Tissue engineering-based therapeutic strategies for vocal fold repair and regeneration.
Vocal folds are soft laryngeal connective tissues with distinct layered structures and complex multicomponent matrix compositions that endow phonatory and respiratory functions. This delicate tissue is easily damaged by various environmental factors and pathological conditions, altering vocal biomechanics and causing debilitating vocal disorders that detrimentally affect the daily lives of suffering individuals. Modern techniques and advanced knowledge of regenerative medicine have led to a deeper understanding of the microstructure, microphysiology, and micropathophysiology of vocal fold tissues. State-of-the-art materials ranging from extracecullar-matrix (ECM)-derived biomaterials to synthetic polymer scaffolds have been proposed for the prevention and treatment of voice disorders including vocal fold scarring and fibrosis. This review intends to provide a thorough overview of current achievements in the field of vocal fold tissue engineering, including the fabrication of injectable biomaterials to mimic in vitro cell microenvironments, novel designs of bioreactors that capture in vivo tissue biomechanics, and establishment of various animal models to characterize the in vivo biocompatibility of these materials. The combination of polymeric scaffolds, cell transplantation, biomechanical stimulation, and delivery of antifibrotic growth factors will lead to successful restoration of functional vocal folds and improved vocal recovery in animal models, facilitating the application of these materials and related methodologies in clinical practice.
Department of Materials Science and Engineering, University of Delaware, Newark, DE 19716, USA.
Linqing
L
Li
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI 53792, USA; Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI 53792, USA.
Jeanna M
JM
Stiadle
Department of Materials Science and Engineering, University of Delaware, Newark, DE 19716, USA.
Hang K
HK
Lau
Department of Biomedical Engineering, University of Delaware, Newark, DE 19716, USA.
Aidan B
AB
Zerdoum
Department of Materials Science and Engineering, University of Delaware, Newark, DE 19716, USA; Department of Biomedical Engineering, University of Delaware, Newark, DE 19716, USA; Delaware Biotechnology Institute, 15 Innovation Way, Newark, DE 19711, USA.
Xinqiao
X
Jia
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI 53792, USA; Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI 53792, USA. Electronic address: thibeaul@surgery.wisc.edu.
Susan L
SL
Thibeault
Department of Materials Science and Engineering, University of Delaware, Newark, DE 19716, USA; Department of Biomedical Engineering, University of Delaware, Newark, DE 19716, USA; Delaware Biotechnology Institute, 15 Innovation Way, Newark, DE 19711, USA. Electronic address: kiick@udel.edu.
Kristi L
KL
Kiick
D000818:Animals; D004867:Equipment Design; D048091:Guided Tissue Regeneration / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D012038:Regeneration / Q000502:physiology; D033581:Stem Cell Transplantation / Q000295:instrumentation / Q000379:methods; D023822:Tissue Engineering / Q000295:instrumentation* / Q000379:methods*; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D014827:Vocal Cords / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*
Animal model; Bioreactor; Collagen; Elastin; Growth factor; Human mesenchymal stem cells; Hyaluronic acid; Lamina propria; Regenerative medicine; Resilin; Tissue engineering; VF fibroblasts; Vocal folds