Airway tissue engineering for congenital laryngotracheal disease.
Regenerative medicine offers hope of a sustainable solution for severe airway disease by the creation of functional, immunocompatible organ replacements. When considering fetuses and newborns, there is a specific spectrum of airway pathologies that could benefit from cell therapy and tissue engineering applications. While hypoplastic lungs associated with congenital diaphragmatic hernia (CDH) could benefit from cellular based treatments aimed at ameliorating lung function, patients with upper airway obstruction could take advantage from a de novo tissue engineering approach. Moreover, the international acceptance of the EXIT procedure as a means of securing the precarious neonatal airway, together with the advent of fetal surgery as a method of heading off postnatal co-morbidities, offers the revolutionary possibility of extending the clinical indication for tissue-engineered airway transplantation to infants affected by diverse severe congenital laryngotracheal malformations. This article outlines the necessary basic components for regenerative medicine solutions in this potential clinical niche.
Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Elizabeth
E
Maughan
Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK; Department of Development and Regeneration, Biomedical Sciences Group, University of Leuven, Leuven, Belgium.
Flore
F
Lesage
Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Colin R
CR
Butler
Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Robert E
RE
Hynds
Ear, Nose and Throat Department, Great Ormond Street Hospital, London, UK.
Richard
R
Hewitt
Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Sam M
SM
Janes
Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Department of Development and Regeneration, Biomedical Sciences Group, University of Leuven, Leuven, Belgium; Department of Paediatric Surgery, Great Ormond Street Hospital, London, UK; Department of Obstetrics and Gynaecology, Fetal Medicine Unit, University Hospitals Leuven, Leuven, Belgium.
Jan A
JA
Deprest
Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Department of Paediatric Surgery, Great Ormond Street Hospital, London, UK. Electronic address: p.decoppi@ucl.ac.uk.
Paolo De
PD
Coppi
D046128:Fetal Therapies / Q000379:methods; D048091:Guided Tissue Regeneration; D006801:Humans; D007231:Infant, Newborn; D007818:Laryngeal Diseases / Q000151:congenital* / Q000601:surgery*; D007830:Larynx / Q000002:abnormalities / Q000601:surgery; D015619:Respiratory System Abnormalities / Q000601:surgery*; D023822:Tissue Engineering / Q000379:methods*; D016378:Tissue Transplantation; D014132:Trachea / Q000002:abnormalities / Q000601:surgery; D014133:Tracheal Diseases / Q000151:congenital* / Q000601:surgery*
Congenital disease; Fetal therapy; Perinatal surgery; Stem cell; Tissue engineering; Trachea; Transplantation