frequently complicated by stenosis and other problems. Regenerative medicine approaches facilitate the use of biological constructs to replace or regenerate normal tissue function. We review the literature of esophageal tissue engineering, discuss its implications, compare the methodologies that have been employed and suggest possible directions for the future. Medline, Embase, the Cochrane Library, National Research Register and ClinicalTrials.gov databases were searched with the following search terms: stem cell and esophagus, esophageal replacement, esophageal tissue engineering, esophageal substitution. Reference lists of papers identified were also examined and experts in this field contacted for further information. All full-text articles in English of all potentially relevant abstracts were reviewed. Tissue engineering has involved acellular scaffolds that were either transplanted with the aim of being repopulated by host cells or seeded prior to transplantation. When acellular scaffolds were used to replace patch and short tubular defects they allowed epithelial and partial muscular migration whereas when employed for long tubular defects the results were poor leading to an increased rate of stenosis and mortality. Stenting has been shown as an effective means to reduce stenotic changes and promote cell migration, whilst omental wrapping to induce vascularization of the construct has an uncertain benefit. Decellularized matrices have been recently suggested as the optimal choice for scaffolds, but smart polymers that will incorporate signalling to promote cell-scaffold interaction may provide a more reproducible and available solution. Results in animal models that have used seeded scaffolds strongly sug- gest that seeding of both muscle and epithelial cells on scaffolds prior to implantation is a prerequisite for complete esophageal replacement. Novel approaches need to be designed to allow for peristalsis and vascularization in the engineered esophagus. Although esophageal tissue engineering potentially offers a real alternative to conventional treatments for severe esophageal disease, important barriers remain that need to be addressed.
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Orlando G, García-Arrarás JE, Soker T, Booth C, Sanders B, Ross CL, De Coppi P, Farney AC, Rogers J, Stratta RJ. Regeneration and bioengineering of the gastrointestinal tract: current status and future perspectives. Dig Liver Dis 2012; 44:714-20. [PMID: 22622201 DOI: 10.1016/j.dld.2012.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Accepted: 04/10/2012] [Indexed: 12/11/2022]
Abstract
The present review aims to illustrate the strategies that are being implemented in regenerative medicine to treat diseases that affect the digestive tract. Possible avenues are twofold: organ bioengineering, where cells are seeded on biological or synthetic scaffolding materials ex vivo and allowed to either mature in bioreactors or be implanted without undergoing any maturation; and regeneration per se, where the diseased tissue or organ is regenerated by recapitulation of its multi-step ontogenesis. This latter avenue may be induced either in vivo or ex vivo. While bioengineering technology has already manufactured segments of the digestive tract and sphincters, pure regeneration of any segment of the digestive tract has not yet been described. However, models of regeneration extrapolated from simple organisms are elucidating the complex yet fascinating mechanisms that regulate the ontogenesis of the digestive tract and are paving the way for the development of new regenerative technologies and methods.
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Affiliation(s)
- Giuseppe Orlando
- Department of General Surgery, Section of Transplantation, Wake Forest University School of Medicine, Winston Salem, NC, USA.
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Kuppan P, Sethuraman S, Krishnan UM. Tissue engineering interventions for esophageal disorders--promises and challenges. Biotechnol Adv 2012; 30:1481-92. [PMID: 22484299 DOI: 10.1016/j.biotechadv.2012.03.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Revised: 03/12/2012] [Accepted: 03/15/2012] [Indexed: 01/11/2023]
Abstract
The diseases of the esophagus include congenital defects like atresia, tracheoesophageal fistula as well as others such as gastro-esophageal reflux disease (GERD), Barrett's esophagus, carcinoma and strictures. All esophageal disorders require surgical intervention and reconstruction with appropriate substitutes. Primary anastomosis is used to treat most cases but treatment of long gap atresia still remains a clinical challenge. Autologous graft therapies using tissues from colon, and small and large intestine or gastric transplantations have been attempted but have constraints like leakage, infection and stenosis at the implanted site, which leads to severe morbidity and mortality. An alternative for autologous grafts are allogenic and xenogenic grafts, which have better availability but disease transmission and immunogenicity limit their applications. Use of biodegradable and biocompatible scaffolds to engineer the esophagus promises to be an effective regenerative strategy for treatment of esophageal disorders. Nanotopography of the fibrous scaffolds mimics the natural extracellular matrix (ECM) of the tissue and incorporation of chemical cues and tailoring mechanical properties provide the right microenvironment for co-culture of different cell types. Scaffolds cultured with esophageal cells (epithelial cells, fibroblast and smooth muscle cells) might show enhancement of the biofunctionality in vivo. This review attempts to address the various strategies and challenges involved in successful tissue engineering of the esophagus.
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Affiliation(s)
- Purushothaman Kuppan
- Centre for Nanotechnology & Advanced Biomaterials, SASTRA University, Thanjavur, Tamil Nadu, India
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