Adamo Davide, Galaverni Giulia, Genna Vincenzo Giuseppe, Lococo Filippo, Pellegrini Graziella
Interdepartmental Centre for Regenerative Medicine "Stefano Ferrari", University of Modena and Reggio Emilia, Modena, Italy.
Holostem Terapie Avanzate S.r.l., Modena, Italy.
Front Bioeng Biotechnol. 2022 May 9;10:846632. doi: 10.3389/fbioe.2022.846632. eCollection 2022.
Breathing, being predominantly an automatic action, is often taken for granted. However, respiratory diseases affect millions of people globally, emerging as one of the major causes of disability and death overall. Among the respiratory dysfunctions, tracheal alterations have always represented a primary challenge for clinicians, biologists, and engineers. Indeed, in the case of wide structural alterations involving more than 50% of the tracheal length in adults or 30% in children, the available medical treatments are ineffective or inapplicable. So far, a plethora of reconstructive approaches have been proposed and clinically applied to face this growing, unmet medical need. Unfortunately, none of them has become a well-established and routinely applied clinical procedure to date. This review summarizes the main clinical reconstructive attempts and classifies them as non-tissue engineering and tissue engineering strategies. The analysis of the achievements and the main difficulties that still hinder this field, together with the evaluation of the forefront preclinical experiences in tracheal repair/replacement, is functional to promote a safer and more effective clinical translation in the near future.
呼吸，主要是一种自动行为，常常被视为理所当然。然而，呼吸系统疾病在全球影响着数百万人，已成为导致残疾和死亡的主要原因之一。在呼吸功能障碍中，气管病变一直是临床医生、生物学家和工程师面临的主要挑战。事实上，对于涉及成人气管长度超过50%或儿童气管长度超过30%的广泛结构改变，现有的医学治疗方法无效或不适用。到目前为止，已经提出并在临床上应用了大量重建方法来满足这一日益增长的未满足医疗需求。不幸的是，到目前为止，它们中没有一种成为成熟且常规应用的临床程序。本综述总结了主要的临床重建尝试，并将它们分为非组织工程和组织工程策略。分析该领域所取得的成就以及仍然阻碍该领域发展的主要困难，同时评估气管修复/置换方面前沿的临床前经验，有助于在不久的将来推动更安全、更有效的临床转化。
