Creation of a decellularized vaginal matrix from healthy human vaginal tissue for potential vagina reconstruction - experimental studies.


Journal

International journal of surgery (London, England)
ISSN: 1743-9159
Titre abrégé: Int J Surg
Pays: United States
ID NLM: 101228232

Informations de publication

Date de publication:
27 Sep 2023
Historique:
received: 26 06 2023
accepted: 21 08 2023
medline: 27 9 2023
pubmed: 27 9 2023
entrez: 27 9 2023
Statut: aheadofprint

Résumé

When a disorder causes absence of a healthy, full-size vagina, various neovaginal creation methods are available. Sometimes dilation or stretching of the vaginal cavity is sufficient, but intestinal or dermal flap tissue is generally required. However, different inherent tissue properties cause complications. Therefore, a lost body part should be replaced with a similar material. The use of organ-specific acellular vaginal tissue carries great potential, as its similar architecture and matrix composition make it suitable for vaginal regeneration. We developed an optimized protocol for decellularization of healthy, human vaginal tissue. Resected colpectomy tissue from 12 healthy transgender patients was used. Successful decellularization was confirmed by applying acellular criteria from in vivo remodeling-reports. Suitability as tissue-mimicking scaffold for vaginal reconstruction was determined by visible structural features, biocompatibility during stretching and presence of visible collagen, elastin, laminin and fibronectin. Histological examination confirmed the preservation of structural features and minimal cellular residue was seen during fluorescence microscopy, DNA and RNA quantification and fragment-length examination. Biomechanical testing showed decreased peak load (55%, P<0.05), strain at rupture (23%, P<0.01) and ultimate tensile stress (55%, P<0.05) after decellularization, while the elastic modulus (68%) did not decrease significantly. Fluorescence microscopy revealed preserved Fibronectin-I/II/III and Laminin-I/II, while Collagen-I and Ficolin-2B were decreased but mostly retained. The absence of cellular residue, moderately altered biomechanical extracellular matrix (ECM) properties and mostly preserved structural proteins, appear to make our decellularized human vaginal matrix a suitable tissue-mimicking scaffold for vagina transplantation when tissue survival through vascularization and innervation are accomplished in the future.

Sections du résumé

BACKGROUND BACKGROUND
When a disorder causes absence of a healthy, full-size vagina, various neovaginal creation methods are available. Sometimes dilation or stretching of the vaginal cavity is sufficient, but intestinal or dermal flap tissue is generally required. However, different inherent tissue properties cause complications. Therefore, a lost body part should be replaced with a similar material. The use of organ-specific acellular vaginal tissue carries great potential, as its similar architecture and matrix composition make it suitable for vaginal regeneration.
METHODS METHODS
We developed an optimized protocol for decellularization of healthy, human vaginal tissue. Resected colpectomy tissue from 12 healthy transgender patients was used. Successful decellularization was confirmed by applying acellular criteria from in vivo remodeling-reports. Suitability as tissue-mimicking scaffold for vaginal reconstruction was determined by visible structural features, biocompatibility during stretching and presence of visible collagen, elastin, laminin and fibronectin.
RESULTS RESULTS
Histological examination confirmed the preservation of structural features and minimal cellular residue was seen during fluorescence microscopy, DNA and RNA quantification and fragment-length examination. Biomechanical testing showed decreased peak load (55%, P<0.05), strain at rupture (23%, P<0.01) and ultimate tensile stress (55%, P<0.05) after decellularization, while the elastic modulus (68%) did not decrease significantly. Fluorescence microscopy revealed preserved Fibronectin-I/II/III and Laminin-I/II, while Collagen-I and Ficolin-2B were decreased but mostly retained.
CONCLUSIONS CONCLUSIONS
The absence of cellular residue, moderately altered biomechanical extracellular matrix (ECM) properties and mostly preserved structural proteins, appear to make our decellularized human vaginal matrix a suitable tissue-mimicking scaffold for vagina transplantation when tissue survival through vascularization and innervation are accomplished in the future.

Identifiants

pubmed: 37755377
doi: 10.1097/JS9.0000000000000727
pii: 01279778-990000000-00680
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

Auteurs

Jayson Sueters (J)

Department of Gynaecology, Amsterdam Reproduction and Development, Amsterdam UMC - location VUmc, De Boelelaan 1117, 1105 AZ Amsterdam, the Netherlands.

Fangxin Xiao (F)

Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
AMS - Musculoskeletal Health, Amsterdam Movement Sciences, VU Research Institutes, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
School of Exercise and Health, Shanghai University of Sport, Changhai Road No. 399, 200438 Shanghai, China.

Jan-Paul Roovers (JP)

Department of Obstetrics and Gynecology, Amsterdam Reproduction and Development, Amsterdam UMC - location VUmc, De Boelelaan 1117, 1105 AZ Amsterdam, the Netherlands.

Mark-Bram Bouman (MB)

Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC - location VUmc, De Boelelaan 1117, 1105 AZ Amsterdam, The Netherlands.

Freek Groenman (F)

Department of Obstetrics and Gynecology, Amsterdam Reproduction and Development, Amsterdam UMC - location VUmc, De Boelelaan 1117, 1105 AZ Amsterdam, the Netherlands.

Huub Maas (H)

Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
AMS - Musculoskeletal Health, Amsterdam Movement Sciences, VU Research Institutes, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.

Judith Huirne (J)

Department of Gynaecology, Amsterdam Reproduction and Development, Amsterdam UMC - location VUmc, De Boelelaan 1117, 1105 AZ Amsterdam, the Netherlands.

Theo Smit (T)

Department of Gynaecology, Amsterdam Reproduction and Development, Amsterdam UMC - location VUmc, De Boelelaan 1117, 1105 AZ Amsterdam, the Netherlands.
Department of Medical Biology, Amsterdam UMC - location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.

Classifications MeSH