Study of bladder regeneration using acellular matrix graft

目的：探讨膀胱脱细胞基质移植(BAMG)再生膀胱的可行性。在啮齿动物模型中，脱细胞基质作为支架很容易诱导膀胱再生，即使在患病的宿主膀胱中也是如此。将血管内皮生长因子蛋白注射到宿主膀胱后，脱细胞基质移植物内的膀胱再生过程得到了加强，组织学和功能研究结果之间存在良好的相关性。因此，这些研究表明，膀胱脱细胞基质移植物(BAMG)可以成功地扩大正常和疾病大鼠的膀胱。在猪的模型中，BAMG内的膀胱再生是可能的，而BAMG的收缩似乎是不可避免的。我们推测，更多的机会为BAMG提供血液供应，可能会加速涉及膀胱再生的过程。下一步，我们研究双侧输尿管同时植入双侧输尿管是否可以增强…的进程。部分替代BAMG的膀胱再生能力更强。植入BAMG后1周，两组宿主膀胱炎性改变明显。BAMG管腔表面未见明显的内窥镜改变。术后2周，两组炎性改变减轻，BMAG上皮化，尤其是靠近宿主膀胱处。输尿管植入组BAMG上皮化程度与植入输尿管相近。植入BAMG后4周，两组BAMG上皮化仍在进行中，但输尿管植入组上皮化更为活跃和扩张。在猪模型中，内窥镜观察显示，双侧输尿管同时植入BAMG上可以增强脱细胞同种异体基质移植物上皮化的潜力。这种利用宿主输尿管和膀胱作为潜在的膀胱再生来源的新方法可以提供快速和完全再生膀胱替代物的可能性。较少

Feasibility of bladder regeneration using bladder acellular matrix graft (BAMG) was investigated. Ina rodent model, acellular matrix as a scaffold was easily applied to induce bladder regeneration even in the diseased host bladder. The process of bladder regeneration within the acellular matrix graft was enhanced after VEGF protein injection into the host bladder, with promising correlation between histological and functional findings. Therefore, these studies demonstrated that normal as well as diseased rat bladder can be successfully augmented with the bladder acellular matrix graft (BAMG). In a porcine model, the bladder regeneration within the BAMG was possible, while the shrinkage of the BAMG appeared to be inevitable. We hypothesized that more chance of providing blood supply to the BAMG could render it possible to accelerate the process involving the bladder regeneration. Next, we investigated whether simultaneous implantation of bilateral ureters onto BAMG can enhance the proce … More ss of bladder regeneration in partial substitution with BAMG. At one week after BAMG implantation, significant inflammatory changes were observed on the host bladder in both groups. No significant endoscopic changes were observed on the luminal surface of BAMG. At two weeks after operation, the inflammatory changes were diminished and epithelization on BMAG was identified, especially close to the host bladder in both groups. Likewise, epithelization on BAMG close to the implanted ureter was observed in ureteral implantation group. At 4 weeks after BAMG implantation, epithelization on BAMG remained in progress in both groups, however; more active and expansive epithelization was found in ureteral implantation group. In a porcine model, endoscopic observation showed that simultaneous implantation of bilateral ureters onto BAMG could enhance the potential of epithelization on the acellular matrix allograft. This new approach using host ureter and bladder as potential source of bladder regeneration can provide the possibility of rapid and complete regeneration of a bladder substitute. Less