Buccal epithelium Expanded and Encapsulated in Scaffold‐Hybrid Approach to Urethral Stricture (BEES‐HAUS) procedure: A novel cell therapy‐based pilot study

Abstract

Objectives To describe the feasibility of a novel cell‐based endoscopic technique using buccal epithelium, expanded and encapsulated in a thermoreversible gelation polymer scaffold for the treatment of urethral stricture. Methods Six male patients with bulbar urethral stricture ranging from 2.0 to 3.5 cm in length were included in this pilot study. Autologous buccal epithelial cells from a small buccal mucosal biopsy were isolated, cultured and encapsulated in thermoreversible gelation polymer scaffold, and were implanted at the stricture site after a wide endoscopic urethrotomy. Results All the patients voided well, with a mean peak flow rate of 24 mL/s. Urethroscopy carried out at 6 months showed healthy mucosa at the urethrotomy site. However, two of the six patients had recurrence at 18 and 24 months, respectively. Conclusions This endoscopic‐based Buccal epithelium Expanded and Encapsulated in Scaffold‐Hybrid Approach to Urethral Stricture (BEES‐HAUS) technique is a promising alternative for the open substitution buccal graft urethroplasty. It is possible to achieve the benefits of open substitution buccal urethroplasty with this endoscopic technique.

Enhanced expression of hyaluronic acid in osteoarthritis-affected knee-cartilage chondrocytes during three-dimensional in vitro culture in a hyaluronic-acid-retaining polymer scaffold

“…The 3D-TGP scaffold has been previously reported to support the culturing of a variety of cells and stem cells, including pluripotent stem cells, mesenchymal stem cells, bone marrow mononuclear cells, hepatocytes, corneal limbal stem cells and chondrocytes, with each study reporting common findings such as the maintenance of the cells' native phenotype and of the stem or progenitor cell phenotype for a longer time than when using other culture systems in vitro [5][6][7]20]. In vivo transplantation of cells along with TGP for cartilage damage [6], urethral strictures [21], corneal limbal stem cell damage [22], liver failure [23] and alveolar bone damage [24] provides an optimal environment for successful clinical outcomes and the maintenance of cells' characteristics for longer time periods as compared with other scaffolds. Therefore, it is prudent to presume that TGP's characteristics help to properly diffuse nutrients and enable paracrine-based cell-signalling mechanisms via soluble factors to help maintain the cells in their native phenotype, which contributes to successful clinical outcomes.…”

Editorial Comment from Dr Takao to Buccal epithelium Expanded and Encapsulated in Scaffold‐Hybrid Approach to Urethral Stricture (BEES‐HAUS) procedure: A novel cell therapy‐based pilot study

“…Vaddi et al . reported the feasibility of a novel cell‐based endoscopic technique using buccal epithelium expanded and encapsulated in a thermoreversible gelation polymer scaffold for the treatment of urethral stricture . Although this study is a preliminary report and recurrence was seen in two of six patients, this technique is promising.…”

Recurrent Anterior Urethral Stricture: Challenges and Solutions

“…This injection decreases recurrence rates after DVIU in animal models and has been trialed in humans with promising but mixed results. 78 , 79 Also available are solid tissue constructs or scaffolds, potentially seeded with autologous cells, designed to simulate native urethral mucosa. 67 These grafts can be constructed from decellularized natural scaffolds (generally bladder, small intestine, or dermis) or fully synthetic polymers and then seeded with cells harvested from bladder biopsy, voided urine, or other sources.…”