Application of Bladder Acellular Matrix in Urinary Bladder Regeneration: The State of the Art and Future Directions

Marta Pokrywczynska,Tomasz Drewa,Iga Gubanska,Gerard Drewa

doi:10.1155/2015/613439

Abstract

Construction of the urinary bladder de novo using tissue engineering technologies is the “holy grail” of reconstructive urology. The search for the ideal biomaterial for urinary bladder reconstruction has been ongoing for decades. One of the most promising biomaterials for this purpose seems to be bladder acellular matrix (BAM). In this review we determine the most important factors, which may affect biological and physical properties of BAM and its regeneration potential in tissue engineered urinary bladder. We also point out the directions in modification of BAM, which include incorporation of exogenous growth factors into the BAM structure. Finally, we discuss the results of the urinary bladder regeneration with cell seeded BAM.

Highlights

The urinary bladder is a complex organ, whose main functions are storage of urine under low and stable pressure and micturition
No less important studies were done by Freytes et al, who determined porcine bladder acellular matrix (BAM) mechanical properties after (I) different techniques of decellularization, which were proven to have the direct impact on BAM mechanical characteristics [58], (II) lyophilisation, sterilisation, and storage, which indicated that structural and mechanical strength changes may be noted in case of long-term storage, but they were not significant [59], and (III) sterilisation procedures—ethylene oxide (EO), gamma irradiation (GI), and electron beam irradiation (e-BI)—which revealed that EO was the most suitable sterilisation technique for BAM to preserve suitable mechanical properties
The results showed that abluminal porosity index (PI) was higher than luminal for both thick and thin BAM

Summary

Introduction

The urinary bladder is a complex organ, whose main functions are storage of urine under low and stable pressure and micturition. The most favourable material for urinary bladder reconstruction has to possess good biocompatibility, biodegradation profile, and mechanical properties, especially fatigue strength and elasticity [5] Due to these requirements, the ideal proposition seems to be extracellular matrix-derived grafts, like bladder acellular matrix (BAM). While new functional tissue is being formed, the BAM scaffold undergoes slow degradation, which over time will result in the remaining presence of just novel tissue (restored in place of implanted scaffold) [7, 8] In this overview, we focused on bladder acellular matrix preparation techniques and factors that have impact on BAM structure, porosity, and mechanical properties. The latest data of published literature indicates that the application of BAM seeded with stem cells will be the main direction of future BAM developments

Bladder Acellular Matrix Preparation

Bladder Acellular Matrix as Release Carriers of Exogenous Growth Factors

Bladder Acellular Matrix as a Scaffold for Cells

Stem Cells and Bladder Acellular in Urinary Bladder Regeneration

Findings

Conclusions