Esophageal reconstruction with ECM and muscle tissue in a dog model
Esophageal reconstruction with ECM and muscle tissue in a dog model
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DOI：
10.1016/j.jss.2005.03.002
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发表时间：
2005-09-01
影响因子：
2.2
通讯作者：
Nieponice, A
中科院分区：
文献类型：
--
作者：
Badylak, SF;Vorp, DA;Nieponice, A
我们进行了一项体内研究，以确定与自体肌肉组织共定位的细胞外基质（ECM）支架是否可以实现食管组织的建设性重塑而不造成狭窄。从猪膀胱中提取的ECM经过加工、脱细胞、配置成管状，并最终消毒，用于犬模型食管重建的生物支架折叠。22只狗被分成4组，3组5只，1组7只。1组和2组分别用ECM或肌肉组织修复。3组和4组分别用ECM加部分（30%）肌肉组织覆盖或完全（100%）肌肉组织覆盖修复。1组和2组因难治性食管狭窄形成，均在约3周内处死。3组5只狗中有4只和4组7只狗中有6只存活了26天至230天，显示出食管组织的建设性重构，形成了组织有序的食管组织层，狭窄最小，食管运动，临床结果正常。对第3组和第4组动物的一部分重塑食管组织的力学测试显示，从相对僵硬、不顺从的ECM管结构向接近正常生物力学特性的组织进行了渐进式重塑。我们得出结论，ECM生物支架加自体肌肉组织，而不是单独的ECM支架或肌肉组织，可以促进结构和功能可接受的食管组织的原位重建。(c) 2005爱思唯尔公司版权所有。
An in vivo study was conducted to determine if an extracellular matrix (ECM) scaffold co-localized with autologous muscle tissue could achieve constructive remodeling of esophageal tissue without stricture. ECM derived from the porcine urinary bladder was processed, decellularized, configured into a tube shape, and terminally sterilized for use as a bioscaf-fold for esophageal reconstruction in a dog model. Twenty-two dogs were divided into four groups, three groups of five and one group of seven. Groups 1 and 2 were repaired with either ECM alone or muscle tissue alone, respectively. Groups 3 and 4 were repaired with ECM plus either a partial (30%) covering with muscle tissue or a complete (100%) covering with muscle tissue, respectively. Animals in groups 1 and 2 were sacrificed within approximately 3 weeks because of the formation of intractable esophageal stricture. Four of five dogs in group 3 and six of seven dogs in group 4 were survived for 26 days to 230 days and showed constructive remodeling of esophageal tissue with the formation of well organized esophageal tissue layers, minimal stricture, esophageal motility, and a normal clinical outcome. Mechanical testing of a subset of the remodeled esophageal tissue from animals in groups 3 and 4 showed progressive remodeling from a relatively stiff, non-compliant ECM tube structure toward a tissue with near normal biomechanical properties. We conclude that ECM bioscaffolds plus autologous muscle tissue, but not ECM scaffolds or muscle tissue alone, can facilitate the in situ reconstitution of structurally and functionally acceptable esophageal tissue. (c) 2005 Elsevier Inc. All rights reserved.