Guo Yilong, Ma Ning, Li Yangqun, Yang Zhe, Chen Sen, Liu Pingping, Gao Qianqian, Luo Sisi, Sun Quan
Department of Comprehensive Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China.
Department of Hypospadias Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100144, China.
BMC Urol. 2024 Dec 23;24(1):282. doi: 10.1186/s12894-024-01605-6.
Current treatments for penile erectile structures reconstruction are limited and remain a great challenge in clinical practice. Tissue engineering techniques using different seed cells and scaffolds to construct a neo-tissue open promising avenues for penile erectile structures repair and replacement and show great promise in the restoration of: structure, mechanical property, and function which matches the original tissue.
A comprehensive literature review was conducted by accessing the NCBI PubMed, Cochrane, and Google Scholar databases from January 1, 1990, to January, 1, 2022 using the search terms "Tissue engineering, Corpus cavernosum (CC), Tunica albuginea (TA), Acellular Matrix, Penile Reconstruction". Articles were screened and assessed by two independent reviewers to determine whether those met the inclusion criteria, and a total of 19 articles were being selected and included in the data analysis.
Tissue engineered cell-seeded scaffold can reconstruct a similar structure to native TA and CC and showed good histocompatibility with no immunological rejection. The results of the evaluation of morphological feature, intracavernosal pressure, and erectile-related nitric oxide (NO) expression were strongly proofs that the tissue engineered graft can significantly improve the penile erectile and ejaculatory function. In addition, increasing the purity of seed cells, improving the mechanical properties of the scaffold, providing appropriate induction for stem cells, and optimizing cell delivery systems are potential approaches to improve reconstructive outcomes. Currently, a larger animal model, comparable in size to the human penis, is needed to test the feasibility of the engineered grafts.
Our review summarized the research in tissue engineering of CC and TA. It showed great promise in reconstructing the functional structures and restoring the erection and ejaculatory function. With continuous advancement in the field, tissue-engineered penile erectile structures hold substantial potential to enhance clinical outcomes for patients.
目前用于阴茎勃起结构重建的治疗方法有限，在临床实践中仍然是一个巨大的挑战。利用不同种子细胞和支架构建新组织的组织工程技术为阴茎勃起结构的修复和置换开辟了有前景的途径，并在恢复与原始组织相匹配的结构、力学性能和功能方面显示出巨大潜力。
通过访问美国国立医学图书馆生物医学数据库（NCBI PubMed）、考克兰图书馆（Cochrane）和谷歌学术数据库，使用检索词“组织工程、海绵体（CC）、白膜（TA）、脱细胞基质、阴茎重建”，对1990年1月1日至2022年1月1日期间的文献进行全面综述。由两名独立评审员筛选和评估文章，以确定其是否符合纳入标准，共筛选出19篇文章纳入数据分析。
组织工程化的种子细胞支架可以重建与天然TA和CC相似的结构，并显示出良好的组织相容性，无免疫排斥反应。对形态特征、海绵体内压和勃起相关一氧化氮（NO）表达的评估结果有力地证明，组织工程化移植物可以显著改善阴茎勃起和射精功能。此外，提高种子细胞的纯度、改善支架的力学性能、为干细胞提供适当的诱导以及优化细胞递送系统是改善重建效果的潜在方法。目前，需要一个与人类阴茎大小相当的大型动物模型来测试工程化移植物的可行性。
我们的综述总结了CC和TA组织工程的研究。它在重建功能结构和恢复勃起及射精功能方面显示出巨大潜力。随着该领域的不断发展，组织工程化阴茎勃起结构在改善患者临床结局方面具有巨大潜力。
