Tracheal reconstruction by mesenchymal stem cells with small intestine submucosa in rabbits.
OBJECTIVE
The increasing number of newborns requiring intubation and artificial ventilation in the sophisticated premature and intensive care units of recent years has been followed by a concomitant increase in the number of children who develop tracheal stenosis as a sequela of prolonged intubation, with a consequent increasing need for tracheal surgical repair. The aim of this study was to evaluate tracheal reconstruction by monolayered autologous mesenchymal stem cells (MSCs) with small intestine submucosa (SIS) in a rabbit model.


METHODS
Twelve male rabbits were randomly divided into three groups: rabbits with tracheal defects without reconstruction (untreated group, n=4), rabbits with tracheal defects given porcine small intestine submucosa graft (SIS group, n=4), and rabbits with tracheal defects that underwent transplantation of monolayered mesenchymal stem cells on SIS (SIS+MSC group, n=4). Histological and endoscopic analyses were performed by hematoxylin-eosin staining (H&E), Prussian blue staining and endoscopy.


RESULTS
Tracheal stenosis in the SIS+MSC group was minimal, compared to the untreated group and SIS group. Specimens obtained from the untreated and SIS groups showed severe infiltration of inflammatory cells and granulation tissue formation into the trachea. In the SIS+MSC group, however, minimal infiltration of the inflammatory cells and granulation tissue formation were observed. Twelve weeks following the operation, regeneration of pseudostratified columnar epithelium was confirmed by H&E staining with minimal inflammatory cell infiltration in the SIS+MSC group. Moreover, Prussian blue staining clearly demonstrated the presence of labeled MSCs in the regenerated tissue of SIS+MSC group.


CONCLUSIONS
These results demonstrate that tracheal reconstruction by MSCs with SIS is effective in rabbits with tracheal defects with minimal mortality and morbidity, which appears to be a promising strategy in the treatment of tracheal defects.
Medical Science Research Institute and Department of Otorhinolaryngology - Head and Neck Surgery, Dongguk University Ilsan Hospital, Gyeonggi, Republic of Korea.
Xiao Fei
XF
Du
Seong Keun
SK
Kwon
Jae-Jun
JJ
Song
Chang Gun
CG
Cho
Seok-Won
SW
Park
D000818:Animals; D004195:Disease Models, Animal; D006097:Granulation Tissue / Q000473:pathology; D007413:Intestinal Mucosa / Q000637:transplantation*; D007421:Intestine, Small / Q000637:transplantation*; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000379:methods*; D020545:Respiratory Mucosa / Q000473:pathology; D013552:Swine; D014135:Tracheal Stenosis / Q000473:pathology / Q000601:surgery*