Purpura Valeria, Bondioli Elena, Cunningham Eric J, De Luca Giovanni, Capirossi Daniela, Nigrisoli Evandro, Drozd Tyler, Serody Matthew, Aiello Vincenzo, Melandri Davide
Emilia Romagna Regional Skin Bank and Burn Centre, Bufalini Hospital, AUSL Romagna, Cesena, Italy.
Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA.
J Tissue Eng. 2018 Dec 22;9:2041731418812613. doi: 10.1177/2041731418812613. eCollection 2018 Jan-Dec.
The circumcision of males is emphatically linked to numerous sexual dysfunctions. Many of the purported benefits do not hold up to the scrutiny of extensive literature surveys. Involuntary circumcision, particularly when not medically warranted, is also associated with many psychological and emotional traumas. Current methods to reconstruct the ablated tissue have significant drawbacks and produce a simple substitute that merely imitates the natural foreskin. Extracellular matrix-based scaffolds have been shown to be highly effective in the repair and regeneration of soft tissues; however, due to the unique nature of the foreskin tissue, commercially available biomaterial scaffolds would yield poor results. Therefore, this study discusses the development and evaluation of a tissue engineering scaffold derived from decellularized human foreskin extracellular matrix for foreskin reconstruction. A chemicophysical decellularization method was applied to human foreskin samples, sourced from consenting adult donors. The resulting foreskin dermal matrices were analyzed for their suitability for tissue engineering purposes, by biological, histological, and mechanical assessment; fresh frozen foreskin was used as a negative control. Sterility of samples at all stages was ensured by microbiological analysis. MTT assay was used to evaluate the absence of viable cells, and histological analysis was used to confirm the maintenance of the extracellular matrix structure and presence/integrity of collagen fibers. Bioactivity was determined by submitting tissue extracts to enzyme-linked immunosorbent assay and quantifying basic fibroblast growth factor content. Mechanical properties of the samples were determined using tensile stress tests. Results found foreskin dermal matrices were devoid of viable cells ( < 0.0001) and the matrix of foreskin dermal matrices was maintained. Basic fibroblast growth factor content doubled within after decellularization ( < 0.0001). Tensile stress tests found no statistically significant differences in the mechanical properties ( < 0.05). These results indicate that the derived foreskin dermal matrix may be suitable in a regenerative approach in the reconstruction of the human foreskin.
男性包皮环切术与众多性功能障碍有着密切联系。许多所谓的益处经不起广泛文献调查的审视。非自愿的包皮环切术，尤其是在没有医学指征的情况下，还会引发许多心理和情感创伤。目前用于重建切除组织的方法存在显著缺陷，只能产生一种简单的替代品，仅仅是模仿天然包皮。基于细胞外基质的支架已被证明在软组织修复和再生方面非常有效；然而，由于包皮组织的独特性质，市售的生物材料支架效果不佳。因此，本研究讨论了一种源自脱细胞人包皮细胞外基质的组织工程支架用于包皮重建的开发与评估。将化学物理脱细胞方法应用于来自成年自愿捐赠者的人包皮样本。通过生物学、组织学和力学评估，分析所得包皮真皮基质是否适合组织工程目的；新鲜冷冻包皮用作阴性对照。通过微生物分析确保所有阶段样本的无菌性。采用MTT法评估活细胞的缺失情况，组织学分析用于确认细胞外基质结构的维持以及胶原纤维的存在/完整性。通过将组织提取物进行酶联免疫吸附测定并定量碱性成纤维细胞生长因子含量来确定生物活性。使用拉伸应力测试确定样本的力学性能。结果发现包皮真皮基质没有活细胞（<0.0001），且包皮真皮基质的基质得以维持。脱细胞后碱性成纤维细胞生长因子含量翻倍（<0.0001）。拉伸应力测试发现力学性能没有统计学上的显著差异（<0.05）。这些结果表明，所获得的包皮真皮基质可能适用于人类包皮重建的再生方法。
