Vocal cord tissue engineering: Pre-clinical scale-up

退伍军人遭受损失的喉的声带覆盖由于创伤或 喉癌可能会导致发音困难，治疗方案包括 有限公司振动替代组织将彻底改变 喉部疾病本提案所述工作的特点是， 优化了组织工程化的基于细胞的外声带替换（COVR）。 将从脂肪组织分离的成人多能细胞在培养皿中培养。 来源于血液制品冷沉淀物的纤维蛋白水凝胶。其结果是一个 完全自体的三维组织替代物。植入后， 兔子，这种结构愈合良好，并产生正常的短期振动， 发声 COVR构建体现在将被引入到一个大型动物模型中， 为人工翻译做准备。这项研究将评估 组织工程植入物的可行性、安全性和有效性。机制 还将通过确定植入细胞的命运来评估作用， 对细胞外基质和炎症的影响。人体细胞将被植入 免疫抑制。计划建立一个犬模型， 在犬中进行了喉部工作，提供了关于正常 发声如果犬科动物是不可能的，那么猪的模型也可以扩大规模 对大型哺乳动物进行了详细的研究。 完成拟议的研究将决定COVR是否 符合安全性和有效性要求，以便进行更大规模的试验。目标是 以恢复正常发声而没有不良事件。如果成功的结果发生在 这项试点研究，一个更大的试验将进行的意图，产生 用于FDA申请的临床前数据。

Veterans suffering loss of the larynx's vocal fold cover due to trauma or laryngeal cancer can suffer disabling voice difficulties, and treatment options are limited. A vibrating replacement tissue would revolutionize the treatment of laryngeal disorders. The work described in this proposal characterizes and optimizes a tissue-engineered Cell-based Outer Vocal cord Replacement (COVR). Adult human multipotent cells isolated from adipose tissue are cultured within fibrin hydrogel derived from the blood product cryoprecipitate. The result is a completely autologous three-dimensional tissue substitute. Upon implantation in rabbits, this construct healed well and produced normal short-term vibration for voicing. The COVR construct will now be introduced in a large animal model in preparation for human translation. This proposed research will assess the feasibility, safety, and efficacy of the tissue-engineered implant. Mechanisms of action will also be assessed by determining the fate of the implanted cells, and the effect on extracellular matrix and inflammation. Human cells will be implanted with immunosuppression. A canine model is planned because extensive prior laryngeal work has been performed in canines, providing ample data on normal phonation. If canines are impossible, a porcine model would also allow scale-up to large mammals and detailed study of the wound healing. Completion of the proposed research will determine whether the COVR meets safety and efficacy requirements to proceed with a larger trial. The goal is to restore normal voicing without adverse events. If successful outcomes occur in this pilot study, a larger trial will be performed with the intention of generating pre-clinical data for FDA application.