1
|
Casarin M, Toniolo I, Todesco M, Carniel EL, Astolfi L, Morlacco A, Moro FD. Mechanical characterization of porcine ureter for the evaluation of tissue-engineering applications. Front Bioeng Biotechnol 2024; 12:1412136. [PMID: 38952671 PMCID: PMC11215493 DOI: 10.3389/fbioe.2024.1412136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 05/21/2024] [Indexed: 07/03/2024] Open
Abstract
Introduction: Clinics increasingly require readily deployable tubular substitutes to restore the functionality of structures like ureters and blood vessels. Despite extensive exploration of various materials, both synthetic and biological, the optimal solution remains elusive. Drawing on abundant literature experiences, there is a pressing demand for a substitute that not only emulates native tissue by providing requisite signals and growth factors but also exhibits appropriate mechanical resilience and behaviour. Methods: This study aims to assess the potential of porcine ureters by characterizing their biomechanical properties in their native configuration through ring and membrane flexion tests. In order to assess the tissue morphology before and after mechanical tests and the eventual alteration of tissue microstructure that would be inserted in material constitutive description, histological staining was performed on samples. Corresponding computational analyses were performed to mimic the experimental campaign to identify the constitutive material parameters. Results: The absence of any damages to muscle and collagen fibres, which only compacted after mechanical tests, was demonstrated. The experimental tests (ring and membrane flexion tests) showed non-linearity for material and geometry and the viscoelastic behaviour of the native porcine ureter. Computational models were descriptive of the mechanical behaviour ureteral tissue, and the material model feasible. Discussion: This analysis will be useful for future comparison with decellularized tissue for the evaluation of the aggression of cell removal and its effect on microstructure. The computational model could lay the basis for a reliable tool for the prediction of solicitation in the case of tubular substitutions in subsequent simulations.
Collapse
Affiliation(s)
- Martina Casarin
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy
| | - Ilaria Toniolo
- Department of Industrial Engineering, University of Padua, Padova, Italy
| | - Martina Todesco
- Department of Civil, Environmental and Architectural Engineering, University of Padua, Padova, Italy
| | | | - Laura Astolfi
- Bioacoustics Research Laboratory, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Alessandro Morlacco
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy
| | - Fabrizio Dal Moro
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy
| |
Collapse
|
2
|
Cai YL, Nan F, Tang GT, Ma Y, Ren Y, Xiong XZ, Zhou RX, Li FY, Cheng NS, Jiang X. Fabrication of 3D printed PCL/PEG artificial bile ducts as supportive scaffolds to promote regeneration of extrahepatic bile ducts in a canine biliary defect model. J Mater Chem B 2023; 11:9443-9458. [PMID: 37727116 DOI: 10.1039/d3tb01250f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
In this study, a 3D porous poly(ε-caprolactone)/polyethylene glycol (PCL/PEG) composite artificial tubular bile duct was fabricated for extrahepatic bile duct regeneration. PCL/PEG composite scaffolds were fabricated by 3D printing, and the molecular structure, mechanical properties, thermal properties, morphology, and in vitro biocompatibility were characterized for further application as artificial bile ducts. A bile duct defect model was established in beagle dogs for in vivo implantation. The results demonstrated that the implanted PE1 ABD, serving as a supportive scaffold, effectively stimulated the regeneration of a new bile duct comprising CK19-positive and CK7-positive epithelial cells within 30 days. Remarkably, after 8 months, the newly formed bile duct exhibited an epithelial layer resembling the normal structure. Furthermore, the study revealed collagen deposition, biliary muscular formation, and the involvement of microvessels and fibroblasts in the regenerative process. In contrast, the anastomotic area without ABD implantation displayed only partial restoration of the epithelial layer, accompanied by fibroblast proliferation and subsequent bile duct fibrosis. These findings underscore the limited inherent repair capacity of the bile duct and underscore the beneficial role of the PE1 ABD artificial tubular bile duct in promoting biliary regeneration.
Collapse
Affiliation(s)
- Yu-Long Cai
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Fang Nan
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Guo-Tao Tang
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Yuan Ma
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Yi Ren
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xian-Ze Xiong
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Rong-Xing Zhou
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Fu-Yu Li
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Nan-Sheng Cheng
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Xia Jiang
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| |
Collapse
|
3
|
Miyazawa M, Aikawa M, Takashima J, Kobayashi H, Ohnishi S, Ikada Y. Pitfalls and promises of bile duct alternatives: A narrative review. World J Gastroenterol 2022; 28:5707-5722. [PMID: 36338889 PMCID: PMC9627420 DOI: 10.3748/wjg.v28.i39.5707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/18/2022] [Accepted: 09/23/2022] [Indexed: 02/06/2023] Open
Abstract
Biliodigestive anastomosis between the extrahepatic bile duct and the intestine for bile duct disease is a gastrointestinal reconstruction that abolishes duodenal papilla function and frequently causes retrograde cholangitis. This chronic inflammation can cause liver dysfunction, liver abscess, and even bile duct cancer. Although research has been conducted for over 100 years to directly repair bile duct defects with alternatives, no bile duct substitute (BDS) has been developed. This narrative review confirms our understanding of why bile duct alternatives have not been developed and explains the clinical applicability of BDSs in the near future. We searched the PubMed electronic database to identify studies conducted to develop BDSs until December 2021 and identified studies in English. Two independent reviewers reviewed studies on large animals with 8 or more cases. Four types of BDSs prevail: Autologous tissue, non-bioabsorbable material, bioabsorbable material, and others (decellularized tissue, 3D-printed structures, etc.). In most studies, BDSs failed due to obstruction of the lumen or stenosis of the anastomosis with the native bile duct. BDS has not been developed primarily because control of bile duct wound healing and regeneration has not been elucidated. A BDS expected to be clinically applied in the near future incorporates a bioabsorbable material that allows for regeneration of the bile duct outside the BDS.
Collapse
Affiliation(s)
- Mitsuo Miyazawa
- Department of Surgery, Teikyo University Mizonokuch Hospital, Kanagawa 213-8507, Japan
| | - Masayasu Aikawa
- Department of Surgery, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
| | - Junpei Takashima
- Department of Surgery, Teikyo University Mizonokuch Hospital, Kanagawa 213-8507, Japan
| | - Hirotoshi Kobayashi
- Department of Surgery, Teikyo University Mizonokuch Hospital, Kanagawa 213-8507, Japan
| | - Shunsuke Ohnishi
- Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Yoshito Ikada
- Department of Bioenvironmental Medicine, Nara Medical University, Nara 634-8521, Japan
| |
Collapse
|
4
|
Jiang X, Xiong X, Lin Y, Lu Y, Cheng J, Cheng N, Zhang J. A composite scaffold fabricated with an acellular matrix and biodegradable polyurethane for the in vivo regeneration of pig bile duct defects. Acta Biomater 2022; 150:238-253. [PMID: 35882348 DOI: 10.1016/j.actbio.2022.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/10/2022] [Accepted: 07/19/2022] [Indexed: 02/05/2023]
Abstract
Bile duct regeneration is urgently needed to restore the normal function of the damaged biliary system. In this study, an artificial bile duct (ABD) was fabricated for extrahepatic bile duct regeneration based on biodegradable polyurethane (BPU) and ureter acellular matrix (UAM) to endow it with favorable biocompatibility and eliminate bile leakage during in vivo bile duct regeneration. The mechanical properties, in vitro simulation of bile flow and cytocompatibility of BPU-UAM ABD were evaluated in vitro, and surgical implantation in the biliary defect site in minipigs was implemented to reveal the in vivo degradation of BPU-UAM and regeneration of the new bile duct. The results indicated that BPU-UAM ABD with a mechanical strength of 11.9 MPa has excellent cytocompatibility to support 3T3 fibroblast survival and proliferation in extraction medium and on the scaffolds. The in vivo implantation of BPU-UAM ABD revealed the change of collagen content throughout the new bile duct regeneration. Biliary epithelial cells were observed at day 70, and continuous biliary epithelial layer formation was observed after 100 days of implantation. Altogether, the BPU-UAM ABD fabricated in this study possesses excellent properties for application study in the regeneration of bile duct. STATEMENT OF SIGNIFICANCE: Extrahepatic bile duct defects carry considerable morbidity and mortality because they are the only pathway for bile to go down into the intestinal tract. At present, no artificial bile duct can promote biliary regeneration. In this study, BPU-UAM ABD was built based on biodegradable polyurethane and ureter acellular matrix to form a continuous compact layer of polyurethane in the internal wall of UAM and avoid bile leakage and experimental failure during in vivo implantation. Our work verified the effectiveness of the synthesized biodegradable polyurethane emulsion-modified urethral acellular matrix in bile regeneration and continuous biliary epithelial layer formation. This study provided a new approach for the curing of bile duct defects and inducing new bile tissue formation.
Collapse
Affiliation(s)
- Xia Jiang
- Regenerative Medicine Research Center, West China Hosp, Sichuan Univ, Chengdu 610041, Sichuan, China
| | - Xianze Xiong
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yixin Lin
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yanrong Lu
- Key Laboratory of Transplant Engineering and Immunology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jingqiu Cheng
- Key Laboratory of Transplant Engineering and Immunology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Nansheng Cheng
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Jie Zhang
- Key Laboratory of Transplant Engineering and Immunology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| |
Collapse
|
5
|
Uemoto Y, Taura K, Nakamura D, Xuefeng L, Nam NH, Kimura Y, Yoshino K, Fuji H, Yoh T, Nishio T, Yamamoto G, Koyama Y, Seo S, Tsuruyama T, Iwaisako K, Uemoto S, Tabata Y, Hatano E. Bile duct regeneration with an artificial bile duct made of gelatin hydrogel non-woven fabrics. Tissue Eng Part A 2022; 28:737-748. [PMID: 35383474 DOI: 10.1089/ten.tea.2021.0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Although choledochojejunostomy is the standard technique for biliary reconstruction, there are various associated problems that need to be solved such as reflux cholangitis. Interposition with an artificial bile duct (ABD) to replace the resected bile duct maintains a physiological conduit for bile and may solve this problem. This study investigated the usefulness of an ABD made of gelatin hydrogel non-woven fabric (GHNF). GHNF was prepared by the solution blow spinning method. The migration and activity of murine fibroblast L929 cells were examined in GHNF sheets. L929 cells migrated into GHNF sheets, where they proliferated and synthesized collagen, suggesting GHNF is a promising scaffold for bile duct regeneration. ABDs made of GHNF were implanted in place of resected bile duct segments in rats. The rats were sacrificed at 2, 6, and 12 weeks post-implantation. The implantation site was histologically evaluated for bile duct regeneration. At postoperative 2 weeks, migrating cells were observed in the ABD pores. The implanted ABD was mostly degraded and replaced by collagen fibers at 6 weeks. Ki67-positive bile duct epithelial cells appeared within the implanted ABD. These were most abundant within the central part of the ABD after 6 weeks. The percentages of Ki67-positive cells were 31.7%±9.1% in the experimental group and 0.8%±0.6% in the sham operation group at 6 weeks (p<0.05), indicating that mature biliary epithelial cells at the stump proliferated to regenerate the biliary epithelium. Biliary epithelial cells had almost completely covered the bile duct lumen at 12 weeks (epithelialization ratios: 10.4%±6.9% at 2 weeks, 93.1%±5.1% at 6 weeks, 99.2%±1.6% at 12 weeks). The regenerated epithelium was positive for the bile duct epithelium marker cytokeratin 19. Bile duct regeneration was accompanied by angiogenesis, as evidenced by the appearance of CD31-positive vascular structures. Capillaries were induced 2 weeks after implantation. The number of capillaries reached a maximum at 6 weeks and decreased to the same level as that of normal bile ducts at 12 weeks. These results showed that an ABD of GHNF contributed to successful bile duct regeneration in rats by facilitating the cell migration required for extracellular matrix synthesis, angiogenesis, and epithelialization.
Collapse
Affiliation(s)
- Yusuke Uemoto
- Kyoto University, 12918, Surgery, Kyoto, Japan.,Kyoto University Institute for Frontier Life and Medical Sciences, 84090, Regeneration Science and Engineering, Kyoto, Kyoto, Japan;
| | | | | | - Li Xuefeng
- Kyoto University, 12918, Surgery, Kyoto, Japan;
| | | | | | - Kenji Yoshino
- Kyoto University, 12918, Surgery, Kyoto, Japan.,Nagahama City Hospital, 37078, Surgery, Nagahama, Shiga, Japan;
| | | | - Tomoaki Yoh
- Kyoto University, 12918, Surgery, Kyoto, Japan;
| | | | | | | | - Satoru Seo
- Kyoto University, 12918, Surgery, Kyoto, Japan;
| | - Tatsuaki Tsuruyama
- Kyoto University Hospital Clinical Bio Resource Center, 593766, Kyoto, Kyoto, Japan;
| | - Keiko Iwaisako
- Doshisha University - Kyotanabe Campus, 358002, Medical Life Systems, Kyotanabe, Kyoto, Japan;
| | - Shinji Uemoto
- Shiga University of Medical Science, 13051, Otsu, Shiga, Japan;
| | - Yasuhiko Tabata
- Kyoto University Institute for Frontier Life and Medical Sciences, 84090, Regeneration Science and Engineering, Kyoto, Kyoto, Japan;
| | | |
Collapse
|
6
|
Song G, Zhao HQ, Liu Q, Fan Z. A review on biodegradable biliary stents: materials and future trends. Bioact Mater 2022; 17:488-495. [PMID: 35415292 PMCID: PMC8968460 DOI: 10.1016/j.bioactmat.2022.01.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/28/2021] [Accepted: 01/10/2022] [Indexed: 12/12/2022] Open
Abstract
Biliary stricture is defined as the reduction and narrowing of the bile duct lumen, which can be caused by many factors such as cancer and inflammation. Biliary stent placement can effectively alleviate benign and malignant biliary strictures. However, the commonly used plastic or metallic biliary stents are far from ideal and do not satisfy all clinical requirements,although several types of biodegradable biliary stents have been developed and used clinically. In this review, we summarized current development status of biodegradable stents with the emphasis on the stent materials. We also presented the future development trends based on the published literature. Summary of current development status of bioresorbable biliary stents with the emphasis on the stent materials. The future development trends based on the published literature. The advantages of bioresorbable biliary stents compared with metallic and plastic biliary stents.
Collapse
|
7
|
Sun Q, Shen Z, Liang X, He Y, Kong D, Midgley AC, Wang K. Progress and Current Limitations of Materials for Artificial Bile Duct Engineering. MATERIALS 2021; 14:ma14237468. [PMID: 34885623 PMCID: PMC8658964 DOI: 10.3390/ma14237468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 01/30/2023]
Abstract
Bile duct injury (BDI) and bile tract diseases are regarded as prominent challenges in hepatobiliary surgery due to the risk of severe complications. Hepatobiliary, pancreatic, and gastrointestinal surgery can inadvertently cause iatrogenic BDI. The commonly utilized clinical treatment of BDI is biliary-enteric anastomosis. However, removal of the Oddi sphincter, which serves as a valve control over the unidirectional flow of bile to the intestine, can result in complications such as reflux cholangitis, restenosis of the bile duct, and cholangiocarcinoma. Tissue engineering and biomaterials offer alternative approaches for BDI treatment. Reconstruction of mechanically functional and biomimetic structures to replace bile ducts aims to promote the ingrowth of bile duct cells and realize tissue regeneration of bile ducts. Current research on artificial bile ducts has remained within preclinical animal model experiments. As more research shows artificial bile duct replacements achieving effective mechanical and functional prevention of biliary peritonitis caused by bile leakage or obstructive jaundice after bile duct reconstruction, clinical translation of tissue-engineered bile ducts has become a theoretical possibility. This literature review provides a comprehensive collection of published works in relation to three tissue engineering approaches for biomimetic bile duct construction: mechanical support from scaffold materials, cell seeding methods, and the incorporation of biologically active factors to identify the advancements and current limitations of materials and methods for the development of effective artificial bile ducts that promote tissue regeneration.
Collapse
Affiliation(s)
- Qiqi Sun
- Key Laboratory of Bioactive Materials for the Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, China; (Q.S.); (D.K.)
| | - Zefeng Shen
- Department of General Surgery, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; (Z.S.); (X.L.)
| | - Xiao Liang
- Department of General Surgery, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; (Z.S.); (X.L.)
| | - Yingxu He
- School of Computing, National University of Singapore, Singapore 119077, Singapore;
| | - Deling Kong
- Key Laboratory of Bioactive Materials for the Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, China; (Q.S.); (D.K.)
| | - Adam C. Midgley
- Key Laboratory of Bioactive Materials for the Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, China; (Q.S.); (D.K.)
- Correspondence: (A.C.M.); (K.W.)
| | - Kai Wang
- Key Laboratory of Bioactive Materials for the Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, China; (Q.S.); (D.K.)
- Correspondence: (A.C.M.); (K.W.)
| |
Collapse
|
8
|
Ramírez-Marín Y, Abad-Contreras DE, Ustarroz-Cano M, Pérez-Gallardo NS, Villafuerte-García L, Puente-Guzmán DM, del Villar-Velasco JL, Rodríguez-López LA, Torres-Villalobos G, Mercado MÁ, Tapia-Jurado J, Martínez-García FD, Harmsen MC, Piña-Barba MC, Giraldo-Gomez DM. Perfusion Decellularization of Extrahepatic Bile Duct Allows Tissue-Engineered Scaffold Generation by Preserving Matrix Architecture and Cytocompatibility. MATERIALS 2021; 14:ma14113099. [PMID: 34198787 PMCID: PMC8201334 DOI: 10.3390/ma14113099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/24/2021] [Accepted: 06/02/2021] [Indexed: 12/19/2022]
Abstract
Reconstruction of bile ducts damaged remains a vexing medical problem. Surgeons have few options when it comes to a long segment reconstruction of the bile duct. Biological scaffolds of decellularized biliary origin may offer an approach to support the replace of bile ducts. Our objective was to obtain an extracellular matrix scaffold derived from porcine extrahepatic bile ducts (dECM-BD) and to analyze its biological and biochemical properties. The efficiency of the tailored perfusion decellularization process was assessed through histology stainings. Results from 4'-6-diamidino-2-phenylindole (DAPI), Hematoxylin and Eosin (H&E) stainings, and deoxyribonucleic acid (DNA) quantification showed proper extracellular matrix (ECM) decellularization with an effectiveness of 98%. Immunohistochemistry results indicate an effective decrease in immunogenic marker as human leukocyte antigens (HLA-A) and Cytokeratin 7 (CK7) proteins. The ECM of the bile duct was preserved according to Masson and Herovici stainings. Data derived from scanning electron microscopy (SEM) and thermogravimetric analysis (TGA) showed the preservation of the dECM-BD hierarchical structures. Cytotoxicity of dECM-BD was null, with cells able to infiltrate the scaffold. In this work, we standardized a decellularization method that allows one to obtain a natural bile duct scaffold with hierarchical ultrastructure preservation and adequate cytocompatibility.
Collapse
Affiliation(s)
- Yolik Ramírez-Marín
- Program of Medical Specialization General Surgery, Division of Posgraduate Studies, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Avenida Universidad 3000, Circuito de Posgrados, Unidad de Posgrado Edificio “E” 2° piso, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, Mexico;
- National Institute of Medical Sciences and Nutrition of Mexico Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc. 16, Tlalpan, Ciudad de México 14080, Mexico; (L.A.R.-L.); (G.T.-V.); (M.Á.M.)
| | - David Eduardo Abad-Contreras
- Laboratory for Biomaterials, Materials Research Institute, National Autonomous University of Mexico (UNAM), Avenida Universidad 3000, Circuito Exterior, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, Mexico; (D.E.A.-C.); (M.C.P.-B.)
| | - Martha Ustarroz-Cano
- Department of Cell and Tissue Biology, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Avenida Universidad 3000, Circuito Interior, Edificio “A” 3° piso, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, Mexico;
| | - Norma S. Pérez-Gallardo
- Surgical Training Section, Faculty of Veterinary Medicine and Animal Husbandry, National Autonomous University of Mexico (UNAM), Avenida Universidad 3000, Circuito Exterior, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, Mexico; (N.S.P.-G.); (L.V.-G.); (D.M.P.-G.); (J.L.d.V.-V.)
| | - Lorena Villafuerte-García
- Surgical Training Section, Faculty of Veterinary Medicine and Animal Husbandry, National Autonomous University of Mexico (UNAM), Avenida Universidad 3000, Circuito Exterior, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, Mexico; (N.S.P.-G.); (L.V.-G.); (D.M.P.-G.); (J.L.d.V.-V.)
| | - Dulce Maria Puente-Guzmán
- Surgical Training Section, Faculty of Veterinary Medicine and Animal Husbandry, National Autonomous University of Mexico (UNAM), Avenida Universidad 3000, Circuito Exterior, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, Mexico; (N.S.P.-G.); (L.V.-G.); (D.M.P.-G.); (J.L.d.V.-V.)
| | - Jorge Luna del Villar-Velasco
- Surgical Training Section, Faculty of Veterinary Medicine and Animal Husbandry, National Autonomous University of Mexico (UNAM), Avenida Universidad 3000, Circuito Exterior, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, Mexico; (N.S.P.-G.); (L.V.-G.); (D.M.P.-G.); (J.L.d.V.-V.)
| | - Leonardo Alejandro Rodríguez-López
- National Institute of Medical Sciences and Nutrition of Mexico Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc. 16, Tlalpan, Ciudad de México 14080, Mexico; (L.A.R.-L.); (G.T.-V.); (M.Á.M.)
| | - Gonzalo Torres-Villalobos
- National Institute of Medical Sciences and Nutrition of Mexico Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc. 16, Tlalpan, Ciudad de México 14080, Mexico; (L.A.R.-L.); (G.T.-V.); (M.Á.M.)
| | - Miguel Ángel Mercado
- National Institute of Medical Sciences and Nutrition of Mexico Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez Secc. 16, Tlalpan, Ciudad de México 14080, Mexico; (L.A.R.-L.); (G.T.-V.); (M.Á.M.)
| | - Jesús Tapia-Jurado
- Unit of Advanced Medical Simulation, Division of Posgraduate Studies, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Avenida Universidad 3000, Circuito de Posgrados, Unidad de Posgrado Edificio “B” 2° piso, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, Mexico;
| | - Francisco Drusso Martínez-García
- Department of Pathology and Medical Biology, University Medical Center Groningen University of Groningen, Hanzeplein 1, 9713 Groningen, The Netherlands; (F.D.M.-G.); (M.C.H.)
| | - Martin Conrad Harmsen
- Department of Pathology and Medical Biology, University Medical Center Groningen University of Groningen, Hanzeplein 1, 9713 Groningen, The Netherlands; (F.D.M.-G.); (M.C.H.)
| | - M. Cristina Piña-Barba
- Laboratory for Biomaterials, Materials Research Institute, National Autonomous University of Mexico (UNAM), Avenida Universidad 3000, Circuito Exterior, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, Mexico; (D.E.A.-C.); (M.C.P.-B.)
| | - David M. Giraldo-Gomez
- Department of Cell and Tissue Biology, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Avenida Universidad 3000, Circuito Interior, Edificio “A” 3° piso, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, Mexico;
- Microscopy Core Facility, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Avenida Universidad 3000, Circuito Interior, Edificio “A” planta baja, Ciudad Universitaria, Coyoacán, Ciudad de México 04510, Mexico
- Correspondence:
| |
Collapse
|
9
|
Shang H, Zeng JP, Wang SY, Xiao Y, Yang JH, Yu SQ, Liu XC, Jiang N, Shi XL, Jin S. Extrahepatic bile duct reconstruction in pigs with heterogenous animal-derived artificial bile ducts: A preliminary experience. World J Gastroenterol 2020; 26:7312-7324. [PMID: 33362386 PMCID: PMC7739164 DOI: 10.3748/wjg.v26.i46.7312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/06/2020] [Accepted: 11/02/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Extrahepatic biliary duct injury (BDI) remains a complicated issue for surgeons. Although several approaches have been explored to address this problem, the high incidence of complications affects postoperative recovery. As a nonimmunogenic scaffold, an animal-derived artificial bile duct (ada-BD) could replace the defect, providing good physiological conditions for the regeneration of autologous bile duct structures without changing the original anatomical and physiologic conditions.
AIM To evaluate the long-term feasibility of a novel heterogenous ada-BD for treating extrahepatic BDI in pigs.
METHODS Eight pigs were randomly divided into two groups in the study. The animal injury model was developed with an approximately 2 cm segmental defect of various parts of the common bile duct (CBD) for all pigs. A 2 cm long novel heterogenous animal-derived bile duct was used to repair this segmental defect (group A, ada-BD-to-duodenum anastomosis to repair the distal CBD defect; group B, ada-BD-to-CBD anastomosis to repair the intermedial CBD defect). The endpoint for observation was 6 mo (group A) and 12 mo (group B) after the operation. Liver function was regularly tested. Animals were euthanized at the above endpoints. Histological analysis was carried out to assess the efficacy of the repair.
RESULTS The median operative time was 2.45 h (2-3 h), with a median anastomosis time of 60.5 min (55-73 min). All experimental animals survived until the endpoints for observation. The liver function was almost regular. Histologic analysis indicated a marked biliary epithelial layer covering the neo-bile duct and regeneration of the submucosal connective tissue and smooth muscle without significant signs of immune rejection. In comparison, the submucosal connective tissue was more regular and thicker in group B than in group A, and there was superior integrity of the regeneration of the biliary epithelial layer. Despite the advantages of the regeneration of the bile duct smooth muscle observed in group A, the effect on the patency of the ada-BD grafts in group B was not confirmed by macroscopic assessment and cholangiography.
CONCLUSION This approach appears to be feasible for repairing a CBD defect with an ada-BD. A large sample study is needed to confirm the durability and safety of these preliminary results.
Collapse
Affiliation(s)
- Hao Shang
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Jian-Ping Zeng
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Si-Yuan Wang
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Ying Xiao
- Department of Pathology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Jiang-Hui Yang
- Department of Pathology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Shao-Qing Yu
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Xiang-Chen Liu
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Nan Jiang
- Institute for Precision Medicine Tsinghua University, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Xia-Li Shi
- Department of Anesthesiology and Operation, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
| | - Shuo Jin
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| |
Collapse
|
10
|
Willemse J, Roos FJM, Voogt IJ, Schurink IJ, Bijvelds M, de Jonge HR, van der Laan LJW, de Jonge J, Verstegen MMA. Scaffolds obtained from decellularized human extrahepatic bile ducts support organoids to establish functional biliary tissue in a dish. Biotechnol Bioeng 2020; 118:836-851. [PMID: 33118611 PMCID: PMC7894321 DOI: 10.1002/bit.27613] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/09/2020] [Accepted: 10/20/2020] [Indexed: 12/12/2022]
Abstract
Biliary disorders can lead to life‐threatening disease and are also a challenging complication of liver transplantation. As there are limited treatment options, tissue engineered bile ducts could be employed to replace or repair damaged bile ducts. We explored how these constructs can be created by seeding hepatobiliary LGR5+ organoids onto tissue‐specific scaffold. For this, we decellularized discarded human extrahepatic bile ducts (EBD) that we recellularized with organoids of different origin, that is, liver biopsies, extrahepatic bile duct biopsies, and bile samples. Here, we demonstrate efficient decellularization of EBD tissue. Recellularization of the EBD extracellular matrix (ECM) with the organoids of extrahepatic origin (EBD tissue and bile derived organoids) showed more profound repopulation of the ductal ECM when compared with liver tissue (intrahepatic bile duct) derived organoids. The bile duct constructs that were repopulated with extrahepatic organoids expressed mature cholangiocyte‐markers and had increased electrical resistance, indicating restoration of the barrier function. Therefore, the organoids of extrahepatic sources are identified to be the optimal candidate for the development of personalized tissue engineered EBD constructs.
Collapse
Affiliation(s)
- Jorke Willemse
- Department of Surgery, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Floris J M Roos
- Department of Surgery, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Iris J Voogt
- Department of Surgery, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Ivo J Schurink
- Department of Surgery, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Marcel Bijvelds
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Hugo R de Jonge
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Luc J W van der Laan
- Department of Surgery, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Jeroen de Jonge
- Department of Surgery, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Monique M A Verstegen
- Department of Surgery, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| |
Collapse
|