Department of Obstetrics and Gynecology, Amsterdam University Medical Center-location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; Amsterdam Reproduction and Development, Amsterdam University Medical Center-location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
Department of Urology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 28, 6525 GA, Nijmegen, the Netherlands; Institute for Molecules and Materials, Radboud University, Heyendaalseweg 135, 6525 AJ, Nijmegen, the Netherlands.
Biomaterials. 2023 Nov;302:122337. doi: 10.1016/j.biomaterials.2023.122337. Epub 2023 Sep 30.
In pelvic organ prolapse (POP) patients, the uterus, bladder and/or rectum descends into vagina due to weakened support tissues. High recurrence rates after POP surgery suggest an urgent need for improved surgical outcomes. Our aim is to promote connective tissue healing that results in stimulated tissue support functions by surgically applying a hydrogel functionalized with biological cues. We used known vaginal wound healing promoting factors (basic fibroblast growth factor, β-estradiol, adipose-derived stem cells) in the biomimetic and injectable polyisocyanide (PIC) hydrogel, which in itself induces regenerative vaginal fibroblast behavior. The regenerative capacity of injected PIC hydrogel, and the additional pro-regenerative effects of these bioactive factors was evaluated in abdominal wounds in rabbits. Assessment of connective tissue healing (tensile testing, histology, immunohistochemistry) revealed that injection with all PIC formulations resulted in a statistically significant stiffness and collagen increase over time, in contrast to sham. Histological evaluation indicated new tissue growth with moderate to mild immune activity at the hydrogel - tissue interface. The results suggest that PIC injection in an abdominal wound improves healing towards regaining load-bearing capacity, which encourages us to investigate application of the hydrogel in a more translational vaginal model for POP surgery in sheep.
在盆腔器官脱垂(POP)患者中,由于支撑组织薄弱,子宫、膀胱和/或直肠会下降到阴道中。POP 手术后的高复发率表明迫切需要改善手术效果。我们的目标是通过手术应用生物信号功能化水凝胶来促进连接组织愈合,从而刺激组织支撑功能。我们在仿生和可注射的聚异氰酸酯(PIC)水凝胶中使用了已知的阴道伤口愈合促进因子(碱性成纤维细胞生长因子、β-雌二醇、脂肪源性干细胞),它本身会诱导再生阴道成纤维细胞行为。在兔的腹部伤口中评估了注射的 PIC 水凝胶的再生能力以及这些生物活性因子的额外促再生作用。对结缔组织愈合的评估(拉伸测试、组织学、免疫组织化学)表明,与假手术相比,所有 PIC 配方的注射都会随着时间的推移导致统计学上显著的刚度和胶原增加。组织学评估表明,在水凝胶-组织界面处有新的组织生长,伴有中度至轻度的免疫活性。这些结果表明,腹部伤口内注射 PIC 可改善愈合,恢复承重能力,这鼓励我们在绵羊 POP 手术的更具转化性阴道模型中研究水凝胶的应用。