膀胱癌部分或根治性膀胱切除术后的膀胱重建策略
Strategies of Bladder Reconstruction after Partial or Radical Cystectomy for Bladder Cancer.
作者信息
Zeng Xiao Xue, Wu Yuyan
机构信息
Department of Health Management, Centre of General Practice, The Seventh Affiliated Hospital, Southern Medical University, No. 28, Desheng Road Section, Liguan Road, Lishui Town, Nanhai District, Foshan City, 528000, Guangdong Province, People's Republic of China.
Benjoe Institute of Systems Bio-Engineering, High Technology Park, Changzhou, 213022, Jiangsu Province, People's Republic of China.
出版信息
Mol Biotechnol. 2025 May;67(5):1735-1751. doi: 10.1007/s12033-024-01163-0. Epub 2024 May 18.
The standard strategy is to reconstruct bladder by use of bowel segments as material in bladder cancer with radical cystectomy clinically. Both natural derived and non natural derived materials are investigated in bladder reconstruction. Studies on mechanical bladder, bladder transplantation and bladder xenotransplantation are currently limited although heart and kidney transplantation or xenotransplantation are successful to a certain extent, and bone prostheses are applied in clinical contexts. Earlier limited number of studies associated with bladder xenograft from animals to humans were not particular promising in results. Although there have been investigations on pig to human cardiac xenotransplantation with CRISPR Cas9 gene editing, the CRISPR Cas technique is not yet widely researched in porcine bladder related gene editing for the potential of human bladder replacement for bladder cancer. The advancement of technologies such as gene editing, bioprinting and induced pluripotent stem cells allow further research into partial or whole bladder replacement strategies. Porcine bladder is suggested as a potential source material for bladder reconstruction due to its alikeness to human bladder. Challenges that exist with all these approaches need to be overcome. This paper aims to review gene editing technology such as the CRISPR Cas systems as tools in bladder reconstruction, bladder xenotransplantation and hybrid bladder with technologies of induced pluripotent stem cells and genome editing, bioprinting for bladder replacement for bladder reconstruction and to restore normal bladder control function after cystectomy for bladder cancer.
标准策略是在临床上对膀胱癌进行根治性膀胱切除术后,使用肠段作为材料重建膀胱。目前在膀胱重建中对天然来源和非天然来源的材料都进行了研究。尽管心脏和肾脏移植或异种移植在一定程度上取得了成功,并且骨假体已应用于临床,但关于机械膀胱、膀胱移植和膀胱异种移植的研究目前仍然有限。早期从动物到人类的膀胱异种移植相关研究数量有限,结果并不特别乐观。尽管已经有关于使用CRISPR Cas9基因编辑进行猪到人的心脏异种移植的研究,但CRISPR Cas技术在猪膀胱相关基因编辑以用于人类膀胱癌膀胱替代潜力方面尚未得到广泛研究。基因编辑、生物打印和诱导多能干细胞等技术的进步使得对部分或全膀胱替代策略的进一步研究成为可能。由于猪膀胱与人类膀胱相似,因此被认为是膀胱重建的潜在来源材料。所有这些方法存在的挑战都需要克服。本文旨在综述如CRISPR Cas系统等基因编辑技术,作为膀胱重建、膀胱异种移植和混合膀胱中的工具,结合诱导多能干细胞技术、基因组编辑、用于膀胱替代的生物打印进行膀胱重建,并在膀胱癌膀胱切除术后恢复正常膀胱控制功能。