Sueters Jayson, de Boer Leonie, Groenman Freek, Huirne Judith A F, Smit Theo H, Zaat Sebastian A J
Department of Gynaecology, Amsterdam UMC - Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Sci Rep. 2024 Dec 30;14(1):31728. doi: 10.1038/s41598-024-82409-4.
Vaginal reconstruction is necessary for various congenital and acquired conditions, including vaginal aplasia, trauma, tumors, and gender incongruency. Current surgical and non-surgical treatments often result in significant complications. Decellularized vaginal matrices (DVMs) from human tissue offer a promising alternative, but require effective sterilization to ensure safety and functionality. This study aimed to develop a sterilization method for decellularized human vaginal wall scaffolds. Based on our previously implemented decellularization technique with minor modifications, we designed and examined three sterilization methods consisting of (i) chemical decellularization, (ii) decellularization with additional peracetic acid/hydrogen peroxide (PAA/HO); (iii) decellularization with antibiotic and antimycotic (AAE) based treatment. Sterilization efficacy was evaluated through controlled contamination with common vaginal microbes and sterility testing subsequent to each sterilization method. The extracellular matrix (ECM) structure was assessed via histological staining. Decellularization alone reduced some added bacterial contaminants but did not achieve complete sterilization. PAA/HO-sterilization resulted in severe ECM damage, rendering it unsuitable. The AAE-treatment demonstrated effective sterilization without compromising the ECM structure. Combined decellularization and AAE-based treatment forms a viable sterilization method for human vaginal wall tissue, maintaining ECM integrity and achieving effective micro-organism elimination. This method holds potential for clinical application in vaginal transplantation.
阴道重建对于各种先天性和后天性疾病都是必要的，包括阴道发育不全、创伤、肿瘤以及性别不一致等情况。目前的手术和非手术治疗常常会导致严重的并发症。来自人体组织的脱细胞阴道基质（DVMs）提供了一种有前景的替代方案，但需要有效的灭菌以确保安全性和功能性。本研究旨在开发一种用于脱细胞人阴道壁支架的灭菌方法。基于我们之前实施的脱细胞技术并进行了微小修改，我们设计并研究了三种灭菌方法，包括（i）化学脱细胞，（ii）额外使用过氧乙酸/过氧化氢（PAA/HO）进行脱细胞；（iii）基于抗生素和抗真菌剂（AAE）的脱细胞处理。通过用常见阴道微生物进行受控污染并在每种灭菌方法后进行无菌测试来评估灭菌效果。通过组织学染色评估细胞外基质（ECM）结构。单纯脱细胞减少了一些添加的细菌污染物，但未实现完全灭菌。PAA/HO灭菌导致严重的ECM损伤，使其不适用。AAE处理在不损害ECM结构的情况下显示出有效的灭菌效果。联合脱细胞和基于AAE的处理形成了一种用于人阴道壁组织的可行灭菌方法，维持了ECM完整性并实现了有效的微生物清除。该方法在阴道移植的临床应用中具有潜力。
