组织工程复合物进行兔尿流改道

临床常使用直接或自身的组织材料来修复尿道组织的缺损,但对较大范围的尿道组织缺损时修复仍是比较棘手的问题。有研究报道,通过脱细胞羊膜修复兔尿道组织较大的缺损,证实脱细胞羊膜修复兔尿道组织缺损后,上皮细胞和平滑肌细胞生长良好,未出现排斥反应和毒性表现,尿道通畅无狭窄。

Tissue-engineered graft for urinary diversion in rabbits

BACKGROUND： For muscle invasive bladder cancer, radical cystectomy is the most effective treatment now and urinary diversion is often necessary. The use of intestinal tissue for urinary diversion is frequently associated with complications.OBJECTIVE： To study the feasibility of tissue-engineered graft using bladder epithelial cells and bladder acellular matrix （BAM） for urinary diversion in rabbits.METHODS： BAM of rabbits was made in vitro. Bladder epithelial cells of rabbits were cultivated and expanded in vitro, then implanted into the BAM and cultured for 7 days before making a 4 cm conduit. In the experimental group, 24 New Zealand rabbits, divided into six groups with four in each, were subjected to excising most of the bladder with bladder trigone retained. Then the retained bladder trigone were anatomized with the conduit which was then wrapped by omentum. In the control group, the conduit was made using unseeded BAM and anatomized with the retained bladder trigone in the four New Zealand rabbits. Specimens of tissue-engineered grafts were obtained at 1, 2, 4, and 8 weeks after surgery respectively and were stained with haematoxylin and eosin. Immunohistochemistry examination was done at 8 weeks postoperatively.RESULTS AND CONCLUSION： All animals were alive in the experimental group. Hematoxylin and eosin staining showed epithelial coverage on the lumen of tissue-engineered conduit. With the time going on, grown epithelial cells gradually integrated with the BAM. Immunohistochemistry showed anti-cytokeratin AE1/AE3 antibody and anti-ZO1 antibody were positive, confirming that there were mature and functional epithelial cells on the lumen of conduit. In the control group, four rabbits were all dead within 2 weeks. Scar formation, atresia, and severe hydronephrosis were found in the process of autopsy. It is feasible to prepare tissue-engineered grafts using bladder epithelial cells and BAM for urinary diversion in rabbits.