Sack Bryan S, Mauney Joshua R, Estrada Carlos R
Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, 02115, USA.
Department of Surgery, Harvard Medical School, Boston, MA, 02115, USA.
Curr Urol Rep. 2016 Feb;17(2):16. doi: 10.1007/s11934-015-0567-x.
Urologic tissue engineering efforts have been largely focused on bladder and urethral defect repair. The current surgical gold standard for treatment of poorly compliant pathological bladders and severe urethral stricture disease is enterocystoplasty and onlay urethroplasty with autologous tissue, respectively. The complications associated with autologous tissue use and harvesting have led to efforts to develop tissue-engineered alternatives. Natural and synthetic materials have been used with varying degrees of success, but none has proved consistently reliable for urologic tissue defect repair in humans. Silk fibroin (SF) scaffolds have been tested in bladder and urethral repair because of their favorable biomechanical properties including structural strength, elasticity, biodegradability, and biocompatibility. SF scaffolds have been used in multiple animal models and have demonstrated robust regeneration of smooth muscle and urothelium. The pre-clinical data involving SF scaffolds in urologic defect repair are encouraging and suggest that they hold potential for future clinical use.
泌尿外科组织工程的努力主要集中在膀胱和尿道缺损修复上。目前，治疗顺应性差的病理性膀胱和严重尿道狭窄疾病的外科金标准分别是回肠膀胱扩大术和自体组织覆盖尿道成形术。与使用和采集自体组织相关的并发症促使人们努力开发组织工程替代方案。天然和合成材料的使用取得了不同程度的成功，但没有一种材料被证明在人类泌尿外科组织缺损修复中始终可靠。丝素蛋白（SF）支架因其良好的生物力学性能，包括结构强度、弹性、生物降解性和生物相容性，已在膀胱和尿道修复中进行了测试。SF支架已用于多种动物模型，并已证明能有力地促进平滑肌和尿路上皮的再生。涉及SF支架用于泌尿外科缺损修复的临床前数据令人鼓舞，并表明它们在未来临床应用中具有潜力。
