Tracheal Repair with Human Umbilical Cord Mesenchymal Stem Cells Differentiated in Chondrocytes Grown on an Acellular Amniotic Membrane: A Pre-Clinical Approach

Abstract

Acellular amniotic membrane (AM) has been studied, with promising results on the reconstruction of lesioned tissues, and has become an attractive approach for tracheal repair. This study aimed to evaluate the repair of the trachea with human umbilical cord mesenchymal stem cells (hucMSCs) differentiated in chondrocytes, grown on an experimental model. Tracheal defects were induced by surgical tracheostomy in 30 New Zealand rabbits, and the acellular amniotic membrane, with or without cells, was covering the defect. The hucMSCs were isolated and cultivated with chondrogenic differentiation over the culture of 14 days, and then grown on the AM. In this study, the AM was biocompatible and hucMSCs differentiated into chondrocytes. Our results demonstrated an important role for AM with cultured cells in the promotion of immature collagen, known to produce tissue regeneration. In addition, cartilaginous tissue was found at the tracheal defects, demonstrated by immunohistology results. This study suggests that this biomaterial implantation can be an effective future therapeutic alternative for patients with tracheal injury.

Decellularized Wharton’s Jelly and Amniotic Membrane Demonstrate Potential Therapeutic Implants in Tracheal Defects in Rabbits

“…In this study, cartilage formation was evaluated using the same Aggrecan marker, where there was no significant difference between the control and the Wharton’s Jelly groups over 30 days [ 17 ]. In another study, Simeoni et al (2021) evaluated a decellularized amniotic membrane as a framework for tracheal lesions using mesenchymal stem cells, finding cartilaginous tissue through the formation of immature collagen in the regions of the tracheal defects after 60 days [ 23 ].…”

Decellularized Wharton Jelly Implants Do Not Trigger Collagen and Cartilaginous Tissue Production in Tracheal Injury in Rabbits

“…Xu, Yong & Duan (2020) presented that decellularized WJ can speed degradation, absorption, and adhesion only when combined with ε-caprolactone and maintained in vivo analysis for a period of 12 months [ 29 ]. Another way is to combine the structure with chondrocytes to accelerate tracheal healing [ 30 ]. When tissue engineering is associated with tracheal regeneration, three elements must be considered: cells, growth factors, and the scaffold responsible for the tissue regeneration [ 1 ].…”

Tracheal Tissue Engineering: Principles and State of the Art

“…The resulting TE construct was implanted on a tracheal injury model of New Zealand rabbits. Histopathological analyses conducted 60 days after surgery revealed the presence of immature cartilage islands [60].…”

“…Besides the chosen cell type and its differentiation, additional factors that deserve consideration are the density of seeded cells, which, in reported studies, varies from 1.6 × 10 5 [60,63] to 1.5 × 10 7 [62], and the efficiency of seeding, which varies according to the method used. Currently, there is no evidence available to define the minimum number of cells that should be retained in the scaffold before it can be successfully implanted.…”