Stem cells were instrumental in creating new functional diaphragm
The diaphragm is a one of the vital organs of the body; it is responsible for several important functions including its very critical role in respiration. During the process of breathing, the diaphragm contracts to add volume to the thoracic cavity, which enables the lungs to make room for more air. It also separates the thoracic and abdominal cavities. The malfunction of the diaphragm can lead to several life threatening conditions, which can be acquired or congenital. Congenital diaphragmatic hernias (CDH) are one of the most common birth defects (1:2500) caused by a malformation, or hole, in the diaphragm.
Currently available surgical interventions are widely used in clinics to repair and reconstruct the diaphragm, both in children and adults. However, they cannot prevent the recurrence of the defect. Unfortunately, surgical repair using natural or artificial patches is still associated with a high rate of morbidity and mortality. In recent years, tissue engineering has been emerging as a promising field of research, offering hope for bridging the gap between organ shortage and transplantation needs.
Internationally renowned scientists in the field of regenerative medicine and tissue engineering devised a technique, which created new diaphragm tissue in the lab using a mixture of stem cells on a 3D scaffold . Researchers first created a suitable biologically derived scaffold obtained by a donor rat. They performed decellularization by using physical or chemical treatments in order to remove all the immunogenic cells and cellular components. However, they preserved all the connective tissue and extracellular matrix, which provides structure and mechanical properties to the tissue. They further tested the diaphragm in vitro for its ability to contract and stretch for a long period of time, and they found that the decellularization process affected the physical properties of the tissue. After decellularization, they seeded the bone marrow-derived alloegenic stem cells on the scaffold and then transplanted into the animals. Twenty-one days after surgery, the diaphragm scaffolds began to function without any signs of infection or implant rejection.
They are further planning to test larger animals before human trails. This study provides a proof of principle, and the approach may be utilized to engineer other organs as well.
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 Elena A. Gubareva, Sebastian Sjöqvist, Irina V. Gilevich, Alexander S. Sotnichenko, Elena V. Kuevda, Mei Ling Lim, Neus Feliu, Greg Lemon, Konstantin A. Danilenko, Ramazan Z. Nakokhov, Ivan S. Gumenyuk, Timofei E. Grigoriev, Sergey V. Krasheninnikov, Alexander G. Pokhotko, Alexander A. Basov, Stepan S. Dzhimak, Ylva Gustafsson, Geoanna Bautista, Antonio Beltrán Rodríguez, Vladimir M. Pokrovsky, Philipp Jungebluth, Sergei N. Chvalun, Mark J. Holterman, Doris A. Taylor, Paolo Macchiarini. Orthotopic transplantation of a tissue engineered diaphragm in rats. Biomaterials, 2015; DOI:10.1016/j.biomaterials.2015.11.020