title: Bladder substitute reconstructed in a physiological pressure environment.
abstract: OBJECTIVE
  Bladder reconstruction performed by enterocystoplasty or with bioengineered substitutes is still associated with complications, which led us to develop an autologous vesical equivalent (VE). This model has already proven its structural conformity. The challenge is to reconstruct our model in a more physiological environment, with the use of a bioreactor that mimics the dynamic of bladder filling and emptying, to acquire physiological properties.
  
  
  METHODS
  Fibroblasts and urothelial cells evolved in a three-dimensional culture to obtain a reconstructed VE. This was then cultured in our bioreactor which delivers a cyclic pressure increase up to 15 cm H(2)O, followed by a rapid decrease, to achieve a dynamically cultured VE (dcVE). To compare with the statically cultured VE, the dcVE was characterized using histology and immunofluorescence. The mechanical resistance was evaluated by uniaxial tensile tests, and the permeability level was measured with 14C-urea.
  
  
  RESULTS
  Compared to our static model, the dynamic culture led to a urothelium profile like that of native bladder. Permeability analysis displayed a profile comparable to native bladder, coinciding with basal cell organization in the dcVE, while an appropriate resistance for suturing and handling was shown.
  
  
  CONCLUSIONS
  This new alternative method offers a promising avenue for regenerative medicine. It is distinguished by its autologous character and its efficiency as a barrier to urea. These properties could significantly reduce inflammation, necrosis, and therefore, possible rejection.
authors.affiliation: Laboratoire d'Organogénèse Expérimentale de l'Université Laval, Génie tissulaire et régénération: LOEX, Centre de recherche FRSQ du Centre hospitalier affilié universitaire de Québec and Département de Chirurgie, Faculté de Médecine, Université Laval, Québec, QC, Canada. sara.ucergy@hotmail.fr
authors.forename: Sara
authors.initials: S
authors.lastname: Bouhout
authors.forename: Robert
authors.initials: R
authors.lastname: Gauvin
authors.forename: Laure
authors.initials: L
authors.lastname: Gibot
authors.forename: David
authors.initials: D
authors.lastname: Aubé
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bolduc
mesh_terms: D001187:Artificial Organs; D019149:Bioreactors; D005455:Fluorescent Antibody Technique; D006801:Humans; D008422:Materials Testing; D011312:Pressure; D019651:Plastic Surgery Procedures / Q000379:methods*; D023822:Tissue Engineering / Q000379:methods*; D001743:Urinary Bladder / Q000502:physiology; D014563:Urodynamics / Q000502:physiology; D019459:Urothelium / Q000502:physiology