1
|
Promm M, Otto W, Götz S, Burger M, Müller K, Rubenwolf P, Neuhuber WL, Rösch WH. Innervation pattern of the unclosed detrusor muscle in classic bladder exstrophy: a study of patients with urothelial overexpression of nerve growth factor. Pediatr Surg Int 2024; 40:69. [PMID: 38441774 PMCID: PMC10914852 DOI: 10.1007/s00383-024-05649-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE An overexpression of nerve growth factor (NGF) in the urothelium is discussed to lead to neuronal hyperinnervation of the bladder detrusor. The aim was to assess the sensory and sympathetic innervation of the detrusor in unclosed exstrophic bladders patients with known overexpression of NGF in the urothelium. METHODS Full-thickness bladder biopsies were prospectively obtained from 34 infants at delayed primary bladder closure between 01/2015 and 04/2020. The bladder biopsies were immunohistochemically stained with antibodies against S100, calcitonin gene-related peptide (anti-CGRP), Neurofilament 200 (anti-NF200), and tyrosine-hydroxylase (anti-TH). Specimens from 6 children with congenital vesicoureterorenal reflux (VUR) served as controls. RESULTS There was no statistically significant difference in nerve fiber density in any of the immunohistochemical assessments (anti-S100 [p = 0.210], anti-CGRP [p = 0.897], anti-NF200 [p = 0.897]), and anti-TH [p = 0.956]) between patients with BE and patients with VUR. However, we observed a trend toward lower nerve fiber densities in exstrophic detrusor. CONCLUSION Overall our results showed an unharmed innervation pattern in this cohort but a lower density of nerve fibers in the detrusor compared to controls. Further studies in patients after successful primary closure are needed to clarify the potential impact of the urothelial overexpression of NGF modulating the innervation pattern in exstrophic bladders.
Collapse
Affiliation(s)
- Martin Promm
- Department of Pediatric Urology, Clinic St. Hedwig, University Medical Center of Regensburg, Steinmetzstr. 1-3, 93049, Regensburg, Germany.
| | - Wolfgang Otto
- Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Landshuter Str. 65, 93053, Regensburg, Germany
| | - Stefanie Götz
- Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Landshuter Str. 65, 93053, Regensburg, Germany
| | - Maximilian Burger
- Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Landshuter Str. 65, 93053, Regensburg, Germany
| | - Karolina Müller
- Center for Clinical Studies, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Peter Rubenwolf
- Department of Pediatric Urology, Clinic St. Hedwig, University Medical Center of Regensburg, Steinmetzstr. 1-3, 93049, Regensburg, Germany
- Department of Urology, University Medical Center Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Winfried L Neuhuber
- Institute of Anatomy and Cell Biology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Universitaetsstr. 19, 91054, Erlangen, Germany
| | - Wolfgang H Rösch
- Department of Pediatric Urology, Clinic St. Hedwig, University Medical Center of Regensburg, Steinmetzstr. 1-3, 93049, Regensburg, Germany
| |
Collapse
|
2
|
Promm M, Otto W, Weber F, Götz S, Burger M, Müller K, Rubenwolf P, Neuhuber W, Roesch WH. Expression of Low Affinity Nerve Growth Factor Receptor p75 in Classic Bladder Exstrophy. Front Pediatr 2021; 9:634343. [PMID: 33692976 PMCID: PMC7937696 DOI: 10.3389/fped.2021.634343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 02/01/2021] [Indexed: 12/04/2022] Open
Abstract
Successful primary closure of classic bladder exstrophy (BE) is crucial for development of bladder capacity and voided continence. It is universally agreed that an intensive pain management including the use of caudal epidural anesthesia is an essential cornerstone for the outcome of this complex surgery. Whether and to what extent pain is caused by structural or functional changes is not yet known. The nerve growth factor (NGF) is regarded as a marker for pain in different bladder disorders. This prospective study investigated the role of histological alterations and NGF in patients with BE including 34 patients with BE and 6 patients with congenital vesicoureterorenal reflux (VUR) who served as controls. Between January 2015 and April 2020 transmural bladder biopsies were taken from the posterior bladder wall during delayed primary bladder closure. The samples were stained for histological evaluation and subjected to immunohistochemistry to analyze NGFR p75. Differences in histological alterations were examined with Fisher's exact test, and Mann-Whitney-U-test was used to compare the NGFR p75 staining intensity between patients with BE and controls. Patients with BE showed significantly more often acute inflammation (p < 0.001), squamous metaplasia (p = 0.002), and cystitis glandularis (p = 0.005) as well as NGFR p75 in the urothelium (p = 0.003) than patients with VUR. A limitation of this study is the small number of participants due to the rare disease entity. Similar to other painful bladder disorders, pain transmission in BE after intitial closure may in part be facilitated by elevated NGF signaling through its receptor.
Collapse
Affiliation(s)
- Martin Promm
- Department of Pediatric Urology, Clinic St. Hedwig, University of Regensburg, Regensburg, Germany
| | - Wolfgang Otto
- Department of Urology, Caritas-St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Florian Weber
- Department of Pathology, University of Regensburg, Regensburg, Germany
| | - Stefanie Götz
- Department of Urology, Caritas-St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Maximilian Burger
- Department of Urology, Caritas-St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Karolina Müller
- Center for Clinical Studies, University Medical Center Regensburg, Regensburg, Germany
| | - Peter Rubenwolf
- Department of Pediatric Urology, Clinic St. Hedwig, University of Regensburg, Regensburg, Germany.,Department of Urology, University Medical Center Frankfurt, Frankfurt, Germany
| | - Winfried Neuhuber
- Institute of Anatomy and Cell Biology, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Wolfgang H Roesch
- Department of Pediatric Urology, Clinic St. Hedwig, University of Regensburg, Regensburg, Germany
| |
Collapse
|
3
|
Razavi M, Hu S, Thakor AS. A collagen based cryogel bioscaffold coated with nanostructured polydopamine as a platform for mesenchymal stem cell therapy. J Biomed Mater Res A 2018; 106:2213-2228. [PMID: 29637738 PMCID: PMC6161703 DOI: 10.1002/jbm.a.36428] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 03/28/2018] [Indexed: 02/06/2023]
Abstract
Cryo-hydrogels (cryogels) are polymer hydrogels formed at sub-zero temperatures. Bioscaffolds created from cryogels have interconnected macropores which allow for cell migration, tissue-ingrowth, unhindered diffusion of solutes and mass transport of therapeutics. In this study, we developed collagen based cryogel bioscaffolds and coated them with polydopamine using a simple two-step technique. Cryogel bioscaffolds were synthesized by collagen crosslinking at -20°C and exhibited a macroporous interconnected architecture with 75% ± 3% porosity. Two groups of pore sizes were observed: 300 ± 50 µm and 30 ± 10 µm in diameter. The addition of a polydopamine coating to cryogel bioscaffolds was confirmed using composition analysis. This resulted in a 41% ± 5% decrease in water uptake, 81% ± 10% decrease in swelling rate and 12% ± 3% decrease in their degree of dissolution (p < 0.05), with a 48% ± 2% increase in stiffness and 57% ± 5% increase in compressive strength (p < 0.05). Seeding adipose tissue-derived mesenchymal stem cells (AD-MSCs) into polydopamine coated-cryogel bioscaffolds resulted in cells demonstrating a 52% ± 4% increase in viability and 33% ± 3% increase in proliferation when compared to AD-MSCs seeded into uncoated-cryogel bioscaffolds (p < 0.05). In summary, our novel polydopamine coated-cryogel bioscaffold represents an efficient and low-cost bioscaffold platform to support MSC therapies. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 2213-2228, 2018.
Collapse
Affiliation(s)
- Mehdi Razavi
- Department of Radiology, Stanford University, Palo Alto, California, 94304
| | - Sophia Hu
- Department of Radiology, Stanford University, Palo Alto, California, 94304
| | - Avnesh S Thakor
- Department of Radiology, Stanford University, Palo Alto, California, 94304
| |
Collapse
|
4
|
Roelofs LA, de Jonge PK, Oosterwijk E, Tiemessen DM, Kortmann BB, de Gier RP, Versteeg EM, Daamen WF, van Kuppevelt TH, Geutjes PJ, Feitz WF. Bladder Regeneration Using Multiple Acellular Scaffolds with Growth Factors in a Bladder. Tissue Eng Part A 2018; 24:11-20. [DOI: 10.1089/ten.tea.2016.0356] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Luc A.J. Roelofs
- Department of Urology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul K.J.D. de Jonge
- Department of Urology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Egbert Oosterwijk
- Department of Urology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dorien M. Tiemessen
- Department of Urology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara B.M. Kortmann
- Department of Urology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Robert P.E. de Gier
- Department of Urology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Elly M.M. Versteeg
- Department of Biochemistry, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Willeke F. Daamen
- Department of Biochemistry, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Toin H. van Kuppevelt
- Department of Biochemistry, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul J. Geutjes
- Department of Urology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wout F.J. Feitz
- Department of Urology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
5
|
Chan EC, Kuo SM, Kong AM, Morrison WA, Dusting GJ, Mitchell GM, Lim SY, Liu GS. Three Dimensional Collagen Scaffold Promotes Intrinsic Vascularisation for Tissue Engineering Applications. PLoS One 2016; 11:e0149799. [PMID: 26900837 PMCID: PMC4762944 DOI: 10.1371/journal.pone.0149799] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 02/04/2016] [Indexed: 12/30/2022] Open
Abstract
Here, we describe a porous 3-dimensional collagen scaffold material that supports capillary formation in vitro, and promotes vascularization when implanted in vivo. Collagen scaffolds were synthesized from type I bovine collagen and have a uniform pore size of 80 μm. In vitro, scaffolds seeded with primary human microvascular endothelial cells suspended in human fibrin gel formed CD31 positive capillary-like structures with clear lumens. In vivo, after subcutaneous implantation in mice, cell-free collagen scaffolds were vascularized by host neovessels, whilst a gradual degradation of the scaffold material occurred over 8 weeks. Collagen scaffolds, impregnated with human fibrinogen gel, were implanted subcutaneously inside a chamber enclosing the femoral vessels in rats. Angiogenic sprouts from the femoral vessels invaded throughout the scaffolds and these degraded completely after 4 weeks. Vascular volume of the resulting constructs was greater than the vascular volume of constructs from chambers implanted with fibrinogen gel alone (42.7±5.0 μL in collagen scaffold vs 22.5±2.3 μL in fibrinogen gel alone; p<0.05, n = 7). In the same model, collagen scaffolds seeded with human adipose-derived stem cells (ASCs) produced greater increases in vascular volume than did cell-free collagen scaffolds (42.9±4.0 μL in collagen scaffold with human ASCs vs 25.7±1.9 μL in collagen scaffold alone; p<0.05, n = 4). In summary, these collagen scaffolds are biocompatible and could be used to grow more robust vascularized tissue engineering grafts with improved the survival of implanted cells. Such scaffolds could also be used as an assay model for studies on angiogenesis, 3-dimensional cell culture, and delivery of growth factors and cells in vivo.
Collapse
Affiliation(s)
- Elsa C. Chan
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, East Melbourne, Victoria, Australia
| | - Shyh-Ming Kuo
- Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Anne M. Kong
- O’Brien Institute Department, St Vincent’s Institute of Medical Research, Fitzroy, Victoria, Australia
| | - Wayne A. Morrison
- O’Brien Institute Department, St Vincent’s Institute of Medical Research, Fitzroy, Victoria, Australia
- Department of Surgery, University of Melbourne, St Vincent’s Hospital Melbourne, Fitzroy, Victoria, Australia
- Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Gregory J. Dusting
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, East Melbourne, Victoria, Australia
- O’Brien Institute Department, St Vincent’s Institute of Medical Research, Fitzroy, Victoria, Australia
| | - Geraldine M. Mitchell
- O’Brien Institute Department, St Vincent’s Institute of Medical Research, Fitzroy, Victoria, Australia
- Department of Surgery, University of Melbourne, St Vincent’s Hospital Melbourne, Fitzroy, Victoria, Australia
- Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Shiang Y. Lim
- O’Brien Institute Department, St Vincent’s Institute of Medical Research, Fitzroy, Victoria, Australia
- Department of Surgery, University of Melbourne, St Vincent’s Hospital Melbourne, Fitzroy, Victoria, Australia
- * E-mail: (GSL); (SYL)
| | - Guei-Sheung Liu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, East Melbourne, Victoria, Australia
- * E-mail: (GSL); (SYL)
| |
Collapse
|
6
|
Roelofs LAJ, Oosterwijk E, Kortmann BBM, Daamen WF, Tiemessen DM, Brouwer KM, Eggink AJ, Crevels AJ, Wijnen RMH, van Kuppevelt TH, Geutjes PJ, Feitz WFJ. Bladder Regeneration Using a Smart Acellular Collagen Scaffold with Growth Factors VEGF, FGF2 and HB-EGF. Tissue Eng Part A 2015; 22:83-92. [PMID: 26441140 DOI: 10.1089/ten.tea.2015.0096] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Tissue engineering may become an alternative to current bladder augmentation techniques. Large scaffolds are needed for clinically significant augmentation, but can result in fibrosis and graft shrinkage. The purpose of this study was to investigate whether smart acellular collagen-heparin scaffolds with growth factors (GFs) VEGF, FGF2, and HB-EGF enhance bladder tissue regeneration and bladder capacity in a large animal model of diseased bladder. Scaffolds of bovine type I collagen with heparin and VEGF, FGF2, and HB-EGF measuring 3.2 cm in diameter were prepared. In 23 fetal sheep, a bladder exstrophy was surgically created at 79 days of gestation. One week after birth (at full term), the bladder was reconstructed by primary closure (PC group) or using a collagen-heparin scaffold with GFs (COLGF group) and compared to a historical group reconstructed with a collagen scaffold without GFs (COL group). Functional (video urodynamics) and histological evaluation was performed 1 and 6 months after bladder repair. The overall survival rate was 57%. Cystograms were normal in all animals, except for low-grade reflux in all groups. Urodynamics showed no statistically significant differences in bladder capacity and compliance between groups. Histological evaluation at 1 month revealed increased urothelium formation, improved angiogenesis, and enhanced ingrowth of smooth muscle cells (SMCs) in the COLGF group compared to the COL group. At 6 months, improved SMC ingrowth was found in the COLGF group compared to the COL group; both scaffold groups showed normal urothelial lining and standard extracellular matrix development. Bladder regeneration using a collagen-heparin scaffold with VEGF, FGF2, and HB-EGF improved bladder tissue regeneration in a large animal model of diseased bladder. Larger GF-loaded constructs need to be tested to reach clinically significant augmentation.
Collapse
Affiliation(s)
- Luc A J Roelofs
- 1 Department of Urology Radboudumc Amalia Children's Hospital, Radboud University Medical Center , Nijmegen, The Netherlands
| | - Egbert Oosterwijk
- 1 Department of Urology Radboudumc Amalia Children's Hospital, Radboud University Medical Center , Nijmegen, The Netherlands
| | - Barbara B M Kortmann
- 1 Department of Urology Radboudumc Amalia Children's Hospital, Radboud University Medical Center , Nijmegen, The Netherlands
| | - Willeke F Daamen
- 2 Department of Biochemistry Radboud University Medical Center , Nijmegen, The Netherlands
| | - Dorien M Tiemessen
- 1 Department of Urology Radboudumc Amalia Children's Hospital, Radboud University Medical Center , Nijmegen, The Netherlands
| | - Katrien M Brouwer
- 2 Department of Biochemistry Radboud University Medical Center , Nijmegen, The Netherlands
| | - Alex J Eggink
- 3 Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Center , Rotterdam, The Netherlands
| | - A Jane Crevels
- 1 Department of Urology Radboudumc Amalia Children's Hospital, Radboud University Medical Center , Nijmegen, The Netherlands
| | - Rene M H Wijnen
- 4 Pediatric Surgery, Erasmus MC, University Medical Center , Rotterdam, The Netherlands
| | - Toin H van Kuppevelt
- 2 Department of Biochemistry Radboud University Medical Center , Nijmegen, The Netherlands
| | - Paul J Geutjes
- 1 Department of Urology Radboudumc Amalia Children's Hospital, Radboud University Medical Center , Nijmegen, The Netherlands
| | - Wout F J Feitz
- 1 Department of Urology Radboudumc Amalia Children's Hospital, Radboud University Medical Center , Nijmegen, The Netherlands
| |
Collapse
|
7
|
Sun Y, Geutjes P, Oosterwijk E, Heerschap A. In vivo magnetic resonance imaging of type I collagen scaffold in rat: improving visualization of bladder and subcutaneous implants. Tissue Eng Part C Methods 2014; 20:964-71. [PMID: 24625324 DOI: 10.1089/ten.tec.2014.0046] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Noninvasive monitoring of implanted scaffolds is important to understand their behavior and role in tissue engineering, in particular to follow their degradation and interaction with host tissue. Magnetic resonance imaging (MRI) is well suited for this goal, but its application is often hampered by the low contrast of scaffolds that are prepared from biomaterials such as type I collagen. The aim of this study was to test iron oxide particles incorporation in improving their MRI contrasts, and to follow their degradation and tissue interactions. Scaffolds with and without iron oxide particles were implanted either subcutaneously or on the bladder of rats. At predetermined time points, in vivo MRI were obtained and tissues were then harvested for histology analysis and transmission electron microscopy. The result showed that the incorporation of iron oxide particles improved MRI contrast of the implants, providing information on their location, shapes, and degradation. Second, the host tissue reaction to the type I collagen implants could be observed in both MRI and histology. Finally, MRI also revealed that the degradation and host tissue reaction of iron particles-loaded scaffolds differed between subcutaneous and bladder implantation, which was substantiated by histology.
Collapse
Affiliation(s)
- Yi Sun
- 1 Department of Radiology, Radboud University Nijmegen Medical Centre , Nijmegen, The Netherlands
| | | | | | | |
Collapse
|
8
|
Tourchi A, Inouye BM, Di Carlo HN, Young E, Ko J, Gearhart JP. New advances in the pathophysiologic and radiologic basis of the exstrophy spectrum. J Pediatr Urol 2014; 10:212-8. [PMID: 24461194 DOI: 10.1016/j.jpurol.2013.11.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 11/25/2013] [Indexed: 11/29/2022]
Abstract
The exstrophy-epispadias complex is a rare spectrum of anomalies affecting the genitourinary system, anterior abdominal wall, and pelvis. Recent advances in the repair of classic bladder exstrophy (CBE) and cloacal exstrophy (CE) have resulted in significant changes in outcomes of surgical management (including higher continence rate, fewer surgical complications, and better cosmesis) and health-related quality of life in these patients. These noteworthy changes resulted from advances in the pathophysiological and genetic backgrounds of this disease and better radiologic assessment of the three-dimensional anatomy of the bony pelvis and its musculature. A PubMed search was performed with the keyword exstrophy. The resulting literature pertaining to genetics, stem cells, imaging, tissue engineering, epidemiology, and endocrinology was reviewed. The following represents an overview of the advances in basic science understanding and imaging of the exstrophy-epispadias spectrum and discusses their possible and future effects on the management of CBE and CE.
Collapse
Affiliation(s)
- Ali Tourchi
- Robert D Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, the Johns Hopkins University School of Medicine, 1800 Orleans St. Suite 7304, Baltimore, MD 21287, USA.
| | - Brian M Inouye
- Robert D Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, the Johns Hopkins University School of Medicine, 1800 Orleans St. Suite 7304, Baltimore, MD 21287, USA
| | - Heather N Di Carlo
- Robert D Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, the Johns Hopkins University School of Medicine, 1800 Orleans St. Suite 7304, Baltimore, MD 21287, USA
| | - Ezekiel Young
- Robert D Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, the Johns Hopkins University School of Medicine, 1800 Orleans St. Suite 7304, Baltimore, MD 21287, USA
| | - Joan Ko
- Robert D Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, the Johns Hopkins University School of Medicine, 1800 Orleans St. Suite 7304, Baltimore, MD 21287, USA
| | - John P Gearhart
- Robert D Jeffs Division of Pediatric Urology, James Buchanan Brady Urological Institute, the Johns Hopkins University School of Medicine, 1800 Orleans St. Suite 7304, Baltimore, MD 21287, USA.
| |
Collapse
|
9
|
Roelofs LAJ, Geutjes PJ, Hulsbergen-van de Kaa CA, Eggink AJ, van Kuppevelt TH, Daamen WF, Crevels AJ, van den Berg PP, Feitz WFJ, Wijnen RMH. Prenatal coverage of experimental gastroschisis with a collagen scaffold to protect the bowel. J Pediatr Surg 2013; 48:516-24. [PMID: 23480905 DOI: 10.1016/j.jpedsurg.2012.07.056] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Revised: 06/30/2012] [Accepted: 07/20/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND/PURPOSE In fetuses with gastroschisis, toxic products in the amniotic fluid and constriction at the defect of the abdominal wall are considered causative of damage to the eviscerated bowel. The aim of this study was to cover the eviscerated bowel in gastroschisis with a collagen scaffold to protect the bowel and induce cell growth into the scaffold, which could lead to skin or abdominal wall formation replacing the scaffold. METHODS In 12 fetal lambs gastroschisis was surgically created at 79 days gestation. A dual-layer type I collagen scaffold was sutured into the skin of the abdominal wall around the defect covering the eviscerated bowel. Lambs were examined after caesarean section at 140 days' gestation. RESULTS Survival was 67%. In 7 of 8 surviving lambs the bowel was found to be covered after birth. One scaffold had ruptured. The bowel was found repositioned in the abdominal cavity in 5 lambs. In 2 lambs it was still partially outside. Only minor adherence of bowel loops and no fibrous peel formation were seen. Connective tissue and skin tissue replaced the scaffold. CONCLUSIONS Prenatal coverage of the bowel in experimental gastroschisis with a collagen scaffold is feasible in fetal lambs, significantly diminished damage to the bowel wall, and skin and connective tissue replaced the scaffold. This technique may be promising in the care of fetuses with this congenital anomaly.
Collapse
Affiliation(s)
- Luc A J Roelofs
- Department of Urology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Janssen DAW, Geutjes PJ, Odenthal J, van Kuppevelt TH, Schalken JA, Feitz WFJ, Heesakkers JFPA. A new, straightforward ex vivo organoid bladder mucosal model for preclinical research. J Urol 2013; 190:341-9. [PMID: 23306090 DOI: 10.1016/j.juro.2012.12.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE We developed an experimental ex vivo organoid bladder mucosal model that can be used for experimental research purposes to create alternatives to current animal models. MATERIALS AND METHODS We developed an ex vivo organoid bladder mucosal model by immobilizing a type I collagen scaffold on the bottom of a Transwell® insert, creating a 2-compartment system. Mucosal biopsies from porcine bladders were placed on top of the scaffold and cultured in different mediums. We evaluated the morphological aspects of biopsy tissue. Cultured samples were assessed by scanning electron microscopy, and immunohistochemical and histochemical staining for cell identification, proliferation and morphology. RESULTS Cells remained viable in Dulbecco's modified Eagle's medium/F-12 and smooth muscle cell medium for up to 3 weeks. The mucosa retained normal morphological characteristics for up to 1 week. Cells (mostly urothelial cells) proliferated and fully covered the scaffold surface within 3 weeks. CONCLUSIONS We developed an experimental ex vivo organoid model of bladder mucosa for preclinical experimental research. This model could be used for high volume screening for pharmacology and toxicology experiments. It has the potential to replace currently used animal models.
Collapse
Affiliation(s)
- Dick A W Janssen
- Department of Urology 659, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
11
|
Brouwer KM, Daamen WF, Reijnen D, Verstegen RH, Lammers G, Hafmans TG, Wismans RG, van Kuppevelt TH, Wijnen RM. Repair of surgically created diaphragmatic defect in rat with use of a crosslinked porous collagen scaffold. J Tissue Eng Regen Med 2012; 7:552-61. [DOI: 10.1002/term.549] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 10/07/2011] [Accepted: 11/15/2011] [Indexed: 11/11/2022]
Affiliation(s)
- Katrien M. Brouwer
- Dept. of Biochemistry 280, NCMLS; Radboud University Nijmegen Medical Centre; P.O. Box 9101; 6500 HB; Nijmegen; The Netherlands
| | - Willeke F. Daamen
- Dept. of Biochemistry 280, NCMLS; Radboud University Nijmegen Medical Centre; P.O. Box 9101; 6500 HB; Nijmegen; The Netherlands
| | - Daphne Reijnen
- Central Animal Facility 231; Radboud University Nijmegen Medical Centre; Geert Grooteplein Noord 29; 6525 EZ; Nijmegen; The Netherlands
| | - Ruud H. Verstegen
- Dept. of Surgery; Radboud University Nijmegen Medical Centre; P.O. Box 9101; 6500 HB; Nijmegen; The Netherlands
| | - Gerwen Lammers
- Dept. of Biochemistry 280, NCMLS; Radboud University Nijmegen Medical Centre; P.O. Box 9101; 6500 HB; Nijmegen; The Netherlands
| | - Theo G. Hafmans
- Dept. of Biochemistry 280, NCMLS; Radboud University Nijmegen Medical Centre; P.O. Box 9101; 6500 HB; Nijmegen; The Netherlands
| | - Ronnie G. Wismans
- Dept. of Biochemistry 280, NCMLS; Radboud University Nijmegen Medical Centre; P.O. Box 9101; 6500 HB; Nijmegen; The Netherlands
| | - Toin H. van Kuppevelt
- Dept. of Biochemistry 280, NCMLS; Radboud University Nijmegen Medical Centre; P.O. Box 9101; 6500 HB; Nijmegen; The Netherlands
| | - René M. Wijnen
- Dept. of Surgery; Radboud University Nijmegen Medical Centre; P.O. Box 9101; 6500 HB; Nijmegen; The Netherlands
| |
Collapse
|
12
|
Deprest JA, Flake AW, Gratacos E, Ville Y, Hecher K, Nicolaides K, Johnson MP, Luks FI, Adzick NS, Harrison MR. The making of fetal surgery. Prenat Diagn 2010; 30:653-67. [PMID: 20572114 DOI: 10.1002/pd.2571] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Fetal diagnosis prompts the question for fetal therapy in highly selected cases. Some conditions are suitable for in utero surgical intervention. This paper reviews historically important steps in the development of fetal surgery. The first invasive fetal intervention in 1963 was an intra-uterine blood transfusion. It took another 20 years to understand the pathophysiology of other candidate fetal conditions and to develop safe anaesthetic and surgical techniques before the team at the University of California at San Francisco performed its first urinary diversion through hysterotomy. This procedure would be abandoned as renal and pulmonary function could be just as effectively salvaged by ultrasound-guided insertion of a bladder shunt. Fetoscopy is another method for direct access to the feto-placental unit. It was historically used for fetal visualisation to guide biopsies or for vascular access but was also abandoned following the introduction of high-resolution ultrasound. Miniaturisation revived fetoscopy in the 1990 s, since when it has been successfully used to operate on the placenta and umbilical cord. Today, it is also used in fetuses with congenital diaphragmatic hernia (CDH), in whom lung growth is triggered by percutaneous tracheal occlusion. It can also be used to diagnose and treat urinary obstruction. Many fetal interventions remain investigational but for a number of conditions randomised trials have established the role of in utero surgery, making fetal surgery a clinical reality in a number of fetal therapy programmes. The safety of fetal surgery is such that even non-lethal conditions, such as myelomeningocoele repair, are at this moment considered a potential indication. This, as well as fetal intervention for CDH, is currently being investigated in randomised trials.
Collapse
Affiliation(s)
- Jan A Deprest
- Division Woman and Child, University Hospitals KU Leuven, Leuven, Belgium.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Fry C, Daneshgari F, Thor K, Drake M, Eccles R, Kanai A, Birder L. Animal models and their use in understanding lower urinary tract dysfunction. Neurourol Urodyn 2010; 29:603-8. [DOI: 10.1002/nau.20903] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|