Bladder muscular wall regeneration with autologous adipose mesenchymal stem cells on three-dimensional collagen-based tissue-engineered prepuce and biocompatible nanofibrillar scaffold

ObjectiveTissue-engineered prepuce scaffold (TEPS) is a collagen-rich matrix with marvelous mechanical properties, promoting in vivo and in vitro tissue regeneration. In this study, adipose-derived mesenchymal stem cells (ADMSCs) were used to seed TEPS for bladder wall regeneration. Its potential in comparison with other materials such as polyglycolic acid (PGA) and nanofibrous scaffolds were evaluated.Materials and methodsRat ADMSCs were cultured and seeded into prepared TEPS. A synthetic matrix of electrospun nanofibrous polyamide was also prepared. Sprague Dawley rats (n = 32) underwent bladder wall regeneration using (a) TEPS, (b) TEPS + PGA, (c) TEPS + nanofibrous scaffold, and (d) ADMSC-seeded TEPS, between bladder mucosa and seromuscular layer. Animals were followed for 30 and 90 days post implantation for evaluation of bladder wall regeneration by determining CD31/34 and SMC α-actin. Cystometric evaluation was also performed in all groups and in four separate rats as sham controls 3 months postoperatively.ResultsHistopathological analysis showed well-organized muscular wall generation in ADMSC-seeded TEPS and TEPS + three-dimensional (3D) nanofibrous scaffold without significant fibrosis after 90 days, while mild to severe fibrosis was detected in groups receiving TEPS and TEPS + PGA. Immunohistochemistry staining revealed the maintenance of CD34+, CD31+, and α-SMA in ADMSC-seeded TEPS and TEPS + 3D nanofibrous scaffold with significantly higher density of CD34+ and CD31+ progenitor cells in ADMSC-seeded TEPS and TEPS + 3D nanofibrous scaffold, respectively.ConclusionsThis work has crucial functional and clinical implications, as it demonstrates the feasibility of ADMSC-seeded TEPS in enhancing the properties of TEPS in terms of bladder wall regeneration.