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Xiang Y, Yan J, Bao X, Gleadall A, Sun T. Investigation of cell infiltration and colonization in 3D porous scaffolds via integrated experimental and computational strategies. J Biotechnol 2024; 382:78-87. [PMID: 38307299 DOI: 10.1016/j.jbiotec.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/29/2024] [Indexed: 02/04/2024]
Abstract
This study aimed to integrate experimental and computational methods to systematically investigate cell infiltration and colonization within porous scaffolds. Poly(lactic acid) discs (Diameter: 6 mm; Thickness: 500 µm) with open pores (Diameter: 400-1100 µm), corners (Angle: 30-120°) and gaps (Distance: 100-500 µm), and cellulosic scaffolds with irregular pores (Diameter: 50-300 µm) were situated in tissue culture plates and cultured with human dermal fibroblasts (HDFs). Both phase contrast and scanning electron microscopy revealed that HDFs initially proliferated on scaffold surfaces, then infiltrated into the porous structures via cell bridging and stacking strategies, which was affected by the initial cell seeding densities, porous structures and culture times. Based on the density-dependent cell growths in two-dimensional cell cultures, power law models were developed to quantitatively simulate cell growths on scaffold surfaces. Model analysis predicted the effect of cell seeding efficiency on cell infiltrations into the porous scaffolds, which was further validated via series cell seeding experiments. The novelty of this research lies in the incorporation of multiple experimental and computational strategies, which enables the mechanistic insights of cell invasion and colonization in porous scaffolds, also facilitates the development of suitable bioprocesses for cell seeding and tissue manufacturing in Tissue Engineering and Regenerative Medicine.
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Affiliation(s)
- Yu Xiang
- Department of Materials, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK
| | - Jiongyi Yan
- Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK
| | - Xujin Bao
- Department of Materials, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK
| | - Andrew Gleadall
- Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK
| | - Tao Sun
- Department of Chemical Engineering, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK.
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2
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Abbas TO, Parangusan H, Yalcin HC, Hassan M, Zakrif L, Zandi N, Pennisi CP. Trilayer composite scaffold for urethral reconstruction: in vitroevaluation of mechanical, biological, and angiogenic properties. Biomed Mater 2024; 19:025022. [PMID: 38194708 DOI: 10.1088/1748-605x/ad1c9c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/09/2024] [Indexed: 01/11/2024]
Abstract
Regeneration of damaged urethral tissue remains a major challenge in the field of lower urinary tract reconstruction. To address this issue, various synthetic and natural biodegradable biomaterials are currently being explored for the fabrication of scaffolds that promote urethral regeneration and healing. In this study, we present an approach to fabricate a trilayer hybrid scaffold comprising a central layer of poly(lactic acid) (PLA) between two layers of chitosan. The chitosan/PLA/chitosan (CPC) scaffolds were fabricated by a sequential electrospinning process and their properties were evaluated for their suitability for urethral tissue engineering. The physical and biological properties of the CPC scaffolds were evaluated in comparison to electrospun PLA scaffolds and acellular dermis (Alloderm) as controls for a synthetic and a natural scaffold, respectively. Compared to the controls, the CPC scaffolds exhibited higher elastic modulus and ultimate tensile strength, while maintaining extensibility and suture retention strength appropriate for clinical use. The CPC scaffolds displayed significant hydrophilicity, which was associated with a higher water absorption capacity of the chitosan nanofibres. The degradation products of the CPC scaffolds did not exhibit cytotoxicity and promoted wound closure by fibroblastsin vitro. In addition, CPC scaffolds showed increased growth of smooth muscle cells, an essential component for functional regeneration of urethral tissue. Furthermore, in a chicken embryo-based assay, CPC scaffolds demonstrated significantly higher angiogenic potential, indicating their ability to promote vascularisation, a crucial aspect for successful urethral reconstruction. Overall, these results suggest that CPC hybrid scaffolds containing both natural and synthetic components offer significant advantages over conventional acellular or synthetic materials alone. CPC scaffolds show promise as potential candidates for further research into the reconstruction of the urethrain vivo.
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Affiliation(s)
- Tariq O Abbas
- Regenerative Medicine Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
- Pediatric Surgery Department, Hamad General Hospital, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- Weill Cornell Medicine-Qatar, Doha, Qatar
- Urology Division, Urology Department, Sidra Medicine, Doha, Qatar
| | | | - Huseyin C Yalcin
- Biomedical Research Centre, Qatar University, Doha, Qatar
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Mohamed Hassan
- Centre for Advanced Materials, Qatar University, Doha, Qatar
| | - Lubna Zakrif
- Biomedical Research Centre, Qatar University, Doha, Qatar
| | - Nooshin Zandi
- Regenerative Medicine Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Cristian P Pennisi
- Regenerative Medicine Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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3
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Wang L, Wang K, Yang M, Yang X, Li D, Liu M, Niu C, Zhao W, Li W, Fu Q, Zhang K. Urethral Microenvironment Adapted Sodium Alginate/Gelatin/Reduced Graphene Oxide Biomimetic Patch Improves Scarless Urethral Regeneration. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2302574. [PMID: 37973550 PMCID: PMC10787096 DOI: 10.1002/advs.202302574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/17/2023] [Indexed: 11/19/2023]
Abstract
The nasty urine microenvironment (UME) is an inherent obstacle that hinders urethral repair due to fibrosis and swelling of the oftentimes adopted hydrogel-based biomaterials. Here, using reduced graphene oxide (rGO) along with double-freeze-drying to strengthen a 3D-printed patch is reported to realize scarless urethral repair. The sodium alginate/gelatin/reduced graphene oxide (SA/Gel/rGO) biomaterial features tunable stiffness, degradation profile, and anti-fibrosis performance. Interestingly, the 3D-printed alginate-containing composite scaffold is able to respond to Ca2+ present in the urine, leading to enhanced structural stability and strength as well as inhibiting swelling. The investigations present that the swelling behaviors, mechanical properties, and anti-fibrosis efficacy of the SA/Gel/rGO patch can be modulated by varying the concentration of rGO. In particular, rGO in optimal concentration shows excellent cell viability, migration, and proliferation. In-depth mechanistic studies reveal that the activation of cell proliferation and angiogenesis-related proteins, along with inhibition of fibrosis-related gene expressions, play an important role in scarless repair by the 3D-printed SA/Gel/rGO patch via promoting urothelium growth, accelerating angiogenesis, and minimizing fibrosis in vivo. The proposed strategy has the potential of resolving the dilemma of necessary biomaterial stiffness and unwanted fibrosis in urethral repair.
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Affiliation(s)
- Liyang Wang
- The Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, 200233, P. R. China
- School of Materials Science and Engineering, Shanghai University of Engineering Science, Shanghai, 201620, P. R. China
| | - Kai Wang
- Clinical Research Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200233, P. R. China
| | - Ming Yang
- The Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, 200233, P. R. China
- Shanghai Eastern Institute of Urologic Reconstruction, Shanghai, 200000, P. R. China
| | - Xi Yang
- Novaprint Therapeutics Suzhou Co., Ltd, Suzhou, 215000, P. R. China
| | - Danyang Li
- The Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, 200233, P. R. China
- School of Materials Science and Engineering, Shanghai University of Engineering Science, Shanghai, 201620, P. R. China
| | - Meng Liu
- The Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, 200233, P. R. China
- Shanghai Eastern Institute of Urologic Reconstruction, Shanghai, 200000, P. R. China
| | - Changmei Niu
- Novaprint Therapeutics Suzhou Co., Ltd, Suzhou, 215000, P. R. China
| | - Weixin Zhao
- Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC, 27155, USA
| | - Wenyao Li
- School of Materials Science and Engineering, Shanghai University of Engineering Science, Shanghai, 201620, P. R. China
| | - Qiang Fu
- The Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, 200233, P. R. China
- Shanghai Eastern Institute of Urologic Reconstruction, Shanghai, 200000, P. R. China
| | - Kaile Zhang
- The Department of Urology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, 200233, P. R. China
- Shanghai Eastern Institute of Urologic Reconstruction, Shanghai, 200000, P. R. China
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Linssen EC, Demmers J, van Dijk CGM, van Dam R, Nicese MN, Cheng C, de Kort LMO, de Graaf P. Extracellular matrix analysis of fibrosis: A step towards tissue engineering for urethral stricture disease. PLoS One 2023; 18:e0294955. [PMID: 38032942 PMCID: PMC10688748 DOI: 10.1371/journal.pone.0294955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/10/2023] [Indexed: 12/02/2023] Open
Abstract
The urogenital tract is a target for many congenital and acquired diseases, both benign and oncogenic. In males, the urethra that transports urine and semen can be obstructed by a fibrotic disease called urethral stricture disease (USD). In severe USD, the whole organ including the vascular embedding, the corpus spongiosum (CS), is affected. Recurrent or severe USD is treated by reconstructive surgery. Tissue engineering may improve the outcome of urethral reconstruction in patients with complicated USD. Currently in urethral reconstruction only the epithelial layer is replaced, no substitution for the CS is provided, while the CS is important for mechanical support and vascularization. To develop a tissue engineering strategy for the CS, it is necessary to know the protein composition of the CS. As the extracellular matrix (ECM) plays an important role in the formation of fibrosis, we analyzed the distribution and localization of ECM components in human healthy and fibrotic CS tissue using immunohistology. The morphology of components of the elastic network were affected in USD. After decellularization a clear enrichment of proteins belonging to the ECM was found. In the proteomic analysis collagens COL15A1 and COL4A2 as well as inter-alpha-trypsin inhibitor ITIH4 were upregulated in fibrotic samples. The glycoproteins Periostin (POSTN), Microfibrillar-associated protein 5 (MFAP5) and EMILIN2 are downregulated in fibrotic tissue. To our knowledge this is the first proteomic study of ECM proteins of the CS in healthy and in USD. With these results a regenerating approach for tissue engineered CS can be developed, including relevant ECM proteins that reduce fibrosis and promote healthy healing in urethral reconstructive surgery.
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Affiliation(s)
- Emma C. Linssen
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jeroen Demmers
- Department of Proteomics, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Roos van Dam
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maria Novella Nicese
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Caroline Cheng
- Department of Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Petra de Graaf
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
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Håkansson J, Jenndahl L, Simonsson S, Johansson ME, Larsson K, Strehl R, Olsen Ekerhult T. De- and recellularized urethral reconstruction with autologous buccal mucosal cells implanted in an ovine animal model. BIOMED ENG-BIOMED TE 2023; 68:493-501. [PMID: 36999273 DOI: 10.1515/bmt-2022-0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/13/2023] [Indexed: 04/01/2023]
Abstract
OBJECTIVES Patients with urethral stricture due to any type of trauma, hypospadias or gender dysphoria suffer immensely from impaired capacity to urinate and are in need of a new functional urethra. Tissue engineering with decellularization of a donated organ recellularized with cells from the recipient patient has emerged as a promising alternative of advanced therapy medicinal products. The aim of this pilot study was to develop an ovine model of urethral transplantation and to produce an individualized urethra graft to show proof of function in vivo. METHODS Donated urethras from ram abattoir waste were decellularized and further recellularized with autologous buccal mucosa epithelial cells excised from the recipient ram and expanded in vitro. The individualized urethral grafts were implanted by reconstructive surgery in rams replacing 2.5 ± 0.5 cm of the native penile urethra. RESULTS After surgery optimization, three ram had the tissue engineered urethra implanted for one month and two out of three showed a partially regenerated epithelium. CONCLUSIONS Further adjustments of the model are needed to achieve a satisfactory proof-of-concept; however, we interpret these findings as a proof of principle and a possible path to develop a functional tissue engineered urethral graft with de- and recellularization and regeneration in vivo after transplantation.
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Affiliation(s)
- Joakim Håkansson
- Division Materials and production, RISE Research Institutes of Sweden, Unit of Biological Function, Borås, Sweden
- Department of Laboratory Medicine, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Stina Simonsson
- Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Martin E Johansson
- Department of Clinical Pathology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Center for Cancer Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karin Larsson
- Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Teresa Olsen Ekerhult
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Urology, Västra Götaland Region, Sahlgrenska University Hospital, Gothenburg, Sweden
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Ascorbic Acid 2-Phosphate-Releasing Supercritical Carbon Dioxide-Foamed Poly(L-Lactide-Co-epsilon-Caprolactone) Scaffolds Support Urothelial Cell Growth and Enhance Human Adipose-Derived Stromal Cell Proliferation and Collagen Production. J Tissue Eng Regen Med 2023. [DOI: 10.1155/2023/6404468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Tissue engineering can provide a novel approach for the reconstruction of large urethral defects, which currently lacks optimal repair methods. Cell-seeded scaffolds aim to prevent urethral stricture and scarring, as effective urothelium and stromal tissue regeneration is important in urethral repair. In this study, the aim was to evaluate the effect of the novel porous ascorbic acid 2-phosphate (A2P)-releasing supercritical carbon dioxide-foamed poly(L-lactide-co-ε-caprolactone) (PLCL) scaffolds (scPLCLA2P) on the viability, proliferation, phenotype maintenance, and collagen production of human urothelial cell (hUC) and human adipose-derived stromal cell (hASC) mono- and cocultures. The scPLCLA2P scaffold supported hUC growth and phenotype both in monoculture and in coculture. In monocultures, the proliferation and collagen production of hASCs were significantly increased on the scPLCLA2P compared to scPLCL scaffolds without A2P, on which the hASCs formed nonproliferating cell clusters. Our findings suggest the A2P-releasing scPLCLA2P to be a promising material for urethral tissue engineering.
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Bertsch C, Maréchal H, Gribova V, Lévy B, Debry C, Lavalle P, Fath L. Biomimetic Bilayered Scaffolds for Tissue Engineering: From Current Design Strategies to Medical Applications. Adv Healthc Mater 2023:e2203115. [PMID: 36807830 DOI: 10.1002/adhm.202203115] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/17/2023] [Indexed: 02/20/2023]
Abstract
Tissue damage due to cancer, congenital anomalies, and injuries needs new efficient treatments that allow tissue regeneration. In this context, tissue engineering shows a great potential to restore the native architecture and function of damaged tissues, by combining cells with specific scaffolds. Scaffolds made of natural and/or synthetic polymers and sometimes ceramics play a key role in guiding cell growth and formation of the new tissues. Monolayered scaffolds, which consist of uniform material structure, are reported as not being sufficient to mimic complex biological environment of the tissues. Osteochondral, cutaneous, vascular, and many other tissues all have multilayered structures, therefore multilayered scaffolds seem more advantageous to regenerate these tissues. In this review, recent advances in bilayered scaffolds design applied to regeneration of vascular, bone, cartilage, skin, periodontal, urinary bladder, and tracheal tissues are focused on. After a short introduction on tissue anatomy, composition and fabrication techniques of bilayered scaffolds are explained. Then, experimental results obtained in vitro and in vivo are described, and their limitations are given. Finally, difficulties in scaling up production of bilayer scaffolds and reaching the stage of clinical studies are discussed when multiple scaffold components are used.
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Affiliation(s)
- Christelle Bertsch
- Institut National de la Santé et de la Recherche Médicale, Inserm UMR_S 1121 Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, 67000, France
| | - Hélène Maréchal
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, Strasbourg, 67200, France
| | - Varvara Gribova
- Institut National de la Santé et de la Recherche Médicale, Inserm UMR_S 1121 Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, 67000, France
| | - Benjamin Lévy
- Institut National de la Santé et de la Recherche Médicale, Inserm UMR_S 1121 Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, 67000, France
| | - Christian Debry
- Institut National de la Santé et de la Recherche Médicale, Inserm UMR_S 1121 Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, 67000, France.,Service d'ORL et de Chirurgie Cervico-Faciale, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, Strasbourg, 67200, France
| | - Philippe Lavalle
- Institut National de la Santé et de la Recherche Médicale, Inserm UMR_S 1121 Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, 67000, France
| | - Léa Fath
- Institut National de la Santé et de la Recherche Médicale, Inserm UMR_S 1121 Biomaterials and Bioengineering, Centre de Recherche en Biomédecine de Strasbourg, 1 rue Eugène Boeckel, Strasbourg, 67000, France.,Service d'ORL et de Chirurgie Cervico-Faciale, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, Strasbourg, 67200, France
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Jiao W, Yu W, Wang Y, Zhang J, Wang Y, He H, Shi G. Fibrinogen/poly(l-lactide-co-caprolactone) copolymer scaffold: A potent adhesive material for urethral tissue regeneration in urethral injury treatment. Regen Ther 2023; 22:136-147. [PMID: 36793307 PMCID: PMC9923042 DOI: 10.1016/j.reth.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/02/2022] [Accepted: 12/13/2022] [Indexed: 01/30/2023] Open
Abstract
Since a scarcity of sufficient grafting materials, several complications can arise after urothelial defect reconstruction surgery, including severe hypospadias. Accordingly, developing alternative therapies, such as urethral restoration via tissue engineering are needed. In the present study, we developed a potent adhesive and repairing material using fibrinogen-poly(l-lactide-co-caprolactone) copolymer (Fib-PLCL) nanofiber scaffold to achieve effective urethral tissue regeneration after seeding with epithelial cells on the surface. The in vitro result found the Fib-PLCL scaffold promoted the attachment and viability of epithelial cells on their surface. The increased expression levels of cytokeratin and actin filaments were observed in Fib-PLCL scaffold than PLCL scaffold. The in vivo urethral injury repairing potential of Fib-PLCL scaffold was evaluated using a rabbit urethral replacement model. In this study, a urethral defect was surgically excised and replaced with the Fib-PLCL and PLCL scaffolds or autograft. As expected, the animals healed well after surgery in the Fib-PLCL scaffold group, and no significant strictures were identified. As expected, the cellularized Fib/PLCL grafts have induced the luminal epithelialization, urethral smooth muscle cell remodelling, and capillary development all at the same time. Histological analysis revealed that the urothelial integrity in the Fib-PLCL group had progressed to that of a normal urothelium, with enhanced urethral tissue development. Based on the results, the present study suggests that the prepared fibrinogen-PLCL scaffold is more appropriate for urethral defect reconstruction.
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Affiliation(s)
- Wei Jiao
- Department of Urology, Shanghai Fifth People's Hospital, Fudan University, No. 801 Heqing Road, Minhang District, Shanghai 200240, China
| | - Wandong Yu
- Department of Urology, Shanghai Fifth People's Hospital, Fudan University, No. 801 Heqing Road, Minhang District, Shanghai 200240, China
| | - Yangyun Wang
- Department of Urology, Shanghai Fifth People's Hospital, Fudan University, No. 801 Heqing Road, Minhang District, Shanghai 200240, China
| | - Jun Zhang
- Department of Urology, Shanghai Fifth People's Hospital, Fudan University, No. 801 Heqing Road, Minhang District, Shanghai 200240, China
| | - Yang Wang
- Department of Urology, Shanghai Fifth People's Hospital, Fudan University, No. 801 Heqing Road, Minhang District, Shanghai 200240, China
| | - Hongbing He
- Shanghai Songli Biotechnology Co., Ltd, Shanghai 201206, China
| | - Guowei Shi
- Department of Urology, Shanghai Fifth People's Hospital, Fudan University, No. 801 Heqing Road, Minhang District, Shanghai 200240, China
- Corresponding author.
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9
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Alternatives to oral mucosa grafts for urethral reconstruction. Nat Rev Urol 2022; 20:259-260. [PMID: 36536071 DOI: 10.1038/s41585-022-00707-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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10
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Xuan Z, Zachar V, Pennisi CP. Sources, Selection, and Microenvironmental Preconditioning of Cells for Urethral Tissue Engineering. Int J Mol Sci 2022; 23:ijms232214074. [PMID: 36430557 PMCID: PMC9697333 DOI: 10.3390/ijms232214074] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/10/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022] Open
Abstract
Urethral stricture is a common urinary tract disorder in men that can be caused by iatrogenic causes, trauma, inflammation, or infection and often requires reconstructive surgery. The current therapeutic approach for complex urethral strictures usually involves reconstruction with autologous tissue from the oral mucosa. With the goal of overcoming the lack of sufficient autologous tissue and donor site morbidity, research over the past two decades has focused on cell-based tissue-engineered substitutes. While the main focus has been on autologous cells from the penile tissue, bladder, and oral cavity, stem cells from sources such as adipose tissue and urine are competing candidates for future urethral regeneration due to their ease of collection, high proliferative capacity, maturation potential, and paracrine function. This review addresses the sources, advantages, and limitations of cells for tissue engineering in the urethra and discusses recent approaches to improve cell survival, growth, and differentiation by mimicking the mechanical and biophysical properties of the extracellular environment.
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11
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Prospects and Challenges of Electrospun Cell and Drug Delivery Vehicles to Correct Urethral Stricture. Int J Mol Sci 2022; 23:ijms231810519. [PMID: 36142432 PMCID: PMC9502833 DOI: 10.3390/ijms231810519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
Current therapeutic modalities to treat urethral strictures are associated with several challenges and shortcomings. Therefore, significant strides have been made to develop strategies with minimal side effects and the highest therapeutic potential. In this framework, electrospun scaffolds incorporated with various cells or bioactive agents have provided promising vistas to repair urethral defects. Due to the biomimetic nature of these constructs, they can efficiently mimic the native cells’ niches and provide essential microenvironmental cues for the safe transplantation of multiple cell types. Furthermore, these scaffolds are versatile platforms for delivering various drug molecules, growth factors, and nucleic acids. This review discusses the recent progress, applications, and challenges of electrospun scaffolds to deliver cells or bioactive agents during the urethral defect repair process. First, the current status of electrospinning in urethral tissue engineering is presented. Then, the principles of electrospinning in drug and cell delivery applications are reviewed. Finally, the recent preclinical studies are summarized and the current challenges are discussed.
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12
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Sobhani S, Khaboushan AS, Jafarnezhad-Ansariha F, Azimzadeh A, Danesh Payeh M, Kajbafzadeh AM. Off-the-shelf acellular fetal skin scaffold as a novel alternative to buccal mucosa graft: the development and characterization of human tissue-engineered fetal matrix in rabbit model of hypospadiasis. Int Urol Nephrol 2022; 54:2187-2195. [PMID: 35776255 DOI: 10.1007/s11255-022-03249-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 06/08/2022] [Indexed: 10/17/2022]
Abstract
AIM In this study, we aimed to develop a novel alternative to buccal mucosal graft from the acellular human fetal skin to manage hypospadias in a rabbit model. We optimized the decellularization protocol to develop and characterize the human tissue-engineered fetal dermal matrix as an "off-the-shelf" natural biomaterial. MATERIAL AND METHODS Human fetal skin was obtained at 16-19 weeks gestational age with respect to a signed informed consent from parents under the university ethical committee approval. The dissected full-thickness fetal skin tissues were placed into SDS and Triton X-100 in different dosages to achieve the optimum decellularization protocol. Histopathology of the acellular fetal matrix was assessed by Hematoxylin & Eosin (H&E) and DAPI staining to confirm the removal of all cell materials, Masson's trichrome staining for collagen evaluation, DNA quantification for confirmation of DNA content, and scanning electron microscopy (SEM) for evaluation of scaffold microstructure. Immunohistochemistry (IHC) staining was used to detect specific dermal markers, namely vimentin, type I collagen, cytokeratin (CK)19. The prepared dermal scaffolds were then grafted on the 8 rabbit models of hypospadias. The rabbits underwent evaluations at 1, 2, 3, and 6 months postoperatively. RESULTS H&E, Masson's trichrome, DAPI staining, and SEM confirmed the significant removal of cells; meanwhile, the ECM was completely preserved. At the time of biopsy, after 2, 4, and 6 months, no evidence of inflammation, fibrosis, necrosis, or rejection was observed. The grafted dermal scaffolds appeared histologically and anatomically normal. It was observed that the scaffolds were recellularized by circulating CD 34 + bone marrow stem cells (BMSCs) inside the body, implicating the body as a natural bioreactor. CONCLUSION The application of acellular fetal skin (AFS) is a safe and feasible method that can decrease surgical time in a complex hypospadias reconstruction. Moreover, AFS demonstrated excellent angiogenesis characteristics and migration of the stem cells to the scaffold observed during the course of treatment. Novel natural AFS scaffold without cell seeding is an excellent alternative to buccal mucosal graft; hence, it can overcome the limitations concerning the graft size and prevent the creation of wounds in oral mucosal tissue.
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Affiliation(s)
- Soheila Sobhani
- Tehran University of Medical Sciences, Pediatric Urology and Regenerative Medicine Research Center, Pediatric Center of Excellence, No. 62, Dr. Gharib's Street, Keshavarz Boulevard 1419433151, Tehran, Iran
| | - Alireza Soltani Khaboushan
- Tehran University of Medical Sciences, Pediatric Urology and Regenerative Medicine Research Center, Pediatric Center of Excellence, No. 62, Dr. Gharib's Street, Keshavarz Boulevard 1419433151, Tehran, Iran
| | - Fahimeh Jafarnezhad-Ansariha
- Tehran University of Medical Sciences, Pediatric Urology and Regenerative Medicine Research Center, Pediatric Center of Excellence, No. 62, Dr. Gharib's Street, Keshavarz Boulevard 1419433151, Tehran, Iran
| | - Ashkan Azimzadeh
- Tehran University of Medical Sciences, Pediatric Urology and Regenerative Medicine Research Center, Pediatric Center of Excellence, No. 62, Dr. Gharib's Street, Keshavarz Boulevard 1419433151, Tehran, Iran
| | | | - Abdol-Mohammad Kajbafzadeh
- Tehran University of Medical Sciences, Pediatric Urology and Regenerative Medicine Research Center, Pediatric Center of Excellence, No. 62, Dr. Gharib's Street, Keshavarz Boulevard 1419433151, Tehran, Iran.
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13
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García-Perdomo HA, Jurado-Penagos A. Application of regenerative medicine and 3d bioprinting in urology. Actas Urol Esp 2022; 46:323-328. [PMID: 35660078 DOI: 10.1016/j.acuroe.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/05/2021] [Indexed: 06/15/2023]
Abstract
In the last two decades, a new purpose has collected great efforts from scientists in all branches of medicine. It is about the possibility to make the body regenerate ill tissues and organs by itself with de right artificial stimuli or the construction of new functional organs to replace the damaged ones. This process comprises various interdisciplinary approaches to healthcare, such as tissue engineering, molecular medicine, biotechnology, and three-dimensional printing. Urologists have been remarkably active in this field of medicine called Regenerative Medicine. The searching of the different requirements like suitable and compatible biomaterials, versatile cells, adequate techniques to construct tissues, available biomolecules, and the knowledge of all these minimizing risks, are some of the aims and the approximations until now. Despite many obstacles, in vitro and in vivo studies are already showing encouraging options. We will review the advances related to the bladder, urethra, ureter, and kidneys. Difficulties such as ethical issues, time investment and high costs, have been some of the drawbacks encountered. Further studies are still required for its clinical application in daily life.
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Affiliation(s)
- Herney Andres García-Perdomo
- Division of Urology/Urooncology, Departament of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia.
| | - Angie Jurado-Penagos
- UROGIV Research Group, School of Medicine, Universidad del Valle, Cali, Colombia
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14
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The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals-Cross-Sectional Multispecialty Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063331. [PMID: 35329016 PMCID: PMC8953417 DOI: 10.3390/ijerph19063331] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/18/2022] [Accepted: 03/05/2022] [Indexed: 12/19/2022]
Abstract
Medicine is a rapidly-evolving discipline, with progress picking up pace with each passing decade. This constant evolution results in the introduction of new tools and methods, which in turn occasionally leads to paradigm shifts across the affected medical fields. The following review attempts to showcase how 3D printing has begun to reshape and improve processes across various medical specialties and where it has the potential to make a significant impact. The current state-of-the-art, as well as real-life clinical applications of 3D printing, are reflected in the perspectives of specialists practicing in the selected disciplines, with a focus on pre-procedural planning, simulation (rehearsal) of non-routine procedures, and on medical education and training. A review of the latest multidisciplinary literature on the subject offers a general summary of the advances enabled by 3D printing. Numerous advantages and applications were found, such as gaining better insight into patient-specific anatomy, better pre-operative planning, mock simulated surgeries, simulation-based training and education, development of surgical guides and other tools, patient-specific implants, bioprinted organs or structures, and counseling of patients. It was evident that pre-procedural planning and rehearsing of unusual or difficult procedures and training of medical professionals in these procedures are extremely useful and transformative.
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15
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García-Perdomo H, Jurado-Penagos A. Aplicación de la medicina regenerativa y la bioimpresión 3D en urología. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Hu J, Ai B, Zhu S, Wang Z, Xia H, Jia W. Electrospun PLGA and PLGA/gelatin scaffolds for tubularized urethral replacement: Studies in vitro and in vivo. J Biomater Appl 2022; 36:956-964. [PMID: 34254864 DOI: 10.1177/08853282211030904] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To investigate the biocompatibility of polylactic acid-glycolic acid copolymer (PLGA) and PLGA/gelatin scaffolds and their suitability for tubular urethral replacement in a canine model. PLGA and PLGA/gelatin scaffolds was constructed by electrospinning. Microstructural differences between the scaffolds was examined by Scanning electron microscopy (SEM) followed by mechanical properties testing. Biocompatibility of the material was evaluated using SEM 4, 8, 12 and 72 h after PLGA and PLGA/gelatin scaffolds co-culture with urothelial cells. And confocal analysis was also used to showed the cell adhesive and growth at 12 h. Approximately 2 cm of the anterior urethra of twelve dogs were removed and replaced with a scaffold. After the surgery for 1 month performed urethrography and for 3 month perform hematoxylin-eosin (H&E) and Masson. The results indicated that PLGA and PLGA/gelatin scaffolds had a void microfilament structure, similar to that of normal acellular matrix tissue. And the tensile strength was decreased whereas the tensile deformation and suture retention strength was increased in PLGA/gelatin scaffolds compared to that in PLGA scaffolds Urothelial cells grew well on both scaffolds. Postoperatively, animals recovered well and urinated spontaneously. However, urethrography showed varying degrees of urethral strictures in the reconstructed urethras. H&E and Masson showed that multilayer urothelial cells were formed in both the proximal and distal segments of the reconstructed urethras but without continuity. There was a small amount of smooth muscle and blood vessels under the epithelium, but regenerative urothelial cells at the midpoint of the reconstructed segment did not continue. Lots of lymphocyte infiltration was observed under the epithelium, some collagen tissue was deposited under the neo-urethral epithelium were observed. In conclusion, PLGA and PLGA/gelatin scaffolds are not suitable for tubularized urethral replacement in the canine model.
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Affiliation(s)
- Jinhua Hu
- Department of Pediatric Urology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Bin Ai
- Department of Radiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Shibo Zhu
- Department of Pediatric Urology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Zhen Wang
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Huimin Xia
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Wei Jia
- Department of Pediatric Urology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
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17
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Mikolaj F, Karolina M, Oliwia K, Jakub K, Adam K, Mariusz B, Patrycja N, Marcin M. Retrograde urethrography, sonouretrography and magnetic resonance urethrography in evaluation of male urethral strictures. Should the novel methods become the new standard in radiological diagnosis of urethral stricture disease? Int Urol Nephrol 2021; 53:2423-2435. [PMID: 34599423 PMCID: PMC8599374 DOI: 10.1007/s11255-021-02994-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 09/10/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE To verify which of the diagnostic modalities: Voiding cystouretrography (VCUG), Sonouretrography (SUG) or Magnetic resonance uretrography (MRU) is the most accurate in the assessment of urethral strictures in males and in what cases the application of novel imaging techniques benefits most. METHODS 55 male patients with a diagnosis of urethral stricture, were enrolled in this prospective study. Initial diagnosis of urethral stricture was based on anamnesis, uroflowmetry and VCUG. Additional imaging procedures-SUG and MRU were performed before the surgery. Virtual models and 3D printed models of the urethra with the stricture were created based on the MRU data. Exact stricture length and location were evaluated by each radiological method and accuracy was verified intraoperatively. Agreement between SUG and MRU assessments of spongiofibrosis was evaluated. MRU images were independently interpreted by two radiologists (MRU 1, MRU 2) and rater reliability was calculated. RESULTS MRU was the most accurate [(95% CI 0.786-0.882), p < 0.0005] with an average overestimation of 1.145 mm (MRU 1) and 0.727 mm (MRU 2) as compared with the operative measure. VCUG was less accurate [(95% CI 0.536-0.769), p < 0.0005] with an average underestimation of 1.509 mm as compared with operative measure. SUG was the least accurate method [(95% CI 0.510-0.776), p < 0.0005] with an average overestimation of 2.127 mm as compared with the operative measure. There was almost perfect agreement of MRU interpretations between the radiologists. CONCLUSIONS VCUG is still considered as a 'gold standard' in diagnosing urethral stricture disease despite its limitations. SUG and MRU provide extra guidance in preoperative planning and should be considered as supplemental for diagnosing urethral stricture. Combination of VCUG and SUG may be an optimal set of radiological tools for diagnosing patients with urethral strictures located in the penile urethra. MRU is the most accurate method and should particularly be considered in cases of post-traumatic or multiple strictures and strictures located in the posterior urethra.
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Affiliation(s)
- Frankiewicz Mikolaj
- Department of Urology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.
| | - Markiet Karolina
- Department of Radiology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Kozak Oliwia
- Department of Radiology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Krukowski Jakub
- Department of Urology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Kałużny Adam
- Department of Urology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Belka Mariusz
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Matuszewski Marcin
- Department of Urology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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18
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Evans EPP, Scholten JTM, Mzyk A, Reyes-San-Martin C, Llumbet AE, Hamoh T, Arts EGJM, Schirhagl R, Cantineau AEP. Male subfertility and oxidative stress. Redox Biol 2021; 46:102071. [PMID: 34340027 PMCID: PMC8342954 DOI: 10.1016/j.redox.2021.102071] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/14/2021] [Accepted: 07/14/2021] [Indexed: 02/08/2023] Open
Abstract
To date 15% of couples are suffering from infertility with 45-50% of males being responsible. With an increase in paternal age as well as various environmental and lifestyle factors worsening these figures are expected to increase. As the so-called free radical theory of infertility suggests, free radicals or reactive oxygen species (ROS) play an essential role in this process. However, ROS also fulfill important functions for instance in sperm maturation. The aim of this review article is to discuss the role reactive oxygen species play in male fertility and how these are influenced by lifestyle, age or disease. We will further discuss how these ROS are measured and how they can be avoided during in-vitro fertilization.
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Affiliation(s)
- Emily P P Evans
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands
| | - Jorien T M Scholten
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands
| | - Aldona Mzyk
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands; Institute of Metallurgy and Materials Science, Polish Academy of Sciences, Reymonta 25, 30-059, Krakow, Poland
| | - Claudia Reyes-San-Martin
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands
| | - Arturo E Llumbet
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands; Laboratory of Genomic of Germ Cells, Biomedical Sciences Institute, Faculty of Medicine, University of Chile. Independencia, 1027, Independencia Santiago, Chile
| | - Thamir Hamoh
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands
| | - Eus G J M Arts
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Romana Schirhagl
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands.
| | - Astrid E P Cantineau
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
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19
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Pien N, Palladino S, Copes F, Candiani G, Dubruel P, Van Vlierberghe S, Mantovani D. Tubular bioartificial organs: From physiological requirements to fabrication processes and resulting properties. A critical review. Cells Tissues Organs 2021; 211:420-446. [PMID: 34433163 DOI: 10.1159/000519207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/25/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Nele Pien
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair Tier I for the Innovation in Surgery, Department of Min-Met-Materials Engineering & Regenerative Medicine, CHU de Quebec Research Center, Laval University, Quebec City, Québec, Canada
- Polymer Chemistry & Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Ghent, Belgium
| | - Sara Palladino
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair Tier I for the Innovation in Surgery, Department of Min-Met-Materials Engineering & Regenerative Medicine, CHU de Quebec Research Center, Laval University, Quebec City, Québec, Canada
- GenT Lab, Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Italy
| | - Francesco Copes
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair Tier I for the Innovation in Surgery, Department of Min-Met-Materials Engineering & Regenerative Medicine, CHU de Quebec Research Center, Laval University, Quebec City, Québec, Canada
| | - Gabriele Candiani
- GenT Lab, Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Italy
| | - Peter Dubruel
- Polymer Chemistry & Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Ghent, Belgium
| | - Sandra Van Vlierberghe
- Polymer Chemistry & Biomaterials Group, Centre of Macromolecular Chemistry, Department of Organic and Macromolecular Chemistry, Ghent University, Ghent, Belgium
| | - Diego Mantovani
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair Tier I for the Innovation in Surgery, Department of Min-Met-Materials Engineering & Regenerative Medicine, CHU de Quebec Research Center, Laval University, Quebec City, Québec, Canada
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20
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Abbas TO, Elawad A, Pullattayil S. AK, Pennisi CP. Quality of Reporting in Preclinical Urethral Tissue Engineering Studies: A Systematic Review to Assess Adherence to the ARRIVE Guidelines. Animals (Basel) 2021; 11:2456. [PMID: 34438913 PMCID: PMC8388767 DOI: 10.3390/ani11082456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 01/12/2023] Open
Abstract
Preclinical research within the area of urethral tissue engineering has not yet been successfully translated into an efficient therapeutic option for patients. This gap could be attributed, in part, to inadequate design and reporting of the studies employing laboratory animals. In this study, a systematic review was conducted to investigate the quality of reporting in preclinical studies utilizing tissue engineering approaches for urethral repair. The scope was on studies performed in rabbits, published between January 2014 and March 2020. Quality assessment of the data was conducted according to the Animal Research: Reporting of in Vivo Experiments (ARRIVE) guidelines by the scoring of a 38-item checklist in different categories. A total of 28 articles that fulfilled the eligibility criteria were included in the study. The range of ARRIVE score was from 0 to 100, taking into consideration having reported the item in question or not. The mean checklist score was 53%. The items that attained the highest scores included the number of animals utilized, the size of control and experimental groups, and the definition of experimental outcomes. The least frequently reported items included the data regarding the experimental procedure, housing and husbandry, determination and justification of the number of animals, and reporting of adverse events. Surprisingly, full disclosure about ethical guidelines and animal protocol approval was missing in 54% of the studies. No paper stated the sample size estimation. Overall, our study found that a large number of studies display inadequate reporting of fundamental information and that the quality of reporting improved marginally over the study period. We encourage a comprehensive implementation of the ARRIVE guidelines in animal studies exploring tissue engineering for urethral repair, not only to facilitate effective translation of preclinical research findings into clinical therapies, but also to ensure compliance with ethical principles and to minimize unnecessary animal studies.
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Affiliation(s)
- Tariq O. Abbas
- Regenerative Medicine Research Group, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark;
- Pediatric Urology Section, Sidra Medicine, Doha 26999, Qatar;
- College of Medicine, Qatar University, Doha 2713, Qatar
- Weill Cornell Medicine Qatar, Doha 24144, Qatar
| | - Abubakr Elawad
- Pediatric Urology Section, Sidra Medicine, Doha 26999, Qatar;
| | | | - Cristian Pablo Pennisi
- Regenerative Medicine Research Group, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark;
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21
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Abou-Hassan A, Barros A, Buchholz N, Carugo D, Clavica F, de Graaf P, de La Cruz J, Kram W, Mergulhao F, Reis RL, Skovorodkin I, Soria F, Vainio S, Zheng S. Potential strategies to prevent encrustations on urinary stents and catheters - thinking outside the box: a European network of multidisciplinary research to improve urinary stents (ENIUS) initiative. Expert Rev Med Devices 2021; 18:697-705. [PMID: 34085555 DOI: 10.1080/17434440.2021.1939010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Urinary stents have been around for the last 4 decades, urinary catheters even longer. They are associated with infections, encrustation, migration, and patient discomfort. Research efforts to improve them have shifted onto molecular and cellular levels. ENIUS brought together translational scientists to improve urinary implants and reduce morbidity.Methods & materials: A working group within the ENIUS network was tasked with assessing future research lines for the improvement of urinary implants.Topics were researched systematically using Embase and PubMed databases. Clinicaltrials.gov was consulted for ongoing trials.Areas covered: Relevant topics were coatings with antibodies, enzymes, biomimetics, bioactive nano-coats, antisense molecules, and engineered tissue. Further, pH sensors, biodegradable metals, bactericidal bacteriophages, nonpathogenic uropathogens, enhanced ureteric peristalsis, electrical charges, and ultrasound to prevent stent encrustations were addressed.Expert opinion: All research lines addressed in this paper seem viable and promising. Some of them have been around for decades but are yet to proceed to clinical application (i.e. tissue engineering). Others are very recent and, at least in urology, still only conceptual (i.e. antisense molecules). Perhaps the most important learning point resulting from this pan-European multidisciplinary effort is that collaboration between all stakeholders is not only fruitful but also truly essential.
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Affiliation(s)
- Ali Abou-Hassan
- Physico-chimie des Électrolytes Et Nanosystèmes Interfaciaux, Sorbonne Université, Paris, France
| | - Alexandre Barros
- 3B's Research Group, University of Minho, BarcoGuimaraes, Portugal
| | | | - Dario Carugo
- Department of Pharmaceutics, School of Pharmacy, University College London, London, UK
| | - Francesco Clavica
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Petra de Graaf
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Julia de La Cruz
- U-merge, Scientific Office, Athens, Greece.,Jesus Uson Minimally Invasive Surgery Centre Foundation. Caceres, Spain
| | - Wolfgang Kram
- Department Of Urology, University Medical Center Rostock, Germany
| | - Filipe Mergulhao
- LEPABE, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Rui L Reis
- 3B's Research Group, University of Minho, BarcoGuimaraes, Portugal
| | - Ilya Skovorodkin
- Organogenesis Laboratory, Disease Networks Research Unit, Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
| | - Federico Soria
- Jesus Uson Minimally Invasive Surgery Centre Foundation. Caceres, Spain
| | - Seppo Vainio
- Flagship GeneCellNano, Infotech Oulu - Kvantum Institut, Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
| | - Shaokai Zheng
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
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22
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van Velthoven MJJ, Ramadan R, Zügel FS, Klotz BJ, Gawlitta D, Costa PF, Malda J, Castilho MD, de Kort LMO, de Graaf P. Gel Casting as an Approach for Tissue Engineering of Multilayered Tubular Structures. Tissue Eng Part C Methods 2021; 26:190-198. [PMID: 32089096 DOI: 10.1089/ten.tec.2019.0280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Several urological structures, such as the male urethra, have a tubular organization consisting of different layers. However, in severe urethral disease, urologists are limited to replacing solely the epithelial layer. In case of severe hypospadias and urethral stricture disease, the underlying supporting structure (the corpus spongiosum) is either absent or fibrotic, causing suboptimal vascularization and therefore increasing the risk of graft failure. Recapitulating the multilayered architecture of the urethra, including supporting structure with tissue engineering, might minimize urethral graft failure. However, current tissue engineering applications for complex multilayered tubular constructs are limited. We describe a gel casting method to tissue engineer multilayered tubular constructs based on fiber-reinforced cell-laden hydrogels. For this, a multichambered polydimethylsiloxane mold was casted with fiber-reinforced hydrogels containing smooth muscle cells (SMCs) and a coculture of endothelial cells and pericytes. The cell-loaded hydrogels were rolled, with the fiber mesh as guidance, into a tubular construct. In the lumen, urothelial cells were seeded and survived for 2 weeks. In the tubular construct, the cells showed good viability and functionality: endothelial cells formed capillary-like structures supported by pericytes and SMCs expressed elastin. With a graft produced by this technique, supported with subepithelial vascularization, urethral reconstructive surgery can be improved. This approach toward tissue engineering of multilayered tubular structures can also be applied to other multilayered tubular structures found in the human body. Impact Statement Recapitulating the multilayered architecture of tubular structures found in the human body might minimize graft failure. Current tissue engineering applications for complex multilayered tubular constructs are limited. Here we describe a gel casting approach based on fiber-reinforced cell-laden hydrogels. A multichambered polydimethylsiloxane mold was casted with cell-loaded, fiber-reinforced hydrogels, with the fiber mesh as guidance, into a tubular construct. A graft produced by this technique can improve reconstructive surgery by providing subepithelial vascularization and thereby can reduce graft failure.
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Affiliation(s)
- Melissa J J van Velthoven
- Department of Urology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Regenerative Medicine Center Utrecht, Utrecht, The Netherlands
| | - Rana Ramadan
- Department of Urology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Regenerative Medicine Center Utrecht, Utrecht, The Netherlands
| | - Franziska S Zügel
- Department of Urology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Regenerative Medicine Center Utrecht, Utrecht, The Netherlands
| | - Barbara J Klotz
- Regenerative Medicine Center Utrecht, Utrecht, The Netherlands.,Department of Oral and Maxillofacial Surgery & Special Dental Care and University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Debby Gawlitta
- Regenerative Medicine Center Utrecht, Utrecht, The Netherlands.,Department of Oral and Maxillofacial Surgery & Special Dental Care and University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Pedro F Costa
- Regenerative Medicine Center Utrecht, Utrecht, The Netherlands.,Department of Orthopaedics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jos Malda
- Regenerative Medicine Center Utrecht, Utrecht, The Netherlands.,Department of Orthopaedics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Equine Sciences, Faculty of Veterinary Medicine, University Utrecht, Utrecht, The Netherlands
| | - Miguel D Castilho
- Regenerative Medicine Center Utrecht, Utrecht, The Netherlands.,Department of Orthopaedics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Laetitia M O de Kort
- Department of Urology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Petra de Graaf
- Department of Urology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Regenerative Medicine Center Utrecht, Utrecht, The Netherlands
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23
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Ye M, Yu L, She Y, Wang S, Wang M, Zhao Q, Gu C, Bian L, Wen N, Gong J, Li L, Meng Y. Healing effects of a protein scaffold loaded with adipose-derived mesenchymal stem cells on radiation-induced vaginal injury in rats. J Int Med Res 2021; 48:300060520958826. [PMID: 33115306 PMCID: PMC7607296 DOI: 10.1177/0300060520958826] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objectives Cervical cancer, the most common female cancer after breast cancer, is
typically treated using radiotherapy. However, pelvic radiotherapy can cause
irreversible damage to the vagina, seriously affecting patients’ quality of
life. In this study, protein scaffolds loaded with rat adipose-derived
mesenchymal stem cells (ADSCs) were implanted into irradiated tissue to
assess their healing potential. Methods We established a rat model of radiation-induced vaginal injury. Complexes
(consisting of protein scaffolds loaded with ADSCs) were implanted into
injury sites. Histological analysis were used to assess regeneration of the
vaginal epithelium. RNA sequencing was used to study the therapeutic
mechanism of the complexes. Results The complexes promoted vaginal epithelial cell regeneration, vaginal tissue
repair and improved vaginal stenosis and contracture. Compared with rats
transplanted with ADSCs, rats transplanted with complexes achieved better
therapeutic effects. Conclusions Protein scaffold-ADSC complexes had a beneficial therapeutic effect on
radiation-induced vaginal injury in rats and may serve as the basis of a
novel therapeutic approach for radiation dermatitis.
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Affiliation(s)
- Mingxia Ye
- Medical School of Chinese PLA, Department of Obstetrics and Gynecology The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ling Yu
- Department of Obstetrics and Gynecology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yujia She
- Department of Obstetrics and Gynecology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shufang Wang
- Blood Transfusion Department, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Min Wang
- Medical School of Chinese PLA, Department of Obstetrics and Gynecology The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Qingdong Zhao
- Medical School of Chinese PLA, Department of Obstetrics and Gynecology The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Chenglei Gu
- The Eighth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lihua Bian
- Department of Obstetrics and Gynecology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Na Wen
- Medical School of Chinese PLA, Department of Obstetrics and Gynecology The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jing Gong
- Anzhen Hospital Affiliated to Capital Medical University, Beijing, China
| | - Lian Li
- Department of Obstetrics and Gynecology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yuanguang Meng
- Department of Obstetrics and Gynecology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
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Abstract
Tissue engineering is one of the most promising scientific breakthroughs of the late 20th century. Its objective is to produce in vitro tissues or organs to repair and replace damaged ones using various techniques, biomaterials, and cells. Tissue engineering emerged to substitute the use of native autologous tissues, whose quantities are sometimes insufficient to correct the most severe pathologies. Indeed, the patient’s health status, regulations, or fibrotic scars at the site of the initial biopsy limit their availability, especially to treat recurrence. This new technology relies on the use of biomaterials to create scaffolds on which the patient’s cells can be seeded. This review focuses on the reconstruction, by tissue engineering, of two types of tissue with tubular structures: vascular and urological grafts. The emphasis is on self-assembly methods which allow the production of tissue/organ substitute without the use of exogenous material, with the patient’s cells producing their own scaffold. These continuously improved techniques, which allow rapid graft integration without immune rejection in the treatment of severely burned patients, give hope that similar results will be observed in the vascular and urological fields.
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Vasyutin I, Butnaru D, Lyundup A, Timashev P, Vinarov A, Kuznetsov S, Atala A, Zhang Y. Frontiers in urethra regeneration: current state and future perspective. Biomed Mater 2021; 16. [PMID: 32503009 DOI: 10.1088/1748-605x/ab99d2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/05/2020] [Indexed: 12/13/2022]
Abstract
Despite the positive achievements attained, the treatment of male urethral strictures and hypospadiases still remains a challenge, particularly in cases of severe urethral defects. Complications and the need for additional interventions in such cases are common. Also, shortage of autologous tissue for graft harvesting and significant morbidity in the location of harvesting present problems and often lead to staged treatment. Tissue engineering provides a promising alternative to the current sources of grafts for urethroplasty. Since the first experiments in urethral substitution with tissue engineered grafts, this topic in regenerative medicine has grown remarkably, as many different types of tissue-engineered grafts and approaches in graft design have been suggested and testedin vivo. However, there have been only a few clinical trials of tissue-engineered grafts in urethral substitution, involving hardly more than a hundred patients overall. This indicates that the topic is still in its inception, and the search for the best graft design is continuing. The current review focuses on the state of the art in urethral regeneration with tissue engineering technology. It gives a comprehensive overview of the components of the tissue-engineered graft and an overview of the steps in graft development. Different cell sources, types of scaffolds, assembling approaches, options for vascularization enhancement and preclinical models are considered.
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Affiliation(s)
- Igor Vasyutin
- Sechenov University, 8-2 Trubetskaya str., Moscow 119991, Russia
| | - Denis Butnaru
- Sechenov University, 8-2 Trubetskaya str., Moscow 119991, Russia
| | - Alexey Lyundup
- Sechenov University, 8-2 Trubetskaya str., Moscow 119991, Russia
| | - Peter Timashev
- Sechenov University, 8-2 Trubetskaya str., Moscow 119991, Russia
| | - Andrey Vinarov
- Sechenov University, 8-2 Trubetskaya str., Moscow 119991, Russia
| | - Sergey Kuznetsov
- Sechenov University, 8-2 Trubetskaya str., Moscow 119991, Russia
| | - Anthony Atala
- Wake Forest Institute for Regenerative Medicine, 391 Technology Way NE, Winston-Salem, NC 27101, United States of America
| | - Yuanyuan Zhang
- Sechenov University, 8-2 Trubetskaya str., Moscow 119991, Russia.,Wake Forest Institute for Regenerative Medicine, 391 Technology Way NE, Winston-Salem, NC 27101, United States of America
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Amesty MV, Chamorro CI, López-Pereira P, Martínez-Urrutia MJ, Sanz B, Rivas S, Lobato R, Fossum M. Creation of Tissue-Engineered Urethras for Large Urethral Defect Repair in a Rabbit Experimental Model. Front Pediatr 2021; 9:691131. [PMID: 34239850 PMCID: PMC8258112 DOI: 10.3389/fped.2021.691131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 05/12/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction: Tissue engineering is a potential source of urethral substitutes to treat severe urethral defects. Our aim was to create tissue-engineered urethras by harvesting autologous cells obtained by bladder washes and then using these cells to create a neourethra in a chronic large urethral defect in a rabbit model. Methods: A large urethral defect was first created in male New Zealand rabbits by resecting an elliptic defect (70 mm2) in the ventral penile urethra and then letting it settle down as a chronic defect for 5-6 weeks. Urothelial cells were harvested noninvasively by washing the bladder with saline and isolating urothelial cells. Neourethras were created by seeding urothelial cells on a commercially available decellularized intestinal submucosa matrix (Biodesign® Cook-Biotech®). Twenty-two rabbits were divided into three groups. Group-A (n = 2) is a control group (urethral defect unrepaired). Group-B (n = 10) and group-C (n = 10) underwent on-lay urethroplasty, with unseeded matrix (group-B) and urothelial cell-seeded matrix (group-C). Macroscopic appearance, radiology, and histology were assessed. Results: The chronic large urethral defect model was successfully created. Stratified urothelial cultures attached to the matrix were obtained. All group-A rabbits kept the urethral defect size unchanged (70 ± 2.5 mm2). All group-B rabbits presented urethroplasty dehiscence, with a median defect of 61 mm2 (range 34-70). In group-C, five presented complete correction and five almost total correction with fistula, with a median defect of 0.3 mm2 (range 0-12.5), demonstrating a significant better result (p = 7.85 × 10-5). Urethrography showed more fistulas in group-B (10/10, versus 5/10 in group-C) (p = 0.04). No strictures were found in any of the groups. Group-B histology identified the absence of ventral urethra in unrepaired areas, with squamous cell metaplasia in the edges toward the defect. In group-C repaired areas, ventral multilayer urothelium was identified with cells staining for urothelial cell marker cytokeratin-7. Conclusions: The importance of this study is that we used a chronic large urethral defect animal model and clearly found that cell-seeded transplants were superior to nonseeded. In addition, bladder washing was a feasible method for harvesting viable autologous cells in a noninvasive way. There is a place for considering tissue-engineered transplants in the surgical armamentarium for treating complex urethral defects and hypospadias cases.
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Affiliation(s)
| | - Clara Ibel Chamorro
- Department of Women's and Children's Health, Bioclinicum J10:20, Karolinska Institutet, Stockholm, Sweden
| | - Pedro López-Pereira
- Department of Pediatric Urology, Hospital Universitario La Paz, Madrid, Spain
| | | | - Beatriz Sanz
- Department of Cell Culture, IdiPAZ Instituto de Investigación Hospital Universitario La Paz, Madrid, Spain
| | - Susana Rivas
- Department of Pediatric Urology, Hospital Universitario La Paz, Madrid, Spain
| | - Roberto Lobato
- Department of Pediatric Urology, Hospital Universitario La Paz, Madrid, Spain
| | - Magdalena Fossum
- Department of Women's and Children's Health, Bioclinicum J10:20, Karolinska Institutet, Stockholm, Sweden.,Division of Pediatric Surgery, Department of Surgical Gastroenterology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Health Sciences, Copenhagen University, Copenhagen, Denmark
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Zamani M, Shakhssalim N, Ramakrishna S, Naji M. Electrospinning: Application and Prospects for Urologic Tissue Engineering. Front Bioeng Biotechnol 2020; 8:579925. [PMID: 33117785 PMCID: PMC7576678 DOI: 10.3389/fbioe.2020.579925] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/18/2020] [Indexed: 12/14/2022] Open
Abstract
Functional disorders and injuries of urinary bladder, urethra, and ureter may necessitate the application of urologic reconstructive surgeries to recover normal urine passage, prevent progressive damages of these organs and upstream structures, and improve the quality of life of patients. Reconstructive surgeries are generally very invasive procedures that utilize autologous tissues. In addition to imperfect functional outcomes, these procedures are associated with significant complications owing to long-term contact of urine with unspecific tissues, donor site morbidity, and lack of sufficient tissue for vast reconstructions. Thanks to the extensive advancements in tissue engineering strategies, reconstruction of the diseased urologic organs through tissue engineering have provided promising vistas during the last two decades. Several biomaterials and fabrication methods have been utilized for reconstruction of the urinary tract in animal models and human subjects; however, limited success has been reported, which inspires the application of new methods and biomaterials. Electrospinning is the primary method for the production of nanofibers from a broad array of natural and synthetic biomaterials. The biomimetic structure of electrospun scaffolds provides an ECM-like matrix that can modulate cells' function. In addition, electrospinning is a versatile technique for the incorporation of drugs, biomolecules, and living cells into the constructed scaffolds. This method can also be integrated with other fabrication procedures to achieve hybrid smart constructs with improved performance. Herein, we reviewed the application and outcomes of electrospun scaffolds in tissue engineering of bladder, urethra, and ureter. First, we presented the current status of tissue engineering in each organ, then reviewed electrospun scaffolds from the simplest to the most intricate designs, and summarized the outcomes of preclinical (animal) studies in this area.
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Affiliation(s)
- Masoud Zamani
- Department of Chemical and Biological Engineering, University at Buffalo, State University of New York, Amherst, NY, United States
| | - Nasser Shakhssalim
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seeram Ramakrishna
- Department of Mechanical Engineering, National University of Singapore, Singapore, Singapore
| | - Mohammad Naji
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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28
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Razzaghi M, Rahavian A, Fallah Karkan M, Allameh F, Ghiasy S, Javanmard B. Use of human amniotic membrane repair of anterior urethral defect: First clinical report. Int J Urol 2020; 27:605-609. [PMID: 32430969 DOI: 10.1111/iju.14257] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 04/02/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the use of human amniotic membrane allograft to prevent urethrocutaneous fistula after tubularized incised plate repair for redo-hypospadias and anterior urethral defects. METHODS This pilot study included 28 patients (mean age 25.3 ± 11 years) with a history of previous failed hypospadia repair, who underwent tubularized incised plate urethroplasty in one session by the same surgical team from April 2016 to April 2019. After the reconstruction of a neourethra and proper hemostasis, a human amniotic membrane allograft - Grafting Scaffold - was used to cover the suture lines. RESULTS The mean follow-up time was 13.3 ± 4.5 months. Two urethrocutaneous fistulas occurred within the first 2 weeks after the surgery, one of which was caused by the infection of the surgical site. No penile torsion, urethral diverticula, meatal stenosis or glans dehiscence was reported. CONCLUSIONS Amniotic membrane graft provides an applicable, low-cost, feasible, biodegradable and safe second cover in redo-hypospadias repairs by tubularized incised plate technique. Its use is technically easy; it has satisfactory cosmetic outcomes and might decrease urethrocutaneous fistula formation.
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Affiliation(s)
- Mohammadreza Razzaghi
- Laser Application in Medical Science Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhossein Rahavian
- Clinical Research Development Unit, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Fallah Karkan
- Laser Application in Medical Science Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Allameh
- Center of Excellence for Training Laser Applications in Medicine, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saleh Ghiasy
- Clinical Research Development Unit, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Babak Javanmard
- Clinical Research Development Unit, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Xu Y, Meng Q, Jin X, Liu F, Yu J. Biodegradable Scaffolds for Urethra Tissue Engineering Based on 3D Printing. ACS APPLIED BIO MATERIALS 2020; 3:2007-2016. [PMID: 35025322 DOI: 10.1021/acsabm.9b01151] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Yifan Xu
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Qinghua Meng
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Xin Jin
- School of Chemistry and Chemical Engineering, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Feng Liu
- Shanghai Fengxian District Central Hospital, Shanghai 201400, China
| | - Jianjun Yu
- Shanghai Fengxian District Central Hospital, Shanghai 201400, China
- The First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China
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30
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The current state of tissue engineering in the management of hypospadias. Nat Rev Urol 2020; 17:162-175. [DOI: 10.1038/s41585-020-0281-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2020] [Indexed: 12/20/2022]
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31
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Sánchez-Pech JC, Rosales-Ibáñes R, Cauich-Rodriguez JV, Carrillo-Escalante HJ, Rodríguez-Navarrete A, Avila-Ortega A, Hernández-Sánchez F. Design, synthesis, characterization, and cytotoxicity of PCL/PLGA scaffolds through plasma treatment in the presence of pyrrole for possible use in urethral tissue engineering. J Biomater Appl 2019; 34:840-850. [PMID: 31630603 DOI: 10.1177/0885328219882638] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Raúl Rosales-Ibáñes
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, Mexico
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Barreto RSN, Romagnolli P, Fratini P, Mess AM, Miglino MA. Mouse placental scaffolds: a three-dimensional environment model for recellularization. J Tissue Eng 2019; 10:2041731419867962. [PMID: 31448074 PMCID: PMC6689918 DOI: 10.1177/2041731419867962] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 07/13/2019] [Indexed: 01/09/2023] Open
Abstract
The rich extracellular matrix (ECM) and availability make placenta eligible as alternative biomaterial source. Herein we produced placental mouse scaffolds by decellularization, and structure, composition, and cytocompatibility were evaluated to be considered as a biomaterial. We obtained a cell-free scaffold containing 9.42 ± 5.2 ng dsDNA per mg of ECM, presenting well-preserved structure and composition. Proteoglycans were widespread throughout ECM without cell nuclei and cell remnants. Collagen I, weak in native placenta, clearly appears in the scaffold after recellularization, opposite distribution was observed for collagen III. Fibronectin was well-observed in placental scaffolds whereas laminin and collagen IV were strong expressed. Placental scaffolds recellularization potential was confirmed after mouse embryonic fibroblasts 3D dynamic culture, resulting in massive scaffold repopulation with cell–cell interactions, cell-matrix adhesion, and maintenance of natural morphology. Our small size scaffolds provide a useful tool for tissue engineering to produce grafts and organ fragments, as well as for cellular biology purposes for tridimensional culture substrate.
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Affiliation(s)
- Rodrigo SN Barreto
- School of Veterinary Medicine and Animal Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Patricia Romagnolli
- School of Veterinary Medicine and Animal Sciences, University of Sao Paulo, Sao Paulo, Brazil
- Federal University of the Southern Frontier, Realeza-PR, Brazil
| | - Paula Fratini
- School of Veterinary Medicine and Animal Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Andrea Maria Mess
- School of Veterinary Medicine and Animal Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Maria Angelica Miglino
- School of Veterinary Medicine and Animal Sciences, University of Sao Paulo, Sao Paulo, Brazil
- Maria Angelica Miglino, School of Veterinary Medicine and Animal Sciences, University of Sao Paulo, Av. Prof. Dr. Orlando Marques de Paiva, 87, University City “Armando Salles de Oliveira,” Butantã, Sao Paulo 05508-270, Brazil.
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Pederzoli F, Joice G, Salonia A, Bivalacqua TJ, Sopko NA. Regenerative and engineered options for urethroplasty. Nat Rev Urol 2019; 16:453-464. [PMID: 31171866 DOI: 10.1038/s41585-019-0198-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2019] [Indexed: 02/07/2023]
Abstract
Surgical correction of urethral strictures by substitution urethroplasty - the use of grafts or flaps to correct the urethral narrowing - remains one of the most challenging procedures in urology and is frequently associated with complications, restenosis and poor quality of life for the affected individual. Tissue engineering using different cell types and tissue scaffolds offers a promising alternative for tissue repair and replacement. The past 30 years of tissue engineering has resulted in the development of several therapies that are now in use in the clinic, especially in treating cutaneous, bone and cartilage defects. Advances in tissue engineering for urethral replacement have resulted in several clinical applications that have shown promise but have not yet become the standard of care.
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Affiliation(s)
- Filippo Pederzoli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Gregory Joice
- Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Trinity J Bivalacqua
- Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Nikolai A Sopko
- Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
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Culenova M, Ziaran S, Danisovic L. Cells Involved in Urethral Tissue Engineering: Systematic Review. Cell Transplant 2019; 28:1106-1115. [PMID: 31237144 PMCID: PMC6767881 DOI: 10.1177/0963689719854363] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The urethra is part of the lower urinary tract and its main role is urine voiding. Its
complex histological structure makes urethral tissue prone to various injuries with
complicated healing processes that often lead to scar formation. Urethral stricture
disease can affect both men and women. The occurrence of this pathology is more common in
men and thus are previous research has been mainly oriented on male urethra
reconstruction. However, commonly used surgical techniques show unsatisfactory results
because of complications. The new and progressively developing field of tissue engineering
offers promising solutions, which could be applied in the urethral regeneration of both
men´s and women´s urethras. The presented systematic review article offers an overview of
the cells that have been used in urethral tissue engineering so far. Urine-derived stem
cells show a great perspective in respect to urethral tissue engineering. They can be
easily harvested and are a promising autologous cell source for the needs of tissue
engineering techniques. The presented review also shows the importance of mechanical
stimuli application on maturating tissue. Sufficient vascularization and elimination of
stricture formation present the biggest challenges not only in customary surgical
management but also in tissue-engineering approaches.
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Affiliation(s)
- Martina Culenova
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Slovakia
| | | | - Lubos Danisovic
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Slovakia.,Regenmed Ltd., Slovakia
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Tissue engineering of the urethra: where are we in 2019? World J Urol 2019; 38:2101-2105. [PMID: 31190151 PMCID: PMC7423849 DOI: 10.1007/s00345-019-02826-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/27/2019] [Indexed: 01/04/2023] Open
Abstract
Purpose The purpose of this review is to assess the potential role of tissue engineering for urethral reconstruction. It is well- recognised that urethrotomy remains the first-line therapy in the treatment of urethral stricture. Following on from the randomised study which recommended no difference between urethrotomy and urethral dilation, Steenkamp et al. reported long-term success rates of only 20%. Patients with longer strictures, penile or distal urethral strictures, and extensive periurethral spongiofibrosis typically do not respond well to repeated incisions. This report reviews the potential role of tissue engineering as applied to augmentation urethroplasty, which is the treatment of choice following failed urethrotomy. Methods A review of the literature was carried out. The principal emphasis was on tissue engineering as applied to augmentation urethroplasty, but an introductory section reviews the use of urethrotomy and the background to contemporary practise with augmentation urethroplasty using oral mucosa. Results It is evident that a cellular matrix which requires the ingrowth of cells is unlikely to be successful except for very short strictures. Other approaches such as injection of stem cells have not been adequately trialled in humans to date. Tissue-engineered substitute for autologous oral mucosa has been used and the results relating to this are reviewed. Conclusions Tissue engineering of autologous tissue for urethroplasty is expensive. It is unnecessary for the majority of cases, but could be potentially useful for very lengthy strictures, for instance, relating to lichen sclerosis. Whilst tissue-engineered oral mucosa has been successfully used, a great deal more work would be necessary to develop an appropriate matrix. Another study has looked at a larger series using an alternative tissue-engineered substitute, but the results have been very disappointing. At present, it has to be concluded that there is no effective and validated tissue engineering solution for the management of urethral stricture disease.
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Rashidbenam Z, Jasman MH, Hafez P, Tan GH, Goh EH, Fam XI, Ho CCK, Zainuddin ZM, Rajan R, Nor FM, Shuhaili MA, Kosai NR, Imran FH, Ng MH. Overview of Urethral Reconstruction by Tissue Engineering: Current Strategies, Clinical Status and Future Direction. Tissue Eng Regen Med 2019; 16:365-384. [PMID: 31413941 DOI: 10.1007/s13770-019-00193-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/03/2019] [Accepted: 01/18/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Urinary tract is subjected to a variety of disorders such as urethral stricture, which often develops as a result of scarring process. Urethral stricture can be treated by urethral dilation and urethrotomy; but in cases of long urethral strictures, substitution urethroplasty with genital skin and buccal mucosa grafts is the only option. However a number of complications such as infection as a result of hair growth in neo-urethra, and stone formation restrict the application of those grafts. Therefore, tissue engineering techniques recently emerged as an alternative approach, aiming to overcome those restrictions. The aim of this review is to provide a comprehensive coverage on the strategies employed and the translational status of urethral tissue engineering over the past years and to propose a combinatory strategy for the future of urethral tissue engineering. METHODs Data collection was based on the key articles published in English language in years between 2006 and 2018 using the searching terms of urethral stricture and tissue engineering on PubMed database. RESULTS Differentiation of mesenchymal stem cells into urothelial and smooth muscle cells to be used for urologic application does not offer any advantage over autologous urothelial and smooth muscle cells. Among studied scaffolds, synthetic scaffolds with proper porosity and mechanical strength is the best option to be used for urethral tissue engineering. CONCLUSION Hypoxia-preconditioned mesenchymal stem cells in combination with autologous cells seeded on a pre-vascularized synthetic and biodegradable scaffold can be said to be the best combinatory strategy in engineering of human urethra.
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Affiliation(s)
- Zahra Rashidbenam
- 1Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, 12th Floor, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Mohd Hafidzul Jasman
- 2Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, 8th Floor, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Pezhman Hafez
- 3Faculty of Medicine and Health Science, UCSI University, No. 1 Jalan Puncak Menara Gading, Taman Connaught, 56000 Kuala Lumpur, Malaysia
| | - Guan Hee Tan
- 2Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, 8th Floor, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Eng Hong Goh
- 2Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, 8th Floor, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Xeng Inn Fam
- 2Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, 8th Floor, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Christopher Chee Kong Ho
- 4School of Medicine, Taylor's University, No. 1 Jalan Taylor's, 47500 Subang Jaya, Selangor Darul Ehsan Malaysia
| | - Zulkifli Md Zainuddin
- 2Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, 8th Floor, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Reynu Rajan
- 5Minimally Invasive, Upper Gastrointestinal and Bariatric Surgery Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, 8th Floor, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Fatimah Mohd Nor
- 6Plastic and Reconstructive Surgery Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Mohamad Aznan Shuhaili
- 5Minimally Invasive, Upper Gastrointestinal and Bariatric Surgery Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, 8th Floor, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Nik Ritza Kosai
- 5Minimally Invasive, Upper Gastrointestinal and Bariatric Surgery Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, 8th Floor, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Farrah Hani Imran
- 6Plastic and Reconstructive Surgery Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
| | - Min Hwei Ng
- 1Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, 12th Floor, Clinical Block, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000 Kuala Lumpur, Malaysia
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Chouhan JD, Thakker PU, Terlecki RP. Engineering of erectile tissue: the state and future of corporal restoration. World J Urol 2019; 38:2109-2113. [DOI: 10.1007/s00345-019-02786-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 04/25/2019] [Indexed: 11/29/2022] Open
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Abbas TO, Yalcin HC, Pennisi CP. From Acellular Matrices to Smart Polymers: Degradable Scaffolds that are Transforming the Shape of Urethral Tissue Engineering. Int J Mol Sci 2019; 20:E1763. [PMID: 30974769 PMCID: PMC6479944 DOI: 10.3390/ijms20071763] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/29/2019] [Accepted: 04/02/2019] [Indexed: 12/24/2022] Open
Abstract
Several congenital and acquired conditions may result in severe narrowing of the urethra in men, which represent an ongoing surgical challenge and a significant burden on both health and quality of life. In the field of urethral reconstruction, tissue engineering has emerged as a promising alternative to overcome some of the limitations associated with autologous tissue grafts. In this direction, preclinical as well as clinical studies, have shown that degradable scaffolds are able to restore the normal urethral architecture, supporting neo-vascularization and stratification of the tissue. While a wide variety of degradable biomaterials are under scrutiny, such as decellularized matrices, natural, and synthetic polymers, the search for scaffold materials that could fulfill the clinical performance requirements continues. In this article, we discuss the design requirements of the scaffold that appear to be crucial to better resemble the structural, physical, and biological properties of the native urethra and are expected to support an adequate recovery of the urethral function. In this context, we review the biological performance of the degradable polymers currently applied for urethral reconstruction and outline the perspectives on novel functional polymers, which could find application in the design of customized urethral constructs.
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Affiliation(s)
- Tariq O Abbas
- Laboratory for Stem Cell Research, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark.
- Pediatric Surgery Department, Hamad General Hospital, 3050 Doha, Qatar.
- College of Medicine, Qatar University, 2713 Doha, Qatar.
- Surgery Department, Weill Cornell Medicine⁻Qatar, 24144 Doha, Qatar.
| | | | - Cristian P Pennisi
- Laboratory for Stem Cell Research, Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark.
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Ramuta TŽ, Kreft ME. Human Amniotic Membrane and Amniotic Membrane-Derived Cells: How Far Are We from Their Use in Regenerative and Reconstructive Urology? Cell Transplant 2019; 27:77-92. [PMID: 29562770 PMCID: PMC6434475 DOI: 10.1177/0963689717725528] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Human amniotic membrane (hAM) is the innermost layer of fetal membranes, which surrounds the developing fetus and forms the amniotic cavity. hAM and hAM-derived cells possess many properties that make them suitable for use in regenerative medicine, such as low immunogenicity, promotion of epithelization, anti-inflammatory properties, angiogenic and antiangiogenic properties, antifibrotic properties, antimicrobial properties, and anticancer properties. Many pathological conditions of the urinary tract lead to organ damage or complete loss of function. Consequently, the reconstruction or replacement of damaged organs is needed, which makes searching for new approaches in regenerative and reconstructive urology a necessity. The use of hAM for treating defects in kidneys, ureters, urinary bladder, and urethra was tested in vitro in cell cultures and in vivo in mice, rats, rabbits, cats, dogs, and also in humans. These studies confirmed the advantages and the potential of hAM for use in regenerative and reconstructive urology as stated above. However, they also pointed out a few concerns we have to take into consideration. These are (1) the lack of a standardized protocol in hAM preparation and storage, (2) the heterogeneity of hAM, and especially (3) low mechanical strength of hAM. Before any wider use of hAM for treating urological defects, the protocols for preparation and storage will need to be standardized, followed by more studies on larger animals and clinical trials, which will altogether extensively assess the potential of hAM use in urological patients.
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Affiliation(s)
- Taja Železnik Ramuta
- 1 Faculty of Medicine, Institute of Cell biology, University of Ljubljana, Ljubljana, Slovenia
| | - Mateja Erdani Kreft
- 1 Faculty of Medicine, Institute of Cell biology, University of Ljubljana, Ljubljana, Slovenia
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Vaddi SP, Reddy VB, Abraham SJ. Buccal epithelium Expanded and Encapsulated in Scaffold-Hybrid Approach to Urethral Stricture (BEES-HAUS) procedure: A novel cell therapy-based pilot study. Int J Urol 2018; 26:253-257. [PMID: 30468021 PMCID: PMC7379713 DOI: 10.1111/iju.13852] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 10/09/2018] [Indexed: 12/01/2022]
Abstract
Objectives To describe the feasibility of a novel cell‐based endoscopic technique using buccal epithelium, expanded and encapsulated in a thermoreversible gelation polymer scaffold for the treatment of urethral stricture. Methods Six male patients with bulbar urethral stricture ranging from 2.0 to 3.5 cm in length were included in this pilot study. Autologous buccal epithelial cells from a small buccal mucosal biopsy were isolated, cultured and encapsulated in thermoreversible gelation polymer scaffold, and were implanted at the stricture site after a wide endoscopic urethrotomy. Results All the patients voided well, with a mean peak flow rate of 24 mL/s. Urethroscopy carried out at 6 months showed healthy mucosa at the urethrotomy site. However, two of the six patients had recurrence at 18 and 24 months, respectively. Conclusions This endoscopic‐based Buccal epithelium Expanded and Encapsulated in Scaffold‐Hybrid Approach to Urethral Stricture (BEES‐HAUS) technique is a promising alternative for the open substitution buccal graft urethroplasty. It is possible to achieve the benefits of open substitution buccal urethroplasty with this endoscopic technique.
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Affiliation(s)
- Surya P Vaddi
- Department of Urology and Renal Transplantation, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India
| | - Vijaya B Reddy
- Department of Urology and Renal Transplantation, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India
| | - Samuel Jk Abraham
- The Mary-Yoshio Translational Hexagon, Nichi-In Center for Regenerative Medicine, Chennai, Tamil Nadu, India.,School of Medicine, Yamanashi University, Yamanashi, Japan.,Edogawa Evolutionary Laboratory of Science, Edogawa Hospital, Tokyo, Japan
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Milenkovic U, Albersen M, Castiglione F. The mechanisms and potential of stem cell therapy for penile fibrosis. Nat Rev Urol 2018; 16:79-97. [DOI: 10.1038/s41585-018-0109-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Versteeg B, van den Broek LJ, Bruisten SM, Mullender M, de Vries HJC, Gibbs S. An Organotypic Reconstructed Human Urethra to Study Chlamydia trachomatis Infection. Tissue Eng Part A 2018; 24:1663-1671. [PMID: 29792385 DOI: 10.1089/ten.tea.2017.0511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Organotypic models to investigate host-microbiome interactions are still a challenge for the field of tissue engineering. This is particularly the case for organs such as the urethra. Several cell line, animal, and tissue models are available to study Chlamydia trachomatis infections, but none fully reflects natural infection in native human tissue. Therefore, we developed an organotypic reconstructed human urethral model (RhU) to study invasive and noninvasive strains of C. trachomatis. Primary urethra cells were used to reconstruct epithelium on a fibroblast populated collagen-fibrin hydrogel, yielding a RhU. Immunohistochemistry was used to compare RhU with native urethral tissue and to visualize the location of C. trachomatis bacteria in RhU after 10-day exposure. RhU closely resembled native urethral tissue with respect to proliferation and differentiation markers (keratins 6, 10, 13, 17, involucrin, SKALP [skin-derived antileucoproteinase], vimentin, and CD31). Exposure of RhU to noninvasive and invasive C. trachomatis strains revealed relevant differences in infection ability because inclusions were observed (indicating active infection) in the epithelial layer after 10 days exposure only to the invasive strain. The noninvasive strain remained localized on the surface of the epithelial layer. Human primary urethral fibroblasts and keratinocytes can be used to construct RhU that closely resembles native tissue and can be used to investigate active C. trachomatis infections. RhU provides a promising model to investigate host-microbiome interactions such as, but not limited to, the human pathogenesis of C. trachomatis.
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Affiliation(s)
- Bart Versteeg
- 1 Department of Infectious Diseases, Public Health Service Amsterdam , Amsterdam, The Netherlands
| | - Lenie J van den Broek
- 2 Department of Molecular Cell Biology and Immunology, VU University Medical Center (VUMC) , Amsterdam, The Netherlands
| | - Sylvia M Bruisten
- 1 Department of Infectious Diseases, Public Health Service Amsterdam , Amsterdam, The Netherlands .,3 Amsterdam Infection and Immunity Institute, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands
| | - Margriet Mullender
- 4 Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center (VUMC) , Amsterdam, The Netherlands
| | - Henry J C de Vries
- 1 Department of Infectious Diseases, Public Health Service Amsterdam , Amsterdam, The Netherlands .,3 Amsterdam Infection and Immunity Institute, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands .,5 Department of Dermatology, Academic Medical Center, University of Amsterdam , Amsterdam, The Netherlands
| | - Susan Gibbs
- 2 Department of Molecular Cell Biology and Immunology, VU University Medical Center (VUMC) , Amsterdam, The Netherlands .,6 Department of Oral Cell Biology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University , Amsterdam, The Netherlands
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Singh A, Lee D, Jeong H, Yu C, Li J, Fang CH, Sabnekar P, Liu X, Yoshida T, Sopko N, Bivalacqua TJ. Tissue-Engineered Neo-Urinary Conduit from Decellularized Trachea. Tissue Eng Part A 2018; 24:1456-1467. [PMID: 29649957 DOI: 10.1089/ten.tea.2017.0436] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Decellularized tissues have been increasingly popular for constructing scaffolds for tissue engineering applications due to their beneficial biological compositions and mechanical properties. It is therefore natural to consider decellularized trachea for construction of tissue-engineered trachea, as well as other tubular organs. A Neo-Urinary Conduit (NUC) is such a tubular organ that works as a passage for urine removal in bladder cancer patients who need a urinary diversion after their diseased bladder is removed. In this study, we report our findings on the feasibility of using a decellularized trachea for NUC applications. As a NUC scaffold, decellularized trachea provides benefits of having not only naturally occurring biological components but also having sufficient mechanical properties and structural integrity. We, therefore, decellularized rabbit trachea, evaluated its mechanical performance, and investigated its ability to support in vitro growth of human smooth muscle cells (hSMCs) and human urothelial cells (hUCs). The decellularized trachea had appropriate biomechanical properties with ultimate tensile strength of ∼0.34 MPa in longitudinal direction and ∼1.0 MPa in circumferential direction and resisted a radial burst pressure of >155 mm Hg. Cell morphology study by scanning electron microscopy further showed that hUCs grown on decellularized trachea adopted a typical flatten and interconnected network structure in the lumen of the scaffold, while they formed a round spherical shape and did not spread on the outer surfaces. SMCs, on the other hand, spread well throughout the scaffold. The gene expression analysis by real time quantitative polymerase chain reaction (RT-qPCR) and immunofluorescence studies further confirmed scaffold's ability to support long-term growth of hSMCs. Since uroepithelium has been shown to regenerate itself over time in vivo, these findings suggest that it is possible to construct a NUC from decellularized trachea without any preseeding of UCs. In future, we plan to translate decellularized trachea in a preclinical animal model and evaluate its biological performance.
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Affiliation(s)
- Anirudha Singh
- 1 Department of Urology, The James Buchanan Brady Urological Institute , The Johns Hopkins School of Medicine, Baltimore, Maryland
- 2 Department of Chemical and Biomolecular Engineering, Johns Hopkins University , Baltimore, Maryland
- 3 Translational Tissue Engineering Center, Johns Hopkins University , Baltimore, Maryland
| | - David Lee
- 3 Translational Tissue Engineering Center, Johns Hopkins University , Baltimore, Maryland
| | - Harrison Jeong
- 2 Department of Chemical and Biomolecular Engineering, Johns Hopkins University , Baltimore, Maryland
| | - Christine Yu
- 4 Department of Biomedical Engineering, Johns Hopkins University , Baltimore, Maryland
| | - Jiuru Li
- 2 Department of Chemical and Biomolecular Engineering, Johns Hopkins University , Baltimore, Maryland
| | - Chen Hao Fang
- 2 Department of Chemical and Biomolecular Engineering, Johns Hopkins University , Baltimore, Maryland
| | - Praveena Sabnekar
- 1 Department of Urology, The James Buchanan Brady Urological Institute , The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Xiaopu Liu
- 1 Department of Urology, The James Buchanan Brady Urological Institute , The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Takahiro Yoshida
- 1 Department of Urology, The James Buchanan Brady Urological Institute , The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Nikolai Sopko
- 1 Department of Urology, The James Buchanan Brady Urological Institute , The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Trinity J Bivalacqua
- 1 Department of Urology, The James Buchanan Brady Urological Institute , The Johns Hopkins School of Medicine, Baltimore, Maryland
- 5 Department of Surgery, Johns Hopkins Medical Institutions and Sidney Kimmel Comprehensive Cancer Center (SKCC) , Baltimore, Maryland
- 6 Department of Oncology, Johns Hopkins Medical Institutions and Sidney Kimmel Comprehensive Cancer Center (SKCC) , Baltimore, Maryland
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Abstract
PURPOSE OF REVIEW Urethral strictures that are refractory to initial management present unique challenges to the reconstructive surgeon. Treatment trends have shifted as new tissue resources are becoming available. There is renewed interest in old methods as skill and technique have improved. We describe the scope of the surgical armamentarium available to develop creative approaches and successful outcomes. RECENT FINDINGS We discuss techniques to maximize the availability of oral mucosa, harvest and use of rectal mucosa, and developments in tissue engineering. Evolving methods to assess success of repair are also described. Urethral reconstruction for refractory urethral strictures requires proficiency with multiple methods as these strictures often require combining techniques for successful treatment.
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Gabbott CM, Sun T. Comparison of Human Dermal Fibroblasts and HaCat Cells Cultured in Medium with or without Serum via a Generic Tissue Engineering Research Platform. Int J Mol Sci 2018; 19:ijms19020388. [PMID: 29382087 PMCID: PMC5855610 DOI: 10.3390/ijms19020388] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/25/2018] [Accepted: 01/25/2018] [Indexed: 12/16/2022] Open
Abstract
A generic research platform with 2-dimensional (2D) cell culture technology, a 3-dimensional (3D) in vitro tissue model, and a scaled-down cell culture and imaging system in between, was utilized to address the problematic issues associated with the use of serum in skin tissue engineering. Human dermal fibroblasts (HDFs) and immortalized keratinocytes (HaCat cells) mono- or co-cultured in serum or serum-free medium were compared and analyzed via the platform. It was demonstrated that serum depletion had significant influence on the attachment of HaCat cells onto tissue culture plastic (TCP), porous substrates and cellulosic scaffolds, which was further enhanced by the pre-seeded HDFs. The complex structures formed by the HDFs colonized within the porous substrates and scaffolds not only prevented the seeded HaCat cells from filtering through the open pores, but also acted as cellular substrates for HaCat cells to attach onto. When mono-cultured on TCP, both HDFs and HaCat cells were less proliferative in medium without serum than with serum. However, both cell types were successfully co-cultured in 2D using serum-free medium if the initial cell seeding density was higher than 80,000 cells/cm2 (with 1:1 ratio). Based on the results from 2D cultures, co-culture of both cell types on modular substrates with small open pores (125 μm) and cellulosic scaffolds with open pores of varying sizes (50–300 µm) were then conducted successfully in serum-free medium. This study demonstrated that the generic research platform had great potential for in-depth understanding of HDFs and HaCat cells cultivated in serum-free medium, which could inform the processes for manufacturing skin cells or tissues for clinical applications.
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Affiliation(s)
- Christopher Michael Gabbott
- Centre for Biological Engineering, Department of Chemical Engineering, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK.
| | - Tao Sun
- Centre for Biological Engineering, Department of Chemical Engineering, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK.
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Abbas TO, Mahdi E, Hasan A, AlAnsari A, Pennisi CP. Current Status of Tissue Engineering in the Management of Severe Hypospadias. Front Pediatr 2018; 5:283. [PMID: 29404308 PMCID: PMC5786532 DOI: 10.3389/fped.2017.00283] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 12/13/2017] [Indexed: 01/29/2023] Open
Abstract
Hypospadias, characterized by misplacement of the urinary meatus in the lower side of the penis, is a frequent birth defect in male children. Because of the huge variation in the anatomic presentation of hypospadias, no single urethroplasty procedure is suitable for all situations. Hence, many surgical techniques have emerged to address the shortage of tissues required to bridge the gap in the urethra particularly in the severe forms of hypospadias. However, the rate of postoperative complications of currently available surgical procedures reaches up to one-fourth of the patients having severe hypospadias. Moreover, these urethroplasty techniques are technically demanding and require considerable surgical experience. These limitations have fueled the development of novel tissue engineering techniques that aim to simplify the surgical procedures and to reduce the rate of complications. Several types of biomaterials have been considered for urethral repair, including synthetic and natural polymers, which in some cases have been seeded with cells prior to implantation. These methods have been tested in preclinical and clinical studies, with variable degrees of success. This review describes the different urethral tissue engineering methodologies, with focus on the approaches used for the treatment of hypospadias. At present, despite many significant advances, the search for a suitable tissue engineering approach for use in routine clinical applications continues.
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Affiliation(s)
- Tariq O. Abbas
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Department of Pediatric Surgery and Urology, Hamad General Hospital, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
| | - Elsadig Mahdi
- Department of Mechanical and Industrial Engineering, Qatar University, Doha, Qatar
| | - Anwarul Hasan
- Department of Mechanical and Industrial Engineering, Qatar University, Doha, Qatar
| | | | - Cristian Pablo Pennisi
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Turunen S, Kaisto S, Skovorodkin I, Mironov V, Kalpio T, Vainio S, Rak-Raszewska A. 3D bioprinting of the kidney—hype or hope? ACTA ACUST UNITED AC 2018. [DOI: 10.3934/celltissue.2018.3.119] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Urinary Tissue Engineering: Challenges and Opportunities. Sex Med Rev 2017; 6:35-44. [PMID: 29066225 DOI: 10.1016/j.sxmr.2017.08.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/09/2017] [Accepted: 08/17/2017] [Indexed: 01/14/2023]
Abstract
INTRODUCTION In this review, we discuss major advancements and common challenges in constructing and regenerating a neo-urinary conduit (NUC). First, we focus on the need for regenerating the urothelium, the hallmark the urine barrier, unique to urinary tissues. Second, we focus on clinically feasible scaffolds based on decellularized matrices and molded collagen that are currently of great research interest. AIM To discuss the major advancements in constructing a tissue-engineered NUC (TE-NUC) and the challenges involved in their successful clinical translation. METHODS A comprehensive search of peer-reviewed literature from PubMed and Google Scholar on subjects related to urothelium regeneration, decellularized tissue matrices, and collagen scaffolds was conducted. MAIN OUTCOME MEASURE We evaluated the main biological and mechanical functions of urinary tissues, the need for TE implants to create a urinary diversion, the reasons for their failures in clinical settings, and the applications of decellularized tissue matrices and collagen-based molded scaffolds in their regeneration. RESULTS It is necessary to create a urine barrier that prevents urine leakage into the stroma that can cause failure of the graft. Despite the regeneration potential of the urothelium, the limited supply of healthy urothelial cells in patients with bladder cancer remains a major challenge. In this context, alternative strategies, such as transdifferentiation of cells into urothelium or engineered scaffolds based on decellularized tissues and molded collagen with robust urine barrier properties, are active areas of research. CONCLUSION There is an immediate need for developing a functional TE-NUC that can improve the quality of life of patients with bladder cancer. It is possible to achieve a TE-NUC by bioengineering an implant that has appropriate biological and mechanical properties to store and transport urine. We anticipate that future advancements in urothelium regeneration and material design will lead us closer to successful neo-urinary tissue constructs. Singh A, Bivalacqua TJ, Sopko N. Urinary Tissue Engineering: Challenges and Opportunities. Sex Med Rev 2018;6:35-44.
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Žiaran S, Galambošová M, Danišovič L. Tissue engineering of urethra: Systematic review of recent literature. Exp Biol Med (Maywood) 2017; 242:1772-1785. [PMID: 28893083 DOI: 10.1177/1535370217731289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The purpose of this article was to perform a systematic review of the recent literature on urethral tissue engineering. A total of 31 articles describing the use of tissue engineering for urethra reconstruction were included. The obtained results were discussed in three groups: cells, scaffolds, and clinical results of urethral reconstructions using these components. Stem cells of different origin were used in many experimental studies, but only autologous urothelial cells, fibroblasts, and keratinocytes were applied in clinical trials. Natural and synthetic scaffolds were studied in the context of urethral tissue engineering. The main advantage of synthetic ones is the fact that they can be obtained in unlimited amount and modified by different techniques, but scaffolds of natural origin normally contain chemical groups and bioactive proteins which increase the cell attachment and may promote the cell proliferation and differentiation. The most promising are smart scaffolds delivering different bioactive molecules or those that can be tubularized. In two clinical trials, only onlay-fashioned transplants were used for urethral reconstruction. However, the very promising results were obtained from animal studies where tubularized scaffolds, both non-seeded and cell-seeded, were applied. Impact statement The main goal of this article was to perform a systematic review of the recent literature on urethral tissue engineering. It summarizes the most recent information about cells, seeded or non-seeded scaffolds and clinical application with respect to regeneration of urethra.
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Affiliation(s)
- Stanislav Žiaran
- 1 Department of Urology, Faculty of Medicine, Comenius University in Bratislava, Bratislava 833 05, Slovak Republic
| | - Martina Galambošová
- 2 Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Bratislava 811 08, Slovak Republic
| | - L'uboš Danišovič
- 2 Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Bratislava 811 08, Slovak Republic.,3 Regenmed Ltd, Bratislava 811 02, Slovak Republic
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Mitra A, Sarin YK. Use of Hormones, Tissue Factors and Bioengineering in the Management of Hypospadias. Indian J Pediatr 2017; 84:564-569. [PMID: 28429283 DOI: 10.1007/s12098-017-2347-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 03/29/2017] [Indexed: 11/26/2022]
Abstract
Hypospadiology is a rapidly evolving field. Progress in the understanding of how hormonal therapy affects the growth of the phallus has allowed surgeons to optimize the tissues for surgery. But conflicting data from a number of studies and a lack of consensus on drugs, their dosing, mode of delivery and timing of use means that the creation of protocols is unlikely to happen in the near future. Nonetheless, there is a hope and the standardization of scientific reporting will make it easier to compare data at the global level. There are reports of the increasing incidence of hypospadias and the etiology is thought to be multifactorial. Although complex interactions between genetic polymorphisms and the environment make it difficult to identify the exact factors responsible for hypospadias, the advent of massively parallel gene sequencing, large scale epigenetic screens and CRISPR technology will definitely ease the process. The knowledge of culprit genes will not only broaden our understanding of embryology and growth but will also enable us to predict and/or modify tissue healing. Advances in tissue engineering are also expected to provide a plethora of biomaterials for urethral reconstruction. The development of this field is directly linked with the elucidation of the processes of proliferation and vascularization coupled with the cataloguing of the growth factors involved. One can safely conclude that the exciting new advances in the field will have far reaching consequences on patient care and counselling.
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Affiliation(s)
- Aparajita Mitra
- Department of Pediatric Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, 110002, India
| | - Yogesh Kumar Sarin
- Department of Pediatric Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, 110002, India.
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