Towards rebuilding vaginal support utilizing an extracellular matrix bioscaffold.
Towards rebuilding vaginal support utilizing an extracellular matrix bioscaffold.
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DOI：
10.1016/j.actbio.2017.05.015
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发表时间：
2017-07-15
影响因子：
9.7
通讯作者：
Moalli PA
中科院分区：
文献类型：
--
作者：
Liang R;Knight K;Easley D;Palcsey S;Abramowitch S;Moalli PA
作为聚丙烯补片的替代品，我们探索了一种来源于膀胱基质（MatriStem™）的细胞外基质（ECM）生物支架用于阴道脱垂的修复。我们的目的是恢复中断的阴道支持模拟应用程序通过经阴道和经腹的方法在猕猴模型中，重点是对阴道结构，功能和宿主免疫反应的影响。在16只猕猴中，剖腹手术后，子宫骶骨韧带和骨盆侧壁的阴道旁附件被完全横断（IACUC# 13081928）。将6层MatriStem切割成后部和前部模板，其中一部分覆盖阴道和手臂，分别模拟子宫骶骨韧带和阴道旁附件。在手术暴露正确的解剖部位后，在8只动物中，在前阴道和后阴道上制作阴道切口，并在放置前将相应的支架通过这些切口（经阴道插入）进入阴道。其余8只动物接受了相同的手术，无阴道切口（经腹插入）。植入后3个月，两个MatriStem组均出现从阴道延伸至骨盆侧壁的牢固组织带。检查MatriStem对阴道影响的实验终点表明，MatriStem无切口组和假手术对照组的阴道生化和生物力学参数、平滑肌厚度和收缩性以及免疫反应相似。在MatriStem切口组中，与假手术组相比，观察到阴道硬度降低41%（P=0.042），胶原蛋白含量降低22%（P=0.008），胶原蛋白亚型III/I增加25%。与假手术组相比，两个基质组的活性MMP 2均增加（均P=0.002）。这项研究提出了一种新的ECM生物支架的应用，作为重建阴道支持的第一步。
As an alternative to polypropylene mesh, we explored an extracellular matrix (ECM) bioscaffold derived from urinary bladder matrix (MatriStem™) in the repair of vaginal prolapse. We aimed to restore disrupted vaginal support simulating application via transvaginal and transabdominal approaches in a macaque model focusing on the impact on vaginal structure, function, and the host immune response. In 16 macaques, after laparotomy, the uterosacral ligaments and paravaginal attachments to pelvic side wall were completely transected (IACUC# 13081928). 6ply MatriStem was cut into posterior and anterior templates with a portion covering the vagina and arms simulating uterosacral ligaments and paravaginal attachments, respectively. After surgically exposing the correct anatomical sites, in 8 animals, a vaginal incision was made on the anterior and posterior vagina and the respective scaffolds were passed into the vagina via these incisions (transvaginal insertion) prior to placement. The remaining 8 animals underwent the same surgery without vaginal incisions (transabdominal insertion). Three months post implantation, firm tissue bands extending from vagina to pelvic side wall appeared in both MatriStem groups. Experimental endpoints examining impact of MatriStem on the vagina demonstrated that vaginal biochemical and biomechanical parameters, smooth muscle thickness and contractility, and immune responses were similar in the MatriStem no incision group and sham-operated controls. In the MatriStem incision group, a 41% decrease in vaginal stiffness (P=0.042), a 22% decrease in collagen content (P=0.008) and a 25% increase in collagen subtypes III/I was observed vs. Sham. Active MMP2 was increased in both Matristem groups vs. Sham (both P=0.002). This study presents a novel application of ECM bioscaffolds as a first step towards the rebuilding of vaginal support.
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影响因子：
9.8
作者：
Boreham, MK;Wai, CY;Word, RA
通讯作者：
Word, RA
DOI：
10.1016/s0002-9378(96)70084-4
发表时间：
1996-12-01
影响因子：
9.8
作者：
Benson, JT;Lucente, V;McClellan, E
通讯作者：
McClellan, E
影响因子：
2.8
作者：
Liang, R;Woo, SLY;Abramowitch, SD
通讯作者：
Abramowitch, SD
影响因子：
4.1
作者：
Agrawal, Vineet;Tottey, Stephen;Badylak, Stephen F.
通讯作者：
Badylak, Stephen F.
影响因子：
2.2
作者：
Badylak, S;Kokini, M;Whitson, B
通讯作者：
Whitson, B