Implantation of physiologically functional bioengineered innervated IAS construct

生理功能生物工程神经支配 IAS 构建体的植入

• 批准号: 7942997
• 负责人: KHALIL N BITAR
• 金额: $ 48.24万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-06-08
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7942997
• 关键词: 3-Dimensional; Accidents; Acetylcholine; Address; Adult; Affect; Age; Animals; Anogenital region; Anus; Anxiety; Applications Grants; Area; Autologous; Biological Neural Networks; Biomedical Engineering; Categories; Cells; Characteristics; Child; Circular layer of muscularis propria of anal canal; Clinical; Clothing; Coculture Techniques; Complex; Contracts; Data; Defect; Devices; Disease; Distress; Drops; Economics; Elderly; Electric Stimulation; Embryo; Enteral; Exclusion; Family; Fecal Impaction; Fecal Incontinence; Female; Fibrosis; Friends; Functional Gastrointestinal Disorders; Harvest; Hematology; High Prevalence; Human; Implant; Incidence; Incontinence; Individual; Infection; Institutionalization; Kidney; Knowledge; Life; Liver; Mechanics; Mental Depression; Modality; Modeling; Mus; Muscle; Muscle Contraction; National Institute of Diabetes and Digestive and Kidney Diseases; Natural History; Natural regeneration; Nature; Neuroglia; Neurons; Neurotransmitters; Organ; Pancreas; Patient Care; Patients; Peripheral; Persons; Physiological; Premature aging syndrome; Prevalence; Prevention; Property; Protocols documentation; Public Health; Quality of life; Regenerative Medicine; Reporting; Research; Risk Factors; Science; Severities; Shame; Skeletal Muscle; Skin; Smooth Muscle; Smooth Muscle Myocytes; Social isolation; Soil; Solutions; Sphincter; Stem cells; Stigmata; Structure of thyroid parafollicular cell; Surgical Flaps; Surveys; Symptoms; System; Time; Tissues; Transplantation; United States National Institutes of Health; Urinary Incontinence; base; caregiving; enema administration; expectation; experience; falls; fetal; gastrointestinal system; high school; human old age (65+); implantation; improved; innovation; nerve stem cell; nerve supply; neural circuit; neuronal circuitry; novel; physical conditioning; precursor cell; pressure; prevent; psychologic; public health relevance; relating to nervous system; repaired; response; sex; social; social stigma; symposium; urologic

DESCRIPTION (provided by applicant): Challenge Area (11) Regenerative Medicine: 11-DK-101: Promote regeneration and repair in the digestive system, liver, pancreas, hematology, kidneys and urological system. Fecal incontinence is a condition with ramifications that extend well beyond the physical manifestations. Many individuals find themselves withdrawing from their social lives and attempting to hide the problem from their families, friends, and even their doctors. The shame, embarrassment, and stigma associated with these conditions pose significant barriers to seeking professional treatment, resulting in many persons who suffer from these conditions without help. As baby boomers approach their sixties, the incidence and public health burden of incontinence are likely to increase. The burdens of fecal incontinence fall into economic and non- economic categories, and each is complex. Individuals who are incontinent may experience anxiety about "accidents," depression, social isolation, and social exclusion. The management of incontinence itself is burdensome. Incontinence requires greater amounts of informal and formal care giving. This was emphasized in the NIH State-of-the-Science Conference in December 2007 [1]. We need to provide solution to enhance the quality of life for individuals with fecal incontinence. Novel hypothesis suggests the effective utilization of knowledge about smooth muscle cells, organs, sphincters and possible replacement of defective IAS sphincters with implantation of bioengineered IAS sphincters are reasonable expectations. This grant proposal offers an effective approach to tackle fecal incontinence. We were able to successfully implant bioengineered rings that were constructed from IAS smooth muscle cells and neuronal precursor cells. In essence we have developed intrinsically innervated IAS constructs in culture that could be used for implantation. The objective of this grant proposal is to implant bioengineered functional IAS constructed from either human or mouse IAS smooth muscle cells with intrinsic innervations connected to extrinsic neural network. These bioengineered IAS constructs will have bioengineered intrinsic neuronal circuitry and will be connected to extrinsic neural network from the animal. Our preliminary data indicates that: (A) in culture, mouse IAS smooth muscle cells co- cultured with Immortomouse Fetal Enteric Neurons (IM-FEN), formed a tight ring around a central post. Peripheral to the ring, the neuronal cells were observed to elongate, branch and form networks around the tight IAS ring. The innervated constructs: 1) contracted and generated sustained force in response to acetylcholine and PdBU; and 2) relaxed in response to VIP and Electrical Filed Stimulation (EFS). (B) Same results were obtained from constructs bioengineered using human IAS smooth muscle cells co-cultured with IM-FEN cells. (C) The innervated bioengineered mouse IAS constructs were successfully implanted under the skin of a strain matched mouse. Rings became vascularized and survived in the animals without any signs of rejection for up to 27 days. (D) Similarly, the innervated bioengineered human IAS constructs were successfully implanted under the skin of an immuno-deficient mouse. Rings became vascularized and survived in the animals without any signs of rejection. (E) Upon harvesting, the vascularized innervated rings maintained their physiological characteristics observed prior to implantation. Our physiological studies confirm that the rings maintain their functional properties are able to develop basal tone and response to contractile and relaxant neurotransmitters as well as EFS. Our preliminary results confirm the proof of concept that bioengineered rings are vascularized upon implantation. The animals tolerate implantation without signs of rejection. This is the first demonstration of physiologically functional bioengineered innervated smooth muscle constructs. These constructs upon implantation were tolerated by recipient animal and became vascularized. These findings represent a substantial advance in GI tissue replacement and transplantation. Based on this, the specific aims of the proposal are: 1. Develop protocols for the culture of ENS progenitor cells and their differentiation into enteric neural and glial cells. 2. Bioengineer a 3-D physiologically functional model of the IAS produced in culture from smooth muscle cells isolated from the IAS of either human or mouse and mouse ENS progenitor cells. 3. Implant an innervated physiologically functional 3-D IAS tissue into a mouse. This is an innovative approach that could result in implantation of bioengineered IAS from autologous cells. This has potential to provide enhanced quality of life to persons with Fecal Incontinence. Furthermore it would have positive implications for research focusing on people suffering from urinary incontinence. PUBLIC HEALTH RELEVANCE: This grant proposal represents an innovative approach that could result in implantation of Bioengineered Internal Anal Sphincter (IAS) from autologous cells. This Bioengineered IAS would have intrinsic neural circuitry derived from embryonic neural progenitor cells. This has potential to provide enhanced quality of life to persons with fecal incontinence. Furthermore it would have positive implication for people suffering from urinary incontinence.

再生医学：11- dk -101：促进消化系统、肝脏、胰腺、血液系统、肾脏和泌尿系统的再生和修复。大便失禁是一种影响远远超出身体表现的情况。许多人发现自己正在退出社交生活，并试图向家人、朋友甚至医生隐瞒自己的问题。与这些疾病相关的羞耻、尴尬和耻辱对寻求专业治疗构成了重大障碍，导致许多患有这些疾病的人得不到帮助。随着婴儿潮一代接近60岁，尿失禁的发病率和公共卫生负担可能会增加。大小便失禁的负担分为经济和非经济两类，每一类都很复杂。大小便失禁的人可能会经历对“事故”的焦虑、抑郁、社会孤立和社会排斥。尿失禁本身的管理是繁重的。失禁需要更多的非正式和正式护理。这在2007年12月的美国国立卫生研究院科学状况会议上得到了强调。我们需要提供解决方案来提高大便失禁患者的生活质量。新的假设表明，有效利用关于平滑肌细胞、器官、括约肌的知识，用生物工程IAS括约肌植入替代缺陷IAS括约肌是合理的期望。这项拨款提案提供了解决大便失禁的有效方法。我们能够成功地植入由IAS平滑肌细胞和神经元前体细胞构建的生物工程环。从本质上讲，我们已经在培养中开发出了可用于植入的内在神经支配的IAS结构。本申请的目的是植入由人类或小鼠IAS平滑肌细胞构建的生物工程功能IAS，其内部神经支配与外部神经网络相连。这些生物工程的IAS结构将具有生物工程的内在神经回路，并将连接到来自动物的外部神经网络。我们的初步数据表明：(A)在培养中，小鼠IAS平滑肌细胞与不朽小鼠胎儿肠神经元（IM-FEN）共培养，在中心柱周围形成一个紧密的环。在环周围，观察到神经元细胞在紧密的IAS环周围伸长、分支并形成网络。神经支配结构：1)对乙酰胆碱和PdBU的反应是收缩和产生持续的力；2)在VIP和电场刺激（EFS）下放松。(B)用人类IAS平滑肌细胞与IM-FEN细胞共培养的生物工程构建物获得了相同的结果。(C)将受神经支配的生物工程小鼠IAS构建物成功植入品系匹配的小鼠皮肤下。环变得血管化，并在动物体内存活了27天，没有任何排斥迹象。(D)同样地，受神经支配的生物工程人类IAS结构成功地植入免疫缺陷小鼠的皮肤下。环变得血管化，并在动物体内存活下来，没有任何排斥迹象。(E)收获后，血管化的神经环保持着床前观察到的生理特征。我们的生理学研究证实，这些环保持了它们的功能特性，能够形成基底张力，并对收缩和松弛的神经递质以及EFS做出反应。我们的初步结果证实了生物工程环在植入时血管化的概念。这些动物能够耐受植入而没有排斥的迹象。这是生理功能的生物工程神经平滑肌结构的第一次演示。这些结构体在植入后被受体动物耐受并血管化。这些发现代表了胃肠道组织替代和移植的重大进展。基于此，本提案的具体目的是：1。制定ENS祖细胞的培养方案，并将其分化为肠神经细胞和胶质细胞。2. 从人类或小鼠的IAS和小鼠ENS祖细胞分离的平滑肌细胞培养中产生的IAS的生物工程三维生理功能模型。3. 在小鼠体内植入有神经支配的具有生理功能的三维IAS组织。这是一种创新的方法，可以从自体细胞中植入生物工程IAS。这有可能提高大便失禁患者的生活质量。此外，这将对关注尿失禁患者的研究产生积极影响。