title: Biomechanical properties of an implanted engineered tubular gut-sphincter complex.
abstract: Neuromuscular diseases of the gut alter the normal motility patterns. Although surgical intervention remains the standard treatment, preservation of the sphincter attached to the rest of the gut is challenging. The present study aimed to evaluate a bioengineered gut-sphincter complex following its subcutaneous implantation for 4 weeks in rats. Engineered innervated human smooth muscle sheets and innervated human sphincters with a predefined alignment were placed around tubular scaffolds to create a gut-sphincter complex. The engineered complex was subcutaneously implanted in the abdomen of the rats for 4 weeks. The implanted tissues were vascularized. In vivo manometry revealed luminal pressure at the gut and the sphincter zone. Tensile strength, elongation at break and Young's modulus of the engineered complexes were similar to those of native rat intestine. Histological and immunofluorescence assays showed maintenance of smooth muscle circular alignment in the engineered tissue, maintenance of smooth muscle contractile phenotype and innervation of the smooth muscle. Electrical field stimulation induced relaxation of the smooth muscle of both the sphincter and the gut parts. Relaxation was partly inhibited by nitric oxide inhibitor indicating nitrergic contribution to relaxation. The present study has demonstrated for the first time a successfully developed and subcutaneously implanted a tubular human-derived gut-sphincter complex. The sphincteric part of Tubular Gut-Sphincter Complex (TGSC) maintained the basal tone characteristic of a native sphincter. The gut part also maintained its specific neuromuscular characteristics. The results of this study provide a promising therapeutic approach to restore gut continuity and motility. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA.|Department of Molecular Medicine and Translational Sciences, Wake Forest School of Medicine, Winston Salem, NC, USA.
authors.forename: Elie
authors.initials: E
authors.lastname: Zakhem
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA.
authors.forename: Mostafa
authors.initials: M
authors.lastname: El Bahrawy
authors.affiliation: Department of General Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Orlando
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA.|Department of Molecular Medicine and Translational Sciences, Wake Forest School of Medicine, Winston Salem, NC, USA.|Virginia Tech-Wake Forest School of Biomedical Engineering and Sciences, Winston Salem, NC, USA.
authors.forename: Khalil N
authors.initials: KN
authors.lastname: Bitar
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D004943:Esophagogastric Junction / Q000502:physiology*; D005455:Fluorescent Antibody Technique; D041981:Gastrointestinal Tract / Q000502:physiology*; D006801:Humans; D020007:Implants, Experimental; D011312:Pressure; D051381:Rats; D013718:Tensile Strength; D023822:Tissue Engineering / Q000379:methods*
keywords: GI regenerative medicine; chitosan scaffold; implantation; intraluminal pressure; mechanical properties; neuromuscular; sphincter