Orthotopic grafting of decellularized human nipple: Setting the stage and putative mechanism of healing

Abstract

A complex skin structure (such as a nipple) can be successfully decellularized under conditions that prevent extracellular matrix crosslinking or undue matrix degradation [1]. This treatment removes cellular antigens, thus mitigating immunorejection concerns and enabling allogeneic transplantation for nipple reconstruction after mastectomy. Non-human primate studies have shown that host-mediated revascularization and re-epithelization of the decellularized nipples occurs within six weeks and nipple projection is maintained over the same timeframe [1]. The mechanisms by which a decellularized graft located on the surface of the body heals are incompletely understood, but are likely to follow a similar path to decellularized allografts that are implanted within the body, with some modifications. The following is a description of probable temporal events leading to healing under this circumstance.

Patient and Surgeon’s Concerns with Post-Mastectomy Nipple Reconstruction: An Alternative to Traditional Nipple Reconstruction

“…22 This process prevents possible immune rejection of the graft, and also retains components that promote the activity of growth factors from both the patient and the graft to initiate re-epithelialization and re-vascularization and provide support for ingrowing cells. 23 Additionally, it is likely that the use of decellularized tissue will be uniquely beneficial for patients who have previously undergone radiation therapy. In cases of NAC replacement using a living autograft, radiation-related side effects, including delayed wound healing, adversely affect the re-vascularization process required to maintain living tissue, thereby resulting in NAC necrosis.…”

Tissue engineering strategies for breast reconstruction: a literature review of current advances and future directions

“…Numerous studies have demonstrated that acellular nipple scaffolds (ANS) are free from cellular antigens and effectively cleared of DNA ( 145 ), using the same threshold of 50 ng/mg of tissue, thereby minimizing the risk of rejection by the recipient’s immune system. Moreover, these scaffolds maintain the integrity and bioactivity of the extracellular matrix, enabling successful reseeding with cells ( 146 , 147 ). They have also shown the capacity to support host-mediated re-cellularization with the growth of epithelial cells, neo-vasculature, and even nerve ingrowth ( 148 ).…”

Stimulasi Puting Susu terhadap Lama Pengeluaran Plasenta

“…Salah satu faktor yang mempengaruhi adalah faktor distensi uterus (Maternity, D, 2016). Faktor hormonal juga dapat mempengaruhi persalinan (Johnson PC, 2020). Hormon oksitosin dapat dihasilkan secara alamiah dari payudara yang dirangsang atau stimulasi puting susu pada ibu (Kuswanti, I, 2014).…”