1
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Maljaars LP, Bendaoud S, Kastelein AW, Guler Z, Hooijmans CR, Roovers JPWR. Application of amniotic membranes in reconstructive surgery of internal organs-A systematic review and meta-analysis. J Tissue Eng Regen Med 2022; 16:1069-1090. [PMID: 36333859 PMCID: PMC10099938 DOI: 10.1002/term.3357] [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: 05/16/2022] [Accepted: 10/20/2022] [Indexed: 11/08/2022]
Abstract
Amniotic membrane (AM) has great potential as a scaffold for tissue regeneration in reconstructive surgery. To date, no systematic review of the literature has been performed for the applications of AM in wound closure of internal organs. Therefore, in this systematic review and meta-analysis, we summarize the literature on the safety and efficacy of AM for the closure of internal organs. A systematic search was performed in MEDLINE-PubMed database and OVID Embase to retrieve human and controlled animal studies on wound closure of internal organs. The Cochrane Risk of Bias tool for randomized clinical trials and the SYRCLE risk of bias tool for animal studies were used. Meta-analyses (MAs) were conducted for controlled animal studies to assess efficacy of closure, mortality and complications in subjects who underwent surgical wound closure in internal organs with the application of AM. Sixty references containing 26 human experiments and 36 animal experiments were included. The MAs of the controlled animal studies showed comparable results with regard to closure, mortality and complications, and suggested improved mechanical strength and lower inflammation scores after AM application when compared to standard surgical closure techniques. This systematic review and MAs demonstrate that the application of AM to promote wound healing of internal organs appears to be safe, efficacious, and feasible.
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Affiliation(s)
- Lennart P Maljaars
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
| | - Sohayla Bendaoud
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
| | - Arnoud W Kastelein
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
| | - Zeliha Guler
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
| | - Carlijn R Hooijmans
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jan-Paul W R Roovers
- Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
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2
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Ławkowska K, Rosenbaum C, Petrasz P, Kluth L, Koper K, Drewa T, Pokrywczynska M, Adamowicz J. Tissue engineering in reconstructive urology-The current status and critical insights to set future directions-critical review. Front Bioeng Biotechnol 2022; 10:1040987. [PMID: 36950181 PMCID: PMC10026841 DOI: 10.3389/fbioe.2022.1040987] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/13/2022] [Indexed: 03/05/2023] Open
Abstract
Advanced techniques of reconstructive urology are gradually reaching their limits in terms of their ability to restore urinary tract function and patients' quality of life. A tissue engineering-based approach to urinary tract reconstruction, utilizing cells and biomaterials, offers an opportunity to overcome current limitations. Although tissue engineering studies have been heralding the imminent introduction of this method into clinics for over a decade, tissue engineering is only marginally applied. In this review, we discuss the role of tissue engineering in reconstructive urology and try to answer the question of why such a promising technology has not proven its clinical usability so far.
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Affiliation(s)
- Karolina Ławkowska
- Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
- *Correspondence: Karolina Ławkowska, ; Clemens Rosenbaum, ; Piotr Petrasz, ; Krzysztof Koper, ; Luis Kluth, ; Tomasz Drewa, ; Marta Pokrywczynska, ; Jan Adamowicz,
| | - Clemens Rosenbaum
- Department of Urology Asklepios Klinik Barmbek Germany, Urologist in Hamburg, Hamburg, Germany
- *Correspondence: Karolina Ławkowska, ; Clemens Rosenbaum, ; Piotr Petrasz, ; Krzysztof Koper, ; Luis Kluth, ; Tomasz Drewa, ; Marta Pokrywczynska, ; Jan Adamowicz,
| | - Piotr Petrasz
- Department of Urology Voivodeship Hospital Gorzów Wielkopolski, Gorzów Wielkopolski, Poland
- *Correspondence: Karolina Ławkowska, ; Clemens Rosenbaum, ; Piotr Petrasz, ; Krzysztof Koper, ; Luis Kluth, ; Tomasz Drewa, ; Marta Pokrywczynska, ; Jan Adamowicz,
| | - Luis Kluth
- Department of Urology, University Medical Center Frankfurt, Frankfurt am Main, Germany
- *Correspondence: Karolina Ławkowska, ; Clemens Rosenbaum, ; Piotr Petrasz, ; Krzysztof Koper, ; Luis Kluth, ; Tomasz Drewa, ; Marta Pokrywczynska, ; Jan Adamowicz,
| | - Krzysztof Koper
- Department of Clinical Oncology and Nursing, Collegium Medicum, Nicolaus Copernicus University, Curie-Skłodowskiej 9, Bydgoszcz, Poland
- *Correspondence: Karolina Ławkowska, ; Clemens Rosenbaum, ; Piotr Petrasz, ; Krzysztof Koper, ; Luis Kluth, ; Tomasz Drewa, ; Marta Pokrywczynska, ; Jan Adamowicz,
| | - Tomasz Drewa
- Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
- *Correspondence: Karolina Ławkowska, ; Clemens Rosenbaum, ; Piotr Petrasz, ; Krzysztof Koper, ; Luis Kluth, ; Tomasz Drewa, ; Marta Pokrywczynska, ; Jan Adamowicz,
| | - Marta Pokrywczynska
- Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
- *Correspondence: Karolina Ławkowska, ; Clemens Rosenbaum, ; Piotr Petrasz, ; Krzysztof Koper, ; Luis Kluth, ; Tomasz Drewa, ; Marta Pokrywczynska, ; Jan Adamowicz,
| | - Jan Adamowicz
- Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
- *Correspondence: Karolina Ławkowska, ; Clemens Rosenbaum, ; Piotr Petrasz, ; Krzysztof Koper, ; Luis Kluth, ; Tomasz Drewa, ; Marta Pokrywczynska, ; Jan Adamowicz,
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3
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Adamowicz J, Kluth LA, Pokrywczynska M, Drewa T. Tissue Engineering and Its Potential to Reduce Prostate Cancer Treatment Sequelae-Narrative Review. Front Surg 2021; 8:644057. [PMID: 34722618 PMCID: PMC8551715 DOI: 10.3389/fsurg.2021.644057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 07/19/2021] [Indexed: 01/08/2023] Open
Abstract
Tissue engineering offers the possibility to overcome limitations of current management for postprostatectomy incontinence and ED. Developed in recent years biotechnological feasibility of mesenchymal stem cell isolation, in vitro cultivation and implantation became the basis for new cell-based therapies oriented to induce regeneration of adult tissue. The perspective to offer patients suffering from post-prostatectomy incontinence or erectile dysfunction minimal invasive one-time procedure utilizing autologous stem cell transplantation is desired management.
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Affiliation(s)
- Jan Adamowicz
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Luis Alex Kluth
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Marta Pokrywczynska
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Tomasz Drewa
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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4
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Wang X, Zhang F, Liao L. Current Applications and Future Directions of Bioengineering Approaches for Bladder Augmentation and Reconstruction. Front Surg 2021; 8:664404. [PMID: 34222316 PMCID: PMC8249581 DOI: 10.3389/fsurg.2021.664404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/24/2021] [Indexed: 12/12/2022] Open
Abstract
End-stage neurogenic bladder usually results in the insufficiency of upper urinary tract, requiring bladder augmentation with intestinal tissue. To avoid complications of augmentation cystoplasty, tissue-engineering technique could offer a new approach to bladder reconstruction. This work reviews the current state of bioengineering progress and barriers in bladder augmentation or reconstruction and proposes an innovative method to address the obstacles of bladder augmentation. The ideal tissue-engineered bladder has the characteristics of high biocompatibility, compliance, and specialized urothelium to protect the upper urinary tract and prevent extravasation of urine. Despite that many reports have demonstrated that bioengineered bladder possessed a similar structure to native bladder, few large animal experiments, and clinical applications have been performed successfully. The lack of satisfactory outcomes over the past decades may have become an important factor hindering the development in this field. More studies should be warranted to promote the use of tissue-engineered bladders in clinical practice.
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Affiliation(s)
- Xuesheng Wang
- Department of Urology, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, China.,Department of Urology, Capital Medical University, Beijing, China.,University of Rehabilitation, Qingdao, China
| | - Fan Zhang
- Department of Urology, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, China.,Department of Urology, Capital Medical University, Beijing, China.,University of Rehabilitation, Qingdao, China
| | - Limin Liao
- Department of Urology, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, China.,Department of Urology, Capital Medical University, Beijing, China.,University of Rehabilitation, Qingdao, China
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5
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Shih KW, Chen WC, Chang CH, Tai TE, Wu JC, Huang AC, Liu MC. Non-Muscular Invasive Bladder Cancer: Re-envisioning Therapeutic Journey from Traditional to Regenerative Interventions. Aging Dis 2021; 12:868-885. [PMID: 34094648 PMCID: PMC8139208 DOI: 10.14336/ad.2020.1109] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 11/09/2020] [Indexed: 01/01/2023] Open
Abstract
Non-muscular invasive bladder cancer (NMIBC) is one of the most common cancer and major cause of economical and health burden in developed countries. Progression of NMIBC has been characterized as low-grade (Ta) and high grade (carcinoma in situ and T1). The current surgical intervention for NMIBC includes transurethral resection of bladder tumor; however, its recurrence still remains a challenge. The BCG-based immunotherapy is much effective against low-grade NMIBC. BCG increases the influx of T cells at bladder cancer site and inhibits proliferation of bladder cancer cells. The chemotherapy is another traditional approach to address NMIBC by supplementing BCG. Notwithstanding, these current therapeutic measures possess limited efficacy in controlling NMIBC, and do not provide comprehensive long-term relief. Hence, biomaterials and scaffolds seem an effective medium to deliver therapeutic agents for restructuring bladder post-treatment. The regenerative therapies such as stem cells and PRP have also been explored for possible solution to NMIBC. Based on above-mentioned approaches, we have comprehensively analyzed therapeutic journey from traditional to regenerative interventions for the treatment of NMIBC.
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Affiliation(s)
- Kuan-Wei Shih
- 1Department of Urology, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Wei-Chieh Chen
- 1Department of Urology, Taipei Medical University Hospital, Taipei 11031, Taiwan.,2Graduate Institute of Clinical Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.,3TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei 11031, Taiwan
| | - Ching-Hsin Chang
- 1Department of Urology, Taipei Medical University Hospital, Taipei 11031, Taiwan.,3TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei 11031, Taiwan.,4Institute of Microbiology and Immunology, National Yang-Ming University, Taipei 11031, Taiwan
| | - Ting-En Tai
- 1Department of Urology, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Jeng-Cheng Wu
- 1Department of Urology, Taipei Medical University Hospital, Taipei 11031, Taiwan.,3TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei 11031, Taiwan.,5Department of Education, Taipei Medical University Hospital, Taipei 11031, Taiwan.,6Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Andy C Huang
- 8Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei,11221, Taiwan.,9Department of Urology, Department of Surgery, Taipei City Hospital Ren-Ai Branch, Taipei 10629, Taiwan
| | - Ming-Che Liu
- 1Department of Urology, Taipei Medical University Hospital, Taipei 11031, Taiwan.,2Graduate Institute of Clinical Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.,3TMU Research Center of Urology and Kidney, Taipei Medical University, Taipei 11031, Taiwan.,7Clinical Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan.,10School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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6
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A new heterotropic vascularized model of total urinary bladder transplantation in a rat model. Sci Rep 2021; 11:3775. [PMID: 33580157 PMCID: PMC7881011 DOI: 10.1038/s41598-021-83128-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 01/04/2021] [Indexed: 11/08/2022] Open
Abstract
This study developed a new procedure of urinary bladder transplantation on a rat model (n = 40). Heterotopic urinary bladder transplantation (n = 10) in the right groin vessels was performed. Direct urinary bladder examination, microangiography, histological analysis, and India ink injection were performed to evaluate the proposed method's functionality. Observation time was four weeks. One week after the procedure, the graft survival rate was 80%, two urinary bladders were lost due to anastomosis failure. The rest of the grafts survived two weeks without any complications. Lack of transitional epithelium or smooth muscle layer loss and lack of inflammatory process development were observed. This study was performed in order to obtain the necessary knowledge about urinary bladder transplantation. The proposed technique offers a new approach to the existing orthotropic models.
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7
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Ramuta TŽ, Kreft ME. Human Amniotic Membrane and Amniotic Membrane-Derived Cells: How Far Are We from Their Use in Regenerative and Reconstructive Urology? Cell Transplant 2019; 27:77-92. [PMID: 29562770 PMCID: PMC6434475 DOI: 10.1177/0963689717725528] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Human amniotic membrane (hAM) is the innermost layer of fetal membranes, which surrounds the developing fetus and forms the amniotic cavity. hAM and hAM-derived cells possess many properties that make them suitable for use in regenerative medicine, such as low immunogenicity, promotion of epithelization, anti-inflammatory properties, angiogenic and antiangiogenic properties, antifibrotic properties, antimicrobial properties, and anticancer properties. Many pathological conditions of the urinary tract lead to organ damage or complete loss of function. Consequently, the reconstruction or replacement of damaged organs is needed, which makes searching for new approaches in regenerative and reconstructive urology a necessity. The use of hAM for treating defects in kidneys, ureters, urinary bladder, and urethra was tested in vitro in cell cultures and in vivo in mice, rats, rabbits, cats, dogs, and also in humans. These studies confirmed the advantages and the potential of hAM for use in regenerative and reconstructive urology as stated above. However, they also pointed out a few concerns we have to take into consideration. These are (1) the lack of a standardized protocol in hAM preparation and storage, (2) the heterogeneity of hAM, and especially (3) low mechanical strength of hAM. Before any wider use of hAM for treating urological defects, the protocols for preparation and storage will need to be standardized, followed by more studies on larger animals and clinical trials, which will altogether extensively assess the potential of hAM use in urological patients.
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Affiliation(s)
- Taja Železnik Ramuta
- 1 Faculty of Medicine, Institute of Cell biology, University of Ljubljana, Ljubljana, Slovenia
| | - Mateja Erdani Kreft
- 1 Faculty of Medicine, Institute of Cell biology, University of Ljubljana, Ljubljana, Slovenia
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8
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Pokrywczynska M, Jundzill A, Warda K, Buchholz L, Rasmus M, Adamowicz J, Bodnar M, Marszalek A, Helmin-Basa A, Michalkiewicz J, Gagat M, Grzanka A, Frontczak-Baniewicz M, Gastecka AM, Kloskowski T, Nowacki M, Ricordi C, Drewa T. Does the Mesenchymal Stem Cell Source Influence Smooth Muscle Regeneration in Tissue-Engineered Urinary Bladders? Cell Transplant 2018; 26:1780-1791. [PMID: 29338385 PMCID: PMC5784518 DOI: 10.1177/0963689717722787] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
A variety of tissue engineering techniques utilizing different cells and biomaterials are currently being explored to construct urinary bladder walls de novo, but so far no approach is clearly superior. The aim of this study was to determine whether mesenchymal stem cells (MSCs) isolated from different sources, (bone marrow [BM-MSCs] and adipose tissue [ADSCs]), differ in their potential to regenerate smooth muscles in tissue-engineered urinary bladders and to determine an optimal number of MSCs for urinary bladder smooth muscle regeneration. Forty-eight rats underwent hemicystectomy and bladder augmentation with approximately 0.8 cm2 graft. In the first and second groups, urinary bladders were reconstructed with small intestinal submucosa (SIS) seeded with 10 × 106 or 4 × 106 ADSCs/cm2, respectively. In the third and fourth groups, urinary bladders were augmented with SIS seeded with 10 × 106 or 4 × 106 BM-MSCs/cm2, respectively. In the fifth group, urinary bladders were augmented with SIS without cells. The sixth group (control) was left intact. Smooth muscle regeneration was evaluated by real-time polymerase chain reaction (RT-PCR) and histological examinations. Histologically, there were no significant differences between urinary bladders augmented with ADSCs and BM-MSCs, but there was a marked increase in smooth muscle formation in bladders augmented with grafts seeded with MSCs in higher density (10 × 106/cm2) compared to lower density (4 × 106/cm2). Molecular analysis revealed that bladders reconstructed with ADSC-seeded grafts expressed higher levels of smooth muscle myosin heavy chain, caldesmon, and vinculin. Bladders augmented with unseeded SIS were fibrotic and devoid of smooth muscles. ADSCs and BM-MSCs have comparable smooth muscle regenerative potential, but the number of MSCs used for graft preparation significantly affects the smooth muscle content in tissue-engineered urinary bladders.
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Affiliation(s)
- Marta Pokrywczynska
- 1 Department of Regenerative Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.,2 The Diabetes Research Institute Federation, Miami, FL, USA.,3 The Cure Alliance, Miami, FL, USA
| | - Arkadiusz Jundzill
- 1 Department of Regenerative Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Karolina Warda
- 1 Department of Regenerative Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Lukasz Buchholz
- 1 Department of Regenerative Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Marta Rasmus
- 1 Department of Regenerative Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Jan Adamowicz
- 1 Department of Regenerative Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Magdalena Bodnar
- 4 Department of Clinical Pathomorphology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Andrzej Marszalek
- 5 Department of Tumor Pathology, Center of Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Helmin-Basa
- 6 Department of Immunology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Jacek Michalkiewicz
- 6 Department of Immunology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Maciej Gagat
- 7 Department of Embryology and Histology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Alina Grzanka
- 7 Department of Embryology and Histology, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | | | - Agata Magdalena Gastecka
- 1 Department of Regenerative Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Tomasz Kloskowski
- 1 Department of Regenerative Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Maciej Nowacki
- 1 Department of Regenerative Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Camillo Ricordi
- 2 The Diabetes Research Institute Federation, Miami, FL, USA.,3 The Cure Alliance, Miami, FL, USA.,9 Diabetes Research Institute and Cell Transplant Program, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Tomasz Drewa
- 1 Department of Regenerative Medicine, Ludwik Rydygier Medical College in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
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9
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Future Research Directions in the Design of Versatile Extracellular Matrix in Tissue Engineering. Int Neurourol J 2018; 22:S66-75. [PMID: 30068068 PMCID: PMC6077942 DOI: 10.5213/inj.1836154.077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 07/12/2018] [Indexed: 12/19/2022] Open
Abstract
Native and artificial extracellular matrices (ECMs) have been widely applied in biomedical fields as one of the most effective components in tissue regeneration. In particular, ECM-based drugs are expected to be applied to treat diseases in organs relevant to urology, because tissue regeneration is particularly important for preventing the recurrence of these diseases. Native ECMs provide a complex in vivo architecture and native physical and mechanical properties that support high biocompatibility. However, the applications of native ECMs are limited due to their tissue-specificity and chemical complexity. Artificial ECMs have been fabricated in an attempt to create a broadly applicable scaffold by using controllable components and a uniform formulation. On the other hands, artificial ECMs fail to mimic the properties of a native ECM; consequently, their applications in tissues are also limited. For that reason, the design of a versatile, hybrid ECM that can be universally applied to various tissues is an emerging area of interest in the biomedical field.
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10
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Adamowicz J, Pokrywczynska M, Van Breda SV, Kloskowski T, Drewa T. Concise Review: Tissue Engineering of Urinary Bladder; We Still Have a Long Way to Go? Stem Cells Transl Med 2017; 6:2033-2043. [PMID: 29024555 PMCID: PMC6430044 DOI: 10.1002/sctm.17-0101] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/18/2017] [Indexed: 12/18/2022] Open
Abstract
Regenerative medicine is a new branch of medicine based on tissue engineering technology. This rapidly developing field of science offers revolutionary treatment strategy aimed at urinary bladder regeneration. Despite many promising announcements of experimental urinary bladder reconstruction, there has been a lack in commercialization of therapies based on current investigations. This is due to numerous obstacles that are slowly being identified and precisely overcome. The goal of this review is to present the current status of research on urinary bladder regeneration and highlight further challenges that need to be gradually addressed. We put an emphasis on expectations of urologists that are awaiting tissue engineering based solutions in clinical practice. This review also presents a detailed characteristic of obstacles on the road to successful urinary bladder regeneration from urological clinician perspective. A defined interdisciplinary approach might help to accelerate planning transitional research tissue engineering focused on urinary tracts. Stem Cells Translational Medicine 2017;6:2033-2043.
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Affiliation(s)
- Jan Adamowicz
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Marta Pokrywczynska
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Tomasz Kloskowski
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Tomasz Drewa
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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11
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Xiao D, Wang Q, Yan H, Lv X, Zhao Y, Zhou Z, Zhang M, Sun Q, Sun K, Li W, Lu M. Adipose-derived stem cells-seeded bladder acellular matrix graft-silk fibroin enhances bladder reconstruction in a rat model. Oncotarget 2017; 8:86471-86487. [PMID: 29156809 PMCID: PMC5689699 DOI: 10.18632/oncotarget.21211] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 08/28/2017] [Indexed: 12/20/2022] Open
Abstract
The unfavourable clinical outcomes of host cell-seeded scaffolds for bladder augmentation warrant improved bioactive biomaterials. This study aimed to examine the feasibility of adipose-derived stem cells (ASCs)-seeded bilayer bladder acellular matrix graft (BAMG)-silk fibroin (SF) scaffold in enhancing bladder reconstruction. Sprague Dawley rats were randomly divided into three groups: the BAMG-SF-ASCs group, the acellular BAMG-SF group and the cystotomy group. The BAMG-SF-ASCs group was sampled at 2, 4 and 12 weeks, and compared with the other groups at 12 weeks. In the BAMG-SF-ASCs group, the normal bladder contour was reformed similar to that in the cystotomy group, with abundant urothelium and smooth muscle regeneration, as well as a suitable scaffold degradation speed, and trivial fibrosis and inflammation. The ASCs seeded in BAMG-SF were maintained in the regenerated region during the 12-week experimental period and significantly enhanced the vessel density, nerve regeneration and bladder function compared with acellular BAMG-SF. In addition, the BAMG-SF-ASCs group presented elevated levels of SDF-1α, VEGF and their receptors, with an obvious increase in ERK 1/2 phosphorylation. BAMG-SF is a promising biomaterial for ASCs seeding to facilitate bladder augmentation and demonstrated an enhanced angiogenic potential possibly related to the SDF-1α/CXCR4 pathway via ERK 1/2 activation.
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Affiliation(s)
- Dongdong Xiao
- Department of Urology and Andrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
| | - Qiong Wang
- Department of Urology, The Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
| | - Hao Yan
- Department of Urology and Andrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
| | - Xiangguo Lv
- Department of Urology and Andrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
| | - Yang Zhao
- Department of Urology and Andrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
| | - Zhe Zhou
- Department of Urology and Andrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
| | - Ming Zhang
- Department of Urology and Andrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
| | - Qian Sun
- The State Key Lab of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Kang Sun
- The State Key Lab of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Wei Li
- The State Key Lab of Metal Matrix Composites, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Mujun Lu
- Department of Urology and Andrology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
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Vranckx JJ, Hondt MD. Tissue engineering and surgery: from translational studies to human trials. Innov Surg Sci 2017; 2:189-202. [PMID: 31579752 PMCID: PMC6754028 DOI: 10.1515/iss-2017-0011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/16/2017] [Indexed: 12/23/2022] Open
Abstract
Tissue engineering was introduced as an innovative and promising field in the mid-1980s. The capacity of cells to migrate and proliferate in growth-inducing medium induced great expectancies on generating custom-shaped bioconstructs for tissue regeneration. Tissue engineering represents a unique multidisciplinary translational forum where the principles of biomaterial engineering, the molecular biology of cells and genes, and the clinical sciences of reconstruction would interact intensively through the combined efforts of scientists, engineers, and clinicians. The anticipated possibilities of cell engineering, matrix development, and growth factor therapies are extensive and would largely expand our clinical reconstructive armamentarium. Application of proangiogenic proteins may stimulate wound repair, restore avascular wound beds, or reverse hypoxia in flaps. Autologous cells procured from biopsies may generate an ‘autologous’ dermal and epidermal laminated cover on extensive burn wounds. Three-dimensional printing may generate ‘custom-made’ preshaped scaffolds – shaped as a nose, an ear, or a mandible – in which these cells can be seeded. The paucity of optimal donor tissues may be solved with off-the-shelf tissues using tissue engineering strategies. However, despite the expectations, the speed of translation of in vitro tissue engineering sciences into clinical reality is very slow due to the intrinsic complexity of human tissues. This review focuses on the transition from translational protocols towards current clinical applications of tissue engineering strategies in surgery.
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Affiliation(s)
- Jan Jeroen Vranckx
- Department of Plastic and Reconstructive Surgery, KU Leuven University Hospitals, 49 Herestraat, B-3000 Leuven, Belgium
| | - Margot Den Hondt
- Laboratory of Plastic Surgery and Tissue Engineering Research, Department of Plastic and Reconstructive Surgery, KU-Leuven University Hospitals, Leuven, Belgium
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Alberti C. Whyever bladder tissue engineering clinical applications still remain unusual even though many intriguing technological advances have been reached? G Chir 2017; 37:6-12. [PMID: 27142819 DOI: 10.11138/gchir/2016.37.1.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
To prevent problematic outcomes of bowel-based bladder reconstructive surgery, such as prosthetic tumors and systemic metabolic complications, research works, to either regenerate and strengthen failing organ or build organ replacement biosubstitute, have been turned, from 90s of the last century, to both regenerative medicine and tissue engineering.Various types of acellular matrices, naturally-derived materials, synthetic polymers have been used for either "unseeded" (cell free) or autologous "cell seeded" tissue engineering scaffolds. Different categories of cell sources - from autologous differentiated urothelial and smooth muscle cells to natural or laboratory procedure-derived stem cells - have been taken into consideration to reach the construction of suitable "cell seeded" templates. Current clinically validated bladder tissue engineering approaches essentially consist of augmentation cystoplasty in patients suffering from poorly compliant neuropathic bladder. No clinical applications of wholly tissue engineered neobladder have been carried out to radical-reconstructive surgical treatment of bladder malignancies or chronic inflammation-due vesical coarctation. Reliable reasons why bladder tissue engineering clinical applications so far remain unusual, particularly imply the risk of graft ischemia, hence its both fibrous contraction and even worse perforation. Therefore, the achievement of graft vascular network (vasculogenesis) could allow, together with the promotion of host surrounding vessel sprouting (angiogenesis), an effective graft blood supply, so avoiding the ischemia-related serious complications.
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Bone Marrow Stem/Progenitor Cells Attenuate the Inflammatory Milieu Following Substitution Urethroplasty. Sci Rep 2016; 6:35638. [PMID: 27762304 PMCID: PMC5071897 DOI: 10.1038/srep35638] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/30/2016] [Indexed: 12/19/2022] Open
Abstract
Substitution urethroplasty for the treatment of male stricture disease is often accompanied by subsequent tissue fibrosis and secondary stricture formation. Patients with pre-existing morbidities are often at increased risk of urethral stricture recurrence brought upon in-part by delayed vascularization accompanied by overactive inflammatory responses following surgery. Within the context of this study, we demonstrate the functional utility of a cell/scaffold composite graft comprised of human bone marrow-derived mesenchymal stem cells (MSC) combined with CD34+ hematopoietic stem/progenitor cells (HSPC) to modulate inflammation and wound healing in a rodent model of substitution urethroplasty. Composite grafts demonstrated potent anti-inflammatory effects with regards to tissue macrophage and neutrophil density following urethral tissue analyses. This was accompanied by a significant reduction in pro-inflammatory cytokines TNFα and IL-1β and further resulted in an earlier transition to tissue remodeling and maturation with a shift in collagen type III to I. Grafted animals demonstrated a progressive maturation and increase in vessel size compared to control animals. Overall, MSC/CD34+ HSPC composite grafts reduce inflammation, enhance an earlier transition to wound remodeling and maturation concurrently increasing neovascularization in the periurethral tissue. We demonstrate the feasibility and efficacy of a stem cell-seeded synthetic graft in a rodent substitution urethroplasty model.
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15
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Nowacki M, Nazarewski Ł, Kloskowski T, Tyloch D, Pokrywczyńska M, Pietkun K, Jundziłł A, Tyloch J, Habib SL, Drewa T. Novel surgical techniques, regenerative medicine, tissue engineering and innovative immunosuppression in kidney transplantation. Arch Med Sci 2016; 12:1158-1173. [PMID: 27695507 PMCID: PMC5016594 DOI: 10.5114/aoms.2016.61919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 02/08/2015] [Indexed: 01/09/2023] Open
Abstract
On the 60th anniversary of the first successfully performed renal transplantation, we summarize the historical, current and potential future status of kidney transplantation. We discuss three different aspects with a potential significant influence on kidney transplantation progress: the development of surgical techniques, the influence of regenerative medicine and tissue engineering, and changes in immunosuppression. We evaluate the standard open surgical procedures with modern techniques and compare them to less invasive videoscopic as well as robotic techniques. The role of tissue engineering and regenerative medicine as a potential method for future kidney regeneration or replacement and the interesting search for novel solutions in the field of immunosuppression will be discussed. After 60 years since the first successfully performed kidney transplantation, we can conclude that the greatest achievements are associated with the development of surgical techniques and with planned systemic immunosuppression.
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Affiliation(s)
- Maciej Nowacki
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
- Chair of Surgical Oncology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | - Łukasz Nazarewski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Kloskowski
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | - Dominik Tyloch
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | - Marta Pokrywczyńska
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | - Katarzyna Pietkun
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | - Arkadiusz Jundziłł
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | - Janusz Tyloch
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
| | - Samy L. Habib
- Department of Geriatrics, Geriatric Research, Education, and Clinical Center, South Texas Veterans Healthcare System, San Antonio, TX, USA
- Department of Cellular and Structural Biology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Tomasz Drewa
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
- Department of General and Oncological Urology, Nicolaus Copernicus Hospital, Torun, Poland
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Pokrywczynska M, Balcerczyk D, Jundzill A, Gagat M, Czapiewska M, Kloskowski T, Nowacki M, Gastecka AM, Bodnar M, Grzanka A, Marszalek A, Drewa T. Isolation, expansion and characterization of porcine urinary bladder smooth muscle cells for tissue engineering. Biol Proced Online 2016; 18:17. [PMID: 27524942 PMCID: PMC4982216 DOI: 10.1186/s12575-016-0047-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 08/03/2016] [Indexed: 01/20/2023] Open
Abstract
Background A key requirements for therapy utilizing the tissue engineering methodologies is use of techniques which have the capability to yield a high number of cells, from small tissue biopsy in a relatively short time. Up to date there was no optimal methods of isolation and expansion of urinary bladder smooth muscle cells (UB-SMCs). The aim of this study was to compare isolation and expansion techniques of UB-SMCs to select the most repeatable and efficient one. Method Five protocols of porcine UB- SMCs isolation including enzymatic and explant techniques and three expansion techniques were compared. Isolation effectiveness was evaluated using trypan blue assay. Cell phenotype was confirmed by immunofluorescence staining. Proliferation rate was analyzed using MTT and X- Celligence system. Cellular senescence was assessed measuring β-galactosidase activity. Results Enzymatic methods using collagenase with dispase (method I) or collagenase only (method III) allowed to isolate much larger number of cells than the methods using trypsin with collagenase (method II) and collagenase after digestion with trypsin (method IV). The success rate of establishment of primary culture was the highest when the isolated cells were cultured in the Smooth muscle Growth Medium-2 (SmGM-2). Expression of the smooth muscle markers- alpha smooth muscle actin and smoothelin was the highest for cells isolated by enzymatic method I and cultured in SmGM-2. There was no significant signs of cell senescence until the 8th passage. Conclusion The most efficient method of establishment of porcine UB-SMCs culture is enzymatic digestion of urinary bladder tissue with collagenase and dispase and culture of isolated cells in SmGM-2. This method was up to 10 times more efficient than other methods used for isolation and culture of UB-SMCs. This is an easy and consistent method for obtaining high numbers of urinary bladder smooth muscle cells.
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Affiliation(s)
- Marta Pokrywczynska
- Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Chair of Urology, Karlowicza 24 Street, 85-092 Bydgoszcz, Poland
| | - Daria Balcerczyk
- Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Chair of Urology, Karlowicza 24 Street, 85-092 Bydgoszcz, Poland
| | - Arkadiusz Jundzill
- Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Chair of Urology, Karlowicza 24 Street, 85-092 Bydgoszcz, Poland
| | - Maciej Gagat
- Chair of Histology and Embryology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College, Bydgoszcz, Poland
| | - Monika Czapiewska
- Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Chair of Urology, Karlowicza 24 Street, 85-092 Bydgoszcz, Poland
| | - Tomasz Kloskowski
- Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Chair of Urology, Karlowicza 24 Street, 85-092 Bydgoszcz, Poland
| | - Maciej Nowacki
- Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Chair of Urology, Karlowicza 24 Street, 85-092 Bydgoszcz, Poland ; Chair of Surgical Oncology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College, Bydgoszcz, Poland
| | - Agata M Gastecka
- Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Chair of Urology, Karlowicza 24 Street, 85-092 Bydgoszcz, Poland
| | - Magdalena Bodnar
- Department of Clinical Pathomorphology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College, Bydgoszcz, Poland
| | - Alina Grzanka
- Chair of Histology and Embryology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College, Bydgoszcz, Poland
| | - Andrzej Marszalek
- Department of Clinical Pathomorphology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College, Bydgoszcz, Poland ; Department of Pathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Tomasz Drewa
- Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Chair of Urology, Karlowicza 24 Street, 85-092 Bydgoszcz, Poland ; Department of Urology, Nicolaus Copernicus Hospital, Torun, Poland
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17
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Adamowicz J, Pokrywczyńska M, Tworkiewicz J, Kowalczyk T, van Breda SV, Tyloch D, Kloskowski T, Bodnar M, Skopinska-Wisniewska J, Marszałek A, Frontczak-Baniewicz M, Kowalewski TA, Drewa T. New Amniotic Membrane Based Biocomposite for Future Application in Reconstructive Urology. PLoS One 2016; 11:e0146012. [PMID: 26766636 PMCID: PMC4713072 DOI: 10.1371/journal.pone.0146012] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 12/12/2015] [Indexed: 02/07/2023] Open
Abstract
Objective Due to the capacity of the amniotic membrane (Am) to support re-epithelisation and inhibit scar formation, Am has a potential to become a considerable asset for reconstructive urology i.e., reconstruction of ureters and urethrae. The application of Am in reconstructive urology is limited due to a poor mechanical characteristic. Am reinforcement with electrospun nanofibers offers a new strategy to improve Am mechanical resistance, without affecting its unique bioactivity profile. This study evaluated biocomposite material composed of Am and nanofibers as a graft for urinary bladder augmentation in a rat model. Material and Methods Sandwich-structured biocomposite material was constructed from frozen Am and covered on both sides with two-layered membranes prepared from electrospun poly-(L-lactide-co-E-caprolactone) (PLCL). Wistar rats underwent hemicystectomy and bladder augmentation with the biocomposite material. Results Immunohistohemical analysis (hematoxylin and eosin [H&E], anti-smoothelin and Masson’s trichrome staining [TRI]) revealed effective regeneration of the urothelial and smooth muscle layers. Anti-smoothelin staining confirmed the presence of contractile smooth muscle within a new bladder wall. Sandwich-structured biocomposite graft material was designed to regenerate the urinary bladder wall, fulfilling the requirements for normal bladder tension, contraction, elasticity and compliance. Mechanical evaluation of regenerated bladder wall conducted based on Young’s elastic modulus reflected changes in the histological remodeling of the augmented part of the bladder. The structure of the biocomposite material made it possible to deliver an intact Am to the area for regeneration. An unmodified Am surface supported regeneration of the urinary bladder wall and the PLCL membranes did not disturb the regeneration process. Conclusions Am reinforcement with electrospun nanofibers offers a new strategy to improve Am mechanical resistance without affecting its unique bioactivity profile.
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Affiliation(s)
- Jan Adamowicz
- Chair of Urology, Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
- Department of General, Oncologic and Pediatric Urology, Nicolaus Copernicus University, Bydgoszcz, Poland
- * E-mail:
| | - Marta Pokrywczyńska
- Chair of Urology, Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | - Jakub Tworkiewicz
- Chair of Urology, Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
- Department of Urology, Nicolaus Copernicus Hospital Batory, Torun, Poland
| | - Tomasz Kowalczyk
- Laboratory of Modeling in Biology and Medicine, Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Shane V. van Breda
- Department of Internal Medicine, Division of Infectious Diseases, University of Pretoria, Pretoria, South Africa
| | - Dominik Tyloch
- Chair of Urology, Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
- Department of General, Oncologic and Pediatric Urology, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Tomasz Kloskowski
- Chair of Urology, Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | - Magda Bodnar
- Department of Clinical Pathomorphology, Faculty of Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Joanna Skopinska-Wisniewska
- Department of Chemistry of Biomaterials and Cosmetics, Faculty of Chemistry, Nicolaus Copernicus University, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Andrzej Marszałek
- Department of Clinical Pathomorphology, Faculty of Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Tomasz A. Kowalewski
- Department of Mechanics and Physics of Fluids, Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland, Poland
| | - Tomasz Drewa
- Chair of Urology, Department of Regenerative Medicine, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
- Department of General, Oncologic and Pediatric Urology, Nicolaus Copernicus University, Bydgoszcz, Poland
- Department of Urology, Nicolaus Copernicus Hospital Batory, Torun, Poland
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Poletajew S, Braticevici B, Brisuda A, Cauni V, Grygorenko V, Lesnyak MZ, Lisiński J, Persu C, Renk K, Radziszewski P. Timing of radical cystectomy in Central Europe - multicenter study on factors influencing the time from diagnosis to radical treatment of bladder cancer patients. Cent European J Urol 2015; 68:9-14. [PMID: 26029471 PMCID: PMC4408384 DOI: 10.5173/ceju.2015.01.444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 08/28/2014] [Accepted: 09/23/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Time that passes between an unfavourable diagnosis to a radical cystectomy (RC) affects oncological outcomes in patients with bladder cancer. Unsatisfactory survival of patients after RC in Central Europe can potentially result from this factor. MATERIAL AND METHODS The aim of this study was to assess the time interval between transurethral resection of the bladder tumor (TURBT) and RC in Central Europe and to identify clinical factors of possible delays. 941 consecutive patients who underwent RC in nine Central European urological centers were enrolled into the study. After the TURBT-RC time was calculated, selected clinical and pathological parameters were tested as potential factors influencing the timing of RC. RESULTS On average, RCs were performed 73.8 days after TURBTs (median - 53, range 0-1587). In 238 patients (25.3%) the time exceeded 12 weeks. Patients with muscle-invasive cancer were operated earlier on than patients with nonmuscle-invasive cancer (67.6 vs.105.2 days, RR = 1.41, p = 0.00). In high volume centers (>30 RC per year) longer TURBT-RC intervals were observed (97.6 vs. 66.3 days, RR = 2.49, p = 0.00). Simultaneously, factors such as female sex (RR = 1.21), more advanced age of patient (>65 years, RR = 1.23), presence of concomitant CIS (RR = 2.43), grade of cancer cells (RR = 1.67) and final post-RC stage (RR = 1.51) had no statistically significant effect on the results (p >0.05). CONCLUSIONS The mean time interval between the diagnosis and radical treatment of patients with bladder cancer in Central Europe is adequate. However, there are still a relatively high number of patients waiting for radical cystectomy longer than 8 weeks. A lower stage of disease as well as a higher case load within of a hospital may delay the surgery.
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Affiliation(s)
| | | | - Antonín Brisuda
- Charles University, 2nd Faculty of Medicine, Teaching Hospital in Motol, Department of Urology, Prague, Czech Republic
| | - Victor Cauni
- Colentina Clinical Hospital, Department of Urology, Bucharest, Romania
| | - Viacheslav Grygorenko
- National Academy of Medical Sciences of Ukraine, Institute of Urology, Department of Restorative Urology and Newest Technology, Kyiv, Ukraine
| | | | - Janusz Lisiński
- Pomeranian Medical University, Department of Urology and Urological Oncology, Szczecin, Poland
| | - Cristian Persu
- Carol Davila Medical University, Department of Urology, Bucharest, Romania
| | - Kacper Renk
- Ceynowa Hospital, Department of Urology, Wejherowo, Poland
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Application of bladder acellular matrix in urinary bladder regeneration: the state of the art and future directions. BIOMED RESEARCH INTERNATIONAL 2015; 2015:613439. [PMID: 25793199 PMCID: PMC4352424 DOI: 10.1155/2015/613439] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 11/15/2014] [Accepted: 11/18/2014] [Indexed: 12/14/2022]
Abstract
Construction of the urinary bladder de novo using tissue engineering technologies is the “holy grail” of reconstructive urology. The search for the ideal biomaterial for urinary bladder reconstruction has been ongoing for decades. One of the most promising biomaterials for this purpose seems to be bladder acellular matrix (BAM). In this review we determine the most important factors, which may affect biological and physical properties of BAM and its regeneration potential in tissue engineered urinary bladder. We also point out the directions in modification of BAM, which include incorporation of exogenous growth factors into the BAM structure. Finally, we discuss the results of the urinary bladder regeneration with cell seeded BAM.
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20
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Blood vessel matrix seeded with cells: a better alternative for abdominal wall reconstruction-a long-term study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:890613. [PMID: 25705696 PMCID: PMC4326343 DOI: 10.1155/2015/890613] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 12/31/2014] [Indexed: 01/07/2023]
Abstract
PURPOSE The aim of this study was to present abdominal wall reconstruction using a porcine vascular graft seeded with MSC (mesenchymal stem cells) on rat model. MATERIAL AND METHODS Abdominal wall defect was prepared in 21 Wistar rats. Acellular porcine-vascular grafts taken from aorta and prepared with Triton X were used. 14 aortic grafts were implanted in place, of which 7 grafts were seeded with rat MSC cells (Group I), and 7 were acellular grafts (Group II). As a control, 7 standard polypropylene meshes were used for defect augmentation (Group III). The assessment method was performed by HE and CD31 staining after 6 months. The mechanical properties have been investigated by Zwick&Roell Z0.5. RESULTS The strongest angiogenesis and lowest inflammatory response were observed in Group I. Average capillaries density was 2.75, 0.75, and 1.53 and inflammatory effect was 0.29, 1.39, and 2.72 for Groups I, II, and III, respectively. The means of mechanical properties were 12.74 ± 1.48, 7.27 ± 1.56, and 14.4 ± 3.7 N/cm in Groups I and II and control, respectively. CONCLUSIONS Cell-seeded grafts have better mechanical properties than acellular grafts but worse than polypropylene mesh. Cells improved mechanical and physiological properties of decellularized natural scaffolds.
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Bury MI, Fuller NJ, Wethekam L, Sharma AK. Bone marrow derived cells facilitate urinary bladder regeneration by attenuating tissue inflammatory responses. Cent European J Urol 2015; 68:115-20. [PMID: 25914850 PMCID: PMC4408398 DOI: 10.5173/ceju.2015.01.526] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 01/10/2015] [Accepted: 01/13/2015] [Indexed: 01/10/2023] Open
Abstract
Introduction Inflammatory responses following tissue injury are essential for proper tissue regeneration. However, dysfunctional or repetitive inflammatory tissue assaults can lead to poor tissue regeneration and ultimate tissue failure via fibrosis. Previous attempts at urinary bladder tissue regeneration utilizing polymeric and biologic scaffolding materials tended to elicit these responses leading to poor tissue regeneration. Recent advances in bladder regeneration utilizing bone marrow derived mesenchymal stem cells (MSCs) and CD34+ hematopoietic stem/progenitor cells (HSPCs) with biocompatible citric acid based scaffolds have provided an environment that not only promotes the growth of architecturally germane and physiologically functional tissue, but also modulates aspects of the innate immune response. Material and methods Within this study MSCs, CD34+ HSPCs, or MSC/CD34+ HSPC seeded POC [poly (1,8-octanediol-co-citrate)] scaffolds were utilized in an established rodent bladder augmentation model to evaluate inflammation as it pertains to bladder tissue regeneration. Results Quantified data from post-augmentation regenerated tissue samples at the 4 week time-point demonstrated that POC/MSC and POC/MSC + CD34+ HSPC grafts markedly reduced the presence of pro-inflammatory CD68+ macrophages and MPO+ neutrophils compared to unseeded POC or POC/CD34+ HSPC-only seeded grafts. Pro-inflammatory cytokines TNFα and IL-1b were also significantly down-regulated with a concomitant increase in the anti-inflammatory cytokines IL-10 and IL-13 in the aforementioned POC/MSC and POC/MSC + CD34+ HSPC composites. Furthermore, this led to fewer instances of bladder tissue granuloma formation combined with greater muscle content and tissue angiogenic events as previous data has demonstrated. Conclusions Data indicates that POC/MSC and POC/MSC + CD34+ HSPC grafts attenuate the innate inflammatory response and promote bladder tissue regeneration.
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Affiliation(s)
- Matthew I Bury
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Urology, Chicago, IL, USA
| | - Natalie J Fuller
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Urology, Chicago, IL, USA
| | - Linnea Wethekam
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Urology, Chicago, IL, USA
| | - Arun K Sharma
- Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Urology, Chicago, IL, USA ; Northwestern University Feinberg School of Medicine, Department of Urology, Chicago, IL, USA ; Northwestern University, Simpson Querrey Institute for BioNanotechnology, Chicago, IL, USA ; Northwestern University, Department of Biomedical Engineering, Evanston, IL, USA
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Kloskowski T, Pokrywczyńska M, Drewa T. Artificial urinary conduit construction using tissue engineering methods. Cent European J Urol 2014; 68:109-14. [PMID: 25914849 PMCID: PMC4408386 DOI: 10.5173/ceju.2015.01.448] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/12/2014] [Accepted: 11/16/2014] [Indexed: 11/24/2022] Open
Abstract
Introduction Incontinent urinary diversion using an ileal conduit is the most popular method used by urologists after bladder cystectomy resulting from muscle invasive bladder cancer. The use of gastrointestinal tissue is related to a series of complications with the necessity of surgical procedure extension which increases the time of surgery. Regenerative medicine together with tissue engineering techniques gives hope for artificial urinary conduit construction de novo without affecting the ileum. Material and methods In this review we analyzed history of urinary diversion together with current attempts in urinary conduit construction using tissue engineering methods. Based on literature and our own experience we presented future perspectives related to the artificial urinary conduit construction. Results A small number of papers in the field of tissue engineered urinary conduit construction indicates that this topic requires more attention. Three main factors can be distinguished to resolve this topic: proper scaffold construction along with proper regeneration of both the urothelium and smooth muscle layers. Conclusions Artificial urinary conduit has a great chance to become the first commercially available product in urology constructed by regenerative medicine methods.
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Affiliation(s)
- Tomasz Kloskowski
- Chair of Regenerative Medicine, Department of Tissue Engineering, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Marta Pokrywczyńska
- Chair of Regenerative Medicine, Department of Tissue Engineering, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Tomasz Drewa
- Chair of Regenerative Medicine, Department of Tissue Engineering, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland ; Nicolaus Copernicus Hospital in Toruń, Department of General and Oncologic Urology, Toruń, Poland
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Pokrywczynska M, Jundzill A, Adamowicz J, Kowalczyk T, Warda K, Rasmus M, Buchholz L, Krzyzanowska S, Nakielski P, Chmielewski T, Bodnar M, Marszalek A, Debski R, Frontczak-Baniewicz M, Mikułowski G, Nowacki M, Kowalewski TA, Drewa T. Is the poly (L- lactide- co- caprolactone) nanofibrous membrane suitable for urinary bladder regeneration? PLoS One 2014; 9:e105295. [PMID: 25162451 PMCID: PMC4146509 DOI: 10.1371/journal.pone.0105295] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 07/22/2014] [Indexed: 12/28/2022] Open
Abstract
The purpose of this study was to compare: a new five-layered poly (L-lactide-co-caprolactone) (PLC) membrane and small intestinal submucosa (SIS) as a control in rat urinary bladder wall regeneration. The five-layered poly (L-lactide-co-caprolactone) membrane was prepared by an electrospinning process. Adipose tissue was harvested from five 8-week old male Wistar rats. Adipose derived stem cells (ADSCs) were seeded in a density of 3×10(6) cells/cm2 onto PLC membrane and SIS scaffolds, and cultured for 5-7 days in the stem cell culture medium. Twenty male Wistar rats were randomly divided into five equal groups. Augmentation cystoplasty was performed in a previously created dome defect. Groups: (I) PLC+ 3×10(6)ADSCs; (II) SIS+ 3×10(6)ADSCs; (III) PLC; (IV) SIS; (V) control. Cystography was performed after three months. The reconstructed urinary bladders were evaluated in H&E and Masson's trichrome staining. Regeneration of all components of the normal urinary bladder wall was observed in bladders augmented with cell-seeded SIS matrices. The urinary bladders augmented with SIS matrices without cells showed fibrosis and graft contraction. Bladder augmentation with the PLC membrane led to numerous undesirable events including: bladder wall perforation, fistula or diverticula formation, and incorporation of the reconstructed wall into the bladder lumen. The new five-layered poly (L-lactide-co-caprolactone) membrane possesses poorer potential for regenerating the urinary bladder wall compared with SIS scaffold.
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Affiliation(s)
- Marta Pokrywczynska
- Chair of Regenerative Medicine, Department of Tissue Engineering, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | - Arkadiusz Jundzill
- Chair of Regenerative Medicine, Department of Tissue Engineering, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | - Jan Adamowicz
- Chair of Regenerative Medicine, Department of Tissue Engineering, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | - Tomasz Kowalczyk
- Department of Theory of Continuous Media, Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Karolina Warda
- Chair of Regenerative Medicine, Department of Tissue Engineering, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | - Marta Rasmus
- Chair of Regenerative Medicine, Department of Tissue Engineering, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | - Lukasz Buchholz
- Chair of Regenerative Medicine, Department of Tissue Engineering, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | - Sandra Krzyzanowska
- Chair of Regenerative Medicine, Department of Tissue Engineering, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | - Pawel Nakielski
- Department of Mechanics and Physics of Fluids, Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Tomasz Chmielewski
- Department of Mechanics and Physics of Fluids, Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Magdalena Bodnar
- Department of Clinical Pathomorphology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | - Andrzej Marszalek
- Department of Clinical Pathomorphology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
- Department of Tumor Pathology, Center of Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Robert Debski
- Department of Pediatrics, Hematology and Oncology, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | | | - Grzegorz Mikułowski
- Department of Intelligent Technologies, Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Maciej Nowacki
- Chair of Regenerative Medicine, Department of Tissue Engineering, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
| | - Tomasz A. Kowalewski
- Department of Mechanics and Physics of Fluids, Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Tomasz Drewa
- Chair of Regenerative Medicine, Department of Tissue Engineering, Nicolaus Copernicus University in Torun, Ludwik Rydygier Medical College in Bydgoszcz, Bydgoszcz, Poland
- Department of Urology, Nicolaus Copernicus Hospital, Torun, Poland
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Kloskowski T, Jundziłł A, Kowalczyk T, Nowacki M, Bodnar M, Marszałek A, Pokrywczyńska M, Frontczak-Baniewicz M, Kowalewski TA, Chłosta P, Drewa T. Ureter regeneration-the proper scaffold has to be defined. PLoS One 2014; 9:e106023. [PMID: 25162415 PMCID: PMC4146565 DOI: 10.1371/journal.pone.0106023] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 07/27/2014] [Indexed: 12/22/2022] Open
Abstract
The aim of this study was to compare two different acellular scaffolds: natural and synthetic, for urinary conduit construction and ureter segment reconstruction. Acellular aortic arch (AAM) and poly(L-lactide-co-caprolactone) (PLCL) were used in 24 rats for ureter reconstruction in both tested groups. Follow-up period was 4 weeks. Intravenous pyelography, histological and immunohistochemical analysis were performed. All animals survived surgical procedures. Patent uretero-conduit junction was observed only in one case using PLCL. In case of ureter segment reconstruction ureters were patent in one case using AAM and in four cases using PLCL scaffolds. Regeneration of urothelium layer and focal regeneration of smooth muscle layer was observed on both tested scaffolds. Obtained results indicates that synthetic acellular PLCL scaffolds showed better properties for ureter reconstruction than naturally derived acellular aortic arch.
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Affiliation(s)
- Tomasz Kloskowski
- Chair of Regenerative Medicine, Department of Tissue Engineering, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
- * E-mail:
| | - Arkadiusz Jundziłł
- Chair of Regenerative Medicine, Department of Tissue Engineering, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Tomasz Kowalczyk
- Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Maciej Nowacki
- Chair of Regenerative Medicine, Department of Tissue Engineering, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Magdalena Bodnar
- Department of Clinical Pathomorphology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Andrzej Marszałek
- Department of Clinical Pathomorphology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Marta Pokrywczyńska
- Chair of Regenerative Medicine, Department of Tissue Engineering, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Tomasz A. Kowalewski
- Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Piotr Chłosta
- Urology Department, Jagiellonian University, Krakow, Poland
| | - Tomasz Drewa
- Chair of Regenerative Medicine, Department of Tissue Engineering, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
- Urology Department, Nicolaus Copernicus Hospital, Toruń, Poland
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