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Nagano S, Fumino S, Kishida T, Wakao J, Hirohata Y, Takayama S, Kim K, Akiyoshi K, Mazda O, Tajiri T, Ono S. Development of a skeletal muscle sheet with direct reprogramming-induced myoblasts on a nanogel-cross-linked porous freeze-dried gel scaffold in a mouse gastroschisis model. Pediatr Surg Int 2024; 40:241. [PMID: 39183231 DOI: 10.1007/s00383-024-05811-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2024] [Indexed: 08/27/2024]
Abstract
PURPOSE In this study, we attempted to create skeletal muscle sheets made of directly converted myoblasts (dMBs) with a nanogel scaffold on a biosheet using a mouse gastroschisis model. METHODS dMBs were prepared by the co-transfection of MYOD1 and MYCL into human fibroblasts. Silicon tubes were implanted under the skin of NOG/SCID mice, and biosheets were formed. The nanogel was a nanoscale hydrogel based on cholesterol-modified pullulan, and a NanoClip-FD gel was prepared by freeze-drying the nanogel. 7 mm in length was created in the abdominal wall of NOG/SCID mice as a mouse gastroschisis model. Matrigel or NanoCliP-FD gel seeded with dMBs was placed on the biosheet and implanted on the model mice. RESULTS Fourteen days after surgery, dMBs with Matrigel showed a small amount of coarse aggregations of muscle-like cells. In contrast, dMBs with NanoCliP-FD gel showed multinucleated muscle-like cells, which were expressed as desmin and myogenin by fluorescent immunostaining. CONCLUSION Nanogels have a porous structure and are useful as scaffolds for tissue regeneration by supplying oxygen and nutrients supply to the cells. Combining dMBs and nanogels on the biosheets resulted in the differentiation and engraftment of skeletal muscle, suggesting the possibility of developing skeletal muscle sheets derived from autologous cells and tissues.
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Affiliation(s)
- Shinta Nagano
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan.
- Department of Immunology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Shigehisa Fumino
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Tsunao Kishida
- Department of Immunology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junko Wakao
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
- Department of Immunology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshiaki Hirohata
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
- Department of Immunology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shohei Takayama
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Kiyokazu Kim
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Kazunari Akiyoshi
- Department of Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Osam Mazda
- Department of Immunology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tatsuro Tajiri
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shigeru Ono
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
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Hashem MA, Metwally E, Mahmoud YK, Helal IE, Ahmed MF. Reconstruction of a partial esophageal defect using tunica vaginalis and buccal mucosa autograft: an experimental study in mongrel dogs. J Vet Med Sci 2023; 85:344-357. [PMID: 36709969 PMCID: PMC10076192 DOI: 10.1292/jvms.22-0319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
In veterinary clinics, esophageal reconstruction is essential in many clinical situations. In this study, two autografts, the tunica vaginalis (TV) and the buccal mucosa (BM), were proposed to reconstruct a semi-circumferential cervical esophageal defect in dogs. This study aimed to verify whether these two grafts could successfully patch esophageal defects. Twelve male mongrel dogs were divided into two groups. Following cervical esophagoplasty, the defective area was patched with either a TV or a BM graft. Comprehensive clinical, serum biochemical, and histological analyses were performed to evaluate the two grafts. Throughout the study (120 days), the dogs survived the procedure well with minor complications. The lumen of the patched areas was covered with mucosa, with slight scar retraction. Compared with that of the natural esophagus, the average relative luminal diameter was not significantly decreased. Importantly, the measured cortisol and inflammatory marker levels returned to the preoperative levels after 14 days. Although histological examination revealed that both grafts repaired the esophageal defect with complete re-epithelialization, the BM graft showed a histological structure similar to that of the natural esophagus. Both grafts effectively repaired the esophageal defect with minor complications; therefore, both are recommended as promising low-cost clinical alternatives for cervical esophagoplasty in dogs.
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Affiliation(s)
- Mohamed A Hashem
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Elsayed Metwally
- Department of Cytology and Histology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Yasmina K Mahmoud
- Department of Biochemistry, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Ibrahim E Helal
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| | - Mahmoud F Ahmed
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
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Elia E, Brownell D, Chabaud S, Bolduc S. Tissue Engineering for Gastrointestinal and Genitourinary Tracts. Int J Mol Sci 2022; 24:ijms24010009. [PMID: 36613452 PMCID: PMC9820091 DOI: 10.3390/ijms24010009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/10/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
The gastrointestinal and genitourinary tracts share several similarities. Primarily, these tissues are composed of hollow structures lined by an epithelium through which materials need to flow with the help of peristalsis brought by muscle contraction. In the case of the gastrointestinal tract, solid or liquid food must circulate to be digested and absorbed and the waste products eliminated. In the case of the urinary tract, the urine produced by the kidneys must flow to the bladder, where it is stored until its elimination from the body. Finally, in the case of the vagina, it must allow the evacuation of blood during menstruation, accommodate the male sexual organ during coitus, and is the natural way to birth a child. The present review describes the anatomy, pathologies, and treatments of such organs, emphasizing tissue engineering strategies.
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Affiliation(s)
- Elissa Elia
- Centre de Recherche en Organogénèse Expérimentale/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Center, Québec, QC G1J 1Z4, Canada
| | - David Brownell
- Centre de Recherche en Organogénèse Expérimentale/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Center, Québec, QC G1J 1Z4, Canada
| | - Stéphane Chabaud
- Centre de Recherche en Organogénèse Expérimentale/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Center, Québec, QC G1J 1Z4, Canada
| | - Stéphane Bolduc
- Centre de Recherche en Organogénèse Expérimentale/LOEX, Regenerative Medicine Division, CHU de Québec-Université Laval Research Center, Québec, QC G1J 1Z4, Canada
- Department of Surgery, Faculty of Medicine, Université Laval, Québec, QC G1V 0A6, Canada
- Correspondence: ; Tel.: +1-418-525-4444 (ext. 42282)
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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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Nakayama Y, Iwai R, Terazawa T, Tajikawa T, Umeno T, Kawashima T, Nakashima Y, Shiraishi Y, Yamada A, Higashita R, Miyazaki M, Oie T, Kadota S, Yabuuchi N, Abe F, Funayama-Iwai M, Yambe T, Miyamoto S. Pre-implantation evaluation of a small-diameter, long vascular graft (Biotube®) for below-knee bypass surgery in goats. J Biomed Mater Res B Appl Biomater 2022; 110:2387-2398. [PMID: 35561095 DOI: 10.1002/jbm.b.35084] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/28/2022] [Accepted: 04/30/2022] [Indexed: 11/06/2022]
Abstract
There are no small-diameter, long artificial vascular grafts for below-knee bypass surgery in chronic limb-threatening ischemia. We have developed tissue-engineered vascular grafts called "Biotubes®" using a completely autologous approach called in-body tissue architecture (iBTA). This study aimed at pre-implantation evaluation of Biotube and its in vivo preparation device, Biotube Maker, for use in below-knee bypass surgery. Forty nine makers were subcutaneously embedded into 17 goats for predetermined periods (1, 2, or 3 months). All makers produced Biotubes as designed without inflammation over all periods, with the exception of a few cases with minor defects (success rate: 94%). Small hole formation occurred in only a few cases. All Biotubes obtained had an inner diameter of 4 mm and a length of 51 to 52 cm with a wall thickness of 594 ± 97 μm. All Biotubes did not kink when completely bent under an internal pressure of 100 mmHg and did not leak without any deformation under a water pressure of 200 mmHg. Their burst strength was 2409 ± 473 mmHg, and suture retention strength was 1.75 ± 0.27 N, regardless of the embedding period, whereas tensile strength increased from 7.5 ± 1.3 N at 1 month to 9.7 ± 2.0 N at 3 months with the embedding period. The amount of water leakage from the needle holes prepared in the Biotube wall was approximately 1/7th of that in expanded polytetrafluoroethylene vascular grafts. The Biotubes could be easily connected to each other without cutting or anastomosis leaks. They could be stored for at least 1 year at room temperature. This study confirmed that even Biotubes formed 1 month after embedding of Biotube Makers had properties comparable to arteries.
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Affiliation(s)
- Yasuhide Nakayama
- Osaka Laboratory, Biotube Co., Ltd, Osaka, Japan.,Department of Cardiovascular Surgery, Oita University Hospital, Oita, Japan
| | - Ryosuke Iwai
- Institute of Frontier Science and Technology, Okayama University of Science, Okayama, Japan
| | - Takeshi Terazawa
- Advanced Medical Engineering Research Center, Asahikawa Medical University, Hokkaido, Japan
| | - Tsutomu Tajikawa
- Department of Mechanical Engineering, Faculty of Engineering Science, Kansai University, Osaka, Japan
| | - Tadashi Umeno
- Department of Cardiovascular Surgery, Oita University Hospital, Oita, Japan
| | - Takayuki Kawashima
- Department of Cardiovascular Surgery, Oita University Hospital, Oita, Japan
| | - Yumiko Nakashima
- Department of Cardiovascular Surgery, Oita University Hospital, Oita, Japan
| | - Yasuyuki Shiraishi
- Pre-Clinical Research Center, Institute of Development, Aging and Cancer, Tohoku University, Miyagi, Japan
| | - Akihiro Yamada
- Pre-Clinical Research Center, Institute of Development, Aging and Cancer, Tohoku University, Miyagi, Japan
| | - Ryuji Higashita
- Osaka Laboratory, Biotube Co., Ltd, Osaka, Japan.,Department of Cardiovascular Surgery, Yokohama General Hospital, Kanagawa, Japan
| | - Manami Miyazaki
- Department of Cardiovascular Surgery, Yokohama General Hospital, Kanagawa, Japan
| | - Tomonori Oie
- Osaka Laboratory, Biotube Co., Ltd, Osaka, Japan
| | - Satoki Kadota
- Department of Development Promotion, Clinical Research, Innovation and Education Center (CRIETO), Tohoku University Hospital, Miyagi, Japan
| | - Nozomi Yabuuchi
- Department of Development Promotion, Clinical Research, Innovation and Education Center (CRIETO), Tohoku University Hospital, Miyagi, Japan
| | - Fumie Abe
- Department of Development Promotion, Clinical Research, Innovation and Education Center (CRIETO), Tohoku University Hospital, Miyagi, Japan
| | - Marina Funayama-Iwai
- Institute of Frontier Science and Technology, Okayama University of Science, Okayama, Japan
| | - Tomoyuki Yambe
- Pre-Clinical Research Center, Institute of Development, Aging and Cancer, Tohoku University, Miyagi, Japan
| | - Shinji Miyamoto
- Department of Cardiovascular Surgery, Oita University Hospital, Oita, Japan
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Mizuno T, Iwai R, Moriwaki T, Nakayama Y. Application of Biosheets as Right Ventricular Outflow Tract Repair Materials in a Rat Model. Front Vet Sci 2022; 9:837319. [PMID: 35464349 PMCID: PMC9024079 DOI: 10.3389/fvets.2022.837319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/17/2022] [Indexed: 11/16/2022] Open
Abstract
Purposes We report the experimental use of completely autologous biomaterials (Biosheets) made by “in-body tissue architecture” that could resolve problems in artificial materials and autologous pericardium. Here, Biosheets were implanted into full-thickness right ventricular outflow tract defects in a rat model. Their feasibility as a reparative material for cardiac defects was evaluated. Methods As the evaluation of mechanical properties of the biosheets, the elastic moduli of the biosheets and RVOT-free walls of rats were examined using a tensile tester. Biosheets and expanded polytetrafluoroethylene sheet were used to repair transmural defects surgically created in the right ventricular outflow tracts of adult rat hearts (n = 9, each patch group). At 4 and 12 weeks after the operation, the hearts were resected and histologically examined. Results The strength and elastic moduli of the biosheets were 421.3 ± 140.7 g and 2919 ± 728.9 kPa, respectively, which were significantly higher than those of the native RVOT-free walls (93.5 ± 26.2 g and 778.6 ± 137.7 kPa, respectively; P < 0.005 and P < 0.001, respectively). All patches were successfully implanted into the right ventricular outflow tract-free wall of rats. Dense fibrous adhesions to the sternum on the epicardial surface were also observed in 7 of 9 rats with ePTFE grafts, whereas 2 of 9 rats with biosheets. Histologically, the vascular-constructing cells were infiltrated into Biosheets. The luminal surfaces were completely endothelialized in all groups at each time point. There was also no accumulation of inflammatory cells. Conclusions Biosheets can be formed easily and have sufficient strength and good biocompatibility as a patch for right ventricular outflow tract repair in rats. Therefore, Biosheet may be a suitable material for reconstructive surgery of the right ventricular outflow tract.
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Affiliation(s)
- Takeshi Mizuno
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
- *Correspondence: Takeshi Mizuno
| | - Ryosuke Iwai
- Research Institute of Technology, Okayama University of Science, Okayama, Japan
| | - Takeshi Moriwaki
- Department of Mechanical Science and Engineering, Faculty of Science and Technology, Hirosaki University, Aomori, Japan
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Mensah A, Chen Y, Christopher N, Wei Q. Membrane Technological Pathways and Inherent Structure of Bacterial Cellulose Composites for Drug Delivery. Bioengineering (Basel) 2021; 9:3. [PMID: 35049712 PMCID: PMC8772700 DOI: 10.3390/bioengineering9010003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 11/16/2022] Open
Abstract
This report summarizes efforts undertaken in the area of drug delivery, with a look at further efforts made in the area of bacterial cellulose (BC) biomedical applications in general. There are many current methodologies (past and present) for the creation of BC membrane composites custom-engineered with drug delivery functionality, with brief consideration for very close applications within the broader category of biomedicine. The most emphasis was placed on the crucial aspects that open the door to the possibility of drug delivery or the potential for use as drug carriers. Additionally, consideration has been given to laboratory explorations as well as already established BC-drug delivery systems (DDS) that are either on the market commercially or have been patented in anticipation of future commercialization. The cellulose producing strains, current synthesis and growth pathways, critical aspects and intrinsic morphological features of BC were given maximum consideration, among other crucial aspects of BC DDS.
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Affiliation(s)
| | | | | | - Qufu Wei
- Key Laboratory of Eco-Textiles, Ministry of Education, Jiangnan University, Wuxi 214122, China; (A.M.); (Y.C.); (N.C.)
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A new method of primary engineering of esophagus using orthotopic in-body tissue architecture. J Pediatr Surg 2021; 56:1186-1191. [PMID: 33845983 DOI: 10.1016/j.jpedsurg.2021.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 03/12/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE Tissue engineering of esophagus is required for management of long-gap esophageal atresia (LGEA). Collagenous connective tissue membranes fabricated by in-body tissue architecture (iBTA), called biosheets, can repair esophageal defects and generate tissues similar to native esophagus. However, iBTA requires second-stage surgery because of heterotopic preparation of biosheets. Our aim was to develop orthotopic iBTA for primary engineering of the esophagus by interposing a tubular mold to the esophageal defect. METHOD The cervical esophagus of six rats was transected. An acrylic tube (internal diameter 2.6 mm, length 7.0 mm) was inserted and fixed between the ends of the upper and lower esophagus, and a 3 mm-long esophageal defect was created. Four weeks later, the rats were sacrificed for histological analysis. RESULTS Postoperatively the rats could intake liquid food. After four weeks, the esophageal defects were filled with regenerated tissues. Histologically the new esophageal walls stained positive for collagen type I. The inner surfaces were covered with stratified squamous epithelium that expressed pan-cytokeratin. In only one of six rats, regeneration of muscular-like tissue was suggested by positive immunohistochemical staining for desmin. CONCLUSION Orthotopic iBTA can regenerate a substitute esophagus with esophageal epithelium and collagenous wall. This technique may be a novel treatment for esophageal atresia with gaps of various lengths including LGEA.
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Okamoto K, Umeno T, Shuto T, Wada T, Anai H, Nishida H, Nakayama Y, Miyamoto S. Three-month outcomes of aortic valve reconstruction using collagenous membranes (biosheets) produced by in-body tissue architecture in a goat model: a preliminary study. BMC Cardiovasc Disord 2021; 21:184. [PMID: 33858334 PMCID: PMC8050917 DOI: 10.1186/s12872-021-01988-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 04/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Autologous pericardium is widely used as a plastic material in intracardiac structures, in the pulmonary artery, and in aortic valve leaflets. For aortic valve reconstruction (AVRec) using the Ozaki procedure, it has produced excellent clinical results over a 10-year period. In-body tissue architecture (iBTA), which is based on the phenomenon of tissue encapsulation of foreign materials, can be used to prepare autologous prosthetic tissues. In this preliminary study, we examined whether biosheets can be used as valve leaflet material for glutaraldehyde-free AVRec by subchronic implantation experiments in goats and evaluated its performance compared with glutaraldehyde-treated autologous pericardium for AVRec. METHODS Biosheets were prepared by embedding molds for two months into the dorsal subcutaneous spaces of goats. Autogenic biosheets (n = 4) cut into the shape of the valve were then implanted to the aortic valve annulus of four goats for three months without glutaraldehyde treatment. Autologous pericardium (n = 4) was used in four goats as a control. Valve function was observed using echocardiography. RESULTS All goats survived the three-month study period. With biosheets, the leaflet surfaces were very smooth and, on histology, partially covered with a thin neointima (including endothelial cells). Biosheets were more thoroughly assimilated into the aortic root compared with autologous pericardium. CONCLUSIONS For the first time, biosheets were used for large animal AVRec. Biosheets could function as leaflets in the aortic position and may have the ability to assimilate into native valves.
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Affiliation(s)
- Keitaro Okamoto
- Department of Cardiovascular Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Yufu , Oita , 879-5593, Japan. .,Department of Cardiovascular Surgery, Oita University Hospital, Oita, Japan.
| | - Tadashi Umeno
- Department of Cardiovascular Surgery, Oita University Hospital, Oita, Japan
| | - Takashi Shuto
- Department of Cardiovascular Surgery, Oita University Hospital, Oita, Japan
| | - Tomoyuki Wada
- Department of Cardiovascular Surgery, Oita University Hospital, Oita, Japan
| | - Hirofumi Anai
- Clinical Engineering, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Haruto Nishida
- Department of Pathology, Oita University Hospital, Oita, Japan
| | | | - Shinji Miyamoto
- Department of Cardiovascular Surgery, Oita University Hospital, Oita, Japan
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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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Kawashima T, Umeno T, Terazawa T, Wada T, Shuto T, Nishida H, Anai H, Nakayama Y, Miyamoto S. Aortic valve neocuspidization with in-body tissue-engineered autologous membranes: preliminary results in a long-term goat model. Interact Cardiovasc Thorac Surg 2021; 32:969-977. [PMID: 33543242 DOI: 10.1093/icvts/ivab015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/03/2020] [Accepted: 12/20/2020] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Aortic valve neocuspidization has shown satisfactory clinical outcomes; however, autologous pericardium durability is a concern for young patients. This study applied an autologous collagenous membrane (Biosheet®), produced by in-body tissue architecture, to aortic valve neocuspidization and investigated its long-term outcome in a goat model. METHODS Moulds were embedded subcutaneously in 6 goats. After 2 months, Biosheets formed in the moulds. We performed aortic valve neocuspidization using a portion of the sheets with a thickness of 0.20-0.35 mm, measured by optical coherence tomography. Animals were subjected to echocardiography and histological evaluation at 6 months (n = 3) and 12 months (n = 3). As a control, the glutaraldehyde-treated autologous pericardium was used in 4 goats that were similarly evaluated at 12 months. RESULTS All animals survived the scheduled period. At 6 months, Biosheets maintained valve function and showed a regeneration response: fusion to the annulus, cell infiltration to the leaflets and appearance of elastic fibres at the ventricular side. After 12 months, the regenerative structure had changed little without regression, and there was negligible calcification in the 1/9 leaflets. However, all cases had one leaflet tear, resulting in moderate-to-severe aortic regurgitation. In the pericardium group, three-fourths of the animals experienced moderate-to-severe aortic regurgitation with a high rate of calcification (9/12 leaflets). CONCLUSIONS Biosheets may have regeneration potential and anti-calcification properties in contrast to autologous pericardium. However, in order to obtain reliable outcome, further improvements are required to strictly control and optimize its thickness, density and homogeneity.
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Affiliation(s)
- Takayuki Kawashima
- Department of Cardiovascular Surgery, Oita University, Yufu, Oita, Japan
| | - Tadashi Umeno
- Department of Cardiovascular Surgery, Oita University, Yufu, Oita, Japan
| | - Takeshi Terazawa
- Department of Mechanical Systems Engineering, Aichi University of Technology, Gamagori, Aichi, Japan
| | - Tomoyuki Wada
- Department of Cardiovascular Surgery, Oita University, Yufu, Oita, Japan
| | - Takashi Shuto
- Department of Cardiovascular Surgery, Oita University, Yufu, Oita, Japan
| | - Haruto Nishida
- Department of Diagnostic Pathology, Oita University, Yufu, Oita, Japan
| | - Hirofumi Anai
- Clinical Engineering Research Center, Oita University, Yufu, Oita, Japan
| | | | - Shinji Miyamoto
- Department of Cardiovascular Surgery, Oita University, Yufu, Oita, Japan
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Camargo de Almeida G, Farion de Aguiar LR, Antunes AG, Belmino Gadelha AA. Foker technique for esophageal reconstruction after cervical esophagostomy. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2020.101735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Kanetaka K, Eguchi S. Regenerative medicine for the upper gastrointestinal tract. Regen Ther 2020; 15:129-137. [PMID: 33426211 PMCID: PMC7770370 DOI: 10.1016/j.reth.2020.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/21/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022] Open
Abstract
The main surgical strategy for gastrointestinal tract malignancy is en bloc resection, which consists of not only resection of the involved organs but also simultaneous resection of the surrounding or adjacent mesenteries that contain lymph vessels and nodes. After resection of the diseased organs, the defect of the gastrointestinal conduit is replaced with organs located downstream, such as the stomach and jejunum. However, esophageal and gastric reconstruction using these natural substitutes is associated with a diminished quality of life due to the loss of the reserve function, damage to the antireflux barrier, and dumping syndrome. Thus, replacement of the deficit after resection with the patient's own regenerated tissue to compensate for the lost function and tissue using regenerative medicine will be an ideal treatment. Many researchers have been trying to construct artificial organs through tissue engineering techniques; however, none have yet succeeded in growing a whole organ because of the complicated functions these organs perform, such as the processing and absorption of nutrients. While exciting results have been reported with regard to tissue engineering techniques concerning the upper gastrointestinal tract, such as the esophagus and stomach, most of these achievements have been observed in animal models, and few successful approaches in the clinical setting have been reported for the replacement of mucosal defects. We review the recent progress in regenerative medicine in relation to the upper gastrointestinal tract, such as the esophagus and stomach. We also focus on the functional capacity of regenerated tissue and its role as a culture system to recapitulate the mechanisms underlying infectious disease. With the emergence of technology such as the fabrication of decellularized constructs, organoids and cell sheet medicine, collaboration between gastrointestinal surgery and regenerative medicine is expected to help establish novel therapeutic modalities in the future.
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Affiliation(s)
- Kengo Kanetaka
- Tissue Engineering and Regenerative Therapeutics in Gastrointestinal Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Miar S, Dion GR, Montelongo S, Ong JL, Bizios R, Guda T. Development of a Bioinspired, Self-Adhering, and Drug-Eluting Laryngotracheal Patch. Laryngoscope 2020; 131:1958-1966. [PMID: 33125169 DOI: 10.1002/lary.29182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/19/2020] [Accepted: 09/19/2020] [Indexed: 11/05/2022]
Abstract
OBJECTIVES/HYPOTHESIS Novel laryngotracheal wound coverage devices are limited by complex anatomy, smooth surfaces, and dynamic pressure changes and airflow during breathing. We hypothesize that a bioinspired mucoadhesive patch mimicking how geckos climb smooth surfaces will permit sutureless wound coverage and also allow drug delivery. STUDY DESIGN ex-vivo. METHODS Polycaprolactone (PCL) fibers were electrospun onto a substrate and polyethylene glycol (PEG) - acrylate flocks in varying densities were deposited to create a composite patch. Sample topography was assessed with laser profilometry, material stiffness with biaxial mechanical testing, and mucoadhesive testing determined cohesive material failure on porcine tracheal tissue. Degradation rate was measured over 21 days in vitro along with dexamethasone drug release profiles. Material handleability was evaluated via suture retention and in cadaveric larynges. RESULTS Increased flocking density was inversely related to cohesive failure in mucoadhesive testing, with a flocking density of PCL-PEG-2XFLK increasing failure strength to 6880 ± 1810 Pa compared to 3028 ± 791 in PCL-PEG-4XFLK density and 1182 ± 262 in PCL-PEG-6XFLK density. The PCL-PEG-2XFLK specimens had a higher failure strength than PCL alone (1404 ± 545 Pa) or PCL-PEG (2732 ± 840). Flocking progressively reduced composite stiffness from 1347 ± 15 to 763 ± 21 N/m. Degradation increased from 12% at 7 days to 16% after 10 days and 20% after 21 days. Cumulative dexamethasone release at 0.4 mg/cm2 concentration was maintained over 21 days. Optimized PCL-PEG-2XFLK density flocked patches were easy to maneuver endoscopically in laryngeal evaluation. CONCLUSIONS This novel, sutureless, patch is a mucoadhesive platform suitable to laryngeal and tracheal anatomy with drug delivery capability. LEVEL OF EVIDENCE NA Laryngoscope, 131:1958-1966, 2021.
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Affiliation(s)
- Solaleh Miar
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, Texas, U.S.A
| | - Gregory R Dion
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, Texas, U.S.A.,Dental and Craniofacial Trauma Research Department, U.S. Army Institute of Surgical Research, San Antonio, Texas, U.S.A
| | - Sergio Montelongo
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, Texas, U.S.A
| | - Joo L Ong
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, Texas, U.S.A
| | - Rena Bizios
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, Texas, U.S.A
| | - Teja Guda
- Department of Biomedical Engineering, University of Texas at San Antonio, San Antonio, Texas, U.S.A
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Mechanical characterization of an in-body tissue-engineered autologous collagenous sheet for application as an aortic valve reconstruction material. J Biomech 2020; 99:109528. [DOI: 10.1016/j.jbiomech.2019.109528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 10/12/2019] [Accepted: 11/05/2019] [Indexed: 11/22/2022]
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Long-term outcomes of patch tracheoplasty using collagenous tissue membranes (biosheets) produced by in-body tissue architecture in a beagle model. Surg Today 2019; 49:958-964. [PMID: 31098758 DOI: 10.1007/s00595-019-01818-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 04/18/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Although various artificial tracheas have been developed, none have proven satisfactory for clinical use. In-body tissue architecture (IBTA) has enabled us to produce collagenous tissues with a wide range of shapes and sizes to meet the needs of individual recipients. In the present study, we investigated the long-term outcomes of patch tracheoplasty using an IBTA-induced collagenous tissue membrane ("biosheet") in a beagle model. METHODS Nine adult female beagles were used. Biosheets were prepared by embedding cylindrical molds assembled with a silicone rod and a slitting pipe into dorsal subcutaneous pouches for 2 months. The sheets were then implanted by patch tracheoplasty. An endoscopic evaluation was performed after 1, 3, or 12 months. The implanted biosheets were harvested for a histological evaluation at the same time points. RESULTS All animals survived the study. At 1 month after tracheoplasty, the anastomotic parts and internal surface of the biosheets were smooth with ciliated columnar epithelium, which regenerated into the internal surface of the biosheet. The chronological spread of chondrocytes into the biosheet was observed at 3 and 12 months. CONCLUSIONS Biosheets showed excellent performance as a scaffold for trachea regeneration with complete luminal epithelium and partial chondrocytes in a 1-year beagle implantation model of patch tracheoplasty.
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Dua KS, Sasikala M. Repairing the human esophagus with tissue engineering. Gastrointest Endosc 2018; 88:579-588. [PMID: 30220298 DOI: 10.1016/j.gie.2018.06.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 06/29/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Kulwinder S Dua
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, U.S.A
| | - Mitnala Sasikala
- Institute of Basic Sciences and Translational Research, Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, India
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iBTA-induced bovine Biosheet for repair of abdominal wall defects in a beagle model: proof of concept. Hernia 2018; 22:1033-1039. [PMID: 30022282 DOI: 10.1007/s10029-018-1799-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 07/13/2018] [Indexed: 12/21/2022]
Abstract
INTRODUCTION We evaluated the usefulness of xeno-Biosheets, an in-body tissue architecture-induced bovine collagenous sheet, as repair materials for abdominal wall defects in a beagle model. MATERIALS AND METHODS Biosheets were prepared by embedding cylindrical molds into subcutaneous pouches of three Holstein cows for 2-3 months and stored in 70% ethanol. The Biosheets were 0.5 mm thick, cut into 2 cm × 2 cm, and implanted to replace defects of the same size in the abdominal wall of nine beagles. The abdominal wall and Biosheets were harvested and subjected to histological evaluation at 1, 3, and 5 months after implantation (n = 3 each). RESULTS The Biosheet and bovine pericardiac patch (control) were not stressed during the suture operation and did not split, and patches were easily implanted on defective wounds. After implantation, the patch did not fall off and was not perforated, and healing was observed nacroscopically in all cases. During the first month of implantation, accumulation of inflammatory cells was observed along with decomposition around the Biosheet. Decomposition was almost complete after 3 months, and the Biosheet was replaced by autologous collagenous connective tissue without rejection. After 5 months, the abdominal wall muscle elongated from the periphery of the newly formed collagen layer and the peritoneum was formed on the peritoneal cavity surface. Regeneration of almost all layers of the abdominal wall was observed. However, almost all pericardium patches were remained even at 5 months with inflammation. CONCLUSION Bovine Biosheets requiring no special post-treatment can be useful as off-the-shelf materials for abdominal wall repair.
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Terazawa T, Nishimura T, Mitani T, Ichii O, Ikeda T, Kosenda K, Tatsumi E, Nakayama Y. Wall thickness control in biotubes prepared using type-C mold. J Artif Organs 2018; 21:387-391. [DOI: 10.1007/s10047-018-1035-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/15/2018] [Indexed: 10/17/2022]
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