Optimal Tissue Engineering Approach for Treating Injured Vocal Folds

项目总结 语音障碍是最常见的沟通障碍，据美国近2000万人报告 每年都有发音困难的症状。这种疾病的治疗费用和工资损失接近13美元。 十亿美元。这些疾病的病因多种多样，但考虑到它们的解剖位置，声带皱折(VF)是 易受多种有害刺激的影响，包括胃内容物反流、医源性损伤和 与发声有关的固有创伤。损伤可导致固有层(LP)结构改变 导致异常的发音生理。到目前为止，还没有任何治疗方法能恢复天然的VF细胞外基质 室颤损伤后(ECM)的组成、结构和功能可能是导致VF预后不佳的基础 伴室颤疤痕的患者。 如果处理得当，细胞外基质可以用作可再吸收的、临床安全的和自然衍生的生物材料。 在减少纤维化的同时促进组织重塑。可注射细胞外基质水凝胶是临床应用的理想材料 和信元交付，特别是考虑到办公室内程序使用 微创手术。我们小组和其他人的工作提供了关于 脱细胞声带固有层(VFLP-ECM)作为注射制剂或作为药物输送载体 治疗细胞，如间充质干细胞。我们广泛地假设VFLP-ECM水凝胶(带有或 没有干细胞)将促进VFS的功能修复。

PROJECT SUMMARY Voice impairment is the most common communication disorder with nearly 20 million people in the US reporting symptoms of dysphonia annually. The cost of treatment and lost wages for this disorder is approaching $13 billion. The etiology of these disorders is diverse, but given their anatomic location, the vocal folds (VFs) are susceptible to a multitude of injurious stimuli, including reflux of gastric contents, iatrogenic injury, and the inherent trauma associated with voice production. Injury can result in altered lamina propria (LP) architecture resulting in aberrant phonatory physiology. To date, no treatment restores the native VF extracellular matrix (ECM) composition, structure, and function following VF injury which likely underlies suboptimal outcomes for patients with VF scar. ECMs, if appropriately processed, can be used as resorbable, clinically safe, and naturally derived biomaterials that promote tissue remodeling while reducing fibrosis. Injectable ECM hydrogels are ideal for clinical application and cell delivery, particularly given the emerging practice and distinct advantages of in-office procedures using minimally invasive approaches. Work from our group and others provide promising data regarding the role of decellularized vocal fold lamina propria (VFLP-ECM) as an injectable agent or as a delivery vehicle for therapeutic cells such as mesenchymal stem cells. We broadly hypothesize that VFLP-ECM hydrogels (with or without stem cells) will promote functional repair of the VFs.