Aframian D J, Redman R S, Yamano S, Nikolovski J, Cukierman E, Yamada K M, Kriete M F, Swaim W D, Mooney D J, Baum B J
Gene Therapy and Therapeutics Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland 20892, USA.
Tissue Eng. 2002 Aug;8(4):649-59. doi: 10.1089/107632702760240562.
Radiation therapy for cancer in the head and neck region leads to a marked loss of salivary gland parenchyma, resulting in a severe reduction of salivary secretions. Currently, there is no satisfactory treatment for these patients. To address this problem, we are using both tissue engineering and gene transfer principles to develop an orally implantable, artificial fluid-secreting device. In the present study, we examined the tissue compatibility of two biodegradable substrata potentially useful in fabricating such a device. We implanted in Balb/c mice tubular scaffolds of poly-L-lactic acid (PLLA), poly-glycolic acid coated with PLLA (PGA/PLLA), or nothing (sham-operated controls) either beneath the skin on the back, a site widely used in earlier toxicity and biocompatibility studies, or adjacent to the buccal mucosa, a site quite different functionally and immunologically. At 1, 3, 7, 14, and 28 days postimplantation, implant sites were examined histologically, and systemic responses were assessed by conventional clinical chemistry and hematology analyses. Inflammatory responses in the connective tissue were similar regardless of site or type of polymer implant used. However, inflammatory reactions were shorter and without epithelioid and giant cells in sham-operated controls. Also, biodegradation proceeded more slowly with the PLLA tubules than with the PGA/PLLA tubules. No significant changes in clinical chemistry and hematology were seen due to the implantation of tubular scaffolds. These results indicate that the tissue responses to PLLA and PGA/PLLA scaffolds are generally similar in areas subjacent to skin in the back and oral cavity. However, these studies also identified several potentially significant concerns that must be addressed prior to initiating any clinical applications of this device.
头颈部癌症的放射治疗会导致唾液腺实质显著丧失,从而使唾液分泌严重减少。目前,对于这些患者尚无令人满意的治疗方法。为了解决这一问题,我们正在运用组织工程学和基因转移原理来研发一种可口服植入的人工分泌液装置。在本研究中,我们检测了两种可生物降解基质的组织相容性,这两种基质可能对制造此类装置有用。我们将聚-L-乳酸(PLLA)管状支架、涂有PLLA的聚乙醇酸(PGA/PLLA)管状支架或无植入物(假手术对照)植入Balb/c小鼠体内,植入部位要么是背部皮肤下方(这是早期毒性和生物相容性研究中广泛使用的部位),要么是颊黏膜附近(这是一个在功能和免疫方面有很大差异的部位)。在植入后1、3、7、14和28天,对植入部位进行组织学检查,并通过常规临床化学和血液学分析评估全身反应。无论使用何种聚合物植入物以及植入部位如何,结缔组织中的炎症反应都相似。然而,假手术对照中的炎症反应持续时间较短,且没有上皮样细胞和巨细胞。此外,PLLA小管的生物降解速度比PGA/PLLA小管慢。管状支架植入后,临床化学和血液学方面未见明显变化。这些结果表明,PLLA和PGA/PLLA支架在背部皮肤下方和口腔区域的组织反应总体相似。然而,这些研究也发现了几个潜在的重大问题,在启动该装置的任何临床应用之前必须加以解决。