Regeneration of Functional Bladder Using Cell-seeded Amnion and P(LA/CL) Scaffolds
Regeneration of Functional Bladder Using Cell-seeded Amnion and P(LA/CL) Scaffolds
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DOI：
10.1089/ten.tea.2022.0078
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发表时间：
2022-10-21
影响因子：
4.1
通讯作者：
Kawauchi，Akihiro
中科院分区：
文献类型：
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作者：
Horii，Tsunehito;Jonin，Kazuyoshi;Kawauchi，Akihiro
长期的膀胱再生没有成功，而不是增加与胃肠道段，因为通常进行膀胱重建。评价接种细胞的生物可吸收材料能否在兔模型中再生半切除的膀胱。将雌性日本白色家兔分为两组：细胞接种材料（CSM）组和对照组（每组n= 6）。对照组兔切除一半膀胱。CSM兔膀胱切除后，用细胞种植羊膜和P（LA/CL）材料缝合。术后6、12、18个月行X线检查和膀胱测压，术后18个月行膀胱组织功能和组织学分析。X线片证实CSM组重建膀胱蠕动良好。在膀胱测压中，CSM组的平均最大膀胱容量、最大膀胱压力和25 mL膀胱容量顺应性在6、12和18个月时显著大于对照组。此外，器官浴研究显示，CSM组在电刺激下随着刺激频率的增加收缩良好，而对照组在中央边缘区的两项测试中均显示出较弱的收缩。此外，CSM组中的新血管形成、尿路上皮和平滑肌形成以及神经再生的比率显著高于对照组。口腔黏膜细胞种植羊膜和胃平滑肌细胞种植P（LA/CL）支架带网膜腹腔植入后再生功能性膀胱，上皮和平滑肌满意，无瘢痕形成1年以上。Impact StatementWithout using gastrointestinal segments再生功能性膀胱一直是泌尿外科重建的巨大挑战。各种材料，如非生物可吸收材料和生物材料，已尝试在动物模型中重建膀胱。然而，由于生物相容性低，风险高，难以制造材料，一年多的长期结果失败。在这项研究中，我们揭示了长期的膀胱再生使用细胞接种羊膜和P（LA/CL）材料在兔模型。经1年多的临床观察，该方法能成功地重建膀胱上皮和平滑肌功能良好的功能性膀胱，无瘢痕形成。
Long-term bladder regeneration has not been successful instead of augmentation with gastrointestinal segments, as is commonly performed for bladder reconstruction. To evaluate whether or not cell-seeded bioabsorbable materials regenerate half-resected bladder in a rabbit model. Female Japanese white rabbits were divided two groups: cell-seeded material (CSM) group and Control (n= 6 each). Control rabbits underwent resection of half the bladder. CSM rabbits were sutured with cell-seeded amniotic membrane and P(LA/CL) material after bladder resection. After 6, 12, and 18 months, rabbits underwent X-ray and cystometry, and bladder tissues after 18 months were subjected to functional and histological analyses. X-ray confirmed the peristaltic movements of the reconstructed bladders in the CSM group. On cystometry, the mean maximum bladder volume, maximum bladder pressure, and 25 mL bladder volume compliance in the CSM group were significantly greater than in the Control group at 6, 12, and 18 months. In addition, organ bath studies showed good contraction under electrical stimulation with increasing stimulation frequency in the CSM group, while, the Control group showed weak contraction on both tests in the central marginal zone. Furthermore, the rates of neovascularization, urothelial and smooth muscle formation, and neurofilamentation in the CSM group were significantly greater than in the Control group. Oral mucosal cell-seeded amniotic membrane and stomach smooth muscle cell-seeded P(LA/CL) scaffold with omentum after abdominal implantation regenerated functional bladder with satisfactory epithelium and smooth muscle without scarring more than 1 year.Impact StatementRegeneration of functional bladder without using gastrointestinal segments has been a huge challenge to urological reconstruction. Various materials, such as nonbioabsorbable materials and biomaterials have been attempted to reconstruct bladder in animal models. However, the long-term results more than a year failed due to the low biocompatibility, high risks, and difficulty creating the materials. In this study, we revealed long-term bladder regeneration using cell-seeded amniotic membrane and P(LA/CL) material in a rabbit model. The new method of bladder reconstruction seems able to regenerate functional bladder with satisfactory bladder epithelium and bladder smooth muscle function without scarring for more than 1 year successfully.