Skip to main content
Erschienen in: International Urogynecology Journal 9/2010

01.09.2010 | Original Article

Tissue-engineered fascia from vaginal fibroblasts for patientsneeding reconstructive pelvic surgery

verfasst von: Man-Jung Hung, Mei-Chin Wen, Chia-Nung Hung, Esther Shih-Chu Ho, Gin-Den Chen, Vivian Cheng Yang

Erschienen in: International Urogynecology Journal | Ausgabe 9/2010

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

Mesh-augmented reconstructive surgery for pelvic organ prolapse (POP) does not meet clinical expectations. A tissue-engineered fascia equivalent needs to be developed.

Methods

Human vaginal fibroblasts (HVFs) from 10 patients were characterized in vitro. Eligible HVFs and a biodegradable scaffold were used to fabricate a fascia equivalent, which was then transplanted in vivo.

Results

The cultured HVFs were divided into high (n = 6) or low (n = 4) collagen I/III ratio groups. Cells of the high-ratio group exhibited significantly higher proliferation potential than those of the low-ratio group (P < 0.05). A fascia equivalent was made with HVFs of the high-ratio group. In the subsequent animal study, a well-organized neo-fascia formation containing HVFs could be traced up to 12 weeks after transplantation.

Conclusions

Our results suggest that a tissue-engineered fascia could be developed from HVFs in vitro and in vivo, which might be an effective treatment for POP in the future.
Literatur
1.
Zurück zum Zitat Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506CrossRefPubMed Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506CrossRefPubMed
2.
Zurück zum Zitat Bump RC, Norton PA (1998) Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin North Am 25:723–746CrossRefPubMed Bump RC, Norton PA (1998) Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin North Am 25:723–746CrossRefPubMed
3.
Zurück zum Zitat Silva WA, Karram MM (2005) Scientific basis for use of grafts during vaginal reconstructive procedures. Curr Opin Obstet Gynecol 17:519–529CrossRefPubMed Silva WA, Karram MM (2005) Scientific basis for use of grafts during vaginal reconstructive procedures. Curr Opin Obstet Gynecol 17:519–529CrossRefPubMed
4.
Zurück zum Zitat Jia X, Glazener C, Mowatt G, MacLennan G, Bain C, Fraser C, Burr J (2008) Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta-analysis. Br J Obstet Gynaecol 115:1350–1361 Jia X, Glazener C, Mowatt G, MacLennan G, Bain C, Fraser C, Burr J (2008) Efficacy and safety of using mesh or grafts in surgery for anterior and/or posterior vaginal wall prolapse: systematic review and meta-analysis. Br J Obstet Gynaecol 115:1350–1361
5.
Zurück zum Zitat Baessler K, Maher CF (2006) Mesh augmentation during pelvic-floor reconstructive surgery: risks and benefits. Curr Opin Obstet Gynecol 18:560–566CrossRefPubMed Baessler K, Maher CF (2006) Mesh augmentation during pelvic-floor reconstructive surgery: risks and benefits. Curr Opin Obstet Gynecol 18:560–566CrossRefPubMed
6.
Zurück zum Zitat Dwyer PL (2009) Minimally invasive surgery in urogynecology. Int Urogynecol J Pelvic Floor Dysfunct 20:485–486CrossRef Dwyer PL (2009) Minimally invasive surgery in urogynecology. Int Urogynecol J Pelvic Floor Dysfunct 20:485–486CrossRef
7.
Zurück zum Zitat De Filippo RE, Yoo JJ, Atala A (2003) Engineering of vaginal tissue in vivo. Tissue Eng 9:301–306CrossRefPubMed De Filippo RE, Yoo JJ, Atala A (2003) Engineering of vaginal tissue in vivo. Tissue Eng 9:301–306CrossRefPubMed
8.
Zurück zum Zitat Atala A, Bauer SB, Soker S, Yoo JJ, Retik AB (2006) Tissue-engineered autologous bladders for patients needing cystoplasty. Lancet 367:1241–1246CrossRefPubMed Atala A, Bauer SB, Soker S, Yoo JJ, Retik AB (2006) Tissue-engineered autologous bladders for patients needing cystoplasty. Lancet 367:1241–1246CrossRefPubMed
9.
Zurück zum Zitat Mitterberger M, Marksteiner R, Margreiter E, Pinggera GM, Colleselli D, Frauscher F, Ulmer H, Fussenegger M, Bartsch G, Strasser H (2007) Autologous myoblasts and fibroblasts for female stress incontinence: a 1-year follow-up in 123 patients. Br J Urol Int 100:1081–1085 Mitterberger M, Marksteiner R, Margreiter E, Pinggera GM, Colleselli D, Frauscher F, Ulmer H, Fussenegger M, Bartsch G, Strasser H (2007) Autologous myoblasts and fibroblasts for female stress incontinence: a 1-year follow-up in 123 patients. Br J Urol Int 100:1081–1085
10.
Zurück zum Zitat Carr LK, Steele D, Steele S, Wagner D, Pruchnic R, Jankowski R, Erickson J, Huard J, Chancellor MB (2008) 1-Year follow-up of autologous muscle-derived stem cell injection pilot study to treat stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19:881–883CrossRefPubMed Carr LK, Steele D, Steele S, Wagner D, Pruchnic R, Jankowski R, Erickson J, Huard J, Chancellor MB (2008) 1-Year follow-up of autologous muscle-derived stem cell injection pilot study to treat stress urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 19:881–883CrossRefPubMed
11.
Zurück zum Zitat Nakanishi Y, Chen G, Komuro H, Ushida T, Kaneko S, Tateishi T, Kaneko M (2003) Tissue-engineered urinary bladder wall using PLGA mesh-collagen hybrid scaffolds: a comparison study of collagen sponge and gel as a scaffold. J Pediatr Surg 38:1781–1784CrossRefPubMed Nakanishi Y, Chen G, Komuro H, Ushida T, Kaneko S, Tateishi T, Kaneko M (2003) Tissue-engineered urinary bladder wall using PLGA mesh-collagen hybrid scaffolds: a comparison study of collagen sponge and gel as a scaffold. J Pediatr Surg 38:1781–1784CrossRefPubMed
12.
Zurück zum Zitat Weiss RA, Weiss MA, Beasley KL, Munavalli G (2007) Autologous cultured fibroblast injection for facial contour deformities: a prospective, placebo-controlled, Phase III clinical trial. Dermatol Surg 33:263–268CrossRefPubMed Weiss RA, Weiss MA, Beasley KL, Munavalli G (2007) Autologous cultured fibroblast injection for facial contour deformities: a prospective, placebo-controlled, Phase III clinical trial. Dermatol Surg 33:263–268CrossRefPubMed
13.
Zurück zum Zitat Mäkinen J, Kähäri VM, Söderström KO, Vuorio E, Hirvonen T (1987) Collagen synthesis in the vaginal connective tissue of patients with and without uterine prolapse. Eur J Obstet Gynecol Reprod Biol 24:319–325CrossRefPubMed Mäkinen J, Kähäri VM, Söderström KO, Vuorio E, Hirvonen T (1987) Collagen synthesis in the vaginal connective tissue of patients with and without uterine prolapse. Eur J Obstet Gynecol Reprod Biol 24:319–325CrossRefPubMed
14.
Zurück zum Zitat Rosch R, Klinge U, Si Z, Junge K, Klosterhalfen B, Schumpelick V (2002) A role for the collagen I/III and MMP-1/-13 genes in primary inguinal hernia? BMC Med Genet 3:2CrossRefPubMed Rosch R, Klinge U, Si Z, Junge K, Klosterhalfen B, Schumpelick V (2002) A role for the collagen I/III and MMP-1/-13 genes in primary inguinal hernia? BMC Med Genet 3:2CrossRefPubMed
15.
Zurück zum Zitat Zheng H, Si Z, Kasperk R, Bhardwaj RS, Schumpelick V, Klinge U, Klosterhalfen B (2002) Recurrent inguinal hernia: disease of the collagen matrix? World J Surg 26:401–408CrossRefPubMed Zheng H, Si Z, Kasperk R, Bhardwaj RS, Schumpelick V, Klinge U, Klosterhalfen B (2002) Recurrent inguinal hernia: disease of the collagen matrix? World J Surg 26:401–408CrossRefPubMed
16.
Zurück zum Zitat Segev Y, Auslender R, Feiner B, Lissak A, Lavie O, Abramov Y (2009) Are women with pelvic organ prolapse at a higher risk of developing hernias? Int Urogynecol J Pelvic Floor Dysfunct 20:1451–1453CrossRefPubMed Segev Y, Auslender R, Feiner B, Lissak A, Lavie O, Abramov Y (2009) Are women with pelvic organ prolapse at a higher risk of developing hernias? Int Urogynecol J Pelvic Floor Dysfunct 20:1451–1453CrossRefPubMed
17.
Zurück zum Zitat Chen G, Sato T, Ohgushi H, Ushida T, Tateishi T, Tanaka J (2005) Culturing of skin fibroblasts in a thin PLGA-collagen hybrid mesh. Biomaterials 26:2559–2566CrossRefPubMed Chen G, Sato T, Ohgushi H, Ushida T, Tateishi T, Tanaka J (2005) Culturing of skin fibroblasts in a thin PLGA-collagen hybrid mesh. Biomaterials 26:2559–2566CrossRefPubMed
18.
Zurück zum Zitat Vandevord PJ, Broadrick KM, Krishnamurthy B, Singla AK (2009) A comparative study evaluating the in vivo incorporation of biological sling materials. Urology (in press) Vandevord PJ, Broadrick KM, Krishnamurthy B, Singla AK (2009) A comparative study evaluating the in vivo incorporation of biological sling materials. Urology (in press)
19.
Zurück zum Zitat Zong W, Zyczynski HM, Meyn LA, Gordy SC, Moalli PA (2007) Regulation of MMP-1 by sex steroid hormones in fibroblasts derived from the female pelvic floor. Am J Obstet Gynecol 196(349):e1–11PubMed Zong W, Zyczynski HM, Meyn LA, Gordy SC, Moalli PA (2007) Regulation of MMP-1 by sex steroid hormones in fibroblasts derived from the female pelvic floor. Am J Obstet Gynecol 196(349):e1–11PubMed
20.
Zurück zum Zitat Zong W, Meyn LA, Moalli PA (2009) The amount and activity of active matrix metalloproteinase 13 is suppressed by estradiol and progesterone in human pelvic floor fibroblasts. Biol Reprod 80:367–374CrossRefPubMed Zong W, Meyn LA, Moalli PA (2009) The amount and activity of active matrix metalloproteinase 13 is suppressed by estradiol and progesterone in human pelvic floor fibroblasts. Biol Reprod 80:367–374CrossRefPubMed
21.
Zurück zum Zitat Bhatia NN, Ho MH (2004) Stem cell therapy for urinary incontinence and pelvic floor disorders: a novel approach. Curr Opin Obstet Gynecol 16:397–398CrossRefPubMed Bhatia NN, Ho MH (2004) Stem cell therapy for urinary incontinence and pelvic floor disorders: a novel approach. Curr Opin Obstet Gynecol 16:397–398CrossRefPubMed
22.
Zurück zum Zitat Lee CH, Moioli EK, Mao JJ (2006) Fibroblastic differentiation of human mesenchymal stem cells using connective tissue growth factor. Conf Proc IEEE Eng Med Biol Soc 1:775–778CrossRefPubMed Lee CH, Moioli EK, Mao JJ (2006) Fibroblastic differentiation of human mesenchymal stem cells using connective tissue growth factor. Conf Proc IEEE Eng Med Biol Soc 1:775–778CrossRefPubMed
Metadaten
Titel
Tissue-engineered fascia from vaginal fibroblasts for patientsneeding reconstructive pelvic surgery
verfasst von
Man-Jung Hung
Mei-Chin Wen
Chia-Nung Hung
Esther Shih-Chu Ho
Gin-Den Chen
Vivian Cheng Yang
Publikationsdatum
01.09.2010
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 9/2010
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-010-1168-3

Weitere Artikel der Ausgabe 9/2010

International Urogynecology Journal 9/2010 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.