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Urinary bladder augmentation with acellular biologic scaffold—A preclinical study in a large animal model
Journal of Biomedical Materials Research Part B: Applied Biomaterials ( IF 3.4 ) Pub Date : 2021-07-29 , DOI: 10.1002/jbm.b.34920
Marta Pokrywczynska 1 , Arkadiusz Jundzill 1 , Jakub Tworkiewicz 1 , Monika Buhl 1 , Daria Balcerczyk 1 , Jan Adamowicz 1 , Tomasz Kloskowski 1 , Marta Rasmus 1 , Kaja Mecinska-Jundzill 2 , Damian Kasinski 1 , Malgorzata Frontczak-Baniewicz 3 , Marcin Holysz 4 , Joanna Skopinska-Wisniewska 5 , Magdalena Bodnar 6 , Andrzej Marszalek 7 , Paulina Antosik 6 , Dariusz Grzanka 6 , Tomasz Drewa 1
Affiliation  

Current strategies in urinary bladder augmentation include use of gastrointestinal segments, however, the technique is associated with inevitable complications. An acellular biologic scaffold seems to be a promising option for urinary bladder augmentation. The aim of this study was to evaluate the utility of bladder acellular matrix (BAM) for reconstruction of clinically significant large urinary bladder wall defects in a long-term porcine model. Urinary bladders were harvested from 10 pig donors. Biological scaffolds were prepared by chemically removing all cellular components from urinary bladder tissue. A total of 10 female pigs underwent hemicystectomy and subsequent bladder reconstruction with BAM. The follow-up study was 6 months. Reconstructed bladders were subjected to radiological, macroscopic, histological, immunohistochemical, and molecular evaluations. Six out of ten animals survived the 6-month follow-up period. Four pigs died during observation due to mechanical failure of the scaffold, anastomotic dehiscence between the scaffold and native bladder tissue, or occluded catheter. Tissue engineered bladder function was normal without any signs of postvoid residual urine in the bladder or upper urinary tracts. Macroscopically, graft shrinkage was observed. Urothelium completely covered the luminal surface of the graft. Smooth muscle regeneration was observed mainly in the peripheral graft region and gradually decreased toward the center of the graft. Expression of urothelial, smooth muscle, blood vessel, and nerve markers were lower in the reconstructed bladder wall compared to the native bladder. BAM seems to be a promising biomaterial for reconstruction of large urinary bladder wall defects. Further research on cell-seeded BAM to enhance urinary bladder regeneration is required.

中文翻译:

用脱细胞生物支架增强膀胱——大型动物模型的临床前研究

目前膀胱增大术的策略包括使用胃肠段,然而,该技术与不可避免的并发症有关。脱细胞生物支架似乎是增加膀胱的一种有前途的选择。本研究的目的是评估膀胱脱细胞基质 (BAM) 在长期猪模型中重建具有临床意义的大膀胱壁缺损的效用。从 10 头猪供体中采集膀胱。通过从膀胱组织中化学去除所有细胞成分来制备生物支架。共有 10 头母猪接受了半囊切除术和随后的 BAM 膀胱重建。随访研究为 6 个月。对重建的膀胱进行放射学、肉眼观察、组织学、免疫组化、和分子评价。10 只动物中有 6 只在 6 个月的随访期内幸存下来。由于支架的机械故障、支架与天然膀胱组织之间的吻合口裂开或导管阻塞,四头猪在观察期间死亡。组织工程膀胱功能正常,没有任何膀胱或上尿路排尿后残留尿液的迹象。肉眼观察到接枝收缩。尿路上皮完全覆盖移植物的管腔表面。平滑肌再生主要在外周移植物区域观察到,并且向移植物中心逐渐减少。与天然膀胱相比,重建膀胱壁中尿路上皮、平滑肌、血管和神经标志物的表达较低。BAM 似乎是用于重建大膀胱壁缺损的有前途的生物材料。需要进一步研究细胞种子 BAM 以增强膀胱再生。
更新日期:2021-07-29
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