Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
Laryngoscope. 2021 Aug;131(8):1732-1740. doi: 10.1002/lary.29178. Epub 2020 Nov 2.
One of the greatest hurdles in tracheal tissue engineering is insufficient vascularization, which leads to delayed mucosal regeneration, inflammation, and restenosis. This study investigated whether a prevascularized segmental tracheal substitute using platysma can enhance tracheal mucosal regeneration.
Three-dimensional (3D) printed scaffolds with (group M) or without (group S) Matrigel coating were implanted under the feeding vessels of the platysma in New Zealand White rabbits (n = 3) to induce vascularization. After 1 or 2 weeks, tracheal defects were created and vascularized scaffolds with feeders of the platysma were transplanted as rotational flaps. As controls, scaffolds with or without Matrigel coating was transplanted into a tracheal defect without prevascularization. Airway patency and epithelization were examined using a rigid bronchoscope every 2 weeks. Surviving animals were euthanized at 24 weeks, and microcomputed tomography and histological evaluation were performed.
Animals with 2 weeks of prevascularization showed longer survival than animals with 0 or 1 weeks of prevascularization regardless of the Matrigel coating. Wider airway patency was observed in group M than group S. Group M showed migration of epithelium over the scaffold from 4 weeks after transplantation and complete coverage with epithelium at 12 weeks, whereas group S showed migration of the epithelium from 14 weeks and incomplete coverage with epithelium even at 24 weeks.
This two-step method, utilizing the platysma as an in vivo bioreactor, may be a promising approach to achieve long-term survival and enhanced luminal patency. Matrigel coating on the scaffold had a synergistic effect on epithelial regeneration.
NA Laryngoscope, 131:1732-1740, 2021.
气管组织工程的最大障碍之一是血管化不足，这会导致黏膜再生延迟、炎症和再狭窄。本研究旨在探讨使用胸锁乳突肌构建预制血管化的气管节段替代物能否促进气管黏膜再生。
在新西兰白兔（n=3）胸锁乳突肌的营养血管下植入具有（M 组）或不具有（S 组）Matrigel 涂层的三维（3D）打印支架，以诱导血管生成。1 或 2 周后，创建气管缺损，并将带有胸锁乳突肌营养血管的血管化支架作为旋转皮瓣移植。作为对照，将具有或不具有 Matrigel 涂层的支架移植到无预血管化的气管缺损中。每 2 周使用硬质支气管镜检查气道通畅性和上皮化。24 周时处死存活动物，进行微计算机断层扫描和组织学评估。
2 周预血管化的动物比 0 或 1 周预血管化的动物存活时间更长，无论是否有 Matrigel 涂层。M 组的气道通畅性比 S 组更宽。M 组在移植后 4 周可见上皮细胞向支架迁移，12 周时完全被上皮细胞覆盖，而 S 组在 14 周时可见上皮细胞迁移，即使在 24 周时也不完全被上皮细胞覆盖。
利用胸锁乳突肌作为体内生物反应器的两步法可能是实现长期存活和增强管腔通畅性的有前途的方法。支架上的 Matrigel 涂层对上皮再生有协同作用。
无 喉科学，131:1732-1740，2021。
