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首页> 外文期刊>Acta biomaterialia >Towards rebuilding vaginal support utilizing an extracellular matrix bioscaffold
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Towards rebuilding vaginal support utilizing an extracellular matrix bioscaffold

机译：利用细胞外基质Bioscaffold重建阴道载体

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As an alternative to polypropylene mesh, we explored an extracellular matrix (ECM) bioscaffold derived from urinary bladder matrix (MatriStem (TM)) in the repair of vaginal prolapse. We aimed to restore disrupted vaginal support simulating application via transvaginal and transabdominal approaches in a macaque model focusing on the impact on vaginal structure, function, and the host immune response. In 16 macaques, after laparotomy, the uterosacral ligaments and paravaginal attachments to pelvic side wall were completely transected (IACUC# 13081928). 6-ply MatriStem was cut into posterior and anterior templates with a portion covering the vagina and arms simulating uterosacral ligaments and paravaginal attachments, respectively. After surgically exposing the correct anatomical sites, in 8 animals, a vaginal incision was made on the anterior and posterior vagina and the respective scaffolds were passed into the vagina via these incisions (transvaginal insertion) prior to placement. The remaining 8 animals underwent the same surgery without vaginal incisions (transabdominal insertion). Three months post implantation, firm tissue bands extending from vagina to pelvic side wall appeared in both MatriStem groups. Experimental endpoints examining impact of MatriStem on the vagina demonstrated that vaginal biochemical and biomechanical parameters, smooth muscle thickness and contractility, and immune responses were similar in the MatriStem no incision group and sham-operated controls. In the MatriStem incision group, a 41% decrease in vaginal stiffness (P = 0.042), a 22% decrease in collagen content (P = 0.008) and a 25% increase in collagen subtypes III/I was observed vs. Sham. Active MMP2 was increased in both Matristem groups vs. Sham (both P = 0.002). This study presents a novel application of ECM bioscaffolds as a first step towards the rebuilding of vaginal support.
机译：作为聚丙烯网格的替代方案，我们探讨了在阴道脱垂的修复中衍生自尿膀胱基质（Matristem（TM））的细胞外基质（ECM）BioscodeLd。我们的旨在通过经猕猴和跨型模型中的经过阴道和跨境方法恢复扰乱的阴道支持模拟应用，这些方法聚焦在阴道结构，功能和宿主免疫应答的影响。在16只猕猴，在剖腹手术之后，子宫韧带和对盆腔侧壁的副植物附着物完全被接受（IACUC＃13081928）。将6-Ply矩阵分别切割成后部和前型模板，分别覆盖阴道和臂模拟子宫韧带和偏瘫附着物的部分。在手术上暴露出正确的解剖部位后，在8只动物中，在前阴道上制作阴道切口，并且在放置之前通过这些切口（经阴道插入）通过各个支架。剩下的8只动物在没有阴道切口的情况下接受了同样的手术（TanceAbinal插入）。植入后三个月，从阴道到盆腔侧壁延伸的坚固的组织带出现在矩阵组中。实验终点检查romistem对阴道上的影响表明，阴道生物化学和生物力学参数，平滑肌厚度和收缩性，并且在rolistem没有切口组和假手术对照中相似。在矩阵切口组中，阴道刚度的41％降低（p = 0.042），胶原含量的22％降低（p = 0.008），观察到胶原蛋白亚型/ i的25％增加。在矩阵基团中增加了活性MMP2与假（P = 0.002）增加。本研究提出了ECM BioscadEds作为朝着改造阴道支持的第一步。

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