骨髓间充质干细胞在脱细胞真皮基质再生过程中的初步研究

较大的腹壁缺损需要应用补片修复来缓解腹横筋膜的张力,人工合成补片的应用一定程度上实现了无张力修补的目的,但它在腹壁外科应用中有诸多的并发症,诸如复发率高,腹腔黏连,肠穿孔导致腹膜炎,侵袭性肠瘘等影响患者术后的正常生活,而脱细胞真皮基质(Acellular dermal matrix,ADM)作为一种新型的生物材料应用在腹壁外科中能解决上述人工合成补片所带来的并发症发挥强大作用且能与周围组织较好的融合,最后改建成宿主自身组织已并在多学科领域中广泛应用;骨髓间充质干细胞(Bone marrow mesenchymal stem cells,BMSCs)能参与组织自我修复,并能分化成为多种功能细胞,分泌各种生长因子,在ADM内源性转归过程中可发挥作用。本文就对骨髓间充质干细胞在ADM生物补片应用于临床疝修补术中转归机制的研究做一综述。     

梯度信号分子功能支架的制备及再生医学应用

再生医学作为新兴的治疗手段,为受损组织再生带来新希望。如何实现生物支架的功能化是提高受损组织再生能力的关键因素之一。天然生物体内存在多种物理、化学信号梯度,调控多种生理学过程,促进细胞黏附、迁移和分化,从而提高组织损伤修复效果。近年来,研究发现在生物支架中引入梯度分布的物理或生物学信号,在组织修复及再生方面展现出独特作用,具有重大应用前景。该文阐述了近年来组织再生中信号梯度功能支架的分类、制备技术及其在再生医学中的研究进展,并对再生医学领域梯度功能支架进行展望。     

自组装多肽纳米纤维支架诱导骨髓间充质干细胞定向分化

组织工程是现代修复重建医学领域的新思路,生物支架和种子细胞是组织工程两大关键要素。自组装多肽纳米纤维支架(SAPNS)是两亲性多肽(PAs)分子在一定条件下自组装成的一类具有三维网状结构的新型生物支架,其结构、生物功能、机械力学等特性类似天然细胞外基质(ECM),其内部经功能化修饰的抗原表位以高浓度呈递在纳米纤维表面并高效选择性地调控种子细胞生物学行为。种子细胞是组织成功再生的必需条件,骨髓间充质干细胞(BMSCs)因其良好的自我更新和多向分化潜能成为了组织工程最佳候选细胞。体外实验表明经特异功能化修饰的SAPNS在有/无辅助因子条件下可促进BMSCs黏附、增殖、迁移和定向分化,动物模型体内实验发现SAPNS结合BMSCs构建的组织工程移植物可修复缺损部位的组织结构和功能,故其在修复重建医学中有良好的应用前景。对SAPNS、自组装、BMSCs、SAPNS诱导BMSCs定向分化等方面进行了综述。     

ECM支架与软骨修复

细胞外基质(extracellular matrix,ECM)支架是含有很多生物活性分子的天然生物材料,可以维持组织内稳态并诱导组织再生。ECM支架最大的优势是其可降解,且不会引起免疫排斥。目前,临床应用中ECM支架已经成功用于心血管、软骨组织等重建。软骨组织工程中,利用ECM支架进行修复的软骨组织具有结构稳定,低免疫原性,生物可降解及天然成分保留完整等优势特点。本综述回顾了ECM支架的来源、制备方案,评述了其在软骨组织修复中的优势与前景,有助于ECM支架在未来更好地应用。     

组织工程的突破与挑战——组织工程国家工程中心科研进展

组织工程技术已被普遍认为是解决组织、器官缺损修复与功能重建的有效手段,它的飞速发展依赖于细胞学、材料学、工程学、临床医学等多学科的交叉渗透.作为组织工程的三大核心,种子细胞、生物材料、组织构建各方面的突破,为组织工程技术的发展奠定了基础.组织工程国家工程中心近年来围绕上述核心开展了系列研究,通过研究胚胎干细胞、成体干细胞、同种异体干细胞、以及发育同源细胞替代的探索,为解决种子细胞来源问题提供了多种选择;生物支架材料的开发,为细胞增殖分化、组织再生提供理想的支持与空间,而生物反应器的开发与应用,进一步提高了组织构建技术,为促进组织的体外形成、重塑和功能成熟创造了条件.在此基础上,开展了大动物体内组织构建和缺损修复的研究,形成了以应用为目标的研究特色,并成功将部分技术应用于临床治疗.本文将对组织工程国家工程中心已有进展做简单介绍并对面临的挑战进行分析.     

纳米硅酸镁锂在组织再生中的应用*

因外伤、肿瘤和先天发育异常等导致的组织缺损会严重影响患者的生理功能和心理健康。组织再生修复过程复杂,随着年龄的增长,机体本身再生修复的能力逐渐减弱,缺损组织的修复多以纤维结构混乱的瘢痕修复为主。硅酸镁锂(laponite,LAP)因其独特的纳米层状结构和表面电化学特点,能够与多种生物分子和药物相互作用,展现了较好的细胞相容性和生物活性,已被广泛应用于组织再生生物材料的功能化改性。综述LAP的性质特点及其在组织再生修复领域的应用,以期推进LAP研究成果更好地向临床转化。     

丝素蛋白在电纺丝法构建组织工程支架中的应用进展

丝素蛋白是天然高分子纤维蛋白,具有良好的物理和机械力学性能及生物相容性,因而在组织工程领域有着广阔的应用前景。文中对丝素蛋白的化学组成、分子结构特点、提取方法以及利用静电纺丝技术在组织工程化支架构建中的应用作了概述。总结了丝素蛋白在用于组织工程材料上的性能和优势以及在人工血管、皮肤、骨组织等工程化支架方面的应用情况,探讨了丝素蛋白支架对细胞在其上生长、增殖和功能的影响,同时对丝素蛋白在组织工程化食道支架及其他再生医学上的应用前景进行了展望。     

慢性肾功能衰竭的治疗现状及研究前景

CRF是威胁人类健康及生命的常见病之一,近年来平均每年以约8%的速度在增长。依靠慢性肾功能衰竭肾脏母体及机体的再生潜能在脱细胞基质支架上修复重建肾脏结构与功能,这将是慢性肾功能衰竭治疗的一种全新的途径。而去细胞基质在组织工程、干细胞及再生医学的大量应用为解决组织器官的修复和重建等难题带来了希望。本文就目前CRF的治疗现状及、肾脏组织工程研究前景进行简要综述。     

人羊膜上皮细胞具有胚胎干细胞和移植免疫耐受等优良特性

干细胞具有自身复制和多向分化的潜能,在体内能够维持组织器官形态和生理功能的稳态,并具有修复外伤和病理引起的损伤的作用。故而,近年来在细胞生物学以及再生医学研究领域倍受重视。可以预见,干细胞在细胞治疗、组织工程、器官修复等方面的临床应用,将有广泛的前景和市场潜力;同时在遗传、发育、分化、调亡等生物学问题研究以及新药开发、药效学和毒性评估等方面,也有着广泛的科学探索和实际应用价值。干细胞研究必将成为生命科学研究的主战场和生物经济最为活跃的     

肌腱组织工程研究进展

随着人口的年龄和预期寿命的增加,尤其是在年轻的人群中,肌腱损伤将变得更加普遍。传统的肌腱修复方法有许多不足之处,其功能重建不能令人满意。组织工程是一个发展的领域,组织工程肌腱体外的构建和体内的应用技术逐渐成熟,为临床上治疗肌腱缺损提供了一种不需要自体肌腱移植而且更加有前景的途径。在肌腱组织工程的研究中所面临的挑战和未来的发展方向为:种子细胞,新型支架材料和力学刺激。近年来肌腱干细胞的发现为种子细胞的选择提供了新思路,力学刺激对组织工程肌腱的影响也逐渐成为热点。本文就组织工程肌腱研究中种子细胞、支架材料和力学刺激的进展做一综述,并对未来的发展进行展望。     

微载体技术在软骨损伤修复中的应用与展望北大核心CSCD

软骨内部无血管结构、细胞外基质含量高的特点,使软骨组织的自我恢复能力很差。在临床治疗中,轻度的软骨缺损通常采用物理治疗或药物治疗方式,严重者需进行手术治疗。近年来,软骨组织工程技术为治疗软骨缺损提供了新的思路,与传统的手术治疗方式相比,结合软骨组织工程技术进行治疗具有创口小、恢复佳的优点。将微载体技术融入组织工程支架的设计中,可以利用微载体直径小、能够负载多种生长因子的特点,进一步扩展支架功能、促进软骨组织再生。文中首先对微载体技术进行介绍,对近年来微载体的主要制备方式和创新内容进行了概括总结,作为后续介绍的基础内容。然后对应用于软骨修复中的微载体进行了材料和功能上的划分,介绍了不同材料、不同功能微载体的属性特征和在软骨修复方面的具体应用,最后结合该领域发展历程对其今后发展趋势及方向进行展望,并基于笔者团队关于骨软骨一体化层状支架的研究,提出了通过微载体优化层状支架性能的思路,有望制备出更贴合天然软骨结构特征的仿生支架。     

Tissue engineering in female pelvic floor reconstruction

Pelvic organ prolapse is a common and frequently occurring disease in middle‐aged and elderly women. Mesh implantation is an ideal surgical treatment. The polypropylene mesh commonly used in clinical practice has good mechanical properties, but there are long‐term complications. The application of tissue engineering technology in the treatment of pelvic organ prolapse disease can not only meet the mechanical requirements of pelvic floor support, but also be more biocompatible than traditional polypropylene mesh, and can promote tissue repair to a certain extent. In this paper, the progress of tissue engineering was summarized to understand the application of tissue engineering in the treatment of pelvic organ prolapse disease and will help in research.     

Secondary aortoenteric fistula

Secondary aortoenteric fistula (SAF) is an uncommon but very important complication of abdominal aortic reconstruction. The complication often occurs months to years after aortic surgery. The clinical manifestation of the aortoenteric fistula is always upper gastrointestinal bleeding. Treatment of the disease is early surgical intervention. If operative treatment is not performed promptly, the mortality is high. A case of secondary aortoduodenal fistula found 6 years after aortic reconstructive surgery, with the clinical presentation of upper gastrointestinal bleeding, is presented. On Immediate exploratory laparotomy, the proximal part of abdominal aorta was clamped. Duodenorrhaphy and aortic reconstruction with patch graft at the proximal suture line of aortic prosthesis was performed. Fortunately there was no pus, so tissue culture was not done. The intervention was concluded with an omentoplasty to protect the patch graft and to separate it from duodenorrhaphy. The patient did well after the surgical management. Because of the increasing number of elective aortic aneurysm repairs in the aging population, it is likely that more patients with secondary aortoenteric fistula will present to the clinical physicians in the future. So, a high index of suspicion is necessary for prompt diagnosis and treatment of this life-threatening event.     

Biological properties of solid free form designed ceramic scaffolds with BMP-2: in vitro and in vivo evaluation

Porous ceramic scaffolds are widely studied in the tissue engineering field due to their potential in medical applications as bone substitutes or as bone-filling materials. Solid free form (SFF) fabrication methods allow fabrication of ceramic scaffolds with fully controlled pore architecture, which opens new perspectives in bone tissue regeneration materials. However, little experimentation has been performed about real biological properties and possible applications of SFF designed 3D ceramic scaffolds. Thus, here the biological properties of a specific SFF scaffold are evaluated first, both in vitro and in vivo, and later scaffolds are also implanted in pig maxillary defect, which is a model for a possible application in maxillofacial surgery. In vitro results show good biocompatibility of the scaffolds, promoting cell ingrowth. In vivo results indicate that material on its own conducts surrounding tissue and allow cell ingrowth, thanks to the designed pore size. Additional osteoinductive properties were obtained with BMP-2, which was loaded on scaffolds, and optimal bone formation was observed in pig implantation model. Collectively, data show that SFF scaffolds have real application possibilities for bone tissue engineering purposes, with the main advantage of being fully customizable 3D structures.     

Tissue-engineered mesh for pelvic floor reconstruction fabricated from silk fibroin scaffold with adipose-derived mesenchymal stem cells

A tissue-engineered mesh fabricated with adipose-derived mesenchymal stem cells (AD-MSCs) cultured on a silk fibroin scaffold is evaluated for use in female pelvic reconstruction. Thirty-five female Sprague Dawley rats were divided into four groups. Group A (n?=?10) were implanted with polypropylene meshes, Group B (n?=?10) with silk fibroin scaffolds and Group C (n?=?10) with tissue-engineered meshes. Group D (n?=?5) acted as the tissue control. The tissue-engineered mesh was produced as follows. AD-MSCs were obtained from adipose tissue of rats designated to Group C. The cells were seeded onto a silk fibroin scaffold, cultured and then observed by scanning electron microscopy (SEM). Histological studies of these meshes were performed at 4 and 12 weeks after implantation and mechanical testing was carried out on all groups before implantation and at 12 weeks after implantation. AD-MSCs displayed fibroblast-like shapes and were able to differentiate into adipocytes or fibroblasts. SEM observation showed that AD-MSCs proliferated and secreted a matrix onto the silk fibroin scaffolds. After implantation of the scaffolds into rats, histological analysis revealed better organized newly formed tissue in Group C than in controls. Group C also had a similar failure force (2.67?±?0.15 vs 2.33?±?0.38 N) and a higher Young’s modulus (2.99?±?0.19 vs 1.68?±?0.20 MPa) than a normal vaginal wall, indicating the potential of this tissue-engineered approach. AD-MSCs were validated as seed cells for tissue engineering. The silk fibroin scaffold thus shows promise for application with AD-MSCs in the fabrication of tissue-engineered mesh with good biocompatibility and appropriate mechanical properties for pelvic floor reconstruction.     

Nanotechnology in regenerative medicine: the materials side

Regenerative medicine is an emerging multidisciplinary field that aims to restore, maintain or enhance tissues and hence organ functions. Regeneration of tissues can be achieved by the combination of living cells, which will provide biological functionality, and materials, which act as scaffolds to support cell proliferation. Mammalian cells behave in vivo in response to the biological signals they receive from the surrounding environment, which is structured by nanometre-scaled components. Therefore, materials used in repairing the human body have to reproduce the correct signals that guide the cells towards a desirable behaviour. Nanotechnology is not only an excellent tool to produce material structures that mimic the biological ones but also holds the promise of providing efficient delivery systems. The application of nanotechnology to regenerative medicine is a wide issue and this short review will only focus on aspects of nanotechnology relevant to biomaterials science. Specifically, the fabrication of materials, such as nanoparticles and scaffolds for tissue engineering, and the nanopatterning of surfaces aimed at eliciting specific biological responses from the host tissue will be addressed.     

A new composite xenograft monocusp patch for reconstruction of the right ventricular outflow tract: A preliminary report

Pulmonary insufficiency secondary to outflow tract reconstruction remains an unsolved problem. Although a number of surgical techniques have been designed to avoid or palliate this condition, none so far has been satisfactory. This report describes a new composite stented porcine monocusp patch, which, because of its desirable hemodynamic characteristics, promises to yield stable and reproducible results. The clinical effectiveness of the patch is documented by its successful application in a patient with tetralogy of Fallot.     

Use of a novel acellular xenograft as a patch for aortic annular enlargement during aortic valve replacement

A patient with a history of aortic valve endocarditis and surgical debridement presented with acute congestive heart failure because of severe aortic stenosis. During valve replacement surgery, an aortic annular enlargement was required to overcome a potential patient-prosthesis mismatch. We describe the use of a novel, bioresorbable, acellular xenograft for the enlargement patch. This material is expected to remodel into native patient tissue over time. This case offers an alternative implant for left heart reconstruction using a regenerative patch.     

Repair and regeneration of osteochondral defects in the articular joints

People suffering from pain due to osteoarthritic or rheumatoidal changes in the joints are still waiting for a better treatment. Although some studies have achieved success in repairing small cartilage defects, there is no widely accepted method for complete repair of osteochondral defects. Also joint replacements have not yet succeeded in replacing of natural cartilage without complications. Therefore, there is room for a new medical approach, which outperforms currently used methods. The aim of this study is to show potential of using a tissue engineering approach for regeneration of osteochondral defects. The critical review of currently used methods for treatment of osteochondral defects is also provided. In this study, two kinds of hybrid scaffolds developed in Hutmacher's group have been analysed. The first biphasic scaffold consists of fibrin and PCL. The fibrin serves as a cartilage phase while the porous PCL scaffold acts as the subchondral phase. The second system comprises of PCL and PCL-TCP. The scaffolds were fabricated via fused deposition modeling which is a rapid prototyping system. Bone marrow-derived mesenchymal cells were isolated from New Zealand White rabbits, cultured in vitro and seeded into the scaffolds. Bone regenerations of the subchondral phases were quantified via micro CT analysis and the results demonstrated the potential of the porous PCL and PCL-TCP scaffolds in promoting bone healing. Fibrin was found to be lacking in this aspect as it degrades rapidly. On the other hand, the porous PCL scaffold degrades slowly hence it provides an effective mechanical support. This study shows that in the field of cartilage repair or replacement, tissue engineering may have big impact in the future. In vivo bone and cartilage engineering via combining a novel composite, biphasic scaffold technology with a MSC has been shown a high potential in the knee defect regeneration in the animal models. However, the clinical application of tissue engineering requires the future research work due to several problems, such as scaffold design, cellular delivery and implantation strategies.     

Urinary bladder matrix promotes site appropriate tissue formation following right ventricle outflow tract repair

The current prevalence and severity of heart defects requiring functional replacement of cardiac tissue pose a serious clinical challenge. Biologic scaffolds are an attractive tissue engineering approach to cardiac repair because they avoid sensitization associated with homograft materials and theoretically possess the potential for growth in similar patterns as surrounding native tissue. Both urinary bladder matrix (UBM) and cardiac ECM (C-ECM) have been previously investigated as scaffolds for cardiac repair with modest success, but have not been compared directly. In other tissue locations, bone marrow derived cells have been shown to play a role in the remodeling process, but this has not been investigated for UBM in the cardiac location, and has never been studied for C-ECM. The objectives of the present study were to compare the effectiveness of an organ-specific C-ECM patch with a commonly used ECM scaffold for myocardial tissue repair of the right ventricle outflow tract (RVOT), and to examine the role of bone marrow derived cells in the remodeling response. A chimeric rat model in which all bone marrow cells express green fluorescent protein (GFP) was generated and used to show the ability of ECM scaffolds derived from the heart and bladder to support cardiac function and cellular growth in the RVOT. The results from this study suggest that urinary bladder matrix may provide a more appropriate substrate for myocardial repair than cardiac derived matrices, as shown by differences in the remodeling responses following implantation, as well as the presence of site appropriate cells and the formation of immature, myocardial tissue.