Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, 44106.
Faculty of Medicine in Urology, Menoufia University, Shebeen El-Kom, Egypt.
J Biomed Mater Res B Appl Biomater. 2019 Apr;107(3):479-489. doi: 10.1002/jbm.b.34138. Epub 2018 Jun 13.
Meshes woven from highly aligned collagen threads crosslinked using either genipin or 1-ethyl-3-(3-dimethylaminopropyl) carboiimide and N-hydroxy succinimide (EDC/NHS) were implanted in a subcutaneous rat model to evaluate their biocompatibility (at 2 weeks, 2 months, and 5 months), mechanical properties (at baseline, 2 months, and 5 months) and ultimately their suitability for use as mid-urethral slings (MUS) for management of stress urinary incontinence. Porcine dermal (Xenmatrix) and monofilament polypropylene (Prolene) meshes were also implanted to provide comparison to clinically used materials. Quantitative histological scoring showed tissue integration in Xenmatrix was almost absent, while the open network of woven collagen and Prolene meshes allowed for cellular and tissue integration. However, strength and stiffness of genipin-crosslinked collagen (GCC), Prolene, and Xenmatrix meshes were not significantly different from those of native rectus fascia and vaginal tissues of animals at 5 months. EDC/NHS-crosslinked collagen (ECC) meshes were degraded so extensively at five months that samples could only be used for histological staining. Picrosirius red and Masson's trichrome staining revealed that integrated tissue within GCC meshes was more aligned (p = 0.02) and appeared more concentrated than ECC meshes at 5 months. Furthermore, immunohistochemical staining showed that GCC meshes attracted a greater number of cells expressing markers for M2 macrophages, those associated with regeneration, than ECC meshes (p = 0.01 for CD206+ cells, p = 0.001 CD163+ cells) at 5 months. As such, GCC meshes hold promise as a new MUS biomaterial based on favorable induction of fibrous tissue resulting in mechanical stiffness matching that of native tissue. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 479-489, 2019.
用京尼平或 1-乙基-3-(3-二甲基氨基丙基)碳化二亚胺和 N-羟基琥珀酰亚胺（EDC/NHS）交联的高度对齐胶原线编织的网被植入皮下大鼠模型中，以评估其生物相容性（在 2 周、2 个月和 5 个月时）、机械性能（在基线时、2 个月和 5 个月时），最终评估其作为治疗压力性尿失禁的中尿道吊带（MUS）的适用性。还植入了猪真皮（Xenmatrix）和单丝聚丙烯（Prolene）网，以与临床使用的材料进行比较。定量组织学评分显示，Xenmatrix 中的组织整合几乎不存在，而编织胶原和 Prolene 网的开放式网络允许细胞和组织整合。然而，在 5 个月时，京尼平交联胶原（GCC）、Prolene 和 Xenmatrix 网的强度和刚度与动物的天然腹直肌筋膜和阴道组织没有显著差异。EDC/NHS 交联胶原（ECC）网在 5 个月时降解得如此严重，以至于只能用于组织学染色。苦味酸天狼星红和 Masson 三色染色显示，在 5 个月时，GCC 网内整合的组织排列更整齐（p = 0.02），且比 ECC 网更集中。此外，免疫组织化学染色显示，GCC 网吸引了更多表达 M2 巨噬细胞标志物的细胞，这些细胞与再生有关，比 ECC 网（CD206+细胞 p = 0.01，CD163+细胞 p = 0.001）更多，5 个月时。因此，GCC 网有望成为一种新的 MUS 生物材料，因为它能诱导产生纤维组织，从而使机械刚度与天然组织相匹配。
