In Vitro Regeneration of Patient-specific Ear-shaped Cartilage and Its First Clinical Application for Auricular Reconstruction.
In Vitro Regeneration of Patient-specific Ear-shaped Cartilage and Its First Clinical Application for Auricular Reconstruction.
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患者特异性耳形软骨的体外再生及其在耳廓重建中的首次临床应用
DOI：
10.1016/j.ebiom.2018.01.011
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发表时间：
2018-03
期刊：
影响因子：
11.1
通讯作者：
Cao Y
中科院分区：
文献类型：
--
作者：
Zhou G;Jiang H;Yin Z;Liu Y;Zhang Q;Zhang C;Pan B;Zhou J;Zhou X;Sun H;Li D;He A;Zhang Z;Zhang W;Liu W;Cao Y
小耳畸形是一种先天性外耳畸形，可严重影响受影响儿童的心理和生理健康。利用组织工程方法在裸鼠体内成功再生人耳状软骨，为耳廓再造提供了一种有前途的方法。然而，由于在细胞来源、形状控制、机械强度、生物安全性、再生软骨的长期稳定性等方面存在技术问题，人体组织工程化耳状软骨尚未应用于临床。利用体外培养技术，采用扩增的小耳软骨细胞、复合生物可降解支架材料，体外构建患者特异性耳状软骨。此外，软骨用于耳廓再造的五个小耳畸形患者，并取得了满意的美学效果与成熟的软骨形成在2.5年的随访中的第一个进行的情况。不同的外科手术也被用来寻找处理组织工程移植物的最佳方法。总之，鉴于体外工程技术和合适的外科手术，该结果代表了组织工程人耳状软骨临床转化的重大突破。本研究已在中国临床试验注册中心（ChiCTR-ICN-14005469）注册。使用扩张的MC和复合可生物降解支架在体外构建了患者特异性耳状软骨。第一例应用组织工程耳状软骨移植治疗的小耳畸形患者随访2.5年。本文还介绍了另外4例手术方式相似和不同的病例。小耳畸形是一种先天性外耳畸形，可严重影响受影响儿童的心理和生理健康。利用扩增的小耳软骨细胞、复合生物降解支架和体外培养技术，体外构建患者特异性耳状软骨，并对5例患者进行了耳状软骨再造的初步临床试验。最长随访2.5年，获得了满意的美学结果和成熟的软骨形成。
Microtia is a congenital external ear malformation that can seriously influence the psychological and physiological well-being of affected children. The successful regeneration of human ear-shaped cartilage using a tissue engineering approach in a nude mouse represents a promising approach for auricular reconstruction. However, owing to technical issues in cell source, shape control, mechanical strength, biosafety, and long-term stability of the regenerated cartilage, human tissue engineered ear-shaped cartilage is yet to be applied clinically. Using expanded microtia chondrocytes, compound biodegradable scaffold, and in vitro culture technique, we engineered patient-specific ear-shaped cartilage in vitro. Moreover, the cartilage was used for auricle reconstruction of five microtia patients and achieved satisfactory aesthetical outcome with mature cartilage formation during 2.5 years follow-up in the first conducted case. Different surgical procedures were also employed to find the optimal approach for handling tissue engineered grafts. In conclusion, the results represent a significant breakthrough in clinical translation of tissue engineered human ear-shaped cartilage given the established in vitro engineering technique and suitable surgical procedure. This study was registered in Chinese Clinical Trial Registry (ChiCTR-ICN-14005469). Patient-specific ear-shaped cartilage was engineered in vitro using expanded MCs and compound biodegradable scaffold. The first microtia case treated with the tissue engineered ear-shaped cartilage was follow-up for 2.5 years. Other four cases with similar and different surgical procedures were also presented. Microtia is a congenital external ear malformation that can seriously influence the psychological and physiological well-being of affected children. Using expanded microtia chondrocytes, compound biodegradable scaffold, and in vitro culture technique, we engineered patient-specific ear-shaped cartilage in vitro, and performed a pilot clinical trial of auricle reconstruction using the engineered ear cartilage on five patients. Satisfactory aesthetical outcome with mature cartilage formation was achieved with the longest follow-up of 2.5 years.
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