Reduced urothelial regeneration in rat bladders augmented with permeable porcine small intestinal submucosa assessed by magnetic resonance imaging.
Reduced urothelial regeneration in rat bladders augmented with permeable porcine small intestinal submucosa assessed by magnetic resonance imaging.
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DOI：
10.1002/jbm.b.33985
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发表时间：
2018-07
期刊：
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通讯作者：
Qing Yang;D. Xia;R. Towner;N. Smith;D. Saunders;K. Fung;C. Aston;B. Greenwood-Van Meerveld;R. Hurst;S. Madihally;B. Kropp;Hsueh-Kung Lin
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作者：
Qing Yang;D. Xia;R. Towner;N. Smith;D. Saunders;K. Fung;C. Aston;B. Greenwood-Van Meerveld;R. Hurst;S. Madihally;B. Kropp;Hsueh-Kung Lin
增强肠膀胱成形术仍然是增加功能障碍膀胱容量和顺应性的金标准外科膀胱重建手术。由于使用患者的肠道具有严重的并发症风险，因此已经探索了替代的可生物降解基质。猪小肠黏膜下层（SIS）因其良好的生物学特性而在膀胱重建中受到广泛关注。然而，试验表明与SIS的再生不一致，这归因于微观结构和机械性能的不均匀性。我们假设SIS对尿液的渗透性不均匀是导致不一致的一个因素。我们测量了渗透性，尿液原位对比增强磁共振成像（MRI），并评估尿道再生尿道上皮细胞标志物在SIS增强大鼠膀胱免疫组化染色。结果显示，SIS增强的大鼠膀胱的渗透性存在显着差异。然后根据MRI结果将商业SIS支架分为无泄漏和泄漏组。苏木精和伊红染色显示，在第14天，相对于非渗漏SIS，渗漏SIS中的炎性细胞数量更多。此外，三色染色显示第28天SIS增强膀胱组之间胶原蛋白分布的主要变化。此外，在非渗漏SIS增强的膀胱中完成了尿路上皮相关标志物（细胞角蛋白AE 1/AE 3，claudin 4和uroplakin III）的表达，而在渗漏SIS增强的膀胱中注意到有限的尿路上皮分化在增强后第14天。这些结果表明，支架对尿液的渗透性可能是猪SIS再生能力变化的原因。MRI技术的应用将有助于了解生物材料性能与再生能力之间的关系。© 2017威利期刊公司. J Biomed Mater Res Part B：Appl Biomater，106 B：1778-1787，2018。
Augmentation enterocystoplasty remains the gold standard surgical bladder reconstruction procedure to increase the capacity and compliance of dysfunctional bladders. Since the use of the patient's intestine has severe risks of complications, alternative biodegradable matrices have been explored. Porcine small intestinal submucosa (SIS) has gained immense interests in bladder reconstruction due to its favorable properties. However, trials have shown inconsistent regeneration with SIS, attributed to the heterogeneity in microstructures and mechanical properties. We hypothesize that uneven SIS permeability to urine is a factor responsible for the inconsistency. We measured permeability to urine in situ using a contrast enhanced-magnetic resonance imaging (MRI), and evaluated urothelium regeneration using immunohistochemical staining of urothelial cell markers in SIS-augmented rat bladders. Results showed significant differences in permeability among SIS-augmented rat bladders. Commercial SIS scaffolds were then categorized into nonleaky and leaky groups based on MRI results. Hematoxylin and eosin staining showed higher numbers of inflammatory cells in leaky SIS on day 14 relative to nonleaky SIS. In addition, trichrome staining showed major changes in the distribution of collagen on day 28 between SIS-augmented bladder groups. Furthermore, expressions of urothelium-associated markers (cytokeratins AE1/AE3, claudin 4, and uroplakin III) were completed in bladders augmented with nonleaky SIS, whereas limited urothelial differentiation was noticed in leaky SIS-augmented bladders at post-augmentative day 14. These results show that scaffold permeability to urine may be responsible for variations in regenerative capacity of porcine SIS. Applications of MRI technique will be helpful to understand a relationship between biomaterial property and regenerative capacity. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1778-1787, 2018.