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Regenerative Medicine

Tissue-engineered ribs for chest wall reconstruction: a case with 12-year follow-up

    Hui-Qi Xie

    Laboratory of Stem Cell & Tissue Engineering, State Key Laboratory of Biotherapy & Regenerative Medicine Research Center, West China Hospital, Sichuan University, 1 Keyuan Silu, Gaopeng Dadao, Chengdu 610041, PR China

    ,
    Fu-Guo Huang

    Department of Orthopedics, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, PR China

    ,
    Yong-Fan Zhao

    Department of Cardiothoracic Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, PR China

    ,
    Ting-Wu Qin

    Laboratory of Stem Cell & Tissue Engineering, State Key Laboratory of Biotherapy & Regenerative Medicine Research Center, West China Hospital, Sichuan University, 1 Keyuan Silu, Gaopeng Dadao, Chengdu 610041, PR China

    ,
    Xiu-Qun Li

    Laboratory of Stem Cell & Tissue Engineering, State Key Laboratory of Biotherapy & Regenerative Medicine Research Center, West China Hospital, Sichuan University, 1 Keyuan Silu, Gaopeng Dadao, Chengdu 610041, PR China

    ,
    Chang Liu

    Department of Radiology, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, PR China

    ,
    Jesse Li-Ling

    Laboratory of Disease Genomics & Bioinformatics, State Key Laboratory of Biotherapy, Sichuan University, Chengdu 610041, PR China

    &
    Zhi-Ming Yang

    Laboratory of Stem Cell & Tissue Engineering, State Key Laboratory of Biotherapy & Regenerative Medicine Research Center, West China Hospital, Sichuan University, 1 Keyuan Silu, Gaopeng Dadao, Chengdu 610041, PR China

    Published Online:https://doi.org/10.2217/rme.14.24

    We hereby report on a case in which a huge chest wall defect generated by resection of a massive aggressive tumor (desmoplastic fibroma) was repaired with osteogenic-induced mesenchymal stem cells embedded in a bone-derived biomaterial. In this case, there were three challenges to overcome: reconstruction of the soft tissue, repair of the skeletal defect of the thoracic wall and repair of the defect in the pleural cavity. The defects of soft tissue and pleural cavity were reconstructed, respectively, with an ipsilateral abdominal flap and a diaphragm muscular flap. The huge defect in the chest wall was successfully repaired with the tissue-engineered ribs, which was confirmed by long-term follow-up with computerized tomography and histological and immunohistochemical evaluations. In view of its effectiveness and safety, tissue-engineered bones may have a broad application for the repair of large skeletal defects and bone regeneration.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1 Losken A, Thourani VH, Carlson GW et al.. A reconstructive algorithm for plastic surgery following extensive chest wall resection. Br. J. Plast. Surg. 57(4), 295–302 (2004).
    • 2 Skoracki RJ, Chang DW. Reconstruction of the chest wall and thorax. J. Surg. Oncol. 94(6), 455–465 (2006).
    • 3 Kajiwara H. A new cardiac wall substitute made of Dacron fabric prosthesis sealed with autologous tissue fragments: comparative studies of neointima formation and bleeding resistant property against fibrinolysis phenomenon with those of a preclotted sealing graft. Artif. Organs 19(1), 64–71 (1995).
    • 4 Delécrin J, Takahashi S, Gouin F, Passuti N. A synthetic porous ceramic as a bone graft substitute in the surgical management of scoliosis: a prospective, randomized study. Spine (Phila Pa 1976) 25(5), 563–569 (2000).
    • 5 Agrawal K, Subbarao KS, Nachiappan M, Arumugam A. An innovative method of reconstruction of large skeletal chest wall defects. Plast. Reconstr. Surg. 102(3), 839–842 (1998).
    • 6 Caplan AI. Review: mesenchymal stem cells: cell-based reconstructive therapy in orthopedics. Tissue Eng. 11(7–8??), 1198–1211 (2005).•• Experience of transplanting knowledge learned from chick limb bud development to the preparation of adult bone marrow-derived mesenchymal stem cells and docking of such cells.
    • 7 Krampera M, Pizzolo G, Aprili G, Franchini M. Mesenchymal stem cells for bone, cartilage, tendon and skeletal muscle repair. Bone 39(4), 678–683 (2006).• Speculation of potential use of mesenchymal stem cells on the basis of experimental evidence.
    • 8 Colter DC, Class R, DiGirolamo CM, Prockop DJ. Rapid expansion of recycling stem cells in cultures of plastic-adherent cells from human bone marrow. Proc. Natl Acad. Sci. USA 97(7), 3213–3218 (2000).
    • 9 Caterson EJ, Nesti LJ, Danielson KG, Tuan RS. Human marrow-derived mesenchymal progenitor cells: isolation, culture expansion, and analysis of differentiation. Mol. Biotechnol. 20(3), 245–256 (2002).
    • 10 Sekiya I, Larson BL, Smith JR, Pochampally R, Cui JG, Prockop DJ. Expansion of human adult stem cells from bone marrow stroma: conditions that maximize the yields of early progenitors and evaluate their quality. Stem Cells 20(6), 530–541 (2002).•• Detailed description for optimization of cell culture and a method for assessing the quality of such culture by morphology.
    • 11 Pittenger MF, Mackay AM, Beck SC et al.. Multilineage potential of adult human mesenchymal stem cells. Science 284(5411), 143–147 (1999).
    • 12 Xie H, Yang F, Deng L et al.. The performance of a bone-derived scaffold material in the repair of critical bone defects in a rhesus monkey model. Biomaterials 28(22), 3314–3324 (2007). •• Animal study that has demonstrated the feasibility to use tissue-engineered bones seeded with bone marrow-derived mesenchymal stem cells for the repair of large bone defects.
    • 13 Böhm P, Kröber S, Greschniok A, Laniado M, Kaiserling E. Desmoplastic fibroma of the bone. A report of two patients, review of the literature, and therapeutic implications. Cancer 78(5), 1011–1023 (1996).
    • 14 Barbashina V, Karabakhtsian R, Aisner S, Bolanowski P, Patterson F, Hameed M. Desmoplastic fibroma of the rib. Arch. Pathol. Lab. Med. 126(6), 721–722 (2002).
    • 15 Hutmacher DW, Schantz JT, Lam CX, Tan KC, Lim TC. State of the art and future directions of scaffold-based bone engineering from a biomaterials perspective. J. Tissue Eng. Regen. Med. 1(4), 245–260 (2007).• Detailed discussion of the important properties of the materials and scaffold design in the making of tissue-engineered bone constructs.
    • 16 Yang Z, Xie H, Li T. Tissue engineering of the musculo-skeletal system – basic research and clinical applications. Hand Surg. 5(1), 49–55 (2000).
    • 17 Huang YZ, Cai JQ, Xue J et al.. The poor osteoinductive capability of human acellular bone matrix. Int. J. Artif. Organs 35(12), 1061–1069 (2012).
    • 18 Vacanti CA, Bonassar LJ, Vacanti MP, Shufflebarger J. Replacement of an avulsed phalanx with tissue-engineered bone. N. Engl. J. Med. 344(20), 1511–1514 (2001).
    • 19 Quarto R, Mastrogiacomo M, Cancedda R et al. Repair of large bone defects with the use of autologous bone marrow stromal cells. N. Engl. J. Med. 344(5), 385–386 (2001). •• One of the earliest clinical applications of tissue-engineered bones (using macroporous hydroxyapatite scaffolds) for the repair of large segmental bone defects.
    • 20 Schmelzeisen R, Schimming R, Sittinger M. Making bone: implant insertion into tissue-engineered bone for maxillary sinus floor augmentation – a preliminary report. J. Craniomaxillofac. Surg. 31(1), 34–39 (2003).
    • 21 Pradel W, Eckelt U, Lauer G. Bone regeneration after enucleation of mandibular cysts: comparing autogenous grafts from tissue-engineered bone and iliac bone. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 101(3), 285–290 (2006).
    • 22 Yang ZM, Huang FG, Qin TW. Bio-derived bone transplantation with tissue engineering technique: preliminary clinical trial. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 16(5), 311–314 (2002).
    • 23 Shen B, Xie FL, Xie QF. Comparative study on graft of autogeneic iliac bone and tissue engineered bone. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 16(6), 429–431 (2002).
    • 24 Salgado AJ, Coutinho OP, Reis RL. Bone tissue engineering: state of the art and future trends. Macromol. Biosci. 4(8), 743–765 (2004).
    • 25 Kneser U, Schaefer DJ, Polykandriotis E, Horch RE. Tissue engineering of bone: the reconstructive surgeon’s point of view. J. Cell Mol. Med. 10(1), 7–19 (2006).
    • 26 Cancedda R, Giannoni P, Mastrogiacomo M. A tissue engineering approach to bone repair in large animal models and in clinical practice. Biomaterials 28(29), 4240–4250 (2007).• Summary of animal experiments and clinical studies of tissue-engineered bones for the repair of large skeletal defects.