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Iwasaki S, Deguchi K, Iwai R, Nakayama Y, Okuyama H. Regeneration Process of an Autologous Tissue-Engineered Trachea (aTET) in a Rat Patch Tracheoplasty Model. Bioengineering (Basel) 2024; 11:243. [PMID: 38534518 DOI: 10.3390/bioengineering11030243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/18/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
The treatment of long-tracheal lesion is difficult because there are currently no viable grafts for tracheal replacement. To solve this problem, we have developed an autologous Tissue-Engineered Trachea (aTET), which is made up of collagenous tissues and cartilage-like structures derived from rat chondrocytes. This graft induced successful long-term survival in a small-animal experiment in our previous study. In this study, we investigated the regeneration process of an aTET to attain reproducible success. We prepared an aTET by using a specially designed mold and performed patch tracheoplasty with an aTET. We assigned twenty-seven rats to three groups according to the three types of patch grafts used: aTET patches (the aTET group), fresh tracheal autograft patches (the Ag group), or polylactic acid and polycaprolactone copolymer sheets (the PPc group). In each group, gross and histological evaluations were performed at 1 month (n = 3), 3 months (n = 3), and 6 months (n = 3) after implantation. We obtained high survival rates in all groups, but only the PPc group attained thick tracheal walls with granular tissues and no tracheal regeneration. On the other hand, the aTET and Ag groups reproducibly achieved complete tracheal regeneration in 6 months. So, an aTET could be a promising candidate for tracheal regeneration grafts.
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Affiliation(s)
- Shun Iwasaki
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Koichi Deguchi
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Ryosuke Iwai
- Research Institute of Technology, Okayama University of Science, 1-1, Ridaicho, Kita-Ku, Okayama 700-0005, Japan
| | - Yasuhide Nakayama
- Osaka Laboratory, Biotube Co., Ltd., 3-10-1 Senriyama-Higashi, Suita 565-0842, Japan
| | - Hiroomi Okuyama
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
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Galvez Alegria C, Gundogdu G, Yang X, Costa K, Mauney JR. Evaluation of Acellular Bilayer Silk Fibroin Grafts for Onlay Tracheoplasty in a Rat Defect Model. Otolaryngol Head Neck Surg 2018; 160:310-319. [PMID: 30274546 DOI: 10.1177/0194599818802267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess the efficacy of acellular bilayer silk fibroin (BLSF) grafts to repair full-thickness tracheal defects and to compare the performance with conventional porcine small intestinal submucosa (SIS) implants. STUDY DESIGN A prospective controlled animal trial in a rat model of onlay tracheoplasty. SETTING Pediatric medical center. SUBJECTS AND METHODS Tracheal reconstruction of adult Sprague-Dawley rats was performed with BLSF (n = 38) or SIS (n = 32) matrices for up to 3 months of implantation. Functional evaluations of repaired conduits as well as histologic, immunohistochemical, and histomorphometric analyses of neotissues were assessed. RESULTS Prior to scheduled euthanasia, survival rates of rats receiving BLSF or SIS grafts were ≥94%, with no clinical signs of airway obstruction observed over the course of the study. Micro-computed tomography analysis revealed that the mean percentage of stenosis was <20% in both implant groups. BLSF and SIS grafts supported formation of pseudostratified ciliated columnar epithelium by 1 week postoperatively; however, each matrix failed to promote de novo chondrogenesis by 3 months following repair. CONCLUSIONS BLSF scaffolds can be used for reconstruction of rat tracheal patch defects with functional outcomes comparable to those of SIS matrices.
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Affiliation(s)
- Cinthia Galvez Alegria
- 1 Urological Diseases Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.,2 Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Gokhan Gundogdu
- 1 Urological Diseases Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.,2 Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Xuehui Yang
- 1 Urological Diseases Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.,2 Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Kyle Costa
- 1 Urological Diseases Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.,2 Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Joshua R Mauney
- 1 Urological Diseases Research Center, Boston Children's Hospital, Boston, Massachusetts, USA.,2 Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA
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Yu Y, Alkhawaji A, Ding Y, Mei J. Decellularized scaffolds in regenerative medicine. Oncotarget 2016; 7:58671-58683. [PMID: 27486772 PMCID: PMC5295461 DOI: 10.18632/oncotarget.10945] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/18/2016] [Indexed: 12/11/2022] Open
Abstract
Allogeneic organ transplantation remains the ultimate solution for end-stage organ failure. Yet, the clinical application is limited by the shortage of donor organs and the need for lifelong immunosuppression, highlighting the importance of developing effective therapeutic strategies. In the field of regenerative medicine, various regenerative technologies have lately been developed using various biomaterials to address these limitations. Decellularized scaffolds, derived mainly from various non-autologous organs, have been proved a regenerative capability in vivo and in vitro and become an emerging treatment approach. However, this regenerative capability varies between scaffolds as a result of the diversity of anatomical structure and cellular composition of organs used for decellularization. Herein, recent advances in scaffolds based on organ regeneration in vivo and in vitro are highlighted along with aspects where further investigations and analyses are needed.
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Affiliation(s)
- Yaling Yu
- Department of Anatomy, Wenzhou Medical University, Wenzhou, China.,Institute of Bioscaffold Transplantation and Immunology, Wenzhou Medical University, Wenzhou, China
| | - Ali Alkhawaji
- Department of Anatomy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Yuqiang Ding
- Institute of Neuroscience, Wenzhou Medical University, Wenzhou, China
| | - Jin Mei
- Department of Anatomy, Wenzhou Medical University, Wenzhou, China.,Institute of Bioscaffold Transplantation and Immunology, Wenzhou Medical University, Wenzhou, China.,Institute of Neuroscience, Wenzhou Medical University, Wenzhou, China
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Saied A, David J, LaBarbera K, Katz SC, Somasundar P. Chemotherapy does not adversely impact outcome following post-incisional hernia repair with biomaterial mesh. J Surg Oncol 2015; 111:725-8. [PMID: 25580588 PMCID: PMC6680137 DOI: 10.1002/jso.23869] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 11/19/2014] [Indexed: 11/11/2022]
Abstract
Background Patients receiving chemotherapy are at increased risk for developing recurrent or post‐incisional hernias (PIH). Biological materials are an alternative to synthetic mesh in contaminated fields. The impact of chemotherapy on biomaterial tissue ingrowth and integration has not been well studied. Methods From 2008 to 2011 patients who underwent PIH repair with biomaterial mesh (Biodesign®) were selected. Patients were divided into two groups: those receiving chemotherapy (CT) and those not receiving chemotherapy (NCT). Results Forty‐five patients were identified, 28 (62%) in the NCT group and 17 (38%) in the CT group. Median follow up for NCT and CT groups were 27 and 17 months, respectively. A total of 9/45 (20%) surgical site infections (SSI) were diagnosed, with 6/28 (21%) in the NCT and 3/17 (18%) in the CT group (P = 0.53). Seroma formation was seen in 5/28 (18%) of NCT patients and 4/17 (23%) in CT group (P = 0.46). Overall hernia recurrence rate was 22%, and the rates of recurrence were similar among the CT 3/17 (18%) and NCT 7/28 (25%) groups (P = 0.42). Conclusion The use of perioperative chemotherapy did not increase the rate of wound complications following PIH repair with biologic mesh in this group of patients. J. Surg. Oncol. 2015 111:725–728. © 2015 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Abdul Saied
- Department of Surgery, Roger Williams Medical Center, Providence, Rhode Island
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Jang YS, Jang CH, Cho YB, Kim M, Kim GH. Tracheal regeneration using polycaprolactone/collagen-nanofiber coated with umbilical cord serum after partial resection. Int J Pediatr Otorhinolaryngol 2014; 78:2237-43. [PMID: 25465447 DOI: 10.1016/j.ijporl.2014.10.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Revised: 10/16/2014] [Accepted: 10/19/2014] [Indexed: 01/10/2023]
Abstract
OBJECTIVES We developed a PCL/collagen nanofiber (PC-NF) scaffold/human umbilical cord serum (hUCS) to facilitate epithelial cell migration after implantation in order to promote regeneration of the tracheal epithelium without having a cell source. MATERIALS AND METHODS The isolated chodrocytes from bovine auricle were used to evaluate the cellular activities cultured in the scaffolds with or without hUCS. A 4mm wide/8mm long, full thickness anterior defect was created in the tracheal rings of rats. An anterior tracheal defect was implanted with a PCL/collagen-NF scaffold (PC-NF) in the control group (n=7), and a PCL/collagen-NF coated with hUCS scaffold (PCU-NF) was implanted in the experimental group (n=7). All rats were sacrificed at 7 weeks postoperatively. The cervical trachea, including the implant site, was resected, and gross and histological examinations were performed. RESULTS The viable cells of PCU-NF scaffold were significantly higher than that of the PCL and PC-NF scaffold at 7 days; the result can be due to the exceptional biological growth factors of the hUCS. The steromicroscopic finding showed that the artificial trachea was covered by perichondrium without dislocation or granulation at 7 weeks postsurgery. When compared to the control group, the PCU-NF group showed a completely regenerated tracheal wall with luminal epilthelization. CONCLUSION As a results of this study, the PCU-NF scaffold promoted cartilage and epithelial regeneration over the artificial trachea without graft inflammation. Partial tracheal reconstruction using PCU-NF scaffold is suitable for enhancing cartilage and epithelial regeneration.
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Affiliation(s)
| | - Chul Ho Jang
- Department of Otolaryngology, Chonnam National University Medical School, Gwangju, South Korea.
| | - Yong Beom Cho
- Department of Otolaryngology, Chonnam National University Medical School, Gwangju, South Korea
| | - Minseong Kim
- Department of Bio-Mechatronics, Sungkyunkwan University (SKKU), Suwon, South Korea
| | - Geun Hyung Kim
- Department of Bio-Mechatronics, Sungkyunkwan University (SKKU), Suwon, South Korea.
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Clinical and biological acceptance of a fibrocollagen-coated mersylene patch for tracheal repair in growing dogs. The Journal of Laryngology & Otology 2014; 128:630-40. [PMID: 25075948 DOI: 10.1017/s0022215114001339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Collagen-covered prostheses can be used as a non-circumferential segmental tracheal replacement. However, the applicability of these implants in young subjects has not yet been reported. METHODS In this experimental, longitudinal study, dogs aged 29-32 days underwent limited segmental tracheal replacement with a polyester prosthesis or were allocated to a control, untreated group. The dogs were evaluated clinically, endoscopically and tomographically for up to one year. RESULTS Although there was evidence of tracheal growth in the experimental group, tomographic measurements were significantly smaller in this group than in the control group throughout the observation period. At the end of the study, there was no evidence of implant rejection, stenosis or collapse. Normal respiratory epithelium had grown across the implanted membrane in the experimental group. CONCLUSION The homologous collagen mersylene membrane allowed for limited structural tracheal growth and was functionally integrated into the segmented tracheal wall in growing dogs.
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Egan KP, Brennan TA, Pignolo RJ. Bone histomorphometry using free and commonly available software. Histopathology 2012; 61:1168-73. [PMID: 22882309 DOI: 10.1111/j.1365-2559.2012.04333.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AIMS Histomorphometric analysis is a widely used technique to assess changes in tissue structure and function. Commercially available programs that measure histomorphometric parameters can be cost-prohibitive. In this study, we compared an inexpensive method of histomorphometry to a current proprietary software program. METHODS AND RESULTS Image J and Adobe Photoshop(®) were used to measure static and kinetic bone histomorphometric parameters. Photomicrographs of Goldner's trichrome-stained femurs were used to generate black-and-white image masks, representing bone and non-bone tissue, respectively, in Adobe Photoshop(®) . The masks were used to quantify histomorphometric parameters (bone volume, tissue volume, osteoid volume, mineralizing surface and interlabel width) in Image J. The resultant values obtained using Image J and the proprietary software were compared and differences found to be statistically non-significant. CONCLUSIONS The wide-ranging use of histomorphometric analysis for assessing the basic morphology of tissue components makes it important to have affordable and accurate measurement options available for a diverse range of applications. Here we have developed and validated an approach to histomorphometry using commonly and freely available software that is comparable to a much more costly, commercially available software program.
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Affiliation(s)
- Kevin P Egan
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Gazala S, Bedard E. Surgisis mesh for tracheal reconstruction. Ann Thorac Surg 2012; 93:2076-7. [PMID: 22632515 DOI: 10.1016/j.athoracsur.2012.01.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 01/10/2012] [Accepted: 01/19/2012] [Indexed: 01/08/2023]
Abstract
Esophagectomy is a commonly performed procedure that has a high morbidity rate. Postesophagectomy anastomotic leaks are not uncommon; however fistulas to the airways remain a rare and often catastrophic complication. Although most fistulas occur from a direct communication between a failed anastomosis and an adjacent airway, other risk factors have been identified, such as tracheal ischemia from extensive mediastinal dissection, intraoperative tracheal injuries, and cuff necrosis from prolonged intubation. Despite advancements in the management of sepsis, leaks and fistulas are still associated with a high mortality rate and continue to challenge esophageal surgeons.
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Affiliation(s)
- Sayf Gazala
- Department of Surgery, University of Alberta, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
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Temiz A, Kazikdas KC, Ergur B, Tugyan K, Bozok S, Kaya D, Guneli E. Esterified hyaluronic acid improves cartilage viability in experimental tracheal reconstruction with an auricular graft. Otolaryngol Head Neck Surg 2010; 143:772-8. [DOI: 10.1016/j.otohns.2010.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 06/30/2010] [Accepted: 07/13/2010] [Indexed: 12/01/2022]
Abstract
OBJECTIVE: The aim of this study was to determine the efficacy of esterified hyaluronic acid (HYAFF) on the vitality of auricular cartilage grafts used for tracheoplasty, with respect to macroscopic and microscopic parameters. STUDY DESIGN: Prospective, controlled. SETTING: Academic research laboratory. SUBJECTS AND METHODS: The study included 14 New Zealand rabbits acquired specifically for the study. The rabbits were divided into two groups: the control group, in which free cartilage grafts were not exposed to any materials or additional procedures (n = 7), and the hyaluronic acid (HA) treatment group, in which auricular grafts and anastomosis lines were covered with HYAFF (n = 7). Free auricular cartilage grafts used for the reconstruction of experimentally created tracheal defects were anastomosed extraluminally. All the rabbits were sacrificed two months post surgery. Samples were collected and examined histopathologically. The sections were stained with hematoxylineosin, Masson's trichrome, and inducible nitric oxide synthase (iNOS) and examined under a light microscope. RESULTS: Fibrosis and cartilage mass significantly differed between the control and HYAFF group ( P < 0.05). Immunohistochemical examination showed that more chondrocytes stained with iNOS in the control group than in the HYAFF group, according to histologists' observations. CONCLUSION: HYAFF catalyzed wound healing with less fibrous tissue formation, had chondroprotective and stimulatory effects on chondrocyte metabolism, and decreased nitric oxide production and apoptosis via improving the nourishment of free auricular cartilage grafts, subsequently preventing hypoxia and oxidative stress, particularly in the early postimplantation period.
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Affiliation(s)
- Abdulkerim Temiz
- Department of Pediatric Surgery, Mustafa Kemal University, Faculty of Medicine Hatay, Turkey
| | - K. Cagdas Kazikdas
- Department of Otorhinolaryngology Rize University, Faculty of Medicine, Rize, Turkey
| | - Bekir Ergur
- Department of Histology and Embryology, Dokuz Eylul University, Faculty of Medicine Izmir, Turkey
| | - Kazim Tugyan
- Department of Histology and Embryology, Dokuz Eylul University, Faculty of Medicine Izmir, Turkey
| | - Sahin Bozok
- Department of Cardiovascular Surgery Rize University, Faculty of Medicine, Rize, Turkey
| | - Durdane Kaya
- The Department of Laboratory Animal Science, Dokuz Eylul University Izmir, Turkey
| | - Ensari Guneli
- The Department of Laboratory Animal Science, Dokuz Eylul University Izmir, Turkey
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Petter-Puchner AH, Fortelny RH, Glaser KS, Redl H. Collagen Implants in Inguinal and Ventral Hernia Repair. J INVEST SURG 2010; 23:280-4. [DOI: 10.3109/08941931003623630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Boutros C, Somasundar P, Espat NJ. Early results on the use of biomaterials as adjuvant to abdominal wall closure following cytoreduction and hyperthermic intraperitoneal chemotherapy. World J Surg Oncol 2010; 8:72. [PMID: 20727181 PMCID: PMC2931502 DOI: 10.1186/1477-7819-8-72] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2010] [Accepted: 08/20/2010] [Indexed: 02/04/2023] Open
Abstract
Background Hyperthermic chemotherapy applies thermal energy to both abdominal wall as well as the intra-abdominal viscera. The combination of the hyperthemia, chemotherapy and cytoreductive surgery (CRS) is associated with a defined risk of abdominal wall and intestinal morbidity reported to be as high as 15%, respectively to date, no studies have evaluated the use of biomaterial mesh as adjuvant to abdominal wall closure in this group of patients. In the present report, we hypothesized that post HIPEC closure with a biomaterial can reduce abdominal wall morbidity after CRS and hyperthermic intraperitoneal chemotherapy. Materials and methods All patients treated with HIPEC in a tertiary care center over 12 months (2008-2009) period were included. Eight patients received cytoreductive surgery followed by HIPEC for 90 minutes using Mitomycin C (15 mg q 45 minutes × 2). Abdominal wall closure was performed using Surgisis (Cook Biotech.) mesh in an underlay position with 3 cm fascial overlap-closure. Operative time, hospital length of stay (LOS) as well as postoperative outcome with special attention to abdominal wall and bowel morbidity were assessed. Results Eight patients, mean age 59.7 ys (36-80) were treated according to the above protocol. The primary pathology was appendiceal mucinous adenocarcinoma (n = 3) colorectal cancer (n = 3), and ovarian cancer (n = 2). Four patients (50%) presented initially with abdominal wall morbidity including incisional ventral hernia (n = 3) and excessive abdominal wall metastatic implants (n = 1). The mean peritoneal cancer index (PCI) was 8.75. Twenty eight CRS were performed (3.5 CRS/patient). The mean operating time was 6 hours. Seven patients had no abdominal wall or bowel morbidity, the mean LOS for these patients was 8 days. During the follow up period (mean 6.3 months), one patient required exploratory laparotomy 2 weeks after surgery and subsequently developed an incisional hernia and enterocutaneous fistula. Conclusion The use of biomaterial mesh in concert with HIPEC enables the repair of concomitant abdominal wall hernia and facilitates abdominal wall closure following the liberal resection of abdominal wall tumors. Biomaterial mesh prevents evisceration on repeat laparotomy and resists infection in immunocompromised patients even when associated with bowel resection.
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Affiliation(s)
- Cherif Boutros
- Hepatobiliary and Surgical Oncology, Roger Williams Medical Center, Providence, RI, USA
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Villegas-Alvarez F, González-Zamora JF, González-Maciel A, Soriano-Rosales R, Pérez-Guille B, Padilla-Sánchez L, Reynoso-Robles R, Ramos-Morales A, Zenteno-Galindo E, Pérez-Torres A, Montalvo-Jave EE. Fibrocollagen-covered prosthesis for a noncircumferential segmental tracheal replacement. J Thorac Cardiovasc Surg 2009; 139:32-7. [PMID: 19660403 DOI: 10.1016/j.jtcvs.2009.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Revised: 02/10/2009] [Accepted: 04/03/2009] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Fibrocollagen-covered polyester meshes can be used as possible substitutions for tracheal segments if they become integrated into the tissue without complications. The aim of this study was to assess a fibrocollagen-covered polyester prosthesis to be used as a substitution for a tracheal segment. METHODS We performed a blind, randomized experimental assay. Adult Wistar rats were assigned to one of 2 groups. Prostheses were made by implanting polyester tubing in a group of animals to cover them with homologous collagen. They were implanted as substitutions of tracheal segments in the experimental group after creating a defect in the anterior wall of the trachea. Clinical, histomorphologic, and immunohistochemical assessments were made at 4 different time points. RESULTS The experimental group presented some respiratory distress signs during the first 7 to 10 days, such as stertors, hissing, and low motor activity. After this initial period, the symptoms subsided progressively and disappeared at the end of the first month. These respiratory symptoms caused no mortality. Initially undifferentiated monolayer cells predominated on the implant's surface, but during the last 2 months, the proportion of epithelial and ciliated cells was similar to that seen in control animals. Types I, III, and V collagen fibers were identified around the mesh. The intraluminal area of the tracheas with prostheses and prosthesis thickness were larger during the 4 months of the experiment. The increase in thickness was due to angiogenesis without evidence of fibrosis or chronic inflammation. CONCLUSIONS Polyester-collagen prostheses used as substitutions of tracheal segments in rats enabled the proliferation of normal respiratory epithelium and maintained tracheal function without collapse, inflammatory reaction, or secondary stenosis.
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Experimental repair of tracheal defect using a bioabsorbable copolymer. J Surg Res 2008; 160:114-21. [PMID: 19482309 DOI: 10.1016/j.jss.2008.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Revised: 10/29/2008] [Accepted: 11/03/2008] [Indexed: 11/24/2022]
Abstract
BACKGROUND We investigated epithelialization and newly formed cartilage in an artificial trachea constructed using a bioabsorbable copolymer. MATERIALS AND METHODS Fifteen male Japanese white rabbits (2.5-2.8 kg) were divided into three groups. A full-thickness anterior defect (4 mm x 10 mm) was created in the trachea. The defect was implanted with one of the following bioabsorbable copolymers: caprolactone-lactide copolymer sponge sheet reinforced with poly(glycolic acid) fiber mesh (Cop) (n = 6, group A), Cop-incorporating gelatin hydrogel (n = 4, group B), and Cop-incorporating gelatin hydrogel with 100 microg of basic fibroblast growth factor (n = 5, group C). Each trachea was reinforced with an external nondegradable polymer stent. Three rabbits in each group were sacrificed at 1, 3, and 6 mo postoperatively and the trachea was evaluated histologically; other animals were sacrificed up to 12 mo postoperatively. RESULTS In groups A, B, and C there were two, one, and one postoperative deaths, respectively. In group A, epithelialization was recognized from 1 mo to 12 mo postoperatively, but no new cartilage was formed during the 12 mo following implantation. In group B, epithelialization was recognized 3 and 6 mo postoperatively, and new cartilage was detected at 6 mo after the operation. In group C, newly formed cartilage and epithelialization were observed 3, 6, and even 12 mo postoperatively. Furthermore, neovascularization was observed in groups B and C. CONCLUSIONS A bioabsorbable copolymer incorporating gelatin hydrogel induces tracheal epithelialization and formation of cartilage and vessels in tracheal defects, and could be available for clinical use in children.
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Gilbert TW, Gilbert S, Madden M, Reynolds SD, Badylak SF. Morphologic Assessment of Extracellular Matrix Scaffolds for Patch Tracheoplasty in a Canine Model. Ann Thorac Surg 2008; 86:967-74; discussion 967-74. [DOI: 10.1016/j.athoracsur.2008.04.071] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Revised: 04/17/2008] [Accepted: 04/21/2008] [Indexed: 02/09/2023]
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Zhang L, Liu Z, Cui P, Zhao D, Chen W. SIS with tissue-cultured allogenic cartilages patch tracheoplasty in a rabbit model for tracheal defect. Acta Otolaryngol 2007; 127:631-6. [PMID: 17503233 DOI: 10.1080/00016480600987750] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
CONCLUSIONS In the rabbit model, small intestinal submucosa (SIS) compounded with tissue-cultured allogenic cartilages appeared to be an efficacious method for the patch repair of partial circumferential tracheal defects instead of autologous grafts. SIS appears to be a safe and promising means of facilitating neovascularization and tissue regeneration. The long-term use of SIS and tissue-cultured allogenic cartilages warrants further investigation. BACKGROUND Tracheal defect reparation remains a challenging surgical problem that can require reconstruction using autologous grafts or artificial stents. This study was performed to evaluate the efficacy of SIS, a biocompatible, acellular matrix, compounded with different tissue-cultured allogenic cartilages, in the repair of a critical-size tracheal defect. MATERIALS AND METHODS A full-thickness defect (4 x 8 mm) was created in tracheal rings four to six in adult rabbits. A piece of 8-ply SIS sandwiched in thyroid cartilage, auricular cartilage, or without cartilage, respectively (designated experiment 1, 2, or 3, respectively), was sutured to the edges of the defect with interrupted 4-0 polypropylene sutures. In control animals, the defect was closed with lamina praetrachealis. All animals were followed until signs of dyspnea became apparent or for 4 or 12 weeks. After follow-up and euthanasia, the trachea was harvested and prepared for histologic evaluation using conventional techniques. RESULTS All animals tolerated the procedure well but two animals in group 1 (n=5), three in group 2 (n=5), and one in group 3 (n=5) had stridor after operation and expired within <1 month with different degrees of obstruction. The other animals in these groups and the control animals (n =3) all survived >1 month. Histologically, neovascularization of the patch was noted with moderate inflammation. The surface of the SIS patch was covered with a lining of ciliated epithelial cells. The tissue-cultured allogenic cartilages degraded to some extent.
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Affiliation(s)
- Longfang Zhang
- Department of Otolaryngology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
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Abstract
A huge variety of graft materials and transplantation approaches have been applied for decades in order to generate a clinically applicable tracheal substitute; so far, without success. Today, tissue engineering, the creation of man-made functional biological organs or tissue replacements from biodegradable carrier structures and autologous cells, may represent an alternative to the shortage of suitable grafts for reconstructive airway surgery. Partial success has been obtained by numerous groups following different concepts and strategies. In this article, tissue engineering approaches towards the bioartificial airway prosthesis are discussed, focusing primarily on recent developments in the field.
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Affiliation(s)
- Thorsten Walles
- Hannover Medical School, Tissue Engineering Network, Podbielskistrasse 380, 30659 Hannover, Germany.
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