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Jerman UD, Veranič P, Cirman T, Kreft ME. Human Amniotic Membrane Enriched with Urinary Bladder Fibroblasts Promote the Re-Epithelization of Urothelial Injury. Cell Transplant 2021; 29:963689720946668. [PMID: 32841052 PMCID: PMC7563929 DOI: 10.1177/0963689720946668] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Culturing cells in three-dimensional systems that include extracellular matrix
components and different cell types mimic the native tissue and as such provide
much more representative results than conventional two-dimensional cell
cultures. In order to develop biomimetic bladder tissue in vitro, we used human
amniotic membrane (AM) extracellular matrix as a scaffold for bladder
fibroblasts (BFs) and urothelial cells. Our aims were to evaluate the
integration of BFs into the AM stroma, to assess the differentiation of the
urothelium on BFs-enriched AM scaffolds, and to evaluate the AM as a urothelial
wound dressing. First, to achieve the optimal integration of BFs into AM stroma,
different intact and de- epithelialized AM (dAM) scaffolds were tested. BFs
secreted matrix metalloproteinase (MMP)-1 and MMP-2 and integrated into the
stroma of all types of AM scaffolds. Second, to establish urothelial tissue
equivalent, urothelial cells were seeded on dAM scaffolds enriched with BFs. The
BFs in the stroma of the AM scaffolds promoted (1) the proliferation of
urothelial cells, (2) the attachment of urothelial cells on AM basal lamina with
hemidesmosomes, and (3) development of multilayered urothelium with expressed
uroplakins and well-developed cell junctions. Third, we established an ex vivo
model of the injured bladder to evaluate the dAM as a wound dressing for
urothelial full-thickness injury. dAM acted as a promising wound dressing since
it enabled rapid re-epithelization of urothelial injury and integrated into the
bladder tissue. Herein, the developed urothelial tissue equivalents enable
further mechanistic studies of bladder epithelial–mesenchymal interactions, and
they could be applied as biomimetic models for preclinical testing of newly
developed drugs. Moreover, we could hypothesize that AM may be suitable as a
dressing of the wound that occurs during transurethral resection of bladder
tumor, since it could diminish the possibility of tumor recurrence, by promoting
the rapid re-epithelization of the urothelium.
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Affiliation(s)
- Urška Dragin Jerman
- Institute of Cell Biology, 37664Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Peter Veranič
- Institute of Cell Biology, 37664Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Tina Cirman
- 86684Blood Transfusion Centre of Slovenia, Ljubljana, Slovenia
| | - Mateja Erdani Kreft
- Institute of Cell Biology, 37664Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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2
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Wang X, Zhang F, Liao L. Current Applications and Future Directions of Bioengineering Approaches for Bladder Augmentation and Reconstruction. Front Surg 2021; 8:664404. [PMID: 34222316 PMCID: PMC8249581 DOI: 10.3389/fsurg.2021.664404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/24/2021] [Indexed: 12/12/2022] Open
Abstract
End-stage neurogenic bladder usually results in the insufficiency of upper urinary tract, requiring bladder augmentation with intestinal tissue. To avoid complications of augmentation cystoplasty, tissue-engineering technique could offer a new approach to bladder reconstruction. This work reviews the current state of bioengineering progress and barriers in bladder augmentation or reconstruction and proposes an innovative method to address the obstacles of bladder augmentation. The ideal tissue-engineered bladder has the characteristics of high biocompatibility, compliance, and specialized urothelium to protect the upper urinary tract and prevent extravasation of urine. Despite that many reports have demonstrated that bioengineered bladder possessed a similar structure to native bladder, few large animal experiments, and clinical applications have been performed successfully. The lack of satisfactory outcomes over the past decades may have become an important factor hindering the development in this field. More studies should be warranted to promote the use of tissue-engineered bladders in clinical practice.
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Affiliation(s)
- Xuesheng Wang
- Department of Urology, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, China.,Department of Urology, Capital Medical University, Beijing, China.,University of Rehabilitation, Qingdao, China
| | - Fan Zhang
- Department of Urology, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, China.,Department of Urology, Capital Medical University, Beijing, China.,University of Rehabilitation, Qingdao, China
| | - Limin Liao
- Department of Urology, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, China.,Department of Urology, Capital Medical University, Beijing, China.,University of Rehabilitation, Qingdao, China
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3
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Moreno-Manzano V, Mellado-López M, Morera-Esteve MJ, Alastrue-Agudo A, Bisbal-Velasco V, Forteza-Vila J, Serrano-Aroca Á, Vera-Donoso CD. Human adipose-derived mesenchymal stem cells accelerate decellularized neobladder regeneration. Regen Biomater 2019; 7:161-169. [PMID: 32296535 PMCID: PMC7147364 DOI: 10.1093/rb/rbz049] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/11/2019] [Accepted: 11/22/2019] [Indexed: 12/16/2022] Open
Abstract
Decellularized natural bladder matrices (neobladders) represent an exciting means to regenerate the bladder following bladder cancer-associated cystectomy. In this study, we compare the evolution of decellularized matrices with recellularized matrices by seeding it with human adipose-derived mesenchymal stem cells (ADSC) after implantation following partial cystectomy in rats. We discovered significant anatomical differences since 10 days after neobladder implantation with the ADSC-containing matrices promoting a significant recovery of mature p63- and cytokeratin 7-positive urothelium. We also discovered significantly induced expression of the vimentin mesoderm marker in the submucosal layer in ADSC-seeded matrices. Interestingly, we found a higher expression of smooth muscle actin in transversal and longitudinal smooth muscle layers with ADSC-seeded matrices. Furthermore, ADSC also showed increased vascularization and nerve innervation of the neobladder as determined by the distribution of CD31 and S100β reactivity, respectively. We believe that ADSC and their paracrine-acting pro-regenerative secretome within decellularized matrices represent an efficient bladder substitution strategy; however, we require a fuller understanding of the mechanisms involved before clinical studies can begin.
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Affiliation(s)
- Victoria Moreno-Manzano
- Neuronal and Tissue Regeneration Lab, Centro de Investigación Príncipe Felipe, Valencia, Spain.,Facultad de Veterinaria y Ciencias Experimentales, Universidad Católica de Valencia San Vicente Mártir, c/Guillem de Castro 94, Valencia 46001, Spain
| | | | | | - Ana Alastrue-Agudo
- Neuronal and Tissue Regeneration Lab, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Viviana Bisbal-Velasco
- Neuronal and Tissue Regeneration Lab, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Jerónimo Forteza-Vila
- Molecular Pathology and Translational Research in Oncology, Unidad Mixta Universidad Católica de Valencia y Centro de Investigación Príncipe Felipe, Spain
| | - Ángel Serrano-Aroca
- Facultad de Veterinaria y Ciencias Experimentales, Universidad Católica de Valencia San Vicente Mártir, c/Guillem de Castro 94, Valencia 46001, Spain
| | - César David Vera-Donoso
- Department of Urology, La Fe University and Polytechnic Hospital and Health Research Institute, Hospital La Fe, Valencia 46026, Spain
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4
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Yudintceva NM, Nashchekina YA, Mikhailova NA, Vinogradova TI, Yablonsky PK, Gorelova AA, Muraviov AN, Gorelov AV, Samusenko IA, Nikolaev BP, Yakovleva LY, Shevtsov MA. Urethroplasty with a bilayered poly-D,L-lactide-co-ε-caprolactone scaffold seeded with allogenic mesenchymal stem cells. J Biomed Mater Res B Appl Biomater 2019; 108:1010-1021. [PMID: 31369698 DOI: 10.1002/jbm.b.34453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/28/2019] [Accepted: 07/17/2019] [Indexed: 01/11/2023]
Abstract
Reconstructive surgery for urethral defects employing tissue-engineered scaffolds represents an alternative treatment for urethroplasty. The aim of this study was to compare the therapeutic efficacy of the bilayer poly-D,L-lactide/poly-ε-caprolactone (PL-PC) scaffold seeded with allogenic mesenchymal stem cells (MSCs) for urethra reconstruction in a rabbit model with conventional urethroplasty employing an autologous buccal mucosa graft (BG). The inner layer of the scaffold based on poly-D,L-lactic acid (PL) was seeded with MSCs, while the outer layer, prepared from poly-ε-caprolactone, protected the surrounding tissues from urine. To track the MSCs in vivo, the latter were labeled with superparamagnetic iron oxide nanoparticles. In rabbits, a dorsal penile defect was reconstructed employing a BG or a PL-PC graft seeded with nanoparticle-labeled MSCs. In the 12-week follow-up period, no complications were detected. Subsequent histological analysis demonstrated biointegration of the PL-PC graft with surrounding urethral tissues. Less fibrosis and inflammatory cell infiltration were observed in the experimental group as compared with the BG group. Nanoparticle-labeled MSCs were detected in the urothelium and muscular layer, co-localizing with the urothelium cytokeratin marker AE1/AE3, indicating the possibility of MSC differentiation into neo-urothelium. Our results suggest that a bilayer MSCs-seeded scaffold could be efficiently employed for urethroplasty.
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Affiliation(s)
- Natalia M Yudintceva
- Institute of Cytology of the Russian Academy of Sciences (RAS), St. Petersburg, Russia
| | - Yulia A Nashchekina
- Institute of Cytology of the Russian Academy of Sciences (RAS), St. Petersburg, Russia
| | - Nataliya A Mikhailova
- Institute of Cytology of the Russian Academy of Sciences (RAS), St. Petersburg, Russia
| | - Tatiana I Vinogradova
- Saint-Petersburg State Research Institute of Phthisiopulmonology of the Ministry of Healthcare of the Russian Federation, St. Petersburg, Russia
| | - Petr K Yablonsky
- Saint-Petersburg State Research Institute of Phthisiopulmonology of the Ministry of Healthcare of the Russian Federation, St. Petersburg, Russia.,Federal State Budgetary Institute, St. Petersburg, Russia
| | - Anna A Gorelova
- Saint-Petersburg State Research Institute of Phthisiopulmonology of the Ministry of Healthcare of the Russian Federation, St. Petersburg, Russia.,St. Luca's City Hospital, St. Petersburg, Russia
| | - Alexandr N Muraviov
- Saint-Petersburg State Research Institute of Phthisiopulmonology of the Ministry of Healthcare of the Russian Federation, St. Petersburg, Russia.,Private University, Saint-Petersburg Medico-Social Institute, St. Petersburg, Russia
| | - Andrey V Gorelov
- Federal State Budgetary Institute, St. Petersburg, Russia.,Pokrovskaya Municipal Hospital, St. Petersburg, Russia
| | - Igor A Samusenko
- Federal State Budgetary Institute, The Nikiforov Russian Center of Emergency and Radiation Medicine, Ministry of Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters, St. Petersburg, Russia
| | - Boris P Nikolaev
- Research Institute of Highly Pure Biopreparations, St. Petersburg, Russia
| | | | - Maxim A Shevtsov
- Institute of Cytology of the Russian Academy of Sciences (RAS), St. Petersburg, Russia.,First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia.,Almazov National Medical Research Centre, Russian Polenov Neurosurgical Institute, St. Petersburg, Russia.,Center for Translational Cancer Research Technische Universität München (TranslaTUM), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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5
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A urine-dependent human urothelial organoid offers a potential alternative to rodent models of infection. Sci Rep 2018; 8:1238. [PMID: 29352171 PMCID: PMC5775255 DOI: 10.1038/s41598-018-19690-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 01/04/2018] [Indexed: 12/13/2022] Open
Abstract
Murine models describe a defined host/pathogen interaction for urinary tract infection, but human cell studies are scant. Although recent human urothelial organoid models are promising, none demonstrate long-term tolerance to urine, the natural substrate of the tissue and of the uropathogens that live there. We developed a novel human organoid from progenitor cells which demonstrates key structural hallmarks and biomarkers of the urothelium. After three weeks of transwell culture with 100% urine at the apical interface, the organoid stratified into multiple layers. The apical surface differentiated into enlarged and flattened umbrella-like cells bearing characteristic tight junctions, structures resembling asymmetric unit membrane plaques, and a glycosaminoglycan layer. The apical cells also expressed cytokeratin-20, a spatial feature of the mammalian urothelium. Urine itself was necessary for full development, and undifferentiated cells were urine-tolerant despite the lack of membrane plaques and a glycosaminoglycan layer. Infection with Enterococcus faecalis revealed the expected invasive outcome, including urothelial sloughing and the formation of intracellular colonies similar to those previously observed in patient cells. This new biomimetic model could help illuminate invasive behaviours of uropathogens, and serve as a reproducible test bed for disease formation, treatment and resolution in patients.
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Alberti C. Whyever bladder tissue engineering clinical applications still remain unusual even though many intriguing technological advances have been reached? G Chir 2017; 37:6-12. [PMID: 27142819 DOI: 10.11138/gchir/2016.37.1.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
To prevent problematic outcomes of bowel-based bladder reconstructive surgery, such as prosthetic tumors and systemic metabolic complications, research works, to either regenerate and strengthen failing organ or build organ replacement biosubstitute, have been turned, from 90s of the last century, to both regenerative medicine and tissue engineering.Various types of acellular matrices, naturally-derived materials, synthetic polymers have been used for either "unseeded" (cell free) or autologous "cell seeded" tissue engineering scaffolds. Different categories of cell sources - from autologous differentiated urothelial and smooth muscle cells to natural or laboratory procedure-derived stem cells - have been taken into consideration to reach the construction of suitable "cell seeded" templates. Current clinically validated bladder tissue engineering approaches essentially consist of augmentation cystoplasty in patients suffering from poorly compliant neuropathic bladder. No clinical applications of wholly tissue engineered neobladder have been carried out to radical-reconstructive surgical treatment of bladder malignancies or chronic inflammation-due vesical coarctation. Reliable reasons why bladder tissue engineering clinical applications so far remain unusual, particularly imply the risk of graft ischemia, hence its both fibrous contraction and even worse perforation. Therefore, the achievement of graft vascular network (vasculogenesis) could allow, together with the promotion of host surrounding vessel sprouting (angiogenesis), an effective graft blood supply, so avoiding the ischemia-related serious complications.
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Yudintceva NM, Nashchekina YA, Blinova MI, Orlova NV, Muraviov AN, Vinogradova TI, Sheykhov MG, Shapkova EY, Emeljannikov DV, Yablonskii PK, Samusenko IA, Mikhrina AL, Pakhomov AV, Shevtsov MA. Experimental bladder regeneration using a poly-l-lactide/silk fibroin scaffold seeded with nanoparticle-labeled allogenic bone marrow stromal cells. Int J Nanomedicine 2016; 11:4521-4533. [PMID: 27660444 PMCID: PMC5019275 DOI: 10.2147/ijn.s111656] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
In the present study, a poly-l-lactide/silk fibroin (PL-SF) bilayer scaffold seeded with allogenic bone marrow stromal cells (BMSCs) was investigated as a potential approach for bladder tissue engineering in a model of partial bladder wall cystectomy in rabbits. The inner porous layer of the scaffold produced from silk fibroin was designed to promote cell proliferation and the outer layer produced from poly-l-lactic acid to serve as a waterproof barrier. To compare the feasibility and efficacy of BMSC application in the reconstruction of bladder defects, 12 adult male rabbits were divided into experimental and control groups (six animals each) that received a scaffold seeded with BMSCs or an acellular one, respectively. For BMSC tracking in the graft in in vivo studies using magnetic resonance imaging, cells were labeled with superparamagnetic iron oxide nanoparticles. In vitro studies demonstrated high intracellular incorporation of nanoparticles and the absence of a toxic influence on BMSC viability and proliferation. Following implantation of the graft with BMSCs into the bladder, we observed integration of the scaffold with surrounding bladder tissues (as detected by magnetic resonance imaging). During the follow-up period of 12 weeks, labeled BMSCs resided in the implanted scaffold. The functional activity of the reconstructed bladder was confirmed by electromyography. Subsequent histological assay demonstrated enhanced biointegrative properties of the PL-SF scaffold with cells in comparison to the control graft, as related to complete regeneration of the smooth muscle and urothelium tissues in the implant. Confocal microscopy studies confirmed the presence of the superparamagnetic iron oxide nanoparticle-labeled BMSCs in newly formed bladder layers, thus indicating the role of stem cells in bladder regeneration. The results of this study demonstrate that application of a PL-SF scaffold seeded with allogenic BMSCs can enhance biointegration of the graft in vivo and support bladder tissue regeneration and function.
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Affiliation(s)
- Natalia M Yudintceva
- Department of Cell Culture, Institute of Cytology of the Russian Academy of Sciences (RAS)
| | - Yulia A Nashchekina
- Department of Cell Culture, Institute of Cytology of the Russian Academy of Sciences (RAS)
- Nanotechnology and Telecommunications, Institute of Physics, Peter the Great St Petersburg Polytechnic University
| | - Miralda I Blinova
- Department of Cell Culture, Institute of Cytology of the Russian Academy of Sciences (RAS)
| | - Nadezhda V Orlova
- Department of Urology, Federal State Institution Saint Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia
| | - Alexandr N Muraviov
- Department of Urology, Federal State Institution Saint Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia
| | - Tatiana I Vinogradova
- Department of Urology, Federal State Institution Saint Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia
| | - Magomed G Sheykhov
- Department of Urology, Federal State Institution Saint Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia
| | - Elena Y Shapkova
- Department of Urology, Federal State Institution Saint Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia
| | - Dmitriy V Emeljannikov
- Department of Urology, Federal State Institution Saint Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia
| | - Petr K Yablonskii
- Department of Urology, Federal State Institution Saint Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia
- Faculty of Medicine, Federal State Budgetary Institute
| | - Igor A Samusenko
- Department of Pathology, Federal State Budgetary Institute “Nikiforov Russian Centre of Emergency and Radiation Medicine” of the Ministry of Health of Russia
| | - Anastasiya L Mikhrina
- Department of Pathomorphology, I.M. Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Science
| | - Artem V Pakhomov
- Department of Radiology, Federal Almazov North-West Medical Research Center
| | - Maxim A Shevtsov
- Department of Cell Culture, Institute of Cytology of the Russian Academy of Sciences (RAS)
- Department of Radiology, Federal Almazov North-West Medical Research Center
- Department of Experimental Medicine, First I.P. Pavlov State Medical University of St Petersburg, St Petersburg, Russia
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Abstract
Substantial clinical need persists for improved autologous tissues to augment or replace the urinary bladder and research has begun to address this using tissue engineering techniques. The implantation of both tissue scaffolds which allow for native bladder tissue ingrowth and autologous bladder grafts created from in vitro cellularization of such scaffolds have been tested clinically; however, successful outcomes in both scenarios have been challenged by insufficient vascularity resulting from large graft sizes, which subsequently limits tissue ingrowth and leads to central graft ischemia. Consequently, recent research has focused on developing better methods to produce scaffolds with increased tissue ingrowth and vascularity. This review provides an update on bladder tissue engineering and outlines the challenges that remain to clinical implementation.
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Bouhout S, Chabaud S, Bolduc S. Organ-specific matrix self-assembled by mesenchymal cells improves the normal urothelial differentiation in vitro. World J Urol 2015; 34:121-30. [PMID: 26008115 DOI: 10.1007/s00345-015-1596-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 05/16/2015] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Enterocystoplasty is the gold standard to perform bladder reconstruction. Since this technique has a high morbidity rate, several matrix scaffolds have been proposed to support the urothelial maturation. Unfortunately, epithelial cells failed to fully integrate the cell-matrix interactions and therefore appropriate signalling pathways of normal differentiation. Based on these observations, we proposed to culture bladder urothelial cells (BUC) onto a matrix self-assembled by bladder mesenchymal cells (BMC), to form a vesical model (VM). METHODS Different serum proportions were assessed to obtain a manipulable matrix deposited by BMC. The BUC were then seeded onto the BMC's matrix to evolve in a three-dimensional culture. Haematoxylin-eosin staining, immunolabeling, scanning electron microscopy, western blot and matrix metalloproteinases analysis were performed for the VM characterization. RESULTS We were able to obtain an original matrix made of collagen-I and presenting specific organization. Matrix remodelling was observed and led to a cellular compartmentalization. The reconstructed urothelium developed in a pseudostratified arrangement, displaying an adequate cellular polarity and apical membrane remodelling of superficial cells. Like native bladder, cytokeratin 14 immunolabeling was not observed in our VM, which indicate the conformity of the development sequence taken by BUC under the influence of the BMC's matrix. CONCLUSION Thus, it was possible to elaborate a VM without the use of exogenous matrices. The particular characteristics of the BMC's matrix permitted the development of an urothelium that shared the phenotype of native tissue. The autologous character of our VM, and its appropriate urothelial maturation, could potentially promote a better integration after grafting.
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Affiliation(s)
- S Bouhout
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Faculté de médecine, Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada.
| | - S Chabaud
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Faculté de médecine, Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
| | - S Bolduc
- Centre de recherche en organogénèse expérimentale de l'Université Laval/LOEX Faculté de médecine, Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
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