Laboratory for Urologic Tissue Engineering and Stem Cell Therapy, Department of Urology, University Hospital, Zurich, Switzerland.
J Tissue Eng Regen Med. 2013 Jul;7(7):515-22. doi: 10.1002/term.547. Epub 2012 Mar 21.
End stage bladder disease can seriously affect patient quality of life and often requires surgical reconstruction with bowel tissue, which is associated with numerous complications. Bioengineering of functional bladder tissue using tissue-engineering techniques could provide new functional tissues for reconstruction. In this review, we discuss the current state of this field and address different approaches to enable physiologic voiding in engineered bladder tissues in the near future.
In a collaborative effort, we gathered researchers from four institutions to discuss the current state of functional bladder engineering. A MEDLINE® and PubMed® search was conducted for articles related to tissue engineering of the bladder, with special focus on the cells and biomaterials employed as well as the microenvironment, vascularisation and innervation strategies used.
Over the last decade, advances in tissue engineering technology have laid the groundwork for the development of a biological substitute for bladder tissue that can support storage of urine and restore physiologic voiding. Although many researchers have been able to demonstrate the formation of engineered tissue with a structure similar to that of native bladder tissue, restoration of physiologic voiding using these constructs has never been demonstrated. The main issues hindering the development of larger contractile tissues that allow physiologic voiding include the development of correct muscle alignment, proper innervation and vascularization.
Tissue engineering of a construct that will support the contractile properties that allow physiologic voiding is a complex process. The combination of smart scaffolds with controlled topography, the ability to deliver multiple trophic factors and an optimal cell source will allow for the engineering of functional bladder tissues in the near future.
晚期膀胱疾病会严重影响患者的生活质量，往往需要用肠组织进行手术重建，而这会引起许多并发症。利用组织工程技术对功能性膀胱组织进行生物工程化处理，可为重建提供新的功能性组织。在本综述中，我们讨论了该领域的现状，并探讨了为使工程化膀胱组织实现生理性排尿而在近期内采用的不同方法。
我们协同来自四个机构的研究人员共同探讨功能性膀胱工程学的现状。对与膀胱组织工程相关的文章进行了 MEDLINE®和 PubMed®检索，特别关注所使用的细胞和生物材料以及所采用的微环境、血管化和神经支配策略。
在过去十年中，组织工程技术的进步为开发可储存尿液并恢复生理性排尿的膀胱组织生物替代品奠定了基础。尽管许多研究人员已经能够证明具有类似于天然膀胱组织结构的工程化组织的形成，但从未证明过使用这些构建体实现生理性排尿。阻碍开发允许生理性排尿的更大收缩性组织的主要问题包括正确的肌肉排列、适当的神经支配和血管化。
支持允许生理性排尿的收缩特性的构建体的组织工程化是一个复杂的过程。将具有受控拓扑结构的智能支架、传递多种营养因子的能力和最佳细胞来源相结合，将允许在不久的将来工程化功能性膀胱组织。
