Electrospun nanofiber mesh with fibroblast growth factor and stem cells for pelvic floor repair

Abstract

Surgical outcome following pelvic organ prolapse (POP) repair needs improvement. We suggest a new approach based on a tissue‐engineering strategy. In vivo, the regenerative potential of an electrospun biodegradable polycaprolactone (PCL) mesh was studied. Six different biodegradable PCL meshes were evaluated in a full‐thickness abdominal wall defect model in 84 rats. The rats were assigned into three groups: (1) hollow fiber PCL meshes delivering two dosages of basic fibroblast growth factor (bFGF), (2) solid fiber PCL meshes with and without bFGF, and (3) solid fiber PCL meshes delivering connective tissue growth factor (CTGF) and rat mesenchymal stem cells (rMSC). After 8 and 24 weeks, we performed a histological evaluation, quantitative analysis of protein content, and the gene expression of collagen‐I and collagen‐III, and an assessment of the biomechanical properties of the explanted meshes. Multiple complications were observed except from the solid PCL‐CTGF mesh delivering rMSC. Hollow PCL meshes were completely degraded after 24 weeks resulting in herniation of the mesh area, whereas the solid fiber meshes were intact and provided biomechanical reinforcement to the weakened abdominal wall. The solid PCL‐CTGF mesh delivering rMSC demonstrated improved biomechanical properties after 8 and 24 weeks compared to muscle fascia. These meshes enhanced biomechanical and biochemical properties, demonstrating a great potential of combining tissue engineering with stem cells as a new therapeutic strategy for POP repair. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:48–55, 2020.

Laparoscopy for the Treatment of Congenital Hernia: Use of Surgical Meshes and Mesenchymal Stem Cells in a Clinically Relevant Animal Model

“…First, there is a lack of uniformity regarding the use of animal models in preclinical trials (Vogels et al, 2017). Even the most recent studies that have investigated the use of stem cells on surgical meshes have been performed in vitro (Gao et al, 2014;Vozzi et al, 2017) or in small animal models, especially in mice (Darzi et al, 2018;Paul et al, 2019;Mukherjee et al, 2020), rats (Altman et al, 2010a;Altman et al, 2010b;Edwards et al, 2015;Iyyanki et al, 2015;Klinger et al, 2016;van Steenberghe et al, 2017;Hansen et al, 2020), and rabbits (Zhao et al, 2012;Cheng et al, 2017). Only a few preclinical studies have been performed in sheep (Gerullis et al, 2013;Gerullis et al, 2014).…”

The use of polymeric meshes for pelvic organ prolapse: Current concepts, challenges, and future perspectives

“…In addition, the newly developed meshes showed superior biocompatibility (compared to PU scaffolds with no 17-β-estradiol), which enhanced the proangiogenic potential of human adipose mesenchymal stem cells and improved tissue integration (Shafaat et al, 2018). formed (Hansen et al, 2019;Roman, Urbánková, et al, 2016;Wu et al, 2016). This is in order to avoid the adverse events often associ- 1.4 ± 0.5 Two different fiber-based PCL meshes, hallow and solid, delivering different dosage of bFGF, and CTGF together with rat MSCs were investigated.…”

“…Although both the mesh types performed well in vivo, the addition of bFGF did not represent an advantage both in the short and in the long term for the regeneration of new tissue (Glindtvad et al, ). Very recently, in an effort to improve the outcomes of the previous study, the same research group redesigned the PCL‐based implant by incorporating GTGF and rat MSCs (Hansen et al, ). The new developed mesh showed better biomechanical and biochemical properties in comparison to the previous one.…”

“…Moreover, as mentioned above, the anatomical structure of pelvic floor is more complex and heterogeneous in comparison to human abdominal wall. Therefore, it is essential that the new proposed solutions will be tested in the clinically relevant position rather than another anatomical site, as very recent studies performed (Hansen et al, ; Roman, Urbánková, et al, ; Wu et al, ). This is in order to avoid the adverse events often associated with new released implants.…”

“…After 24 weeks of implantation in a rat abdominal wall model, multiple complications were observed except from the solid PCL-CTGF mesh delivering rMSC, which showed better biomechanical as well as biochemical outcomes in comparison to the same mesh incorporated with bFGF. (Hansen et al, 2019) PCL/PEO-fibrinogen/bFGF solid fibers 1.61 ± 0.13 1.5 ± 0.4 PCL/PEO-fibrinogen/CTGF solid fibers studies with detailed follow-up to evaluate mesh safety and efficacy (Vashaghian et al, 2018).…”