1
|
Fujita N, Sugiyama F, Tsuboi M, Nakamura HK, Nishimura R, Nakayama Y, Fujita A. Bladder Reconstruction in Cats Using In-Body Tissue Architecture (iBTA)-Induced Biosheet. Bioengineering (Basel) 2024; 11:615. [PMID: 38927851 PMCID: PMC11200650 DOI: 10.3390/bioengineering11060615] [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: 03/31/2024] [Revised: 05/29/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Urinary tract diseases are common in cats, and often require surgical reconstruction. Here, to explore the possibility of urinary tract reconstruction in cats using in-body tissue architecture (iBTA), biosheets fabricated using iBTA technology were implanted into the feline bladder and the regeneration process was histologically evaluated. The biosheets were prepared by embedding molds into the dorsal subcutaneous pouches of six cats for 2 months. A section of the bladder wall was removed, and the biosheets were sutured to the excision site. After 1 and 3 months of implantation, the biosheets were harvested and evaluated histologically. Implantable biosheets were formed with a success rate of 67%. There were no major complications following implantation, including tissue rejection, severe inflammation, or infection. Urinary incontinence was also not observed. Histological evaluation revealed the bladder lumen was almost entirely covered by urothelium after 1 month, with myofibroblast infiltration into the biosheets. After 3 months, the urothelium became multilayered, and mature myocytes and nerve fibers were observed at the implantation site. In conclusion, this study showed that tissue reconstruction using iBTA can be applied to cats, and that biosheets have the potential to be useful in both the structural and functional regeneration of the feline urinary tract.
Collapse
Affiliation(s)
- Naoki Fujita
- Laboratory of Veterinary Surgery, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo 113-0032, Japan
| | - Fumi Sugiyama
- Laboratory of Veterinary Surgery, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo 113-0032, Japan
| | - Masaya Tsuboi
- Laboratory of Veterinary Pathology, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo 113-0032, Japan
| | - Hazel Kay Nakamura
- Laboratory of Veterinary Surgery, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo 113-0032, Japan
| | - Ryohei Nishimura
- Laboratory of Veterinary Surgery, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo 113-0032, Japan
| | | | - Atsushi Fujita
- Laboratory of Veterinary Surgery, Graduate School of Agriculture and Life Sciences, The University of Tokyo, Tokyo 113-0032, Japan
| |
Collapse
|
2
|
Zhao P, Li X, Fang Q, Wang F, Ao Q, Wang X, Tian X, Tong H, Bai S, Fan J. Surface modification of small intestine submucosa in tissue engineering. Regen Biomater 2020; 7:339-348. [PMID: 32793379 PMCID: PMC7414999 DOI: 10.1093/rb/rbaa014] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/25/2020] [Accepted: 03/10/2020] [Indexed: 12/11/2022] Open
Abstract
With the development of tissue engineering, the required biomaterials need to have the ability to promote cell adhesion and proliferation in vitro and in vivo. Especially, surface modification of the scaffold material has a great influence on biocompatibility and functionality of materials. The small intestine submucosa (SIS) is an extracellular matrix isolated from the submucosal layer of porcine jejunum, which has good tissue mechanical properties and regenerative activity, and is suitable for cell adhesion, proliferation and differentiation. In recent years, SIS is widely used in different areas of tissue reconstruction, such as blood vessels, bone, cartilage, bladder and ureter, etc. This paper discusses the main methods for surface modification of SIS to improve and optimize the performance of SIS bioscaffolds, including functional group bonding, protein adsorption, mineral coating, topography and formatting modification and drug combination. In addition, the reasonable combination of these methods also offers great improvement on SIS surface modification. This article makes a shallow review of the surface modification of SIS and its application in tissue engineering.
Collapse
Affiliation(s)
- Pan Zhao
- Department of Tissue Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Avenue, Shenbei New District, Shenyang 110122, China
| | - Xiang Li
- Department of Cell Biology, School of Life Sciences, China Medical University, 77 Puhe Avenue, Shenbei New District, Shenyang 110122, China
| | - Qin Fang
- Cardiac Surgery, Liaoning First Hospital of China Medical University, No. 155 Nanjing Street, Heping District, Shenyang, Liaoning 110122, China
| | - Fanglin Wang
- Department of Tissue Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Avenue, Shenbei New District, Shenyang 110122, China
| | - Qiang Ao
- Department of Tissue Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Avenue, Shenbei New District, Shenyang 110122, China
| | - Xiaohong Wang
- Department of Tissue Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Avenue, Shenbei New District, Shenyang 110122, China
| | - Xiaohong Tian
- Department of Tissue Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Avenue, Shenbei New District, Shenyang 110122, China
| | - Hao Tong
- Department of Tissue Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Avenue, Shenbei New District, Shenyang 110122, China
| | - Shuling Bai
- Department of Tissue Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Avenue, Shenbei New District, Shenyang 110122, China
| | - Jun Fan
- Department of Tissue Engineering, School of Fundamental Sciences, China Medical University, 77 Puhe Avenue, Shenbei New District, Shenyang 110122, China
| |
Collapse
|
3
|
Xia D, Yang Q, Fung K, Towner RA, Smith N, Saunders D, Greenwood‐Van Meerveld B, Kropp BP, Madihally SV, Lin H. Immunomodulatory response of layered small intestinal submucosa in a rat bladder regeneration model. J Biomed Mater Res B Appl Biomater 2018; 107:1960-1969. [DOI: 10.1002/jbm.b.34289] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/11/2018] [Accepted: 11/10/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Ding Xia
- Department of UrologyTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030 Hubei People's Republic of China
- Department of UrologyUniversity of Oklahoma Health Sciences Center Oklahoma City Oklahoma 73104
| | - Qing Yang
- Department of UrologyUniversity of Oklahoma Health Sciences Center Oklahoma City Oklahoma 73104
| | - Kar‐Ming Fung
- Department of PathologyUniversity of Oklahoma Health Sciences Center Oklahoma City Oklahoma 73104
- Department of Veterans Affairs Medical Center Oklahoma City Oklahoma 73104
| | - Rheal A. Towner
- Department of PathologyUniversity of Oklahoma Health Sciences Center Oklahoma City Oklahoma 73104
- Advanced Magnetic Resonance CenterOklahoma Medical Research Foundation Oklahoma City Oklahoma 73104
- Oklahoma Center for Neuroscience Oklahoma City Oklahoma 73104
| | - Nataliya Smith
- Advanced Magnetic Resonance CenterOklahoma Medical Research Foundation Oklahoma City Oklahoma 73104
| | - Debra Saunders
- Advanced Magnetic Resonance CenterOklahoma Medical Research Foundation Oklahoma City Oklahoma 73104
| | - Beverley Greenwood‐Van Meerveld
- Oklahoma Center for Neuroscience Oklahoma City Oklahoma 73104
- Department of PhysiologyUniversity of Oklahoma Health Sciences Center Oklahoma City Oklahoma 73104
| | - Bradley P. Kropp
- Department of UrologyTongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030 Hubei People's Republic of China
| | | | - Hsueh‐Kung Lin
- Department of UrologyUniversity of Oklahoma Health Sciences Center Oklahoma City Oklahoma 73104
- Oklahoma Center for Neuroscience Oklahoma City Oklahoma 73104
- School of Chemical Engineering, Oklahoma State University Stillwater Oklahoma 74078
| |
Collapse
|
4
|
Smolar J, Horst M, Sulser T, Eberli D. Bladder regeneration through stem cell therapy. Expert Opin Biol Ther 2018; 18:525-544. [DOI: 10.1080/14712598.2018.1439013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Jakub Smolar
- Department of Urology, University Hospital Zurich, Schlieren, Switzerland
| | - Maya Horst
- Department of Urology, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Tulio Sulser
- Department of Urology, University Hospital Zurich, Zurich, Switzerland
| | - Daniel Eberli
- Department of Urology, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
5
|
Yang Q, Xia D, Towner RA, Smith N, Saunders D, Fung KM, Aston CE, Greenwood-Van Meerveld B, Hurst RE, Madihally SV, Kropp BP, Lin HK. Reduced urothelial regeneration in rat bladders augmented with permeable porcine small intestinal submucosa assessed by magnetic resonance imaging. J Biomed Mater Res B Appl Biomater 2017; 106:1778-1787. [DOI: 10.1002/jbm.b.33985] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 08/02/2017] [Accepted: 08/16/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Qing Yang
- Department of Urology; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma 73104
| | - Ding Xia
- Department of Urology; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma 73104
- Department of Urology; Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology; Wuhan Hubei 430030 People's Republic of China
| | - Rheal A. Towner
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation; Oklahoma City Oklahoma 73104
- Oklahoma Center for Neuroscience; Oklahoma City Oklahoma 73104
- Department of Pathology; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma 73104
| | - Nataliya Smith
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation; Oklahoma City Oklahoma 73104
| | - Debra Saunders
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation; Oklahoma City Oklahoma 73104
| | - Kar-Ming Fung
- Department of Urology; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma 73104
- Oklahoma Center for Neuroscience; Oklahoma City Oklahoma 73104
- Oklahoma City Department of Veterans Affairs Medical Center; Oklahoma City Oklahoma 73104
| | - Christopher E. Aston
- Department of Pediatrics; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma 73104
| | - Beverley Greenwood-Van Meerveld
- Oklahoma Center for Neuroscience; Oklahoma City Oklahoma 73104
- Department of Physiology; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma 73104
| | - Robert E. Hurst
- Department of Urology; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma 73104
- Department of Biochemistry and Molecular Biology; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma 73104
| | | | - Bradley P. Kropp
- Department of Urology; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma 73104
| | - Hsueh-Kung Lin
- Department of Urology; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma 73104
- Oklahoma Center for Neuroscience; Oklahoma City Oklahoma 73104
- Department of Physiology; University of Oklahoma Health Sciences Center; Oklahoma City Oklahoma 73104
| |
Collapse
|
6
|
Chan YY, Sandlin SK, Kurzrock EA, Osborn SL. The Current Use of Stem Cells in Bladder Tissue Regeneration and Bioengineering. Biomedicines 2017; 5:biomedicines5010004. [PMID: 28536347 PMCID: PMC5423492 DOI: 10.3390/biomedicines5010004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 12/23/2016] [Accepted: 12/26/2016] [Indexed: 12/17/2022] Open
Abstract
Many pathological processes including neurogenic bladder and malignancy necessitate bladder reconstruction, which is currently performed using intestinal tissue. The use of intestinal tissue, however, subjects patients to metabolic abnormalities, bladder stones, and other long-term sequelae, raising the need for a source of safe and reliable bladder tissue. Advancements in stem cell biology have catapulted stem cells to the center of many current tissue regeneration and bioengineering strategies. This review presents the recent advancements in the use of stem cells in bladder tissue bioengineering.
Collapse
Affiliation(s)
- Yvonne Y Chan
- Department of Urology, Davis School of Medicine, University of California, Sacramento, CA 95817, USA.
| | - Samantha K Sandlin
- Department of Urology, Davis School of Medicine, University of California, Sacramento, CA 95817, USA.
- Stem Cell Program, Institute for Regenerative Cures, University of California, Davis Medical Center, Sacramento, CA 95817, USA.
| | - Eric A Kurzrock
- Department of Urology, Davis School of Medicine, University of California, Sacramento, CA 95817, USA.
- Stem Cell Program, Institute for Regenerative Cures, University of California, Davis Medical Center, Sacramento, CA 95817, USA.
| | - Stephanie L Osborn
- Department of Urology, Davis School of Medicine, University of California, Sacramento, CA 95817, USA.
- Stem Cell Program, Institute for Regenerative Cures, University of California, Davis Medical Center, Sacramento, CA 95817, USA.
| |
Collapse
|
7
|
Bladder reconstruction using stem cells seeded on multilayered scaffolds in a mucosa preserving partial cystectomy model. Tissue Eng Regen Med 2015. [DOI: 10.1007/s13770-015-9098-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
8
|
Lin HK, Madihally SV, Palmer B, Frimberger D, Fung KM, Kropp BP. Biomatrices for bladder reconstruction. Adv Drug Deliv Rev 2015; 82-83:47-63. [PMID: 25477305 DOI: 10.1016/j.addr.2014.11.020] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 11/17/2014] [Accepted: 11/24/2014] [Indexed: 12/22/2022]
Abstract
There is a demand for tissue engineering of the bladder needed by patients who experience a neurogenic bladder or idiopathic detrusor overactivity. To avoid complications from augmentation cystoplasty, the field of tissue engineering seeks optimal scaffolds for bladder reconstruction. Naturally derived biomaterials as well as synthetic and natural polymers have been explored as bladder substitutes. To improve regenerative properties, these biomaterials have been conjugated with functional molecules, combined with nanotechology, or seeded with exogenous cells. Although most studies reported complete and functional bladder regeneration in small-animal models, results from large-animal models and human clinical trials varied. For functional bladder regeneration, procedures for biomaterial fabrication, incorporation of biologically active agents, introduction of nanotechnology, and application of stem-cell technology need to be standardized. Advanced molecular and medical technologies such as next generation sequencing and magnetic resonance imaging can be introduced for mechanistic understanding and non-invasive monitoring of regeneration processes, respectively.
Collapse
Affiliation(s)
- Hsueh-Kung Lin
- Department of Urology, The Children's Hospital of Oklahoma, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Sundar V Madihally
- Department of Chemical Engineering, 423 Engineering North, Oklahoma State University, Stillwater, OK 74078, USA
| | - Blake Palmer
- Department of Urology, The Children's Hospital of Oklahoma, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Dominic Frimberger
- Department of Urology, The Children's Hospital of Oklahoma, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Kar-Ming Fung
- Department of Urology, The Children's Hospital of Oklahoma, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Bradley P Kropp
- Department of Urology, The Children's Hospital of Oklahoma, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
| |
Collapse
|
9
|
Tissue Engineered Cystoplasty Augmentation for Treatment of Neurogenic Bladder Using Small Intestinal Submucosa: An Exploratory Study. J Urol 2014; 192:544-50. [DOI: 10.1016/j.juro.2014.01.116] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2014] [Indexed: 11/17/2022]
|
10
|
Kajbafzadeh AM, Sabetkish S, Heidari R, Ebadi M. Tissue-engineered cholecyst-derived extracellular matrix: a biomaterial for in vivo autologous bladder muscular wall regeneration. Pediatr Surg Int 2014; 30:371-80. [PMID: 24468716 DOI: 10.1007/s00383-014-3474-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare the biocompatibility and histological aspects of cholecyst-derived extra cellular matrix (CDECM) graft, either alone or with application of autologous detrusor muscles small fragments (ADMSF) on rabbit bladder mucosa for bladder augmentation. METHODS The gallbladders were acellularized and evaluated for preserved acellular matrix scaffold and biophysical properties. Thirty rabbits were divided into five groups. Rabbits in the control group underwent partial detrusorectomy followed by perivesical fat coverage. Groups I and II underwent the same procedure and bladder mucosa was covered either by acellular rabbit gallbladder (ARG) (group I) or acellular sheep gallbladder (ASG) (group II). Groups III and IV underwent detrusorectomy and the bladder mucosal was seeded by ADMSF and covered by ARG (group III), or ASG (group IV). Biopsies were taken at 4, 12, and 24 weeks postoperatively. RESULTS Higher expression of CD34 endothelial progenitor cells, CD31 microvessels, α-smooth muscle actin, S100, and cytokeratin with more organized muscular wall generation was demonstrated in groups III and IV. Expression of IHC markers was higher in groups III and IV compared with groups I and II in all the time points. CONCLUSION The current study confirmed that autologous fragment-seeded CDECM can be considered as a reliable natural collagen scaffold for bladder augmentation.
Collapse
Affiliation(s)
- Abdol-Mohammad Kajbafzadeh
- Section of Tissue Engineering and Stem Cells Therapy, Pediatric Urology Research Center, Children's Hospital Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Qaribs Street, Keshavarz Boulevard, 1419433151, Tehran, Iran,
| | | | | | | |
Collapse
|
11
|
Luc G, Durand M, Collet D, Guillemot F, Bordenave L. Esophageal tissue engineering. Expert Rev Med Devices 2014; 11:225-41. [PMID: 24387697 DOI: 10.1586/17434440.2014.870470] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Esophageal tissue engineering is still in an early state, and ideal methods have not been developed. Since the beginning of the 20th century, advances have been made in the materials that can be used to produce an esophageal substitute. Three approaches to scaffold-based tissue engineering have yielded good results. The first development concerned non-absorbable constructs based on silicone and collagen. The need to remove the silicone tube is the main disadvantage of this material. Polymeric absorbable scaffolds have been used since the 1990s. The main polymeric material used is poly (glycolic) acid combined with collagen. The problem of stenosis remains prevalent in most studies using an absorbable construct. Finally, decellularized scaffolds have been used since 2000. The promises of this new approach are unfulfilled. Indeed, stenosis occurs when the esophageal defect is circumferential regardless of the scaffold materials. Cell supplementation can decrease the rate of stenosis, but the type(s) of cells and their roles have not been defined. Finally, esophageal tissue engineering cannot provide a functional esophageal substitute, and further development is necessary prior to conducting human clinical studies.
Collapse
Affiliation(s)
- Guillaume Luc
- Department of Digestive Surgery, University Hospital Haut-Lévêque, Av de Magellan, 33604 Pessac cedex, France
| | | | | | | | | |
Collapse
|
12
|
Abstract
Urinary diversion after radical cystectomy in patients with bladder cancer normally takes the form of an ileal conduit or neobladder. However, such diversions are associated with a number of complications including increased risk of infection. A plausible alternative is the construction of a neobladder (or bladder tissue) in vitro using autologous cells harvested from the patient. Biomaterials can be used as a scaffold for naturally occurring regenerative stem cells to latch onto to regrow the bladder smooth muscle and epithelium. Such engineered tissues show great promise in urologic tissue regeneration, but are faced with a number of challenges. For example, the differentiation mesenchymal stem cells from various sources can be difficult and the smooth muscle cells formed do not precisely mimic the natural cells.
Collapse
|
13
|
Roth CC, Mondalek FG, Kibar Y, Ashley RA, Bell CH, Califano JA, Madihally SV, Frimberger D, Lin HK, Kropp BP. Bladder regeneration in a canine model using hyaluronic acid-poly(lactic-co-glycolic-acid) nanoparticle modified porcine small intestinal submucosa. BJU Int 2010; 108:148-55. [PMID: 20942834 DOI: 10.1111/j.1464-410x.2010.09757.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE • To determine if hyaluronic acid (HA) can be incorporated into porcine small intestinal submucosa (SIS) through poly (lactide-co-glycolide-acid) (PLGA) nanoparticles to improve the consistency of the naturally derived biomaterial and promote bladder tissue regeneration. METHODS • Beagle dogs were subjected to 40% partial cystectomy followed by bladder augmentation with commercial SIS or HA-PLGA-modified SIS. • Urodynamic testing was performed before and after augmentation to assess bladder volume. • A scoring system was created to evaluate gross and histological presentations of regenerative bladders. RESULTS • All dogs showed full-thickness bladder regeneration. • Histological assessment showed improved smooth muscle regeneration in the HA-PLGA-modified SIS group. • For both groups of dogs, urodynamics and graft measurements showed an approximate 40% reduction in bladder capacity and graft size from pre-augmentation to post-regeneration measurements. • Application of the scoring system and statistical analysis failed to show a significant difference between the groups. CONCLUSIONS • SIS can be modified through the addition of HA-PLGA nanoparticles. The modified grafts showed evidence of improved smooth muscle regeneration on histological assessment, although this difference was not evident on a novel grading scale. • The volume loss and graft shrinkage experienced are consistent with previous models of SIS bladder regeneration at the 10-week time point. • Additional research into the delivery of HA and the long-term benefits of HA on bladder regeneration is needed to determine the full benefit of HA-PLGA-modified SIS. In addition, a more objective biochemical characterization will be needed to evaluate the quality of regeneration.
Collapse
Affiliation(s)
- Christopher C Roth
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City School of Chemical Engineering, Oklahoma State University, Stillwater, OK, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Powers MY, Campbell BG, Weisse C. Porcine Small Intestinal Submucosa Augmentation Urethroplasty and Balloon Dilatation of a Urethral Stricture Secondary to Inadvertent Prostatectomy in a Dog. J Am Anim Hosp Assoc 2010; 46:358-65. [DOI: 10.5326/0460358] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 10-month-old, male German shepherd dog experienced inadvertent prostatectomy during cryptorchidectomy. Cystourethral anastomosis was performed 1 day later. The dog developed stranguria and incontinence. A proximal urethral stricture was diagnosed with a contrast urethrogram 5 weeks later. Urethral augmentation with an onlay graft of porcine small intestinal submucosa was performed. Urinary diversion was accomplished with a urethral catheter followed by a cystostomy tube. The stricture recurred over the next 6 weeks. Three urethral balloon dilatations were performed 3 days apart, with the third attempt resulting in expansion of the stricture. Twenty-two months postdilatation, the dog intermittently urinated with a steady stream and had mild to moderate urinary incontinence.
Collapse
Affiliation(s)
- Michelle Y. Powers
- Department of Veterinary Clinical Sciences (Powers, Campbell), College of Veterinary Medicine, Washington State University, 100 Grimes Way, Pullman, Washington 99164-6610 and the
- Section of Small Animal Surgery (Weisse), Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3850 Spruce Street, Philadelphia, Pennsylvania 19104-6010
- From the
| | - Bonnie G. Campbell
- Department of Veterinary Clinical Sciences (Powers, Campbell), College of Veterinary Medicine, Washington State University, 100 Grimes Way, Pullman, Washington 99164-6610 and the
- Section of Small Animal Surgery (Weisse), Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3850 Spruce Street, Philadelphia, Pennsylvania 19104-6010
- From the
| | - Chick Weisse
- Department of Veterinary Clinical Sciences (Powers, Campbell), College of Veterinary Medicine, Washington State University, 100 Grimes Way, Pullman, Washington 99164-6610 and the
- Section of Small Animal Surgery (Weisse), Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3850 Spruce Street, Philadelphia, Pennsylvania 19104-6010
- From the
| |
Collapse
|
15
|
Wongsetthachai P, Pramatwinai C, Banlunara W, Kalpravidh M. Urinary bladder wall substitution using autologous tunica vaginalis in male dogs. Res Vet Sci 2010; 90:156-9. [PMID: 20542305 DOI: 10.1016/j.rvsc.2010.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 02/27/2010] [Accepted: 05/13/2010] [Indexed: 10/19/2022]
Abstract
Fresh autologous tunica vaginalis was experimentally used for partial substitution of the excised urinary bladder wall in ten male mongrel dogs. The substituted areas of two dogs were examined macroscopically and histologically at 2, 4, 6, 8, and 10 weeks after surgery. Two control dogs underwent partial cystectomy and primary wall closure without substitution. The regenerated transitional epithelium completely covered the substituted portion and smooth muscle regeneration was present at 6 weeks. The bladder walls at the closure area of one control dog and at the substituted portions of two dogs at 10 weeks were indistinguishable macroscopically from the native bladder with all layers of the bladder wall present histologically. According to the macroscopic and histological findings and simplicity of the technique, tunica vaginalis can be used as an alternative graft for bladder wall substitution. Calcification and bone metaplasia observed were similar to those found after using other tissue grafts.
Collapse
Affiliation(s)
- P Wongsetthachai
- Department of Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | | | | | | |
Collapse
|
16
|
Parshotam Kumar G, Barker A, Ahmed S, Gerath J, Orford J. Urinary bladder auto augmentation using INTEGRA and SURGISIS: an experimental model. Pediatr Surg Int 2010; 26:275-80. [PMID: 19885663 DOI: 10.1007/s00383-009-2521-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/13/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We present our experience with an experimental urinary bladder auto augmentation model using SURGISIS and INTEGRA (collagen layer) in comparison with seromuscular enterocystoplasty. The aim of the study was to evaluate the change in compliance and elasticity of the urinary bladder. MATERIALS AND METHODS Eighteen lambs were divided into three different groups. Auto augmentation was performed using the seromuscular layer of small bowel, SURGISIS or the collagen layer of INTEGRA. After 3 months of the initial procedure, the lambs were re-operated, the bladder compliance was measured and the urinary bladder was submitted for histological examination and assessment of elasticity. The lambs were euthanized. RESULTS The postoperative period was uneventful in 17 lambs except for intestinal obstruction in one lamb from the seromuscular enterocystoplasty group. A statistically significant difference in compliance was observed with SURGISIS and the INTEGRA. Histologically, there was neovascularization in all the specimens from the SURGISIS and INTEGRA groups with the presence of fibrosis in the SURGISIS group. The INTEGRA group showed better elastic properties than the SURGISIS. CONCLUSIONS Urinary bladder auto augmentation using the collagen layer of INTEGRA showed better functional and histological results when compared with SURGISIS and demucosalized enterocystoplasty in the present model.
Collapse
|
17
|
Agrawal V, Brown BN, Beattie AJ, Gilbert TW, Badylak SF. Evidence of innervation following extracellular matrix scaffold-mediated remodelling of muscular tissues. J Tissue Eng Regen Med 2010; 3:590-600. [PMID: 19701935 DOI: 10.1002/term.200] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Naturally occurring porcine-derived extracellular matrix (ECM) has successfully been used as a biological scaffold material for site-specific reconstruction of a wide variety of tissues. The site-specific remodelling process includes rapid degradation of the scaffold, with concomitant recruitment of mononuclear, endothelial and bone marrow-derived cells, and can lead to the formation of functional skeletal and smooth muscle tissue. However, the temporal and spatial patterns of innervation of the remodelling scaffold material in muscular tissues are not well understood. A retrospective study was conducted to investigate the presence of nervous tissue in a rat model of abdominal wall reconstruction and a canine model of oesophageal reconstruction in which ECM scaffolds were used as inductive scaffolds. Evidence of mature nerve, immature nerve and Schwann cells was found within the remodelled ECM at 28 days in the rat body wall model, and at 91 days post surgery in a canine model of oesophageal repair. Additionally, a microscopic and morphological study that investigated the response of primary cultured neurons seeded upon an ECM scaffold showed that neuronal survival and outgrowth were supported by the ECM substrate. Finally, matricryptic peptides resulting from rapid degradation of the ECM scaffold induced migration of terminal Schwann cells in a concentration-dependent fashion in vitro. The findings of this study suggest that the reconstruction of tissues in which innervation is an important functional component is possible with the use of biological scaffolds composed of extracellular matrix.
Collapse
Affiliation(s)
- Vineet Agrawal
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
| | | | | | | | | |
Collapse
|
18
|
Abstract
Many medical conditions require surgical reconstruction of hollow organs. Tissue engineering of organs and tissues is a promising new technique without harvest site morbidity. An ideal biomaterial should be biocompatible, support tissue formation and provide adequate structural support. It should degrade gradually and provide an environment allowing for cell-cell interaction, adhesion, proliferation, migration, and differentiation. Although tissue formation is feasible, functionality has never been demonstrated. Mainly the lack of proper innervation and vascularisation are hindering contractility and normal function. In this chapter we critically review the current state of engineering hollow organs with a special focus on innervation and vascularisation.
Collapse
|
19
|
Landma J, Olweny E, Collyer W, Andreoni C, Carlin B, Yan Y, Clayman RV. Small Intestine Submucosa: Intrinsic and Anastomotic Tensile Strength of SIS Using Laser Welding, Fibrin Glue, -Vascular Closure Staples, Endo-GlA Staples and Sutures. MINIM INVASIV THER 2009. [DOI: 10.3109/13645700009093710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
20
|
Pribitkin EA, Ambro BT, Bloeden E, O'Hara BJ. Rabbit Ear Cartilage Regeneration With a Small Intestinal Submucosa Graft. Laryngoscope 2009; 114:1-19. [PMID: 15475771 DOI: 10.1097/00005537-200409001-00001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES/HYPOTHESIS The objective was to demonstrate that interpositional grafting with porcine small intestinal submucosa promotes cartilage regeneration following excision of rabbit auricular cartilage. STUDY DESIGN Blinded, controlled study. METHODS Eight New Zealand white rabbits underwent excision of auricular cartilage on two sites with and two sites without preservation of perichondrium. Porcine small intestinal submucosa was implanted into one site with and one site without intact perichondrium. Remaining sites served as control sites. Histological assessment was performed at 3 (n = 4) and 6 (n = 3) months and at 1 year (n = 1) after grafting. RESULTS Histological evaluation showed cartilage regeneration accompanied by chronic inflammation in areas in which porcine small intestinal submucosa was implanted between layers of intact perichondrium. Other sites failed to show significant cartilage regeneration. CONCLUSION The results of the study using porcine small intestinal submucosa as a bioscaffold for cartilage regeneration are promising and justify further animal and human studies.
Collapse
Affiliation(s)
- Edmund A Pribitkin
- Department of Otolaryngology-Head and Neck Surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
| | | | | | | |
Collapse
|
21
|
Ueno T, Oga A, Takahashi T, Pappas TN. Small intestinal submucosa (SIS) in the repair of a cecal wound in unprepared bowel in rats. J Gastrointest Surg 2007; 11:918-22. [PMID: 17476557 DOI: 10.1007/s11605-007-0171-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Porcine-derived small intestinal submucosa (SIS) has been accepted as an acellular matrix for tissue regeneration. However, its use for remodeling gastrointestinal defects has been poorly investigated. Our previous study of the rodent stomach has demonstrated that the SIS stimulates regeneration of native tissue under acidic conditions. The purpose of this paper was to investigate the feasibility of using SIS as a bioscaffold for a colonic defect in unprepared bowel. METHODS A 1 x 1-cm whole layer was excised on the anterior wall of the cecum in 24 rats, followed by onlay repair with SIS. Measurement outcomes included animal survival, mesh stability in situ, and histologic evaluation at 3 weeks and 6 months. RESULTS Rats showed a significant weight gain and had no evidence of postoperative leakage. All wounds were secured and associated with either omental or other fatty adhesions. Histological findings revealed that intact mucosa covered the area of the graft in all cases 6 months after surgery and that the defect was completely replaced by the normal constituents (mucosa, muscle, and nerve cells) of the bowel wall. CONCLUSIONS SIS was largely successful in promoting healing in a cecal wound in unprepared bowel and serving as a bioscaffold for regeneration of the native colonic tissue. Small intestinal submucosa may be useful in surgical anastomoses to promote healing and presumably prevent leakage.
Collapse
Affiliation(s)
- Tomio Ueno
- Department of Surgery II, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi 755-8505, Japan.
| | | | | | | |
Collapse
|
22
|
Hiraki T, Pavcnik D, Uchida BT, Timmermans HA, Wu RH, Niyyati M, Keller FS, Rösch J. Small intestinal submucosa sandwich Zilver stent-grafts for TIPS: experimental pilot study in swine. MINIM INVASIV THER 2007; 14:32-8. [PMID: 16754151 DOI: 10.1080/13645700510010818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of this study was the evaluation of preliminary suitability of the piglet small intestinal submucosa (SIS) sandwich Zilver endograft for experimental transjugular intrahepatic portosystemic shunt (TIPS) creation. TIPS was created in six swine. The five surviving animals underwent the follow-up portogram and were sacrificed at four weeks after TIPS creation. Gross and histologic examination was performed in all animals. TIPS creation was successful in all animals. One animal died four days after TIPS creation. In the five surviving animals, one shunt was occluded and four shunts were stenosed on the follow-up portogram. The mean percentage narrowing of the most advanced stenoses was 72% (range, 60%-100%). The most advanced stenosis was located in the parenchymal tract in three shunts and in the hepatic vein portion in one shunt. Gross and histologic examination showed abundant neointimal formation composed mainly of fibroblasts leading to the significant shunt stenoses. The piglet SIS sandwich Zilver stent-graft was found to offer only limited TIPS patency and should not be used for the definitive long-term TIPS study.
Collapse
Affiliation(s)
- T Hiraki
- Dotter Interventional Institute, Oregon Health and Science University, Portland, Oregon 97239, USA
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Editorial Comment on: Porcine Small Intestinal Submucosa Graft for Repair of Anterior Urethral Strictures. Eur Urol 2007. [DOI: 10.1016/j.eururo.2007.01.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
24
|
Caione P, Capozza N, Zavaglia D, Palombaro G, Boldrini R. In vivo bladder regeneration using small intestinal submucosa: experimental study. Pediatr Surg Int 2006; 22:593-9. [PMID: 16773371 DOI: 10.1007/s00383-006-1705-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2006] [Indexed: 10/24/2022]
Abstract
Significant side effects are correlated with bladder augmentation. Recently, small intestinal submucosa (SIS) has been proposed for clinical use. The efficacy of SIS bladder regeneration was studied in a porcine experimental model. Partial cystectomy (40-60% of bladder wall) was performed and replaced by SIS graft. Animals were planned to be killed at 2 weeks, 5 weeks and 3 months. Bladder capacity at 40 cmH(2)O pressure and macroscopic graft morphology were assessed before and after SIS implant. Histological examination was carried out with computer assisted morphometric analysis for collagen/smooth muscle ratio. Student's t test was adopted for statistical analysis. Two piglets died on the 9th and 10th post-operative day due to urinary peritonitis. The remaining piglets were killed after uneventful post-operative period at 5 weeks (two animals) and 3 months (two animals). The bladder capacity was reduced (-18%) at the 5 week follow-up and quite similar to the pre-operative volume (+2.5%) at the 3 months control. No diverticular formation, bladder calculi, mucus and urinary infection were found. The SIS graft resulted not significantly contracted. Histology at 10 days showed SIS membrane lined by transitional epithelium islands with some capillaries. At 5 weeks, transitional epithelium was fully covering the graft; new blood vessels and fibroblasts with smooth muscle cells were observed. At 3 months, the SIS was not evident. Two layers were defined: inner transitional epithelium, outer collagen with fibroblasts and muscular bundles. Computer assisted morphometric analysis showed collagen/muscle ratio 70/30% (normal bladder=56/44%, P<0.05). The SIS was effective as a scaffold for bladder wall regeneration in four out of six animals. Long-term studies are required to confirm the efficacy of the newly developed wall and for eventual clinical use.
Collapse
Affiliation(s)
- P Caione
- Division of Pediatric Urology, Department of Nephrology and Urology, Bambino Gesù Children's Hospital and Research Institute, 00165, Rome, Italy.
| | | | | | | | | |
Collapse
|
25
|
Santucci RA, Barber TD. Resorbable extracellular matrix grafts in urologic reconstruction. Int Braz J Urol 2005; 31:192-203. [PMID: 15992421 DOI: 10.1590/s1677-55382005000300002] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2005] [Accepted: 03/05/2005] [Indexed: 11/21/2022] Open
Abstract
PURPOSE There is an increasingly large body of literature concerning tissue-engineering products that may be used in urology. Some of these are quite complex (such as multilayer patient-specific cell-seeded implants) yet the most simple and successful products to date are also the most uncomplicated: resorbable acellular extra-cellular matrices (ECMs) harvested from animals. ECMs have been used in a variety of difficult urologic reconstruction problems, and this review is intended to summarize this complex literature for the practicing urologist. METHODS Medline search of related terms such as "SIS, small intestinal submucosa, ECM, extracellular matrix, acellular matrix and urologic reconstruction". Manuscripts missed in the initial search were taken from the bibliographies of the primary references. RESULTS Full review of potential clinical uses of resorbable extra-cellular matrices in urologic reconstruction. CONCLUSIONS Currently, the "state of the art" in tissue engineering solutions for urologic reconstruction means resorbable acellular xenograft matrices. They show promise when used as a pubovaginal sling or extra bolstering layers in ureteral or urethral repairs, although recent problems with inflammation following 8-ply pubovaginal sling use and failures after 1- and 4-ply SIS repair of Peyronie's disease underscore the need for research before wide adoption. Preliminary data is mixed concerning the potential for ECM urethral patch graft, and more data is needed before extended uses such as bladder augmentation and ureteral replacement are contemplated. The distant future of ECMs in urology likely will include cell-seeded grafts with the eventual hope of producing "off the shelf" replacement materials. Until that day arrives, ECMs only fulfill some of the requirements for the reconstructive urologist.
Collapse
|
26
|
Leungwattanakij S, Pummangura N, Ratana-Olarn K. Penile enhancement using a porcine small intestinal submucosa graft in a rat model. Int J Impot Res 2005; 18:39-43. [PMID: 16049525 DOI: 10.1038/sj.ijir.3901358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Several biodegradable materials have been experimented for penile enhancement, but none show the potential for clinical use. This study was designed to use porcine small intestinal submucosa (SIS) augmenting the normal tunica albuginea to increase the functional girth of the rat penis. In all, 20 adult male Sprague-Dawley rats constituted the study population. The animals were divided into two groups: group 1 consisted of the control (n=10) and group 2 (n=10) consisted of rats that underwent penile enhancement by a longitudinal I-shaped incision of the tunica albuginea on both sides, and the dissection of the plane between tunica albuginea and cavernosal tissue was carried out (n=10). The incision was then patched with a 3 x 10 mm2 piece of SIS, using a 6/0 nylon suture material. The penile length and mid-circumference were then measured using a Vernier Caliper before and 2 months after surgery. All rat penises underwent histological examination using Masson's trichome and Verhoff's van Giesen's stain for collagen and elastic fibers. The penile length, mid-circumference and degree of fibrosis score were expressed as mean+/-s.e. (standard error) and analyzed using a Wilcoxon rank-sum test. A statistical significance was accepted at P-value < or =0.05. Our results showed similar preoperative penile length and circumference in both groups. However, 2 months after the surgery, the mean penile circumference of the SIS group has grown significantly larger than the control group, while the mean penile length remained unchanged. The histological study of the rat penises revealed minimal amounts of fibrosis under the graft, and the elastic fibers of the graft showed orientation in a circular manner. In conclusion, SIS appears promising for material use in a penile enhancement.
Collapse
|
27
|
Niyyati M, Petersen BD, Pavcnik D, Uchida BT, Timmermans HA, Hiraki T, Wu RH, Brountzos E, Keller FS, Rösch J. A flexible stent with small intestinal submucosa covering for direct intrahepatic portocaval shunt: experimental pilot study in swine. Cardiovasc Intervent Radiol 2005; 28:215-20. [PMID: 15719186 DOI: 10.1007/s00270-003-0261-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The suitability of the flexible sandwich Zilver stent-graft (SZSG) with a biologically active tissue layer (small intestinal submucosa) for creation of the intravascular ultrasound (IVUS)-guided direct intrahepatic portocaval shunt (DIPS) was explored in six young swine in a search for a flexible system to replace the rigid polytetrafluoroethylene (PTFE) stent originally used by this group with limited success. The portal vein was punctured from the inferior vena cava through the caudate lobe of the liver using IVUS guidance. After balloon dilation of the puncture tract, DIPS was successfully created in all animals with use of an SZSG 9 mm in diameter and 6 cm or 8 cm long. Only one DIPS remained well patent at 14 days when the animal had to be killed because of encephalopathy. DIPS in the other five animals were found to be either severely stenosed (3 animals) or occluded (2 animals) at 4 weeks due to accelerated formation of neointimal hyperplasia (NIH) in the liver parenchymal portion of the shunt and superimposed thrombosis. The lack of high pressure in the portal system contributed to early endograft closure. The flexible stent and the covering fail badly. The reason for this could be due to either component. More work is required to find a reliable flexible system with long-term patency. Exploration of the IVUS-guided direct extrahepatic portocaval shunt is suggested.
Collapse
Affiliation(s)
- Mahtab Niyyati
- Dotter Interventional Institute, Oregon Health & Science University L342, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Abstract
Bioscaffolds derived from xenogeneic extracellular matrix (ECM) have been used in numerous tissue engineering applications. The safety and efficacy of such scaffolds when used for the repair and reconstruction of numerous body tissues including musculoskeletal, cardiovascular, urogenital and integumentary structures has been shown in both preclinical animal studies and in human clinical studies. More than 200,000 human patients have been implanted with xenogeneic ECM scaffolds. These ECM scaffolds are typically prepared from porcine organs such as small intestine or urinary bladder, which are subjected to decellularization and terminal sterilization without significant loss of the biologic effects of the ECM. The composition of these bioscaffolds includes the structural and functional proteins that are part of native mammalian extracellular matrix. The three-dimensional organization of these molecules distinguishes ECM scaffolds from synthetic scaffold materials and is associated with constructive tissue remodeling instead of scar tissue. The biologic response to these xenogeneic bioscaffolds, including the immune response, is discussed herein.
Collapse
Affiliation(s)
- Stephen F Badylak
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, 100 Technology Drive, Suite 200, Pittsburgh, PA 15219, USA.
| |
Collapse
|
29
|
Greca FH, Sousa Filho ZAD, Silva ADPGD, Leonel IS, Soccol AT, Feres AN, Longhi P. Utilização da submucosa de intestino delgado porcino como retalho para aumento da capacidade vesical em cães. Acta Cir Bras 2004. [DOI: 10.1590/s0102-86502004000600015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objetivo: Avaliar a biocompatibilidade de um enxerto xenogênico de SID como meio de ampliação da capacidade vesical. Métodos: Oito cães mestiços foram submetidos à laparotomia e abertura da bexiga por incisão mediana de 3cm em sua face ventral. Para aumento da capacidade vesical, bem como sua reconstituição, foi interposto um segmento de submucosa porcina, fixando-o à parede vesical. No 30°dia de pós-operatório os animais foram sacrificados e procedeu-se à análise macroscópica. As peças foram então encaminhadas para fixação, coloração e análise microscópica. Resultados: Não se observou seroma, hematoma, abscesso, fístula, deiscência, aderências, litíase e a não incorporação do enxerto. Microscopicamente observou-se em todos os casos uma proliferação do urotélio que recobriu toda a superfície do enxerto, além da presença de fibras musculares lisas no local do implante. Verificou-se proliferação conjuntiva, principalmente às custas de colágeno imaturo do tipo III e reação inflamatória crônica em todos os animais. A proliferação vascular foi acentuada e a reabsorção da membrana foram também observadas. Conclusão: Asubmucosa de intestino delgado porcino participou como um substrato para a regeneração da bexiga e pode ser uma futura alternativa na reconstrução do trato urinário.
Collapse
|
30
|
Nuininga JE, van Moerkerk H, Hanssen A, Hulsbergen CA, Oosterwijk-Wakka J, Oosterwijk E, de Gier RPE, Schalken JA, van Kuppevelt TH, Feitz WFJ. A rabbit model to tissue engineer the bladder. Biomaterials 2004; 25:1657-61. [PMID: 14697867 DOI: 10.1016/s0142-9612(03)00519-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A rabbit model was used for the evaluation of a collagen-based biomatrix of small intestinal submucosa (SIS, COOK) in comparison to a biochemically reconstructed biomatrix for bladder tissue regeneration. Rabbits underwent partial cystectomy and cystoplasty with SIS patch graft or with a biochemically defined collagen biomatrix. The grafts of the regenerated bladder wall were harvested at different intervals and tissue regeneration was evaluated. The results of the SIS and biochemically defined biomatrix grafts were comparable. At harvesting, we found five bladder stones and encrustation of the biomatrix in 21/56 animals. No stone formation was observed in the control group. The results of the molecularly defined biomatrix are thus far comparable to SIS. Both matrices show good epithelialization and ingrowth of smooth muscle cells. Both biomatrices show considerable encrustation, which appears to disappear in time. The rabbit model is suitable for bladder tissue engineering studies as it is an easy model to use. In this model, besides tissue regeneration, also some of the clinical problems are seen such as encrustation of foreign body material in the bladder. These aspects are subject for further pre-clinical studies in this animal model.
Collapse
Affiliation(s)
- J E Nuininga
- Department of Urology, Pediatric Urology Center, University Medical Center, Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Landman J, Olweny E, Sundaram CP, Andreoni C, Collyer WC, Rehman J, Jerde TJ, Lin HK, Lee DI, Nunlist EH, Humphrey PA, Nakada SY, Clayman RV. Laparoscopic mid sagittal hemicystectomy and bladder reconstruction with small intestinal submucosa and reimplantation of ureter into small intestinal submucosa: 1-year followup. J Urol 2004; 171:2450-5. [PMID: 15126874 DOI: 10.1097/01.ju.0000127756.64619.27] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE We evaluated the long-term results of laparoscopic hemicystectomy and bladder replacement with small intestinal submucosa (SIS) with ureteral reimplantation into the SIS material. MATERIALS AND METHODS A total of 12 minipigs underwent laparoscopic hemicystectomy. Six pigs underwent bladder reconstruction with SIS and ipsilateral ureteral reimplantation. The remaining 6 control pigs underwent hemicystectomy and primary bladder closure with ipsilateral nephroureterectomy. Preoperative and followup evaluations included blood chemistry, radiography and urodynamic evaluations. The 6, 3, 6 and 9-week, and 12-month followup evaluations included biopsies. At 1 year the animals were sacrificed. Histopathological and contractility studies, and reverse transcriptase-polymerase chain reaction for growth factors and basement membrane components were performed. RESULTS Bladder capacity and bladder compliance were similar in the 2 groups at all time points. One pig per group died, that is a control at the 9-month evaluation due to an anesthetic complication and an SIS pig 7 months after bladder reconstruction due to spontaneous bladder rupture at the anastomotic site. In the SIS group 4 of 5 surviving pigs had unobstructed reimplanted ureters without evidence of hydroureteronephrosis, while 1 had high grade obstruction at the reimplantation site. Histopathology study after 1 year revealed muscle at the graft periphery and center but it consisted of small fused bundles with significant fibrosis. Nerves were present at the graft periphery and center but they were decreased in number. CONCLUSIONS Laparoscopic SIS bladder reconstruction and ureteral reimplantation into the SIS after hemicystectomy are technically feasible. However, compared to primary bladder closure no advantage in bladder capacity or compliance was documented.
Collapse
Affiliation(s)
- Jaime Landman
- Department of Pathology, Washington University School of Medicine, St Louis, Missouri,
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Soergel TM, Cain MP, Kaefer M, Gitlin J, Casale AJ, Davis MM, Rink RC. Complications of Small Intestinal Submucosa for Corporal Body Grafting for Proximal Hypospadias. J Urol 2003; 170:1577-8; 1578-9. [PMID: 14501665 DOI: 10.1097/01.ju.0000083802.87337.af] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Small intestinal submucosa (SIS) has been described for corporal body grafting in cases of severe penile curvature. We reviewed our experience with a 2-stage repair using corporal body grafting with SIS for proximal hypospadias and severe chordee. MATERIALS AND METHODS A retrospective chart review was performed on 12 patients with penoscrotal hypospadias and severe chordee. Corporal grafting was performed with a 4-layer SIS graft (STRATASIS, Cook Biotech, Spencer, Indiana). Patients were evaluated postoperatively with clinic visits after both stages of repair to assess results. RESULTS Corporal body grafting with SIS was performed in 12 patients between June and December 2001. Average patient age at the time of stage 1 repair was 9 months. Of the 12 patients 8 (66%) had no complications and 10 (83%) have a straight phallus following stage 2 repair. Complications occurred in 4 patients (33%), 2 of which were minor and did not require surgical correction. There were 2 major complications related to the SIS graft, 1 of which required excision of the graft and replacement with a tunica albuginea flap, and the other required 3 dorsal plications to correct residual chordee. CONCLUSIONS Our experience using the 4-layer SIS resulted in 2 major complications requiring surgical correction during stage 2 repair. This rate exceeds the complications reported with either dermal or tunica vaginalis grafts. Currently we have stopped using SIS for corporal grafting.
Collapse
Affiliation(s)
- Trevor M Soergel
- Department of of Urology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, USA
| | | | | | | | | | | | | |
Collapse
|
33
|
Abstract
Canine TCC of the bladder is a disease for which early detection and multimodality therapy are likely to produce the most favorable results. Urine screening tests are being investigated as tools to permit earlier detection. The possibility of tumor seeding must be considered when obtaining urine for analysis and when performing surgery. Because these tumors tend to be very locally invasive at the time of diagnosis and are likely to metastasize, cures are unlikely. Currently, combination protocols using chemotherapy and the nonsteroidal anti-inflammatory agent piroxicam show the most promise in producing tumor responses. Surgery and radiation therapy are useful treatment modalities in select cases. Despite advances in treatment of canine TCC, median survival times reported for prospective clinical trials have never exceeded 1 year, regardless of the treatment modality. Development of accurate tests for early tumor detection could have a significant impact on the success of treatment of this tumor in canine patients.
Collapse
Affiliation(s)
- Carolyn J Henry
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Division of Hematology and Oncology, Department of Medicine, School of Medicine, University of Missouri-Columbia, Columbia, MO 65211, USA.
| |
Collapse
|
34
|
Abstract
Tissue engineering in urology is a broad term used to describe the development of alternative tissue sources for diseased or dysfunctional native urologic tissue. This article reviews the recently published techniques involving synthetic and natural biodegradable matrices alone, known as "unseeded" scaffolds, and the latest data on "seeded" scaffolds, which are impregnated with cultured cells from urologic organs. Recent discoveries in reporter gene labeling of urologic tissue are discussed as a new method to identify and track the fates of these transplanted cells in vivo. This article also investigates how these bioengineering techniques are applied to synthetic and natural scaffolds, such as polyglycolic acid and porcine small intestine submucosa, to increase bladder capacity, repair urethral strictures, and replace corporal plaques in Peyronie's disease. Furthermore, recently published reports that these materials have been seeded with chondrocytes to create corporal rods for penile prostheses and stents for ureteral and urethral stricture disease are discussed. With these latest developments as a foundation, the future directions of tissue engineering in urology are presented.
Collapse
Affiliation(s)
- Adam R Metwalli
- Pediatric Urology and Tissue Engineering Laboratory, Department of Urology, University of Oklahoma Health Science Center, 1100 North Lindsay, Oklahoma City, OK 73104, USA
| | | | | |
Collapse
|
35
|
Multilayered Small Intestinal Submucosa is Inferior to Autologous Bowel for Laparoscopic Bladder Augmentation. J Urol 2002. [DOI: 10.1097/00005392-200211000-00109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
36
|
Greca FH, Biondo-Simões MDLP, Santos EAAD, Zanelatto-Gonçalves PC, Chin EWK, Ioshii SO. Retalho de submucosa de intestino delgado autólogo para aumento da capacidade da bexiga: estudo experimental em cães. Rev Col Bras Cir 2002. [DOI: 10.1590/s0100-69912002000500009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Os procedimentos disponíveis para correção de lesões do trato urinário não são livres de complicações. Recentemente, uma nova opção tem sido investigada: o uso da submucosa de intestino delgado (SIS). Constituída de uma matriz extracelular que não apresenta tendências à rejeição, a SIS é capaz de permitir o crescimento de vasos sangüíneos, participar de processos de diferenciação celular e de ser resistente contra o desenvolvimento de processos infecciosos. O objetivo deste estudo foi avaliar a histocompatibilidade de um enxerto autólogo de submucosa de intestino delgado (SIS), quando utilizado para a ampliação da bexiga urinária. MÉTODO: Utilizaram-se oito cães adultos, pesando entre 10 e 15kg. Realizou-se laparotomia mediana e enterectomia de um segmento de jejuno de 10cm, localizado a 20cm da flexura duodeno-jejunal, seguida de anastomose terminoterminal. Desse segmento de intestino obteve-se, por dissecção, a camada submucosa. Após esvaziamento da bexiga por punção, fez-se uma incisão mediana de 3cm em sua parede, compreendendo todas as camadas. Um segmento de 3 x 2,5cm de SIS foi fixado às bordas da incisão com sutura contínua, laçada de fio absorvível 3.0 de poliglecaprone-25. No 30º dia de pós-operatório os animais foram submetidos à retirada da bexiga para estudo histopatológico. RESULTADOS: Não se observou reação inflamatória aguda. Reação inflamatória crônica esteve presente com graus discreto e moderado. A infiltração fibroblástica foi moderada. A presença de células gigantes de corpo estranho foi mínima. A epitelização foi satisfatória, não sendo completa em apenas um dos oito implantes. Ocorreu incorporação predominante de fibras colágenas tipo III, cuja média correspondeu a 70,7% do colágeno total. A reabsorção da mucosa foi moderada em 7/8 dos implantes. CONCLUSÃO: Os resultados indicam que ocorre regeneração da bexiga, quando é utilizada a submucosa de intestino delgado como substrato. A submucosa de intestino delgado autóloga pode ser uma alternativa viável na reconstrução da bexiga urinária.
Collapse
|
37
|
Hodde J, Record R, Tullius R, Badylak S. Fibronectin peptides mediate HMEC adhesion to porcine-derived extracellular matrix. Biomaterials 2002; 23:1841-8. [PMID: 11950054 DOI: 10.1016/s0142-9612(01)00310-6] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Extracellular matrices (ECM) derived from porcine tissues have been shown to support the successful repair and remodeling of injured tissues when evaluated in animal models. Cell-matrix interactions, including ligand-integrin associations that facilitate endothelial cell adhesion, are clearly important in the tissue remodeling process. The goal of the present study was to identify the peptide sequences within the ubiquitous protein fibronectin (FN) that may be important in the initial interactions between the host endothelial cells and the ECM scaffold. Human microvascular endothelial cells (HMEC) were seeded upon porcine ECM after having been subjected to pretreatment with peptide ligands derived from tissue FN and were allowed to attach for 20 min. Non-adherent cells were removed and the remaining, tritium-labeled cells attached to the ECM were counted. Results showed that cyclo-RGD and REDV, but not LDV or PHSRN, play a role in mediating the attachment of HMEC to porcine ECM.
Collapse
Affiliation(s)
- Jason Hodde
- Department of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA.
| | | | | | | |
Collapse
|
38
|
|
39
|
Chen MK, Badylak SF. Small bowel tissue engineering using small intestinal submucosa as a scaffold. J Surg Res 2001; 99:352-8. [PMID: 11469910 DOI: 10.1006/jsre.2001.6199] [Citation(s) in RCA: 155] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Small intestinal submucosa (SIS) is an extracellular matrix used in tissue engineering studies to create de novo abdominal wall, urinary bladder, tendons, blood vessels, and dura mater. The purpose of this study is to evaluate the feasibility of using SIS as a scaffold for small bowel regeneration in an in situ xenograft model. MATERIALS AND METHODS Twenty-three dogs had a partial defect created on the small bowel wall which was repaired with a SIS patch. Four dogs underwent small bowel resection with placement of an interposed tube of SIS. The animals were followed 2 weeks to 1 year. RESULTS Three of the 23 dogs with SIS placed as a patch died shortly after surgery due to leakage from the site. The other 20 dogs survived up to time of elective necropsy with no evidence of intestinal dysfunction. At necropsy, the bowel circumference in the patched area had no stenosis. Histological evaluation showed the presence of a mucosal epithelial layer, varying amount of smooth muscle, sheets of collagen, and a serosal covering. Architecturally, the layers were not well organized in the submucosal region. An abundance of inflammatory cells was present in the early postoperative period but receded with time. All 4 dogs with a tubular segment of SIS interposed had significant problems. One had partial obstruction at 1 month, and 3 died in the early postoperative period due to leakage. CONCLUSIONS This preliminary study suggests that SIS patches can be used for small bowel regeneration. Tubular segmental replacement is not feasible at this time.
Collapse
Affiliation(s)
- M K Chen
- Department of Surgery, University of Florida, Gainesville, FL 32610, USA.
| | | |
Collapse
|
40
|
URETERAL RECONSTRUCTION: SMALL INTESTINE SUBMUCOSA FOR THE MANAGEMENT OF STRICTURES AND DEFECTS OF THE UPPER THIRD OF THE URETER. J Urol 2001. [DOI: 10.1097/00005392-200105000-00088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
41
|
Pariente JL, Kim BS, Atala A. In vitro biocompatibility assessment of naturally derived and synthetic biomaterials using normal human urothelial cells. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 2001; 55:33-9. [PMID: 11426395 DOI: 10.1002/1097-4636(200104)55:1<33::aid-jbm50>3.0.co;2-7] [Citation(s) in RCA: 165] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The reconstruction of urinary tissues often employs various types of biomaterials, and adequate material biocompatibility is essential for the successful reconstruction of urinary tissues. In this study we utilized a primary normal human urothelial cell culture system to evaluate the in vitro biocompatibility of a number of naturally derived biomaterials [i.e., bladder submucosa, small intestinal submucosa, collagen, and alginate] and polymeric biomaterials [i.e., poly(glycolic acid), poly(L-lactic acid), poly(lactic-co-glycolic acid), and silicone] that are either experimentally or clinically used in urinary reconstructive surgery. To determine the cytotoxic and bioactive effects of these biomaterials, the cell viability, metabolic activity, apoptotic properties, and DNA-synthesis activity were measured with four types of assays [Neutral Red, 3-(4,5-dimethylthiazol-2-yl)-2,5diphenyl tetrazolium bromide, apoptotic activity, and tritiated thymidine incorporation assays] using extract and direct contact methods. Most of the biomaterials tested did not induce significant cytotoxic effects and exhibited normal metabolic function and cell growth in vitro. This normal primary human urothelial cell culture model is suitable for in vitro biocompatibility assessments and is able to provide information on the cell-biomaterial interactions and the ability of biomaterials to support bioactive cell functions.
Collapse
Affiliation(s)
- J L Pariente
- Laboratory for Tissue Engineering and Cellular Therapeutics, Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA
| | | | | |
Collapse
|
42
|
|
43
|
|
44
|
PORTIS ANDREWJ, ELBAHNASY ABDELHAMIDM, SHALHAV ARIEHL, BREWER ALLISON, HUMPHREY PETER, MCDOUGALL ELSPETHM, CLAYMAN RALPHV. LAPAROSCOPIC AUGMENTATION CYSTOPLASTY WITH DIFFERENT BIODEGRADABLE GRAFTS IN AN ANIMAL MODEL. J Urol 2000. [DOI: 10.1016/s0022-5347(05)67207-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- ANDREW J. PORTIS
- From the Department of Surgery/Division of Urologic Surgery, Washington University School of Medicine, the Department of Urology, Tanta University, Tanta, Egypt, The Department of Pathology, and The Department of Radiology (Mallinckrodt Institute of Radiology), Washington University School of Medicine, St. Louis, Missouri
| | - ABDELHAMID M. ELBAHNASY
- From the Department of Surgery/Division of Urologic Surgery, Washington University School of Medicine, the Department of Urology, Tanta University, Tanta, Egypt, The Department of Pathology, and The Department of Radiology (Mallinckrodt Institute of Radiology), Washington University School of Medicine, St. Louis, Missouri
| | - ARIEH L. SHALHAV
- From the Department of Surgery/Division of Urologic Surgery, Washington University School of Medicine, the Department of Urology, Tanta University, Tanta, Egypt, The Department of Pathology, and The Department of Radiology (Mallinckrodt Institute of Radiology), Washington University School of Medicine, St. Louis, Missouri
| | - ALLISON BREWER
- From the Department of Surgery/Division of Urologic Surgery, Washington University School of Medicine, the Department of Urology, Tanta University, Tanta, Egypt, The Department of Pathology, and The Department of Radiology (Mallinckrodt Institute of Radiology), Washington University School of Medicine, St. Louis, Missouri
| | - PETER HUMPHREY
- From the Department of Surgery/Division of Urologic Surgery, Washington University School of Medicine, the Department of Urology, Tanta University, Tanta, Egypt, The Department of Pathology, and The Department of Radiology (Mallinckrodt Institute of Radiology), Washington University School of Medicine, St. Louis, Missouri
| | - ELSPETH M. MCDOUGALL
- From the Department of Surgery/Division of Urologic Surgery, Washington University School of Medicine, the Department of Urology, Tanta University, Tanta, Egypt, The Department of Pathology, and The Department of Radiology (Mallinckrodt Institute of Radiology), Washington University School of Medicine, St. Louis, Missouri
| | - RALPH V. CLAYMAN
- From the Department of Surgery/Division of Urologic Surgery, Washington University School of Medicine, the Department of Urology, Tanta University, Tanta, Egypt, The Department of Pathology, and The Department of Radiology (Mallinckrodt Institute of Radiology), Washington University School of Medicine, St. Louis, Missouri
| |
Collapse
|
45
|
Reddy PP, Barrieras DJ, Wilson G, Bägli DJ, McLorie GA, Khoury AE, Merguerian PA. Regeneration of functional bladder substitutes using large segment acellular matrix allografts in a porcine model. J Urol 2000; 164:936-41. [PMID: 10958712 DOI: 10.1097/00005392-200009020-00005] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE We previously reported on the short-term (4 weeks) morphometric analysis of a large bladder acellular matrix allograft used as a bladder bioprosthesis (average size 24 cm.2). We demonstrated cellular repopulation through the entire thickness of the graft. We now present the long-term (12 weeks) morphometric results of graft regenerated porcine bladders using segments measuring an average of 40 cm.2. MATERIALS AND METHODS Bladders harvested from pigs were subjected to detergent and enzymatic extractions to render them acellular. Partial cystectomy was performed in 21 pigs and the defect was repaired with a bladder acellular matrix allograft (average size 40.52 cm.2). Of the animals 8 were sacrificed at 1, 2 and 4 weeks and 13 were sacrificed at 8 and 12 weeks. To evaluate cellular repopulation and matrix reorganization the native bladder and graft were analyzed using standard histological and immunofluorescent techniques. To evaluate for calcium deposits in the grafts a radiological evaluation of the graft was performed after explantation. RESULTS All animals survived the surgical procedure and there were no significant urinary leaks. No stones were noted in any of the bladders. At 1 week there was a diffuse infiltration with acute inflammatory cells. At 2 weeks the luminal surface of the graft was lined with a single layer of urothelium, and there was stromal infiltration with unorganized smooth muscle cells and angiogenesis. At 4 weeks the urothelium was multilayered with organizing groups of smooth muscle cells and angiogenesis. At 8 and 12 weeks there was repopulation throughout the bladder acellular matrix allograft implant with all native cellular components participating. CONCLUSIONS We present evidence that large patch bladder acellular matrix allograft implantation is technically feasible and may prove to be a viable surgical alternative to bladder augmentation with intestinal segments. Its advantages may include the potential for complete and functional regeneration of a bladder substitute.
Collapse
Affiliation(s)
- P P Reddy
- Division of Urology, Department of Surgery, The Hospital for Sick Children, University of Toronto, Ontario, Canada
| | | | | | | | | | | | | |
Collapse
|
46
|
Badylak S, Meurling S, Chen M, Spievack A, Simmons-Byrd A. Resorbable bioscaffold for esophageal repair in a dog model. J Pediatr Surg 2000; 35:1097-103. [PMID: 10917304 DOI: 10.1053/jpsu.2000.7834] [Citation(s) in RCA: 237] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE Porcine-derived, xenogeneic extracellular matrix (ECM) derived from either the small intestinal submucosa (SIS) or urinary bladder submucosa (UBS) was used as a tissue scaffold for esophageal repair in a dog model. METHODS Patch defects measuring approximately 5 cm in length and encompassing 40% to 50% of the circumference of the esophagus or complete circumferential segmental defects measuring 5 cm in length were created by surgical resection in healthy adult female dogs. The defects were repaired with ECM scaffolds derived from either SIS or UBS. The animals were kept alive for periods ranging from 4 days to 15 months. RESULTS The xenogeneic scaffolds used for repair of the patch defects were resorbed completely within 30 to 60 days and showed replacement by skeletal muscle, which was oriented appropriately and contiguous with adjacent normal esophageal skeletal muscle, organized collagenous connective tissue, and a complete and intact squamous epithelium. No signs of clinical esophageal dysfunction were seen in any of the animals with the patch defect repair. The xenogeneic scaffolds configured into tubes for repair of the segmental defects all showed stricture within 45 days of surgery. CONCLUSION These ECMs show promise as a treatment option for esophageal repair, but stricture remains problematic for complete tube grafts.
Collapse
Affiliation(s)
- S Badylak
- Department of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907-1296, USA
| | | | | | | | | |
Collapse
|
47
|
Abstract
PURPOSE We determined the origin of smooth muscle cells in acellular bladder matrix grafts. MATERIALS AND METHODS A total of 15 female Sprague-Dawley rats underwent partial cystectomy and grafting with an acellular matrix derived from rat bladder. The grafts were examined 1, 2, 3 and 4 weeks after grafting by immunohistochemical studies for smooth muscle markers and by transmission electron microscopy for smooth muscle morphology. Bladder matrix and bladder epithelium recombinants were created and grafted subcutaneously and under the renal capsule in nude mice. Recombinants were examined 1, 2, 3 and 4 weeks postoperatively by immunohistochemical studies for bladder epithelium and bladder smooth muscle. RESULTS Smooth muscle ingrowth into acellular matrix was initially seen at 2 weeks. The immunohistochemical and electron microscopic characteristics of the cells were similar to those of fetal smooth muscle 2 weeks and newborn smooth muscle 4 weeks after grafting. Matrix epithelium recombinants displayed mature bladder epithelium with 3 to 7 layers but they did not support the ingrowth of smooth muscle cells. CONCLUSIONS Mature bladder smooth muscle cells undergo dedifferentiation, migration and redifferentiation to repopulate an acellular matrix graft. It is unlikely that adult fibroblasts from the surrounding tissue are induced by epithelium and matrix to form smooth muscle. The contractile behavior of bladder substitute materials likely reflects the properties of the host bladder.
Collapse
|
48
|
Kropp BP. Developmental Aspects of the Contractile Smooth Muscle Component in Small Intestinal Submucosa Regenerated Urinary Bladder. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1999; 462:129-35. [PMID: 10599419 DOI: 10.1007/978-1-4615-4737-2_10] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Affiliation(s)
- B P Kropp
- Children's Hospital of Oklahoma, University of Oklahoma Health Science Center, Oklahoma City 73104, USA
| |
Collapse
|