Urethral Tissue Reconstruction Using the Acellular Dermal Matrix Patch Modified with Collagen-Binding VEGF in Beagle Urethral Injury Models

The Regenerative Microenvironment of the Tissue Engineering for Urethral Strictures

Urethral stricture caused by various reasons has threatened the quality of life of patients for decades. Traditional reconstruction methods, especially for long-segment injuries, have shown poor outcomes in treating urethral strictures. Tissue engineering for urethral regeneration is an emerging concept in which special designed scaffolds and seed cells are used to promote local urethral regeneration. The scaffolds, seed cells, various factors and the host interact with each other and form the regenerative microenvironment. Among the various interactions involved, vascularization and fibrosis are the most important biological processes during urethral regeneration. Mesenchymal stem cells and induced pluripotent stem cells play special roles in stricture repair and facilitate long-segment urethral regeneration, but they may also induce carcinogenesis and genomic instability during reconstruction. Nevertheless, current technologies, such as genetic engineering, molecular imaging, and exosome extraction, provide us with opportunities to manage seed cell-related regenerative risks. In this review, we described the interactions among seed cells, scaffolds, factors and the host within the regenerative microenvironment, which may help in determining the exact molecular mechanisms involved in urethral stricture regeneration and promoting clinical trials and the application of urethral tissue engineering in patients suffering from urethral stricture.

Acellular dermal matrix in urethral reconstruction

The management of severe urethral stricture has always posed a formidable challenge. Traditional approaches such as skin flaps, mucosal grafts, and urethroplasty may not be suitable for lengthy and intricate strictures. In the past two decades, tissue engineering solutions utilizing acellular dermal matrix have emerged as potential alternatives. Acellular dermal matrix (ADM) is a non-immunogenic biological collagen scaffold that has demonstrated its ability to induce layer-by-layer tissue regeneration. The application of ADM in urethral reconstruction through tissue engineering has become a practical endeavor. This article provides an overview of the preparation, characteristics, advantages, and disadvantages of ADM along with its utilization in urethral reconstruction via tissue engineering.

Adipose stem cells in tissue regeneration and repair: From bench to bedside

ADSCs are a large number of mesenchymal stem cells in Adipose tissue, which can be applied to tissue engineering. ADSCs have the potential of multi-directional differentiation, and can differentiate into bone tissue, cardiac tissue, urothelial cells, skin tissue, etc. Compared with other mesenchymal stem cells, ADSCs have a multitude of promising advantages, such as abundant number, accessibility in cell culture, stable function, and less immune rejection. There are two main methods to use ADSCs for tissue repair and regeneration. One is to implant the "ADSCs-scaffold composite" into the injured site to promote tissue regeneration. The other is cell-free therapy: using ADSC-exos or ADSC-CM alone to release a large number of miRNAs, cytokines and other bioactive substances to promote tissue regeneration. The tissue regeneration potential of ADSCs is regulated by a variety of cytokines, signaling molecules, and external environment. The differentiation of ADSCs into different tissues is also induced by growth factors, ions, hormones, scaffold materials, physical stimulation, and other factors. The specific mechanisms are complex, and most of the signaling pathways need to be further explored. This article reviews and summarizes the mechanism and clinical application of ADSCs in tissue injury repair so far, and puts forward further problems that need to be solved in this field, hoping to provide directions for further research in this field.

Decellularization techniques of human foreskin for tissue engineering application

The rapid development of tissue engineering (TE) and regenerative medicine brings an acute need for biocompatible and bioactive biological scaffolds to regenerate or restore damaged tissue. Great attention is focused on the decellularization of tissues or even whole organs, and the subsequent colonization of such decellularized extracellular matrices by recipient cells. The foreskin is an integral, normal part of the external genitalia that forms the anatomical covering of the glans penis and the urinary meatus of all human and non-human primates. It is mucocutaneous tissue that marks the boundary between mucosa and skin. In this work, we compared two innovative decellularization techniques for human foreskins obtained from donors. We compared the efficacy and feasibility of these protocols and the biosafety of prepared acellular dermal matrixes that can serve as a suitable scaffold for TE. The present study confirms the feasibility of foreskin decellularization based on enzymatic or detergent methods. Both techniques conserved the ultrastructure and composition of natural ECM while being DNA-free and non-toxic, making it an excellent scaffold for follow-up research and TE applications.

Current perspectives in hypospadias research: A scoping review of articles published in 2021 (Review)

Hundreds of papers are written about hypospadias every year referring to all aspects of the pathology, being one of the most common congenital malformations. The present study conducted a scoping review of articles published in 2021 to present the main issues and summarize current perspectives and achievements in the field. It searched for the keyword 'hypospadias' in the three most popular databases (PubMed, Scopus and Web of Science). After the analysis of the publications, they were categorized into different domains. The present review was performed respecting the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA ScR) guidelines. A total of 284 articles were included. These were published in 142 different journals. The most accessed was the Journal of Paediatric Urology with 54 articles. The main identified domains were related to surgical techniques, postoperative care, complications, anesthesia, anatomical factors, genetics, environmental factors, endocrinology, associated malformations, questionnaires and recommendations, management, biological materials, animal models, retrospective studies of centers, social media, bibliometrics, small gestational age, neoplasm, or fertility. Promising modifications of existing surgical techniques were presented with improved outcomes for both the proximal and distal types of hypospadias. Relevant anatomical and etiological, and also genetic factors were clarified. Aspects of the peri- and postoperative management referring to the antibiotherapy, analgesia, dressing techniques, and the future use of novel bioengineering agents to prevent, reduce or treat the occurring complications were discussed.

A functionalized collagen-I scaffold delivers microRNA 21-loaded exosomes for spinal cord injury repair

MicroRNA (miRNA)-based therapies have shown great potential in the repair of spinal cord injury (SCI). MicroRNA 21 (miR21) has been proven to have an essential protective effect on SCI. However, there are some challenges for miRNAs application due to their easy degradation and ineffective cell penetration. As natural vesicles, exosomes were considered ideal carriers for miRNAs delivery for their advantages of low immunogenicity, inherent stability and tissue/cell penetration. However, poor targeting and the low capacity of specific miRNAs impede their practical applications. This study aims to develop a type of genetically engineered miR21-loaded exosomes that can be entrapped in collagen-I (Col-I) scaffold to repair SCI. The collagen-binding domain (CBD)-fused lysosome-associated membrane glycoprotein 2b (Lamp2b) protein (CBD-LP) and miR21 were overexpressed in host HEK293T (293T) cells that were used to produce engineered miR21-loaded exosomes. The CBD peptide fused in Lamp2b on the exosome surface can stably tether exosomes to Col-I scaffold, facilitate the retention of miR21-loaded exosomes in lesion sites, promote the sustained release of miR21 to cells. Finally, a functionalized Col-I scaffold biomaterial enriched with miR21-loaded exosomes was developed and it could benefit the repair of SCI. STATEMENT OF SIGNIFICANCE: MiRNA-based therapeutics have promising potential in spinal cord injury (SCI) repair. However, easy degradation and ineffective cell penetration impede miRNAs application. Exosomes are natural vehicles for miRNAs delivery but face the challenge of diffusion in vivo. Here, the collagen-binding domain (CBD)-fused Lamp2b and miR21 were overexpressed in HEK293T cells to produce miR21-loaded and CBD-modified exosomes (CBD-LP-miR21-EXOs). The CBD modified on the exosome surface can stably tether exosomes to collagen-I scaffold to form functionalized CBD-LP-miR21-EXO-Col scaffold that can facilitate the retention of miR21-loaded exosomes, promote the sustained release of miR21 to cells and finally benefit SCI repair. Furthermore, this type of functionalized collagen-I materials can be widely applied for other tissue injury repairs by enriching the CBD-LP-EXOs loaded with appropriate miRNAs.

A Novel Hybrid Membrane for Urinary Conduit Substitutes Based on Small Intestinal Submucosa Coupled with Two Synthetic Polymers

Among the urinary tract's malignancies, bladder cancer is the most frequent one: it is at the tenth position of most common cancers worldwide. Currently, the gold standard therapy consists of radical cystectomy, which results in the need to create a urinary diversion using a bowel segment from the patient. Nevertheless, due to several complications associated with bowel resection and anastomosis, which significantly affect patient quality of life, it is becoming extremely important to find an alternative solution. In our recent work, we proposed the decellularized porcine small intestinal submucosa (SIS) as a candidate material for urinary conduit substitution. In the present study, we create SIS-based hybrid membranes that are obtained by coupling decellularized SIS with two commercially available polycarbonate urethanes (Chronoflex AR and Chronoflex AR-LT) to improve SIS mechanical resistance and impermeability. We evaluated the hybrid membranes by means of immunofluorescence, two-photon microscopy, FTIR analysis, and mechanical and cytocompatibility tests. The realization of hybrid membranes did not deteriorate SIS composition, but the presence of polymers ameliorates the mechanical behavior of the hybrid constructs. Moreover, the cytocompatibility tests demonstrated a significant increase in cell growth compared to decellularized SIS alone. In light of the present results, the hybrid membrane-based urinary conduit can be a suitable candidate to realize a urinary diversion in place of an autologous intestinal segment. Further efforts will be performed in order to create a cylindrical-shaped hybrid membrane and to study its hydraulic behavior.

Application of Acellular Dermal Matrix in Gynaecology—A Current Review

The aim of our study is to draw attention to the multitude of applications of acellular dermal matrix (ADM) in the surgical treatment of urogynaecological disorders, such as reduction in the reproductive organs, and in reconstructive gynaecology. Despite the existence of numerous operational methods and materials, the effectiveness of transvaginal operation is still insufficient. Native tissue operations are often not durable enough, while operations with synthetic materials have numerous side effects, such as infections, hematomas, vaginal erosion, or dyspareunia. Hence, the search continues for a different material with a better efficacy and safety profile than those previously mentioned. It seems that ADM can meet these requirements and be a useful material for urogynaecological surgery. Key words related to the usage of ADM in gynaecological reconstructive surgery were used to search relevant databases (NCBI MedLine, Clinical Key, Clinicaltrials.gov). This manuscript is based on 43 literature sources, 28 (65.11%) of which were released after 2016. Older sources are cited for the purpose of presenting basic science, or other important issues related to the manuscript. ADM seems to be an ideal material for urogynaecological and reconstructive surgery. It has high durability, and thus high effectiveness. Moreover, it does not have the side effects typical for synthetic materials. There are no reports of material rejection, erosion or dyspareunia directly related to the presence of the mesh. Due to the difficulties in obtaining ADM and the need to perform additional tests, this material is not common in routine clinical practice. Therefore, the number of cases and the size of the research groups are insufficient to clearly define the potential of mesh from biological tissue. However, the results are so promising that it is worth considering a wider introduction to the use of this material. Our hope is that increasing clinicians’ awareness of this topic will lead to more studies comparing methods using native tissues or synthetic materials and those using ADM.

Graphene oxide encapsulated forsterite scaffolds to improve mechanical properties and antibacterial behavior

It is very desirable to have good antibacterial properties and mechanical properties at the same time for bone scaffolds. Graphene oxide (GO) can increase the mechanical properties and antibacterial performance, while forsterite (Mg2SiO4) as the matrix can increase forsterite/GO scaffolds' biological activity for bone tissue engineering. Interconnected porous forsterite scaffolds were developed by space holder processes for bone tissue engineering in this research. The forsterite/GO scaffolds had a porosity of 76-78% with pore size of 300-450 μm. The mechanism of the mechanical strengthening, antibacterial activity, and cellular function of the forsterite/GO scaffold was evaluated. The findings show that the compressive strength of forsterite/1wt.% GO scaffold (2.4±0.1 MPa) was significantly increased, in comparison to forsterite scaffolds without GO (1.4±0.1 MPa). Validation of the samples' bioactivity was attained by forming a hydroxyapatite (HAp) layer on the forsterite/GO surface within in vitro immersion test. The results of cell viability demonstrated that synthesized forsterite scaffolds with low GO did not show cytotoxicity and enhanced cell proliferation. Antibacterial tests showed that the antibacterial influence of forsterite/GO scaffold was strongly correlated with GO concentration from 0.5 to 2 wt.%. The scaffold encapsulated with 2wt.% GO had the great antibacterial performance with bacterial inhibition rate around 90%. As results show, the produced forsterite/1wt.% GO can be an attractive option for bone tissue engineering.