Читать книгу The SAGE Encyclopedia of Stem Cell Research - Группа авторов - Страница 125

Regenerative medicine strategies are being researched and developed for every type of tissue and organ within the urinary system. The bulk of research involving regenerative medicine strategies with the bladder has taken place within the past decade. There exists a wealth of regenerative medicine technologies, with products in discovery, preclinical testing, and clinical trials. Research is underway to expand both cell source and biomaterials options for regenerative medicine applications. Researchers have established the feasibility of using regenerative medicine to treat neurogenic bladder and the future promises that regenerative medicine therapies and treatment options will expand to patients with other bladder diseases and, ultimately, additional organs.

In modern bladder regeneration research, precursor urothelial and smooth-muscle cells are isolated and expanded to numbers suitable for regenerative medicine strategies from normal and neurogenic human bladder tissue. To use regenerative medicine strategies on the bladder, urothelial and smooth-muscle cells have been isolated and expanded to numbers suitable for regenerative medicine approaches from normal human bladder tissue. This has established a greater ability for clinicians to use autologous homologous cells in regenerative medicine for bladder augmentation and regeneration in humans. In preclinical studies, cell-free and progenitor cell-seeded, bladder-molded scaffolds made from specially constructed biodegradable polymers were compared. Several studies reveal that cell-free implants resulted in bladder wall reparative healing and the cells were needed to regenerate the bladder. In addition, the cell-seeded implants had a long-term durability and were bioresponsive to the recipients’ needs for bladder functionality.

Regenerative medicine therapies for bladder augmentation following cystoplasty were first used in humans in 1998. In a small study, implants made from collagen or poly(lactic-co-glycolic acid) (PLGA)-based scaffolds seeded with autologous progenitor cells were tested. Patients showed increased compliance, decreased end-filling pressures, increased capacities, and longer dry periods after implantation. This initial study first established the feasibility and safety of using regenerative medical products as an alternative to gastrointestinal tissue for bladder generation. Since this study, the production of progenitor cell-seeded, PLGA-based scaffolds for clinical use has been standardized and is currently in phase II clinical trials. Future goals are products for urinary diversion and total-bladder replacement, ultimately enhancing or fully restoring bladder function and nerve development.