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猪小肠黏膜下层(SIS)作为组织工程化尿导管的合适支架:使用新方法进行脱细胞、生物力学和生物相容性表征。

Porcine Small Intestinal Submucosa (SIS) as a Suitable Scaffold for the Creation of a Tissue-Engineered Urinary Conduit: Decellularization, Biomechanical and Biocompatibility Characterization Using New Approaches.

机构信息

Department of Surgery, Oncology and Gastroenterology, Giustiniani 2, 35128 Padua, Italy.

L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, via N. Giustiniani 2, 35128 Padua, Italy.

出版信息

Int J Mol Sci. 2022 Mar 4;23(5):2826. doi: 10.3390/ijms23052826.

Abstract

Bladder cancer (BC) is among the most common malignancies in the world and a relevant cause of cancer mortality. BC is one of the most frequent causes for bladder removal through radical cystectomy, the gold-standard treatment for localized muscle-invasive and some cases of high-risk, non-muscle-invasive bladder cancer. In order to restore urinary functionality, an autologous intestinal segment has to be used to create a urinary diversion. However, several complications are associated with bowel-tract removal, affecting patients' quality of life. The present study project aims to develop a bio-engineered material to simplify this surgical procedure, avoiding related surgical complications and improving patients' quality of life. The main novelty of such a therapeutic approach is the decellularization of a porcine small intestinal submucosa (SIS) conduit to replace the autologous intestinal segment currently used as urinary diversion after radical cystectomy, while avoiding an immune rejection. Here, we performed a preliminary evaluation of this acellular product by developing a novel decellularization process based on an environmentally friendly, mild detergent, i.e., Tergitol, to replace the recently declared toxic Triton X-100. Treatment efficacy was evaluated through histology, DNA, hydroxyproline and elastin quantification, mechanical and insufflation tests, two-photon microscopy, FTIR analysis, and cytocompatibility tests. The optimized decellularization protocol is effective in removing cells, including DNA content, from the porcine SIS, while preserving the integrity of the extracellular matrix despite an increase in stiffness. An effective sterilization protocol was found, and cytocompatibility of treated SIS was demonstrated from day 1 to day 7, during which human fibroblasts were able to increase in number and strongly organize along tissue fibres. Taken together, this in vitro study suggests that SIS is a suitable candidate for use in urinary diversions in place of autologous intestinal segments, considering the optimal results of decellularization and cell proliferation. Further efforts should be undertaken in order to improve SIS conduit patency and impermeability to realize a future viable substitute.

摘要

膀胱癌(BC)是世界上最常见的恶性肿瘤之一,也是癌症死亡的一个重要原因。BC 是通过根治性膀胱切除术切除膀胱的最常见原因之一,根治性膀胱切除术是治疗局限性肌层浸润性和某些高危、非肌层浸润性膀胱癌的金标准。为了恢复尿功能,必须使用自体肠段来创建尿流改道。然而,肠道切除与许多并发症相关,影响患者的生活质量。本研究项目旨在开发一种生物工程材料,以简化这一手术过程,避免相关手术并发症,提高患者的生活质量。这种治疗方法的主要新颖之处在于脱细胞猪小肠黏膜下层(SIS)导管的使用,以替代目前根治性膀胱切除术后用于尿流改道的自体肠段,同时避免免疫排斥。在这里,我们通过开发一种基于环保、温和去污剂(即 Tergitol)的新型脱细胞方法,取代最近宣布的有毒 Triton X-100,对这种无细胞产品进行了初步评估。通过组织学、DNA、羟脯氨酸和弹性蛋白定量、机械和充气测试、双光子显微镜、FTIR 分析和细胞相容性测试来评估处理效果。优化的脱细胞方案有效地去除了猪 SIS 中的细胞,包括 DNA 含量,同时保持了细胞外基质的完整性,尽管其硬度增加。发现了一种有效的灭菌方案,并且处理后的 SIS 的细胞相容性在第 1 天至第 7 天期间得到了证明,在此期间,人成纤维细胞能够增加数量并沿着组织纤维强烈组织。总之,这项体外研究表明,SIS 是替代自体肠段用于尿流改道的合适候选物,考虑到脱细胞和细胞增殖的最佳结果。为了提高 SIS 导管的通畅性和抗渗性,以实现未来的可行替代品,还需要进一步努力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/851c/8910833/3b43542a0b17/ijms-23-02826-g001.jpg

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