Clinical transplantation of a tissue-engineered airway (Publication with Expression of Concern. See vol. 401, 2023) (Publication with Expression of Concern. See vol. 401, pg. 536, 2023)
Clinical transplantation of a tissue-engineered airway (Publication with Expression of Concern. See vol. 401, 2023) (Publication with Expression of Concern. See vol. 401, pg. 536, 2023)
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DOI：
10.1016/s0140-6736(08)61598-6
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发表时间：
2008-12-13
期刊：
影响因子：
168.9
通讯作者：
Birchall, Martin A.
中科院分区：
文献类型：
--
作者：
Macchiarini, Paolo;Jungebluth, Philipp;Birchall, Martin A.
正常气道的丧失是毁灭性的。取代大型航空公司的尝试遇到了严重的问题。组织工程替代的先决条件是合适的基质、细胞、理想的机械特性和无抗原性。我们的目标是使用组织工程方案对管状气管基质进行双工程，并评估该技术在终末期气道疾病患者中的应用。方法：我们从人供体气管中取出细胞和MHC抗原，然后用上皮细胞和间充质干细胞衍生的软骨细胞进行定植，这些软骨细胞是从受体（一位患有终末期支气管软化症的30岁女性）的细胞中培养出来的。然后用这个移植物代替受体的左主支气管。发现移植物立即为受者提供了功能性气道，改善了她的生活质量，并在4个月时具有正常的外观和机械性能。患者无抗供体抗体，未使用免疫抑制药物。结果表明，我们可以制造出一种细胞组织工程气道，其机械性能允许正常功能，并且没有排斥风险。研究结果表明，自体细胞结合适当的生物材料可能为严重临床疾病患者提供成功的治疗。西班牙卫生调查机构卡洛斯三世研究所卫生与消费资助部；布里斯托尔大学Charles Courtenay-Cowlin基金；英国关节炎研究运动；以及詹姆斯都铎基金会
Background The loss of a normal airway is devastating. Attempts to replace large airways have met with serious problems. Prerequisites for a tissue-engineered replacement are a suitable matrix, cells, ideal-mechanical properties, and the absence of antigenicity. We aimed to bicengineer tubular tracheal matrices, using a tissue-engineering protocol, and to assess the application of this technology in a patient with-end-stage airway disease.Methods We removed cells and MHC antigens from a human donor trachea, which was then readily colonised by epithelia] cells and mesenchymal stem-cell.derived chondrocytes that had been cultured from cells taken from the recipient (a 30-year old woman with end-stage bronchomalacia). This graft was then used to replace the recipient's left main bronchus.Findings The graft immediately provided the recipient with a functional airway, improved her quality of life, and had a normal appearance and mechanical properties at 4 months. The patient had no anti-donor antibodies and was not on immunosuppressive drugs.Interpretation The results show that we can produce a cellular, tissue-engineered airway with mechanical properties that allow normal functioning, and which is free from the risks of rejection. The findings suggest that autologous cells combined with appropriate biomaterials might provide successful treatment for patients with serious clinical disorders.Funding Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III, Fondo de Investigacion Sanitaria, Spain; Charles Courtenay-Cowlin Fund, University of Bristol; UK Arthritis Research Campaign; and the James Tudor Foundation.