title: Fabrication of Large Size Ex Vivo-Produced Oral Mucosal Equivalents for Clinical Application.
abstract: The soft tissue reconstruction of significant avulsed and/or surgically created tissue defects requires the ability to manufacture substantial soft tissue constructs for repair of the resulting wounds. In this study, we detail the issues that need to be addressed in upsizing the manufacture of larger tissue-engineered devices (ex vivo-produced oral mucosa equivalent [EVPOME]) in vitro from a methodology previously used for smaller constructs. The larger-sized EVPOME, consisting of autologous human oral keratinocytes and a dermal substitute, AlloDerm(®), was fabricated for the purpose of reconstructing large clinical defects. Regulated as an autologous somatic cell therapy product, the fabrication process abided by current Good Manufacturing Practices and current Good Tissue Practices as required by the Center for Biologics Evaluation and Research (CBER) of the United States Food and Drug Administration (FDA). Successful fabrication of large EVPOMEs utilized a higher cell seeding density (5.3×10(5) cells/cm(2)) with a relatively thinner AlloDerm, ranging from 356.6 to 508.0 μm in thickness. During the air-liquid interface culture, the thickness of the scaffold affected the medium diffusion rate, which, in turn, resulted in changes of epithelial stratification. Histologically, keratinocyte progenitor (p63), proliferation (Ki-67), and late differentiation marker (filaggrin) expression showed differences correlating with the expression of glucose transporter-1 (GLUT1) in the EVPOMEs from the thickest (550-1020 μm) to the thinnest (228.6-330.2 μm) AlloDerm scaffold. Glucose consumption and 2-deoxyglucose (2DG) uptake showed direct correlation with scaffold thickness. The scaffold size and thickness have an impact on the cellular phenotype and epithelial maturation in the manufacturing process of the EVPOME due to the glucose accessibility influenced by the diffusion rate. These outcomes provide basic strategies to manufacture a large-sized, healthy EVPOME graft for reconstructing large mucosa defects.
authors.affiliation: 1 Department of Oral and Maxillofacial Surgery, University of Michigan Health System, Ann Arbor, Michigan.|2 Course for Oral Life Science, Department of Biomimetics, Postgraduate School of Medical and Dental Sciences, Niigata University , Niigata, Japan .
authors.forename: Hiroko
authors.initials: H
authors.lastname: Kato
authors.affiliation: 1 Department of Oral and Maxillofacial Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Marcelo
authors.affiliation: 1 Department of Oral and Maxillofacial Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: James B
authors.initials: JB
authors.lastname: Washington
authors.affiliation: 1 Department of Oral and Maxillofacial Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Eve L
authors.initials: EL
authors.lastname: Bingham
authors.affiliation: 1 Department of Oral and Maxillofacial Surgery, University of Michigan Health System, Ann Arbor, Michigan.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Feinberg
mesh_terms: D000328:Adult; D002452:Cell Count; D003847:Deoxyglucose / Q000378:metabolism; D004058:Diffusion; D004848:Epithelium / Q000378:metabolism; D005260:Female; D000091344:Filaggrin Proteins; D006801:Humans; D015603:Keratinocytes / Q000166:cytology; D008297:Male; D009061:Mouth Mucosa / Q000502:physiology*; D013194:Staining and Labeling; D046509:Tissue Culture Techniques; D023822:Tissue Engineering / Q000379:methods*
chemical_list: C000717249:FLG protein, human; D000091344:Filaggrin Proteins; D003847:Deoxyglucose