Regeneration of trachea graft with cartilage support, vascularization, and epithelization
Regeneration of trachea graft with cartilage support, vascularization, and epithelization
复制标题
具有软骨支持、血管化和上皮化的气管移植物再生
DOI：
10.1016/j.actbio.2019.03.003
复制
发表时间：
2019-04-15
影响因子：
9.7
通讯作者：
Cao, Yilin
中科院分区：
文献类型：
--
作者：
Li, Dan;Yin, Zongqi;Cao, Yilin
长段气管缺损的修复与功能重建一直是临床的一大难题。寻找理想的气管移植替代品是解决这一问题的唯一途径。本研究提出了一系列构建仿生活气管替代物的新策略。对于管状软骨的支撑问题，采用基于软骨细胞高密度培养的软骨片技术，避免了材料引发的炎症反应，从而在自体山羊模型中形成成熟的软骨样组织。在上皮化问题上，采用口腔黏膜上皮的自体移植，实现气管管腔粘膜覆盖。最后，采用显微外科技术分离双血供斜方肌平筋膜瓣，使再生软骨和移植上皮同时实现稳定的预血管化。综合上述策略，在山羊模型中成功构建了管状软骨支持的血管化上皮化气管替代物。重建气管具有与天然气管相当的肌肉-软骨-筋膜-粘膜多层结构，可实现稳定存活和长期气道功能维持，为长段气管缺损的修复和永久性功能重建提供了一种有前景的气管替代品。长段气管缺损的修复一直是临床的一大难题。寻找理想的气管移植替代品是解决这一问题的唯一途径。本研究通过软骨再生、显微外科和口腔黏膜移植的技术整合，在山羊自体模型中成功构建了具有良好血管化、上皮化和管状软骨支持的复杂气管替代物。重建气管替代物具有与天然气管完全相似的肌肉-软骨-筋膜-粘膜多层结构，可实现稳定生存和长期气道功能维持。本研究为长节段气管缺损的永久性功能重建提供了可行的策略和理想的气管替代物。(C) 2019材料学报Elsevier Ltd.出版。版权所有。
The repair and functional reconstruction of long-segment tracheal defects is always a great challenge in the clinic. Finding an ideal substitute for tracheal transplantation is the only way to solve this problem. The current study proposed a series of novel strategies for constructing a bionic living trachea substitute. For the issue of tubular cartilage support, cartilage sheet technique based on high-density culture of chondrocytes was adopted to avoid the inflammatory reaction triggered by the materials and thus formed mature cartilage-like tissue in autologous goat model. For the issue of epithelialization, the autologous transplantation of oral mucosal epithelium was used to realize mucosa coverage of the constructed trachea lumen. Finally, the flat trapezius fascia flap with double blood supply was separated by microsurgical techniques to achieve stable pre-vascularization of both the regenerated cartilage and the grafted epithelium simultaneously. By integrating the above strategies, the vascularized and epithelialized tracheal substitute with tubular cartilage support was successfully constructed in a goat model. The reconstructed trachea possessed a multiple layer structure of muscle-cartilage-fascia-mucosa comparable to the native trachea, and thus might realize stable survival and long-term airway function maintenance, providing a promising tracheal substitute for the repair and permanent functional reconstruction of long-segment tracheal defects.Statement of SignificanceThe repair of long-segment tracheal defects is always a great challenge in the clinic. Finding an ideal substitute for tracheal transplantation is the only way to solve this problem. In the current study, by technical integration of cartilage regeneration, microsurgery, and oral mucosa transplantation, a complex tracheal substitute with satisfactory vascularization, epithelialization, and tubular cartilage support was successfully constructed in a goat autologous model. The reconstructed trachea substitute possessed a multiple layer structure of muscle-cartilage-fascia-mucosa exactly similar to native trachea, and thus might realize stable survival and long-term airway function maintenance. The current study provides feasible strategies and ideal tracheal substitutes for permanent functional reconstruction of long-segmental trachea defects. (C) 2019 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.