Colorectal tissue engineering: A comparative study between porcine small intestinal submucosa (SIS) and chitosan hydrogel patches.
OBJECTIVE
Tissue engineering may provide new operative tools for colorectal surgery in elective indications. The aim of this study was to define a suitable bioscaffold for colorectal tissue engineering.


METHODS
We compared 2 bioscaffolds with in vitro and in vivo experiments: porcine small intestinal submucosa (SIS) versus chitosan hydrogel matrix. We assessed nontoxicity of the scaffold in vitro by using human adipose-derived stem cells (hADSC). In vivo, a 1 × 2-cm colonic wall defect was created in 16 rabbits. Animals were divided randomly into 2 groups according to the graft used, SIS or chitosan hydrogel. Graft area was explanted at 4 and 8 weeks. The end points of in vivo experiments were technical feasibility, behavior of the scaffold, in situ putative inflammatory effect, and the quality of tissue regeneration, in particular smooth muscle layer regeneration.


RESULTS
In vitro, hADSC attachment and proliferation occurred on both scaffolds without a substantial difference. After proliferation, hADSCs kept their mesenchymal stem cell characteristics. In vivo, one animal died in each group. Eight weeks after implantation, the chitosan scaffold allowed better wound healing compared with the SIS scaffold, with more effective control of inflammatory activity and an integral regeneration of the colonic wall including the smooth muscle cell layer.


CONCLUSIONS
The outcomes of in vitro experiments did not differ greatly between the 2 groups. Macroscopic and histologic findings, however, revealed better wound healing of the colonic wall in the chitosan group suggesting that the chitosan hydrogel could serve as a better scaffold for colorectal tissue engineering.
Department of Digestive Surgery, CHU de Bordeaux, University of Bordeaux, Bordeaux, France; Bioingénierie tissulaire, University of Bordeaux, Bordeaux, France; INSERM, Bioingenierie tissulaire, U1026, Bordeaux, France; CHU de Bordeaux, CIC 1401, Bordeaux, France. Electronic address: quentin.denost@chu-bordeaux.fr.
Quentin
Q
Denost
Department of Digestive Surgery, CHU de Bordeaux, University of Bordeaux, Bordeaux, France; Bioingénierie tissulaire, University of Bordeaux, Bordeaux, France; INSERM, Bioingenierie tissulaire, U1026, Bordeaux, France.
Jean-Philippe
JP
Adam
Department of Digestive Surgery, CHU de Bordeaux, University of Bordeaux, Bordeaux, France; Bioingénierie tissulaire, University of Bordeaux, Bordeaux, France; INSERM, Bioingenierie tissulaire, U1026, Bordeaux, France.
Arnaud
A
Pontallier
Université de Lyon, Université Claude Bernard Lyon 1, Villeurbanne Cedex, France.
Alexandra
A
Montembault
Bioingénierie tissulaire, University of Bordeaux, Bordeaux, France; INSERM, Bioingenierie tissulaire, U1026, Bordeaux, France.
Reine
R
Bareille
Bioingénierie tissulaire, University of Bordeaux, Bordeaux, France; INSERM, Bioingenierie tissulaire, U1026, Bordeaux, France.
Robin
R
Siadous
CHU de Bordeaux, CIC 1401, Bordeaux, France.
Samantha
S
Delmond
Department of Digestive Surgery, CHU de Bordeaux, University of Bordeaux, Bordeaux, France.
Eric
E
Rullier
Université de Lyon, Université Claude Bernard Lyon 1, Villeurbanne Cedex, France.
Laurent
L
David
Bioingénierie tissulaire, University of Bordeaux, Bordeaux, France; INSERM, Bioingenierie tissulaire, U1026, Bordeaux, France; CHU de Bordeaux, CIC 1401, Bordeaux, France.
Laurence
L
Bordenave
D000273:Adipose Tissue / Q000166:cytology; D000818:Animals; D049109:Cell Proliferation; D002478:Cells, Cultured; D048271:Chitosan; D003106:Colon / Q000166:cytology / Q000502:physiology / Q000601:surgery; D003107:Colorectal Surgery / Q000379:methods*; D048091:Guided Tissue Regeneration / Q000379:methods; D006801:Humans; D020100:Hydrogels; D066298:In Vitro Techniques; D007413:Intestinal Mucosa / Q000166:cytology*; D007421:Intestine, Small / Q000166:cytology*; D023421:Models, Animal; D011817:Rabbits; D013234:Stem Cells / Q000166:cytology; D013552:Swine; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds
D020100:Hydrogels; D048271:Chitosan