title: [Urinary bladder substitution using combined membrane based on secretions of human mesenchymal stem cells and type I collagen].
abstract: OBJECTIVE
  Despite the widespread use of intestinal cystoplasty, urinary bladder substitution remains a challenging problem due to the complexity of operations and the potentially high risk of complications. A promising alternative may be bio-engineered collagen-based matrices containing stem cells or their secretions.
  
  
  METHODS
  To evaluate the effectiveness of this bladder substitution modality, an experiment was conducted on 14 male rabbits. The animals underwent resection of urinary bladder, and the formed defect was substituted with a membrane of type I collagen (series 1, 5 rabbits) or a membrane of the same composition containing a conditioned medium with secretion of mesenchymal stem/stromal cells derived from human adipose tissue (series 2, 5 rabbits). In the comparison group (4 rabbits) resection of the bladder and the closure of the defect was carried out without bladder substitution (series 3).
  
  
  RESULTS
  At 1 month after surgery, there was a complete epithelization of the inner surface of the implant, and body tissues replaced the collagen matrix. In series 1, the collagen implant was replaced mainly by connective tissue ingrown with occasional solitary smooth muscle cells. In series 2, the newly formed bladder wall contained numerous smooth muscle cells, growing into the collagen matrix and forming the muscular coat. In series 3, the muscular layer regeneration at the scar site was also noted, but it was less intense, which was confirmed by morphometry. In series 2, more active vascularization of the collagen implant occurred due to neo-angiogenesis, which was more intense than that in series 3, and especially in series 1. Functional studies revealed a reduced bladder functional capacity in series 1 and 3, while in series 2 it was close to normal. During filling cystometry, changes in intra-vesical pressure profile in series 2 were close to normal, while in series 1 and 3 infusion of a small volume of saline resulted in a marked increase in intra-vesical pressure, showing a reduced compliance of the reconstructed bladder. Discussion The study findings show that implants based on type I collagen can be effectively used to substitute a part of the urinary bladder wall, but bio-engineered collagen matrix grafts containing cell regeneration stimulants secreted by stem cells in their culture medium seem to be more promising.
authors.affiliation: Medical Scientific Educational Center of M.V. Lomonosov Moscow State University, Moscow.|N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology branch of P. A. Herzen Federal Medical Research Center of Minzdrav of Russia, Moscow.
authors.forename: V I
authors.initials: VI
authors.lastname: Kirpatovckii
authors.affiliation: Medical Scientific Educational Center of M.V. Lomonosov Moscow State University, Moscow.
authors.forename: D M
authors.initials: DM
authors.lastname: Kamalov
authors.affiliation: Medical Scientific Educational Center of M.V. Lomonosov Moscow State University, Moscow.
authors.forename: A Yu
authors.initials: AY
authors.lastname: Efimenko
authors.affiliation: Medical Scientific Educational Center of M.V. Lomonosov Moscow State University, Moscow.|Faculty of Fundamental Medicine of Lomonosov Moscow State University, Moscow.
authors.forename: P I
authors.initials: PI
authors.lastname: Makarevich
authors.affiliation: Medical Scientific Educational Center of M.V. Lomonosov Moscow State University, Moscow.|LLC Gene and Cell Therapy, Moscow.
authors.forename: G D
authors.initials: GD
authors.lastname: Sagaradze
authors.affiliation: LLC Gene and Cell Therapy, Moscow.
authors.forename: O A
authors.initials: OA
authors.lastname: Makarevich
authors.affiliation: Medical Scientific Educational Center of M.V. Lomonosov Moscow State University, Moscow.|LLC Gene and Cell Therapy, Moscow.
authors.forename: P P
authors.initials: PP
authors.lastname: Nimiritskii
authors.affiliation: LLC IMTEK, Moscow.
authors.forename: E O
authors.initials: EO
authors.lastname: Osidak
authors.affiliation: Russian Cardiology Scientific Industrial Complex of Minzdrav of Russia, Moscow.
authors.forename: S P
authors.initials: SP
authors.lastname: Domogatskii
authors.affiliation: Faculty of Fundamental Medicine of Lomonosov Moscow State University, Moscow.
authors.forename: V K
authors.initials: VK
authors.lastname: Karpov
authors.affiliation: Medical Scientific Educational Center of M.V. Lomonosov Moscow State University, Moscow.|Faculty of Fundamental Medicine of Lomonosov Moscow State University, Moscow.
authors.forename: Z H A
authors.initials: ZH
authors.lastname: Akopyan
authors.affiliation: Medical Scientific Educational Center of M.V. Lomonosov Moscow State University, Moscow.|Faculty of Fundamental Medicine of Lomonosov Moscow State University, Moscow.
authors.forename: V A
authors.initials: VA
authors.lastname: Tkachuk
authors.affiliation: Medical Scientific Educational Center of M.V. Lomonosov Moscow State University, Moscow.|Faculty of Fundamental Medicine of Lomonosov Moscow State University, Moscow.
authors.forename: A A
authors.initials: AA
authors.lastname: Kamalov
mesh_terms: D000273:Adipose Tissue / Q000502:physiology; D000818:Animals; D024042:Collagen Type I; D017077:Culture Media, Conditioned; D020007:Implants, Experimental; D008567:Membranes, Artificial; D059630:Mesenchymal Stem Cells / Q000378:metabolism*; D009130:Muscle, Smooth / Q000502:physiology; D011817:Rabbits; D019651:Plastic Surgery Procedures; D012038:Regeneration; D054457:Tissue Scaffolds; D001743:Urinary Bladder / Q000502:physiology* / Q000601:surgery*; D013520:Urologic Surgical Procedures
chemical_list: D024042:Collagen Type I; D017077:Culture Media, Conditioned; D008567:Membranes, Artificial
keywords: bio-engineered matrix; bladder substitution; stem cell secretion products; the mesenchymal stem/stromal cells of human adipose tissue; type I collagen