Prenatal tracheal reconstruction with a hybrid amniotic mesenchymal stem cells-engineered construct derived from decellularized airway.
OBJECTIVE
This study was aimed at examining an airway construct engineered from autologous amniotic mesenchymal stem cells (aMSCs) and a xenologous decellularized airway scaffold as a means for tracheal repair.


METHODS
Fetal lambs (N = 13) with a tracheal defect were divided into 2 groups. One group (acellular, n = 6) was repaired with a decellularized leporine tracheal segment. The other group (engineered, n = 7) received an identical graft seeded with expanded/labeled autologous aMSCs. Newborns were euthanized for multiple analyses.


RESULTS
Eleven lambs survived to term, 10 of which could breathe at birth. Engineered grafts showed a significant increase in diameter in vivo (P = .04) unlike acellular grafts (P = .62), although variable stenosis was present in all implants. Engineered constructs exhibited full epithelialization, compared with none of the acellular grafts (P = .002). Engineered grafts had a significantly greater degree of increase in elastin levels after implantation than acellular implants (P = .04). No such differences were noted in collagen and glycosaminoglycan contents. Donor cells were detected in engineered grafts, which displayed a pseudostratified columnar epithelium.


CONCLUSIONS
Constructs engineered from aMSCs and decellularized airway undergo enhanced remodeling and epithelialization in vivo when compared with equivalent acellular implants. Amniotic mesenchymal stem cell-engineered airways may become an alternative for perinatal airway repair.
Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
Fabienne L
FL
Gray
Christopher G
CG
Turner
Azra
A
Ahmed
Catherine E
CE
Calvert
David
D
Zurakowski
Dario O
DO
Fauza
D000653:Amniotic Fluid / Q000166:cytology; D000818:Animals; D001705:Bioprosthesis; D002478:Cells, Cultured; D004847:Epithelial Cells / Q000166:cytology; D005260:Female; D046128:Fetal Therapies / Q000379:methods*; D020007:Implants, Experimental; D059630:Mesenchymal Stem Cells / Q000166:cytology*; D011247:Pregnancy; D011817:Rabbits; D012756:Sheep; D023822:Tissue Engineering; D054457:Tissue Scaffolds; D014132:Trachea / Q000196:embryology* / Q000293:injuries / Q000601:surgery*; D014182:Transplantation, Autologous