Bi-layer silk fibroin grafts support functional tissue regeneration in a porcine model of onlay esophagoplasty.

Autor:	Algarrahi K; Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA.; Department of Surgery, Harvard Medical School, Boston, MA, USA., Franck D; Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA., Cristofaro V; Department of Surgery, Harvard Medical School, Boston, MA, USA.; Division of Urology, Veterans Affairs Boston Healthcare System, West Roxbury, MA, USA.; Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA., Yang X; Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA., Savarino A; Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA., Affas S; Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA.; Department of Surgery, Harvard Medical School, Boston, MA, USA., Schäfer FM; Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA., Ghezzi C; Department of Biomedical Engineering, Tufts University, Medford, MA, USA., Jennings R; Department of Surgery, Harvard Medical School, Boston, MA, USA., Nedder A; Animal Resource at Children's Hospital, Boston Children's Hospital, Boston, MA, USA., Kaplan DL; Department of Biomedical Engineering, Tufts University, Medford, MA, USA., Sullivan MP; Department of Surgery, Harvard Medical School, Boston, MA, USA.; Division of Urology, Veterans Affairs Boston Healthcare System, West Roxbury, MA, USA.; Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA., Estrada CR Jr; Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA.; Department of Surgery, Harvard Medical School, Boston, MA, USA., Mauney JR; Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA.; Department of Surgery, Harvard Medical School, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Journal of tissue engineering and regenerative medicine [J Tissue Eng Regen Med] 2018 Feb; Vol. 12 (2), pp. e894-e904. Date of Electronic Publication: 2017 Jun 20.
DOI:	10.1002/term.2402
Abstrakt:	Partial circumferential, full thickness defects of the esophagus can occur as a result of organ perforation or tumour resection, or during surgical reconstruction of strictured segments. Complications associated with autologous tissue flaps conventionally utilized for defect repair necessitate the development of new graft options. In this study, bi-layer silk fibroin (BLSF) scaffolds were investigated for their potential to support functional restoration of partial circumferential defects in a porcine model of esophageal repair. Onlay thoracic esophagoplasty with BLSF matrices (~3 x 1.5 cm) was performed in adult swine (N = 6) for 3 months of implantation. All animals receiving BLSF grafts survived with no complications and were capable of solid food consumption. Radiographic esophagrams revealed preservation of organ continuity with no evidence of contrast extravasation or strictures. Fluoroscopic analysis demonstrated peristaltic contractions. Ex vivo tissue bath studies displayed contractile responses to carbachol, electric field stimulation, and KCl while isoproterenol produced tissue relaxation. Histological and immunohistochemical evaluations of neotissues showed a stratified, squamous epithelium, a muscularis mucosa composed of smooth muscle bundles, and a muscularis externa organized into circular and longitudinal layers, with a mix of striated skeletal muscle fascicles interspersed with smooth muscle. De novo innervation and vascularization were observed throughout the graft sites and consisted of synaptophysin-positive neuronal boutons and vessels lined with CD31-positive endothelial cells. The results of this study demonstrate that BLSF scaffolds can facilitate constructive remodeling of partial circumferential, full thickness esophageal defects in a large animal model. Copyright © 2017 John Wiley & Sons, Ltd. (Copyright © 2017 John Wiley & Sons, Ltd.)
Databáze:	MEDLINE
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