Tissue engineered extracellular matrices (ECMs) in urology: Evolution and future directions |
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Authors: | N.F. Davis,E.M. Cunnane,F.J. O Brien,J.J. Mulvihill,M.T. Walsh |
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Affiliation: | 1. Department of Urology and Transplant Surgery, Beaumont Hospital, Dublin, Ireland;2. School of Engineering, Bernal Institute, Health Research Institute, University of Limerick, Limerick, Ireland;3. Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, Dublin 2, Ireland |
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Abstract: | Autologous gastrointestinal tissue has remained the gold-standard reconstructive biomaterial in urology for >100 years. Mucus-secreting epithelium is associated with lifelong metabolic and neuromechanical complications when implanted into the urinary tract. Therefore, the availability of biocompatible tissue-engineered biomaterials such as extracellular matrix (ECM) scaffolds may provide an attractive alternative for urologists. ECMs are decellularised, biodegradable membranes that have shown promise for repairing defective urinary tract segments in vitro and in vivo by inducing a host-derived tissue remodelling response after implantation. In urology, porcine small intestinal submucosa (SIS) and porcine urinary bladder matrix (UBM) are commonly selected as ECMs for tissue regeneration. Both ECMs support ingrowth of native tissue and differentiation of multi-layered urothelial and smooth muscle cells layers while providing mechanical support in vivo. In their native acellular state, ECM scaffolds can repair small urinary tract defects. Larger urinary tract segments can be repaired when ECMs are manipulated by seeding them with various cell types prior to in vivo implantation. In the present review, we evaluate and summarise the clinical potential of tissue engineered ECMs in reconstructive urology with emphasis on their long-term outcomes in urological clinical trials. |
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Keywords: | Tissue engineering Regenerative medicine Reconstructive urology Extracellular matrix Stem cells Biomedical engineering ECM extracellular matrix SIS small intestinal submucosa UBM urinary bladder matrix PTFE polytetrafluoroethylene 3D three-dimensional ESRD end-stage renal disease ADSCs adipose derived stem cells SMC smooth muscle cell VECM vascular extracellular matrix PGA polyglycolic acid PGA/PLA polyglycolide/polylactide BAMG bladder acellular matrix graft ADM acellular dermal matrix |
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