Several urinary tract pathologic conditions, such as strictures, cancer, and obliterations, require reconstructive plastic surgery. Reconstruction of the urinary tract is an intractable task for urologists due to insufficient autologous tissue. Limitations of autologous tissue application prompted urologists to investigate ideal substitutes. Tissue engineering is a new direction in these cases. Advances in tissue engineering over the last 2 decades may offer alternative approaches for the urinary tract reconstruction. The main components of tissue engineering include biomaterials and cells. Biomaterials can be used with or without cultured cells. This paper focuses on cell sources, biomaterials, and existing methods of tissue engineering for urinary tract reconstruction in China. The paper also details challenges and perspectives involved in urinary tract reconstruction.
. [J]. Asian Journal of Urology, 2018, 5(2): 57-68.
Zou Qingsong,Fu Qiang. Tissue engineering for urinary tract reconstruction and repair: Progress and prospect in China. Asian Journal of Urology, 2018, 5(2): 57-68.
Table 1 Tissue engineering approaches used for renal reconstruction in China.
Research
Animals for modeling
Cell types
Biomaterial/artificial tissue
Repaired length
Duration of observation
Fu et al., 2012 [71]
Mice
Ureteral epithelial cells
PLLA-collagen nanofibrous
-
2 weeks
Xu et al., 2012 [73]
Rats
Bladder epithelial cells
PLLA
0.9 cm
3 weeks
Liao et al., 2013 [9]
Rabbits
BMSCs + SMCs
BAM
4 cm
16 weeks
Zhao et al., 2012 [10]
Rabbits
Mesothelial cells
BAM
3 cm
16 weeks
Shi et al., 2012 [37]
Mice
ADSCs induced epithelial cells
PLA/collagen scaffolds
-
2 weeks
Meng et al., 2015 [74]
Rabbits
ADSCs + SMCs
BAM
4 cm
16 weeks
Table 2 Tissue engineering approaches for ureteral reconstruction in China.
Research
Animals for modeling
Cell types
Biomaterial/artificial tissue
Repaired surface defect
Duration of observation
Zhu et al., 2011 [75]
Rabbits
-
BAM
-
24 weeks
Wang and Liao, 2014 [76]
Rabbits
-
SIS
10 cm × 3 cm × 3 mm
24 weeks
Zhao et al., 2015 [77]
Rats
-
BAM-silk fibroin (SF)
10 mm × 10 mm
12 weeks
Jiang et al., 2015 [78]
Rabbits
-
VEGF-loaded nanoparticles-modified BAM
2 cm × 3 cm
12 weeks
Xiong et al., 2015 [79]
Swine
-
VEGF-loaded nanoparticles-modified BAM
35%-50% of the bladder
12 weeks
Chen et al., 2014 [80]
Rats
-
FGF modified BAM
A diameter of 1 cm
12 weeks
Chen et al., 2010 [81]
Rats
-
FGF modified collagen scaffolds
Half of bladder upper
12 weeks
Zhou et al., 2013 [82]
Rats
-
PDGF and VEGF modified BAM
4 cm × 5 cm
24 weeks
Jiang et al., 2016 [83]
Rabbits
-
FGF and VEGF modified BAM
2 cm × 3 cm
12 weeks
Chen et al., 2011 [85]
Swine
VEGF modified EPCs
BAM
40% of the bladder
24 weeks
Zhang et al., 2004 [86]
Mice
SMCs + UCs
SIS
1 cm × 1 cm
12 weeks
Zhu et al., 2010 [87]
Rabbits
ADSCs
BAM
1.5 cm × 1.5 cm
24 weeks
Zhe et al., 2016 [88]
Rats
ADSCs
BAM
-
14 weeks
Yuan et al., 2013 [89]
Canine
hUMSCs
BAM
40% of the bladder
12 weeks
Table 3 Tissue engineering approaches for bladder reconstruction in China.
Research
Animals for modeling
Biomaterial/artificial tissue
Repaired length
Duration of observation
Yang et al., 2004 [90]
Rabbits
Urethral extracellular matrix
1.0-1.5 cm
24 weeks
Wang et al., 2005 [91]
Rabbits
Human cadaveric bladder submucosa
0.5-1.0 cm
24 weeks
Huang et al., 2006 [92]
Rabbits
Porcine SIS
2 cm
12 weeks
Huang et al., 2014 [94]
Rabbits
3D porous BAM
1.5 cm
3 months
Wang et al., 2013 [95]
Rabbit
BAM + PLGA conjugated with VEGF
3 cm
3 months
Lv et al., 2016 [96]
Rabbits
Oxygenating keratin/silk fibroin scaffold
1.5 cm × 0.8 cm
6 months
Jia et al., 2015 [97]
Beagle dog
Collagen-binding VEGF
5 cm
6 months
Table 4 Cell-free grafts applied in urethral reconstruction in China.
Research
Animals for modeling
Cell types
Biomaterial/artificial tissue
Repaired length
Duration of observation
Fu et al., 2008 [99]
Rabbits
Foreskin epidermal cells
Acellular collagen matrix
1.5 cm
12 months
Fu et al., 2007 [15]
Rabbits
Foreskin epidermal cells
Acellular collagen matrix
1.5 cm
6 months
Xie et al., 2013 [100]
Female beagle dogs
Urothelial cells
Electrospun silk fibroin matrices
3 cm × 1 cm
6 months
Gu et al., 2012 [101]
Rabbits
Mesothelial cells
BAM
1.5 cm
6 months
Li et al., 2013 [105]
Rabbits
BMSCs + SMCs
BAM
2.0 cm
16 weeks
Li et al., 2014 [38]
Rabbits
Epith-rASCs
BAM
2.0 cm × 0.8 cm
6 months
Li et al., 2013 [106]
Rabbits
(TGF-β1 siRNA) fibroblasts + Oral keratinocytes
BAM
2.0 × 0.8 cm
6 months
Wang et al., 2014 [104]
Rabbits
Urethral epithelium cells
Denuded human amniotic scaffold
0.5 cm × 1 cm
3 months
Huang et al., 2015 [108]
Rabbits
Lingual keratinocytes
3D porous bacterial cellulose
2.0 cm × 0.8 cm
3 months
Zhang et al., 2015 [107]
Rabbits
Bladder epithelial cells + fibroblasts
ICG-001 delivering collagen/(PLLA-CL) nanofibrous
2.0 cm × 0.8 cm
3 months
Table 5 Cell-seeded grafts applied in urethral reconstruction in China.
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