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Kapat K, Gondane P, Kumbhakarn S, Takle S, Sable R. Challenges and Opportunities in Developing Tracheal Substitutes for the Recovery of Long-Segment Defects. Macromol Biosci 2024:e2400054. [PMID: 39008817 DOI: 10.1002/mabi.202400054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 06/21/2024] [Indexed: 07/17/2024]
Abstract
Tracheal resection and reconstruction procedures are necessary when stenosis, tracheomalacia, tumors, vascular lesions, or tracheal injury cause a tracheal blockage. Replacement with a tracheal substitute is often recommended when the trauma exceeds 50% of the total length of the trachea in adults and 30% in children. Recently, tissue engineering and other advanced techniques have shown promise in fabricating biocompatible tracheal substitutes with physical, morphological, biomechanical, and biological characteristics similar to native trachea. Different polymers and biometals are explored. Even with limited success with tissue-engineered grafts in clinical settings, complete healing of tracheal defects remains a substantial challenge due to low mechanical strength and durability of the graft materials, inadequate re-epithelialization and vascularization, and restenosis. This review has covered a range of reconstructive and regenerative techniques, design criteria, the use of bioprostheses and synthetic grafts for the recovery of tracheal defects, as well as the traditional and cutting-edge methods of their fabrication, surface modification for increased immuno- or biocompatibility, and associated challenges.
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Affiliation(s)
- Kausik Kapat
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research Kolkata, 168, Maniktala Main Road, Kankurgachi, Kolkata, West Bengal, 700054, India
| | - Prashil Gondane
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research Kolkata, 168, Maniktala Main Road, Kankurgachi, Kolkata, West Bengal, 700054, India
| | - Sakshi Kumbhakarn
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research Kolkata, 168, Maniktala Main Road, Kankurgachi, Kolkata, West Bengal, 700054, India
| | - Shruti Takle
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research Kolkata, 168, Maniktala Main Road, Kankurgachi, Kolkata, West Bengal, 700054, India
| | - Rahul Sable
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research Kolkata, 168, Maniktala Main Road, Kankurgachi, Kolkata, West Bengal, 700054, India
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2
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Neto AE, Foltz KM, Fuchs T, Gamba LK, Denk MA, Silveira PCL, do Nascimento TG, Clemencia AM, Francisco JC, de Noronha L, Guarita-Souza LC. Decellularized Wharton's Jelly and Amniotic Membrane Demonstrate Potential Therapeutic Implants in Tracheal Defects in Rabbits. Life (Basel) 2024; 14:782. [PMID: 38929764 PMCID: PMC11204711 DOI: 10.3390/life14060782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/12/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Tracheal grafts have been investigated for over a century, aiming to replace various lesions. However, tracheal reconstruction surgery remains a challenge, primarily due to anatomical considerations, intraoperative airway management, the technical complexity of reconstruction, and the potential postoperative morbidity and mortality. Due to research development, the amniotic membrane (AM) and Wharton's Jelly (WJ) arise as alternatives within the new set of therapeutic alternatives. These structures hold significant therapeutic potential for tracheal defects. This study analyzed the capacity of tracheal tissue regeneration after 60 days of decellularized WJ and AM implantation in rabbits submitted to conventional tracheostomy. METHODS An in vivo experimental study was carried out using thirty rabbits separated into three groups (Control, AM, and WJ) (n = 10). The analyses were performed 60 days after surgery through immunohistochemistry. RESULTS Different immunomarkers related to scar regeneration, such as aggrecan, TGF-β1, and α-SMA, were analyzed. However, they highlighted no significant difference between the groups. Collagen type I, III, and Aggrecan also showed no significant difference between the groups. CONCLUSIONS Both scaffolds appeared to be excellent frameworks for tissue engineering, presenting biocompatibility and a desirable microenvironment for cell survival; however, they did not display histopathological benefits in trachea tissue regeneration.
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Affiliation(s)
- Aloysio Enck Neto
- Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba 80215-901, PR, Brazil; (K.M.F.); (L.K.G.); (T.G.d.N.); (J.C.F.); (L.d.N.); (L.C.G.-S.)
| | - Katia Martins Foltz
- Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba 80215-901, PR, Brazil; (K.M.F.); (L.K.G.); (T.G.d.N.); (J.C.F.); (L.d.N.); (L.C.G.-S.)
| | - Thiago Fuchs
- Veterinary Medicine Undergraduated Program, University of Contestado (UNC), Mafra 89300-000, SC, Brazil;
| | - Luize Kremer Gamba
- Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba 80215-901, PR, Brazil; (K.M.F.); (L.K.G.); (T.G.d.N.); (J.C.F.); (L.d.N.); (L.C.G.-S.)
| | - Marcos Antonio Denk
- Biomedicine Undergraduate Program, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, PR, Brazil;
| | - Paulo Cesar Lock Silveira
- Program of Postgraduate in Science of Health, Laboratory of Experimental Physiopathology, Universidade do Extremo Sul Catarinense (UNESC), Criciúma 88806-000, SC, Brazil; (P.C.L.S.); (A.M.C.)
| | - Thatyanne Gradowski do Nascimento
- Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba 80215-901, PR, Brazil; (K.M.F.); (L.K.G.); (T.G.d.N.); (J.C.F.); (L.d.N.); (L.C.G.-S.)
| | - Alice Machado Clemencia
- Program of Postgraduate in Science of Health, Laboratory of Experimental Physiopathology, Universidade do Extremo Sul Catarinense (UNESC), Criciúma 88806-000, SC, Brazil; (P.C.L.S.); (A.M.C.)
| | - Julio César Francisco
- Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba 80215-901, PR, Brazil; (K.M.F.); (L.K.G.); (T.G.d.N.); (J.C.F.); (L.d.N.); (L.C.G.-S.)
| | - Lucia de Noronha
- Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba 80215-901, PR, Brazil; (K.M.F.); (L.K.G.); (T.G.d.N.); (J.C.F.); (L.d.N.); (L.C.G.-S.)
| | - Luiz César Guarita-Souza
- Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba 80215-901, PR, Brazil; (K.M.F.); (L.K.G.); (T.G.d.N.); (J.C.F.); (L.d.N.); (L.C.G.-S.)
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3
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Wan H, Xiang J, Mao G, Pan S, Li B, Lu Y. Recent Advances in the Application of 3D-Printing Bioinks Based on Decellularized Extracellular Matrix in Tissue Engineering. ACS OMEGA 2024; 9:24219-24235. [PMID: 38882108 PMCID: PMC11170705 DOI: 10.1021/acsomega.4c02847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/10/2024] [Accepted: 05/17/2024] [Indexed: 06/18/2024]
Abstract
In recent years, 3D bioprinting with various types of bioinks has been widely used in tissue engineering to fabricate human tissues and organs with appropriate biological functions. Decellularized extracellular matrix (dECM) is an excellent bioink candidate because it is enriched with a variety of bioactive proteins and bioactive factors and can provide a suitable environment for tissue repair or tissue regeneration while reducing the likelihood of severe immune rejection. In this Review, we systematically review recent advances in 3D bioprinting and decellularization technologies and comprehensively detail the latest research and applications of dECM as a bioink for tissue engineering in various systems, with the aim of providing a reference for researchers in tissue engineering to better understand the properties of dECM bioinks.
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Affiliation(s)
- Haoxin Wan
- Department
of Thoracic Surgery, The First Affiliated
Hospital of Soochow University, Suzhou 215000, China
| | - Jian Xiang
- Affiliated
Hospital of Yangzhou University, Yangzhou 225000, China
| | - Guocai Mao
- Department
of Thoracic Surgery, The First Affiliated
Hospital of Soochow University, Suzhou 215000, China
| | - Shu Pan
- Department
of Thoracic Surgery, The First Affiliated
Hospital of Soochow University, Suzhou 215000, China
| | - Bing Li
- The
Second Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - Yi Lu
- Clinical
Medical College, Yangzhou University, Yangzhou 225000, China
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4
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Yang M, Li H, Zhou Y, Li H, Wei H, Cheng Q. Airway collapse hinders recovery in bronchoscopy therapy for postintubation tracheal stenosis patients. Eur Arch Otorhinolaryngol 2024; 281:3061-3069. [PMID: 38582815 PMCID: PMC11065913 DOI: 10.1007/s00405-024-08602-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/05/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Expiratory central airway collapse (ECAC) following postintubation airway stenosis (PITS) is a rare phenomenon. The impact of airway malacia and collapse on the prognosis and the success rate of bronchoscopic interventional therapy in patients with PITS had been inadequately investigated. OBJECTIVE The aim of this research was to assess the influence of airway malacia and collapse on the efficacy of bronchoscopic interventional therapy in patients with PITS. DESIGN This retrospective analysis examined the medical documentation of individuals diagnosed with PITS who underwent bronchoscopic intervention at the tertiary interventional pulmonology center of Emergency General Hospital from 2014 to 2021. MAIN OUTCOME MEASURES Data pertaining to preoperative, perioperative, and postoperative stages were documented and subjected to analysis. RESULTS The patients in malacia and collapse group (MC group) exhibited a higher frequency of perioperative complications, including intraoperative hypoxemia, need for reoperation within 24 h, and postoperative intensive care unit admission rate (P < 0.05, respectively). Meanwhile, patients in group MC demonstrated significantly worse postoperative scores (higher mMRC score and lower KPS score) compared to those in pure stenosis group (P < 0.05, respectively), along with higher degrees of stenosis after treatment and a lower success rate of bronchoscopic intervention therapy cured (P < 0.05, respectively). Pearson analysis results showed that these terms were all significantly correlated with the occurrence of airway malacia and collapse in the airway (P < 0.05, respectively). CONCLUSION The presence of malacia or collapse in patients with PITS was associated with increased perioperative complications following bronchoscopic interventional therapy, and significantly reduced the long-term cure rate compared to patients with pure tracheal stenosis. Trial registration Chinese Clinical Trial Registry on 06/12/2021. REGISTRATION NUMBER ChiCTR2100053991.
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Affiliation(s)
- Mingyuan Yang
- Center of Anesthesiology and Pain, Emergency General Hospital, Beijing, 100028, China
| | - Hong Li
- Center of Anesthesiology and Pain, Emergency General Hospital, Beijing, 100028, China
| | - Yunzhi Zhou
- Department of Pulmonary and Critical Care Medicine, Emergency General Hospital, Beijing, China
| | - Hao Li
- Center of Anesthesiology and Pain, Emergency General Hospital, Beijing, 100028, China
| | - Huafeng Wei
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Qinghao Cheng
- Center of Anesthesiology and Pain, Emergency General Hospital, Beijing, 100028, China.
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5
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de Frémicourt K, Wurtz A, Georgescu D, Sarsam M. Extended autologous tracheal replacement by a novel pedicled thoraco-chondro-costal flap: a cadaveric proof of concept. Eur J Cardiothorac Surg 2024; 65:ezae063. [PMID: 38400739 DOI: 10.1093/ejcts/ezae063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/21/2023] [Accepted: 02/21/2024] [Indexed: 02/26/2024] Open
Abstract
OBJECTIVES Our aim was to report an anatomic model of an autologous flap based on the internal thoracic blood supply: the pedicled thoraco-chondro-costal flap; and establish the feasibility of various types of extended tracheal replacement with this novel flap, according to a newly proposed topographic classification. METHODS In a cadaveric model, a cervicotomy combined with median sternotomy was performed. The incision was extended laterally to expose the chest wall. The internal thoracic pedicle was freed from its origin down to the upper limit of the delineated flap to be elevated. The perichondria and adjacent periostea were incised longitudinally to remove cartilages and adjacent rib segments, preserving perichondria and periostea. A full-thickness quadrangular chest wall flap pedicled on internal thoracic vessels was then elevated and shaped into a neo conduit to replace the trachea with the pleura as an inner lining. RESULTS Various types of extended non-circumferential and full-circumferential tracheal replacements were achieved with this composite flap. No anastomosis tension was noticed despite the absence of release manoeuvres. CONCLUSIONS This model could represent a suitable autologous tracheal substitute, which is long, longitudinally flexible and eventually transversely rigid. No microsurgical vascular anastomoses are required. The technique is reproducible. The perichondria and periostea would regenerate vascularized neo-cartilaginous rings, potentially decreasing the need for long-term stenting. The inner pleural lining could potentially transform into ciliated epithelium as shown in previous preclinical studies.
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Affiliation(s)
- Kim de Frémicourt
- Department of ENT and Oncological Surgery, Henri Becquerel Anticancer Center, Rouen, 1 Rue d'Amiens, 76038, Rouen, France
| | - Alain Wurtz
- Lille University, 1 Pl. de Verdun, Lille, 59000, France
| | - Dragos Georgescu
- Department of ENT and Oncological Surgery, Henri Becquerel Anticancer Center, Rouen, 1 Rue d'Amiens, 76038, Rouen, France
| | - Matthieu Sarsam
- Department of Thoracic and Cardiac Surgery, Rouen University Hospital, 37 Bd Gambetta, 76000, Rouen, France
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Wang B, Fei X, Yin HF, Xu XN, Zhu JJ, Guo ZY, Wu JW, Zhu XS, Zhang Y, Xu Y, Yang Y, Chen LS. Photothermal-Controllable Microneedles with Antitumor, Antioxidant, Angiogenic, and Chondrogenic Activities to Sequential Eliminate Tracheal Neoplasm and Reconstruct Tracheal Cartilage. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2309454. [PMID: 38098368 DOI: 10.1002/smll.202309454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Indexed: 03/16/2024]
Abstract
The optimal treatment for tracheal tumors necessitates sequential tumor elimination and tracheal cartilage reconstruction. This study introduces an innovative inorganic nanosheet, MnO2 /PDA@Cu, comprising manganese dioxide (MnO2 ) loaded with copper ions (Cu) through in situ polymerization using polydopamine (PDA) as an intermediary. Additionally, a specialized methacrylic anhydride modified decellularized cartilage matrix (MDC) hydrogel with chondrogenic effects is developed by modifying a decellularized cartilage matrix with methacrylic anhydride. The MnO2 /PDA@Cu nanosheet is encapsulated within MDC-derived microneedles, creating a photothermal-controllable MnO2 /PDA@Cu-MDC microneedle. Effectiveness evaluation involved deep insertion of the MnO2 /PDA@Cu-MDC microneedle into tracheal orthotopic tumor in a murine model. Under 808 nm near-infrared irradiation, facilitated by PDA, the microneedle exhibited rapid overheating, efficiently eliminating tumors. PDA's photothermal effects triggered controlled MnO2 and Cu release. The MnO2 nanosheet acted as a potent inorganic nanoenzyme, scavenging reactive oxygen species for an antioxidant effect, while Cu facilitated angiogenesis. This intervention enhanced blood supply at the tumor excision site, promoting stem cell enrichment and nutrient provision. The MDC hydrogel played a pivotal role in creating a chondrogenic niche, fostering stem cells to secrete cartilaginous matrix. In conclusion, the MnO2 /PDA@Cu-MDC microneedle is a versatile platform with photothermal control, sequentially combining antitumor, antioxidant, pro-angiogenic, and chondrogenic activities to orchestrate precise tracheal tumor eradication and cartilage regeneration.
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Affiliation(s)
- B Wang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - X Fei
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - H F Yin
- Department of Infection Management, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - X N Xu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - J J Zhu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - Z Y Guo
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - J W Wu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - X S Zhu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - Y Zhang
- Department of Orthopedics, Shanghai Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China
| | - Y Xu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - Y Yang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
- Central Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
- School of Materials Science and Engineering, Tongji University, Shanghai, 201804, China
| | - L S Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
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7
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Klabukov I, Atiakshin D, Kogan E, Ignatyuk M, Krasheninnikov M, Zharkov N, Yakimova A, Grinevich V, Pryanikov P, Parshin V, Sosin D, Kostin AA, Shegay P, Kaprin AD, Baranovskii D. Post-Implantation Inflammatory Responses to Xenogeneic Tissue-Engineered Cartilage Implanted in Rabbit Trachea: The Role of Cultured Chondrocytes in the Modification of Inflammation. Int J Mol Sci 2023; 24:16783. [PMID: 38069106 PMCID: PMC10706106 DOI: 10.3390/ijms242316783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Immune responses to tissue-engineered grafts made of xenogeneic materials remain poorly studied. The scope of current investigations is limited by the lack of information on orthotopically implanted grafts. A deeper understanding of these processes is of great importance since innovative surgical approaches include the implantation of xenogeneic decellularized scaffolds seeded by cells. The purpose of our work is to study the immunological features of tracheal repair during the implantation of tissue-engineered constructs based on human xenogeneic scaffolds modified via laser radiation in rabbits. The samples were stained with hematoxylin and Safranin O, and they were immunostained with antibodies against tryptase, collagen II, vimentin, and CD34. Immunological and inflammatory responses were studied by counting immune cells and evaluating blood vessels and collagen. Leukocyte-based inflammation prevailed during the implantation of decellularized unseeded scaffolds; meanwhile, plasma cells were significantly more abundant in tissue-engineered constructs. Mast cells were insignificantly more abundant in tissue-engineered construct samples. Conclusions: The seeding of decellularized xenogeneic cartilage with chondrocytes resulted in a change in immunological reactions upon implantation, and it was associated with plasma cell infiltration. Tissue-engineered grafts widely differed in design, including the type of used cells. The question of immunological response depending on the tissue-engineered graft composition requires further investigation.
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Affiliation(s)
- Ilya Klabukov
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
- Obninsk Institute for Nuclear Power Engineering, National Research Nuclear University MEPhI, 249031 Obninsk, Russia
| | - Dmitri Atiakshin
- Scientific and Educational Resource Center for Innovative Technologies of Immunophenotyping, Digital Spatial Profiling and Ultrastructural Analysis, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Evgenia Kogan
- Strukov Department of Pathological Anatomy, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Michael Ignatyuk
- Scientific and Educational Resource Center for Innovative Technologies of Immunophenotyping, Digital Spatial Profiling and Ultrastructural Analysis, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Mikhail Krasheninnikov
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Nickolay Zharkov
- Strukov Department of Pathological Anatomy, Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Anna Yakimova
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
| | - Vyacheslav Grinevich
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
| | - Pavel Pryanikov
- Russian Child Clinical Hospital, Pirogov Russian National Research Medical University, 119571 Moscow, Russia
| | - Vladimir Parshin
- National Medical Research Center of Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation, 127473 Moscow, Russia
| | - Dmitry Sosin
- Centre for Strategic Planning and Management of Biomedical Health Risks of the Federal Medical Biological Agency, 119121 Moscow, Russia
| | - Andrey A. Kostin
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Peter Shegay
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
| | - Andrey D. Kaprin
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Denis Baranovskii
- National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Koroleva St. 4, 249036 Obninsk, Russia; (A.Y.)
- Department of Urology and Operative Nephrology, Patrice Lumumba Peoples Friendship University of Russia (RUDN University), 117198 Moscow, Russia
- Department of Biomedicine, University of Basel, Petersplatz 1, 4001 Basel, Switzerland
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8
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Khan RL, Khraibi AA, Dumée LF, Corridon PR. From waste to wealth: Repurposing slaughterhouse waste for xenotransplantation. Front Bioeng Biotechnol 2023; 11:1091554. [PMID: 36815880 PMCID: PMC9935833 DOI: 10.3389/fbioe.2023.1091554] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Slaughterhouses produce large quantities of biological waste, and most of these materials are underutilized. In many published reports, the possibility of repurposing this form of waste to create biomaterials, fertilizers, biogas, and feeds has been discussed. However, the employment of particular offal wastes in xenotransplantation has yet to be extensively uncovered. Overall, viable transplantable tissues and organs are scarce, and developing bioartificial components using such discarded materials may help increase their supply. This perspective manuscript explores the viability and sustainability of readily available and easily sourced slaughterhouse waste, such as blood vessels, eyes, kidneys, and tracheas, as starting materials in xenotransplantation derived from decellularization technologies. The manuscript also examines the innovative use of animal stem cells derived from the excreta to create a bioartificial tissue/organ platform that can be translated to humans. Institutional and governmental regulatory approaches will also be outlined to support this endeavor.
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Affiliation(s)
- Raheema L. Khan
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Ali A. Khraibi
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Ludovic F. Dumée
- Department of Chemical Engineering, College of Engineering, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Research and Innovation Center on CO2 and Hydrogen (RICH), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Peter R. Corridon
- Department of Immunology and Physiology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Healthcare Engineering Innovation Center, Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
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9
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Martinod E, Radu DM, Onorati I, Portela AMS, Peretti M, Guiraudet P, Destable MD, Uzunhan Y, Freynet O, Chouahnia K, Duchemann B, Kabbani J, Maurer C, Brillet PY, Fath L, Brenet E, Debry C, Buffet C, Leenhardt L, Clero D, Julien N, Vénissac N, Tronc F, Dutau H, Marquette CH, Juvin C, Lebreton G, Cohen Y, Zogheib E, Beloucif S, Planès C, Trésallet C, Bensidhoum M, Petite H, Rouard H, Miyara M, Vicaut E. Airway replacement using stented aortic matrices: Long-term follow-up and results of the TRITON-01 study in 35 adult patients. Am J Transplant 2022; 22:2961-2970. [PMID: 35778956 DOI: 10.1111/ajt.17137] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/14/2022] [Accepted: 06/23/2022] [Indexed: 01/25/2023]
Abstract
Over the past 25 years, we have demonstrated the feasibility of airway bioengineering using stented aortic matrices experimentally then in a first-in-human trial (n = 13). The present TRITON-01 study analyzed all the patients who had airway replacement at our center to confirm that this innovative approach can be now used as usual care. For each patient, the following data were prospectively collected: postoperative mortality and morbidity, late airway complications, stent removal and status at last follow-up on November 2, 2021. From October 2009 to October 2021, 35 patients had airway replacement for malignant (n = 29) or benign (n = 6) lesions. The 30-day postoperative mortality and morbidity rates were 2.9% (n = 1/35) and 22.9% (n = 8/35) respectively. At a median follow-up of 29.5 months (range 1-133 months), 27 patients were alive. There have been no deaths directly related to the implanted bioprosthesis. Eighteen patients (52.9%) had stent-related granulomas requiring a bronchoscopic treatment. Ten among 35 patients (28.6%) achieved a stent free survival. The actuarial 2- and 5-year survival rates (Kaplan-Meier estimates) were respectively 88% and 75%. The TRITON-01 study confirmed that airway replacement using stented aortic matrices can be proposed as usual care at our center. Clinicaltrials.gov Identifier: NCT04263129.
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Affiliation(s)
- Emmanuel Martinod
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Université Paris Cité, Fondation Alain Carpentier, Laboratoire de Recherche Bio-chirurgicale, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Dana M Radu
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Université Paris Cité, Fondation Alain Carpentier, Laboratoire de Recherche Bio-chirurgicale, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Ilaria Onorati
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Université Paris Cité, Fondation Alain Carpentier, Laboratoire de Recherche Bio-chirurgicale, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Ana Maria Santos Portela
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Marine Peretti
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Patrice Guiraudet
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Marie-Dominique Destable
- Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Yurdagül Uzunhan
- Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Pneumologie, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Olivia Freynet
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Pneumologie, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Kader Chouahnia
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Oncologie, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Boris Duchemann
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Oncologie, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Jamal Kabbani
- Hôpital Le Raincy-Montfermeil, Pneumologie, Montfermeil, France
| | - Cyril Maurer
- Hôpital Le Raincy-Montfermeil, Pneumologie, Montfermeil, France
| | - Pierre-Yves Brillet
- Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France.,AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Radiologie, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Léa Fath
- Hôpitaux Universitaires de Strasbourg, Oto-Rhino-Laryngologie, Strasbourg, France
| | - Esteban Brenet
- Centre Hospitalier Universitaire de Reims, Oto-Rhino-Laryngologie, Reims, France
| | - Christian Debry
- Hôpitaux Universitaires de Strasbourg, Oto-Rhino-Laryngologie, Strasbourg, France
| | - Camille Buffet
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Endocrinologie, Paris, France
| | - Laurence Leenhardt
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Endocrinologie, Paris, France
| | - Dominique Clero
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Oto-Rhino-Laryngologie, Paris, France
| | - Nicolas Julien
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Oto-Rhino-Laryngologie, Paris, France
| | - Nicolas Vénissac
- Hôpitaux Universitaires de Lille, Chirurgie Thoracique, Lille, France
| | - François Tronc
- Hôpitaux Universitaires de Lyon, Chirurgie Thoracique, Lyon, France
| | - Hervé Dutau
- Assistance Publique - Hôpitaux de Marseille, Pneumologie, Hôpital Universitaire Nord, Marseille, France
| | | | - Charles Juvin
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Chirurgie Cardiaque, Paris, France
| | - Guillaume Lebreton
- AP-HP, Sorbonne Université, Hôpital La Pitié-Salpêtrière, Chirurgie Cardiaque, Paris, France
| | - Yves Cohen
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Réanimation, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Elie Zogheib
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Anesthésie-Réanimation, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Sadek Beloucif
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Anesthésie-Réanimation, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Carole Planès
- Inserm UMR1272, Hypoxie et Poumon, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | - Christophe Trésallet
- AP-HP, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Digestive, Université Sorbonne Paris Nord, Faculté de Médecine SMBH, Bobigny, France
| | | | - Hervé Petite
- B3OA UMR CNRS 7052, Université Paris Cité CNRS, Paris, France
| | - Hélène Rouard
- AP-HP, EFS Ile de France, Banque des Tissus, La Plaine Saint-Denis, France
| | - Makoto Miyara
- Sorbonne Université, Inserm, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Département d'Immunologie, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Eric Vicaut
- AP-HP, Unité de Recherche Clinique, Hôpitaux Saint Louis-Lariboisière-Fernand Widal, Université Paris Cité, Paris, France
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10
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Glycosaminoglycan, Antimicrobial Defence Molecule and Cytokine Appearance in Tracheal Hyaline Cartilage of Healthy Humans. J Funct Morphol Kinesiol 2022; 7:jfmk7030055. [PMID: 35893329 PMCID: PMC9326615 DOI: 10.3390/jfmk7030055] [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: 06/27/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open
Abstract
Hyaline cartilage is an important tracheal structure, yet little is known about its molecular composition, complicating investigation of pathologies and replacement options. Our aim was to research tracheal hyaline cartilage structure, protective tissue factors and variations in healthy humans. The tissue material was obtained from 10 cadavers obtained from the Riga Stradins University Institute of Anatomy and Anthropology archive. Tissues were stained with Bismarck brown and PAS for glycosaminoglycans, and immunohistochemistry was performed for HBD-2, HBD-3, HBD-4, IL-10 and LL-37. The slides were inspected by light microscopy and Spearman's rank correlation coefficient was calculated. The extracellular matrix was positive across hyaline cartilage for PAS, yet Bismarck brown marked positive proliferation and growth zones. Numerous positive cells for both factors were found in all zones. All of the antimicrobial defence molecules and cytokines were found in a moderate number of cells, except in the mature cell zone with few positive cells. Spearman's rank correlation coefficient revealed strong and moderate correlations between studied factors. Hyaline cartilage is a tracheal defence structure with a moderate number of antimicrobial defence protein and cytokine immunoreactive cells as well as numerous glycosaminoglycan positive cells. The extracellular matrix glycosaminoglycans provide structural scaffolding and intercellular signalling. The correlations between the studied factors confirm the synergistic activity of them.
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11
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Illuzzi E, Wells C, Hackett A, Ricco D, Haran A, Gittens C, Sevillano M, Castro M, Develleres E, Ramos MS, Zhang Z, Oropello J, Kohli-Seth R. Postoperative Nursing Care of a Deceased Donor Tracheal Transplant Recipient. Crit Care Nurse 2022; 42:12-18. [PMID: 35640895 DOI: 10.4037/ccn2022747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Certain airway disorders, such as tracheal stenosis, can severely affect the ability to breathe, reduce quality of life, and increase morbidity and mortality. Treatment options for long-segment tracheal stenosis include multistage tracheal replacement with biosynthetic material, autotransplantation, and allotransplantation. These interventions have not demonstrated long-term dependable results because of lack of adequate blood supply to the organ and ciliated epithelium. A new transplant program featuring single-stage long-segment tracheal transplant addresses this concern. CLINICAL FINDINGS The patient was a 56-year-old woman with a history of obesity, type 2 diabetes, hypertension, hyperlipidemia, liver sarcoidosis, 105-pack-year smoking history, and asthma. A severe asthma exacerbation in 2014 required prolonged intubation, and she subsequently developed long-segment cricotracheal stenosis. In 2015 she underwent an unsuccessful tracheal resection followed by failed attempts at tracheal stenting and dilation procedures. These attempts at stenting resulted in a permanent extended-length tracheostomy and ultimately ventilator dependency. INTERVENTIONS The patient underwent a single-stage long-segment deceased donor tracheal transplant. Important nursing considerations included hemodynamic monitoring, airway management and securement, graft assessment, stoma and wound care, nutrition, medication administration, and patient education. CONCLUSION High-quality nursing care postoperatively in the intensive care unit is critical to safe and effective treatment of the tracheal transplant recipient and success of the graft. To effectively treat these patients, nurses need relevant education and training. This article is the first documentation of postoperative nursing care following single-stage long-segment tracheal transplant.
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Affiliation(s)
- Ella Illuzzi
- Ella Illuzzi is a nurse practitioner in the transplant intensive care unit at Mount Sinai Hospital, New York, New York
| | - Celia Wells
- Celia Wells is the Senior Director of Nursing at Mount Sinai Hospital
| | - Anna Hackett
- Anna Hackett is a clinical research assistant at Mount Sinai Hospital
| | - Darlene Ricco
- Darlene Ricco is a staff nurse in the surgical and transplant intensive care units at Mount Sinai Hospital
| | - Anne Haran
- Anne Haran is a staff nurse in the surgical and transplant intensive care units at Mount Sinai Hospital
| | - Christal Gittens
- Christal Gittens is a staff nurse in the surgical and transplant intensive care units at Mount Sinai Hospital
| | - Maria Sevillano
- Maria Sevillano is a certified wound care nurse at Mount Sinai Hospital
| | - Meryl Castro
- Meryl Castro is a staff nurse in the surgical and transplant intensive care units at Mount Sinai Hospital
| | - Eva Develleres
- Eva Develleres is a staff nurse in the surgical and transplant intensive care units at Mount Sinai Hospital
| | - Mardisa Samson Ramos
- Mardisa Samson Ramos is the nurse manager of the surgical and transplant intensive care units at Mount Sinai Hospital
| | - Ziya Zhang
- Ziya Zhang is a clinical research assistant at Mount Sinai Hospital
| | - John Oropello
- John Oropello is the Director of the transplant intensive care unit at Mount Sinai Hospital
| | - Roopa Kohli-Seth
- Roopa Kohli-Seth is the Director of the Institute for Critical Care Medicine at Mount Sinai Hospital
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12
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Baranovskii D, Demner J, Nürnberger S, Lyundup A, Redl H, Hilpert M, Pigeot S, Krasheninnikov M, Krasilnikova O, Klabukov I, Parshin V, Martin I, Lardinois D, Barbero A. Engineering of Tracheal Grafts Based on Recellularization of Laser-Engraved Human Airway Cartilage Substrates. Cartilage 2022; 13:19476035221075951. [PMID: 35189712 PMCID: PMC9137320 DOI: 10.1177/19476035221075951] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Implantation of tissue-engineered tracheal grafts represents a visionary strategy for the reconstruction of tracheal wall defects after resections and may develop into a last chance for a number of patients with severe cicatricial stenosis. The use of a decellularized tracheal substrate would offer an ideally stiff graft, but the matrix density would challenge efficient remodeling into a living cartilage. In this study, we hypothesized that the pores of decellularized laser-perforated tracheal cartilage (LPTC) tissues can be colonized by adult nasal chondrocytes (NCs) to produce new cartilage tissue suitable for the repair of tracheal defects. DESIGN Human, native tracheal specimens, isolated from cadaveric donors, were exposed to decellularized and laser engraving-controlled superficial perforation (300 μm depth). Human or rabbit NCs were cultured on the LPTCs for 1 week. The resulting revitalized tissues were implanted ectopically in nude mice or orthotopically in tracheal wall defects in rabbits. Tissues were assayed histologically and by microtomography analyses before and after implantation. RESULTS NCs were able to efficiently colonize the pores of the LPTCs. The extent of colonization (i.e., percentage of viable cells spanning >300 μm of tissue depth), cell morphology, and cartilage matrix deposition improved once the revitalized constructs were implanted ectopically in nude mice. LPTCs could be successfully grafted onto the tracheal wall of rabbits without any evidence of dislocation or tracheal stenosis, 8 weeks after implantation. Rabbit NCs, within the LPTCs, actively produced new cartilage matrix. CONCLUSION Implantation of NC-revitalized LPTCs represents a feasible strategy for the repair of tracheal wall defects.
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Affiliation(s)
- Denis Baranovskii
- Thoracic Surgery, University Hospital Basel, Basel, Switzerland,Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland,Department of Regenerative Technologies and Biofabrication, National Medical Research Radiological Center, Obninsk, Russia,Research and Educational Resource Center for Cellular Technologies, Peoples’ Friendship University of Russia, Moscow, Russia
| | - Jan Demner
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Sylvia Nürnberger
- Division of Trauma Surgery, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria,Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna, Austria
| | - Alexey Lyundup
- Research and Educational Resource Center for Cellular Technologies, Peoples’ Friendship University of Russia, Moscow, Russia,Department of Advanced Cell Technologies, Sechenov University, Moscow, Russia
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Vienna, Austria
| | - Morgane Hilpert
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Sebastien Pigeot
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Michael Krasheninnikov
- Research and Educational Resource Center for Cellular Technologies, Peoples’ Friendship University of Russia, Moscow, Russia
| | - Olga Krasilnikova
- Department of Regenerative Technologies and Biofabrication, National Medical Research Radiological Center, Obninsk, Russia,Department of Advanced Cell Technologies, Sechenov University, Moscow, Russia
| | - Ilya Klabukov
- Department of Regenerative Technologies and Biofabrication, National Medical Research Radiological Center, Obninsk, Russia,Department of Advanced Cell Technologies, Sechenov University, Moscow, Russia
| | - Vladimir Parshin
- Institute of Clinical Medicine, Sechenov University, Moscow, Russia
| | - Ivan Martin
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland,Ivan Martin, Department of Biomedicine, Tissue Engineering Laboratory, University Hospital Basel, University of Basel, Basel, 4031, Switzerland.
| | | | - Andrea Barbero
- Department of Biomedicine, University Hospital Basel, University of Basel, Basel, Switzerland
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