Here, we report the design and development of highly
stretchable,
compliant, and enzymatic-resistant transiently cross-linked decellularized
extracellular matrixes (dECMs) (e.g., porcine small intestine submucosa/dSIS,
urinary bladder matrix/dUBM, bovine pericardium/dBP, bovine dermis/dBD,
and human dermis/dHD). Specifically, these dECMs were modified with
long aliphatic chains (C9, C14, and C18). Upon modification, dECMs
became significantly resistant to enzymatic degradation for extended
periods, showed increased water contact angle (>20%–90%),
and
stretched >200% than their control counterparts. Modified dECMs
are
compliant, undergoing 100% elongation at only 0.3–0.5 MPa of
applied tensile stress (∼10%–25% of their control counterparts),
similar to the control bladder tissue. Furthermore, modified dECMs
remain structurally stable at the physiological temperature with increased
storage and loss modulus values but decreased tan δ values compared
to their control counterparts. Although modification reduces cell
adhesion, the gene expressions in polarized macrophages remain unchanged
(e.g., TGFβ, CD163, and CD86), except for the modified bovine
pericardium (dBP) where a significant decrease in TNFα gene
expression is observed. When implanted in the rat subcutaneous model,
modified dECMs degraded relatively slowly and did not cause significant
fibrotic tissue formation. The numbers of pro-regenerative macrophages
increased to several folds in a later time point of evaluation. Modified
dECM also supported the bladder wall regeneration with formations
of the urothelium, lamina propria, blood vessels, and muscle bundles
and reduced the occurrence of calculi formation by 50% in a rat bladder
augmentation model. We anticipate that the enhanced stretchability,
compliance, and physiological stability of dECMs indicate their suitability
for urologic tissue regeneration.