Hu Yun-fei, Yang Si-xing, Wang Ling-long, Jin Hua-min
Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Chin J Traumatol. 2008 Oct;11(5):274-8. doi: 10.1016/s1008-1275(08)60055-3.
To investigate the curative effect and histocompatibility of reconstruction of traumatic urethral defect of rabbit using urethral extracellular matrix (ECM).
Urethral ECM was obtained by excision of the urethra in 20 donor rabbits. In experimental group, 20 rabbits were resected a 1.0 cm-1.5 cm segment of the urethra and artificially made a model of traumatic urethral defect, then reconstructed by the urethral extracellular matrix of the same length. The rabbit immunity response was assessed by lymphocyte transformation test and serum TNF-alpha level. The reconstructed urethral segments were stained with hematoxylin-eosin and Van Gieson stain and observed by histological examination postoperatively. The urethrography, urethroscopy and urodynamic examinations were performed.
There was no significant difference in stimulative index of lymphocyte transformation between ECM group and control group. The serum TNF-alpha levels of ECM group slightly rose, but the increase was not significant as compared with control group. On postoperative day 10, epithelial cell had migrated from each side and small vessels were found in the extracellular matrix. In the 3rd week, several layers of urothelium covered the whole surface of the matrix tube. In the 6th week, the disorganized arrangements of smooth muscle fibers were firstly observed by Van Gieson staining. In the 24th week, the smooth muscle cells increased and the matrix tube appeared fairly similar to normal urethral wall components. The urethroscopy and urodynamic evaluation revealed that the surface of reconstructed urethra was smooth and emiction was unobstructed.
The urethral extracellular matrix might be an ideal and safe biomaterial for the reconstruction of urethral traumatic defect.
探讨应用尿道细胞外基质（ECM）修复兔创伤性尿道缺损的疗效及组织相容性。
取20只供体兔的尿道，制备尿道ECM。实验组20只兔切除1.0 cm - 1.5 cm长尿道段，人工制造创伤性尿道缺损模型，然后用等长的尿道细胞外基质进行修复。通过淋巴细胞转化试验和血清肿瘤坏死因子-α（TNF-α）水平评估兔免疫反应。术后对修复的尿道段进行苏木精-伊红染色和范吉森染色，组织学观察。行尿道造影、尿道镜检查和尿动力学检查。
ECM组与对照组淋巴细胞转化刺激指数差异无统计学意义。ECM组血清TNF-α水平略有升高，但与对照组相比升高不显著。术后第10天，上皮细胞从两侧迁移，细胞外基质中有小血管。第3周，多层尿路上皮覆盖基质管整个表面。第6周，范吉森染色首次观察到平滑肌纤维排列紊乱。第24周，平滑肌细胞增多，基质管与正常尿道壁成分相当相似。尿道镜和尿动力学评估显示，修复后的尿道表面光滑，排尿通畅。
尿道细胞外基质可能是修复尿道创伤性缺损的理想、安全生物材料。
