Bioengineering the gut: future prospects of regenerative medicine

Abstract

Functions of the gastrointestinal tract include motility, digestion and absorption of nutrients. These functions are mediated by several specialized cell types including smooth muscle cells, neurons, interstitial cells and epithelial cells. In gastrointestinal diseases, some of the cells become degenerated or fail to accomplish their normal functions. Surgical resection of the diseased segments of the gastrointestinal tract is considered the gold-standard treatment in many cases, but patients might have surgical complications and quality of life can remain low. Tissue engineering and regenerative medicine aim to restore, repair, or regenerate the function of the tissues. Gastrointestinal tissue engineering is a challenging process given the specific phenotype and alignment of each cell type that colonizes the tract - these properties are critical for proper functionality. In this Review, we summarize advances in the field of gastrointestinal tissue engineering and regenerative medicine. Although the findings are promising, additional studies and optimizations are needed for translational purposes.

Folding artificial mucosa with cell-laden hydrogels guided by mechanics models

“…Tissue engineering continues to impact tissue replacement, disease modeling, and drug development (44,45). In particular, the engineering of hollow or tubular organs such as stomach, intestine, and urinary bladder remains important as the treatment of diseases such as stomach cancer and inflammatory bowel disease often necessitates the removal of part of the organ (46)(47)(48)(49). Despite the early success of using biomaterials such as collagen and polyglycolic acid to regenerate the mucosa and muscular layer for different organs (48,50), limited functional improvement such as insignificant change in bladder volume has been recorded after the implantation of tissue-engineered stomach and urinary bladder (49,51).…”

Composite Scaffolds Based on Intestinal Extracellular Matrices and Oxidized Polyvinyl Alcohol: A Preliminary Study for a New Regenerative Approach in Short Bowel Syndrome

“…In TE, the use of decellularized matrices gained special attention owing to their clinical success in tissue reconstruction and their advantage of preserving the native architecture of the tissue along with the ECM [ 49 , 50 ]. Indeed, the identification of the adequate decellularization protocol is a challenge, as many methods do not allow maintaining both the mechanical properties and inherent biofactors [ 42 , 51 ].…”

Tissue engineering of the gastroesophageal junction

“…Of these three, the esophagus is the easiest to replicate due to its relatively simple muscular structure and squamous epithelium. Indeed, many reviews have been published recently which discuss the various material, cell, and bioreactor choices made to generate problem‐specific tissue engineering solutions (Bitar & Zakhem, 2016; Kanetaka et al, 2018; Londono & Badylak, 2015; Tan et al, 2012). The approaches range from acellular scaffolds to bilayered, recellularized constructs and even scaffold‐free organoid bioprinting (Takeoka et al, 2019).…”

“…The field of tissue engineering is making steady progress in addressing challenges with vascularization of thick tissue constructs and sourcing patient‐specific cells through induced pluripotent stem cells and adult progenitor cells. Progress is also being made in innervation to establish physiologic control over contractile tissues and incorporate neural progenitors into gut organoids (Bitar & Zakhem, 2016; Workman et al, 2016). Tissue engineering attempts for treating defects in the esophageal body have been successful to the point of running early clinical trials (Kanetaka, Kobayashi, & Eguchi, 2018).…”