Pelvic organ prolapse(POP) occurs when the pelvic organs(bladder, bowel or uterus) herniate into the vagina, causing incontinence, voiding, bowel and sexual dysfunction, negatively impacting upon a woman's quality...Pelvic organ prolapse(POP) occurs when the pelvic organs(bladder, bowel or uterus) herniate into the vagina, causing incontinence, voiding, bowel and sexual dysfunction, negatively impacting upon a woman's quality of life. POP affects 25% of all women and results from childbirth injury. For 19% of all women, surgical reconstructive surgery is required for treatment, often augmented with surgical mesh. The surgical treatment fails in up to 30% of cases or results in adverse effects, such as pain and mesh erosion into the bladder, bowel or vagina. Due to these complications the Food and Drug Administration cautioned against the use of vaginal mesh and several major brands have been recently been withdrawn from market. In this review we will discuss new cell-based approaches being developed for the treatment of POP. Several cell types have been investigated in animal models, including a new source of mesenchymal stem/stromal cells(MSC) derived from human endometrium. The unique characteristics of endometrial MSC, methods for their isolation and purification and steps towards their development for good manufacturing practice production will be described. Animal models that could be used to examine the potential for this approach will also be discussed as will a rodent model showing promise in developing an endometrial MSC-based therapy for POP. The development of a preclinical large animal model for assessing tissue engineering constructs for treating POP will also be mentioned.展开更多
Recent regenerative medicine and tissue engineering strategies(using cells, scaffolds, medical devices and gene therapy) have led to fascinating progress of translation of basic research towards clinical applications....Recent regenerative medicine and tissue engineering strategies(using cells, scaffolds, medical devices and gene therapy) have led to fascinating progress of translation of basic research towards clinical applications. In the past decade, great deal of research has focused on developing various three dimensional(3D) organs, such as bone, skin, liver, kidney and ear,using such strategies in order to replace or regenerate damaged organs for the purpose of maintaining or restoring organs' functions that may have been lost due to aging, accident or disease. The surface properties of a material or a device are key aspects in determining the success of the implant in biomedicine, as the majority of biological reactions in human body occur on surfaces or interfaces. Furthermore, it has been established in the literature that cell adhesion and proliferation are, to a great extent, influenced by the micro- and nanosurface characteristics of biomaterials and devices. In addition, it has been shown that the functions of stem cells, mesenchymal stem cells in particular, could be regulated through physical interaction with specific nanotopographical cues. Therefore, guided stem cell proliferation, differentiation and function are of great importance in the regeneration of 3D tissues and organs using tissue engineering strategies. This review will provide an update on the impact of nanotopography on mesenchymal stem cells for the purpose of developing laboratory-based 3D organs and tissues, as well as the most recent research and case studies on this topic.展开更多
Since the first kidney transplant was performed in 1954 immense progress has been made in the world of transplantation. Modern immunosuppressive regimens have led to increasing graft and patient survival after solid o...Since the first kidney transplant was performed in 1954 immense progress has been made in the world of transplantation. Modern immunosuppressive regimens have led to increasing graft and patient survival after solid organ transplantation. Furthermore, these advances have opened the door to new fields of transplantation such as composite tissue allotransplantation. These developments have made possible numerous types of transplantation including, but not limited to face, penile, and uterine transplantation. Moreover, innovations in genetic engineering and stem cell technology have contributed to rapid developments in the fields of xenotransplantation and the engineering of functional organs from induced pluripotent stem cells. As the prevalence of chronic diseases rises, so too will the necessity for organ transplantation. Thus, the transplant innovations of the modern era need to be expanded upon so as to continue to discover new ways to address organ shortages and the complications of transplantation.展开更多
Recipients of solid organ transplants(SOT) and stem cell transplants(SCT) constitute a group of patients at risk for tuberculosis(TB) development. The prevalence of active TB in patients undergoing SOT is higher than ...Recipients of solid organ transplants(SOT) and stem cell transplants(SCT) constitute a group of patients at risk for tuberculosis(TB) development. The prevalence of active TB in patients undergoing SOT is higher than in patients undergoing SCT, probably due to the shorter period of immunosuppression in the latter. We reviewed the importance of SCT in individuals with hematological malignancies. Most TB cases occur in transplant patients by reactivation of latent infection after immunosuppression, most often within the first year after transplant, leading to graft loss and in some cases, death. Relevant variables to assess the risk of TB infection in a transplant recipient include the donor's and recipient's medical histories, imaging results, microbiology and tuberculin skin test(TST) and interferon-gamma release assays(IGRA). TST is routinely performed in the donor and recipient before transplantation. If TST is > 5 mm in the recipient or > 10 mm in the donor, it is necessary to exclude active TB(pulmonary and renal). Chemopro-phylaxis is recommended in TST(+) recipients and in recipients with recent seroconversion, in donors with a history of untreated TB or in contact with an individual with active TB, if radiological images are suspicious and the IGRA is(+). The drug of choice is isoniazid. These topics are herewith reviewed.展开更多
The long term consequence of immunosuppressive therapy in kidney transplantation has prompted investigation of alternative means to modify the immune response to the allograft. Cell based therapies are potentially att...The long term consequence of immunosuppressive therapy in kidney transplantation has prompted investigation of alternative means to modify the immune response to the allograft. Cell based therapies are potentially attractive as they may provide a long lasting immunomodulatory effect, may repair tissues and reduce the necessity to take immunosuppressive drug therapy. Of the current cell therapies, mesenchymal stem cells have now been trialled in small numbers of human kidney transplantation with apparent safety and potential efficacy. Many issues however need to be resolved before these cells will become mainstays of transplant immunosuppression including ex vivo modification to enhance immunomodulatory properties, cell number, route and frequency of administration as well as cellular source of origin.展开更多
文摘Pelvic organ prolapse(POP) occurs when the pelvic organs(bladder, bowel or uterus) herniate into the vagina, causing incontinence, voiding, bowel and sexual dysfunction, negatively impacting upon a woman's quality of life. POP affects 25% of all women and results from childbirth injury. For 19% of all women, surgical reconstructive surgery is required for treatment, often augmented with surgical mesh. The surgical treatment fails in up to 30% of cases or results in adverse effects, such as pain and mesh erosion into the bladder, bowel or vagina. Due to these complications the Food and Drug Administration cautioned against the use of vaginal mesh and several major brands have been recently been withdrawn from market. In this review we will discuss new cell-based approaches being developed for the treatment of POP. Several cell types have been investigated in animal models, including a new source of mesenchymal stem/stromal cells(MSC) derived from human endometrium. The unique characteristics of endometrial MSC, methods for their isolation and purification and steps towards their development for good manufacturing practice production will be described. Animal models that could be used to examine the potential for this approach will also be discussed as will a rodent model showing promise in developing an endometrial MSC-based therapy for POP. The development of a preclinical large animal model for assessing tissue engineering constructs for treating POP will also be mentioned.
文摘Recent regenerative medicine and tissue engineering strategies(using cells, scaffolds, medical devices and gene therapy) have led to fascinating progress of translation of basic research towards clinical applications. In the past decade, great deal of research has focused on developing various three dimensional(3D) organs, such as bone, skin, liver, kidney and ear,using such strategies in order to replace or regenerate damaged organs for the purpose of maintaining or restoring organs' functions that may have been lost due to aging, accident or disease. The surface properties of a material or a device are key aspects in determining the success of the implant in biomedicine, as the majority of biological reactions in human body occur on surfaces or interfaces. Furthermore, it has been established in the literature that cell adhesion and proliferation are, to a great extent, influenced by the micro- and nanosurface characteristics of biomaterials and devices. In addition, it has been shown that the functions of stem cells, mesenchymal stem cells in particular, could be regulated through physical interaction with specific nanotopographical cues. Therefore, guided stem cell proliferation, differentiation and function are of great importance in the regeneration of 3D tissues and organs using tissue engineering strategies. This review will provide an update on the impact of nanotopography on mesenchymal stem cells for the purpose of developing laboratory-based 3D organs and tissues, as well as the most recent research and case studies on this topic.
文摘Since the first kidney transplant was performed in 1954 immense progress has been made in the world of transplantation. Modern immunosuppressive regimens have led to increasing graft and patient survival after solid organ transplantation. Furthermore, these advances have opened the door to new fields of transplantation such as composite tissue allotransplantation. These developments have made possible numerous types of transplantation including, but not limited to face, penile, and uterine transplantation. Moreover, innovations in genetic engineering and stem cell technology have contributed to rapid developments in the fields of xenotransplantation and the engineering of functional organs from induced pluripotent stem cells. As the prevalence of chronic diseases rises, so too will the necessity for organ transplantation. Thus, the transplant innovations of the modern era need to be expanded upon so as to continue to discover new ways to address organ shortages and the complications of transplantation.
文摘Recipients of solid organ transplants(SOT) and stem cell transplants(SCT) constitute a group of patients at risk for tuberculosis(TB) development. The prevalence of active TB in patients undergoing SOT is higher than in patients undergoing SCT, probably due to the shorter period of immunosuppression in the latter. We reviewed the importance of SCT in individuals with hematological malignancies. Most TB cases occur in transplant patients by reactivation of latent infection after immunosuppression, most often within the first year after transplant, leading to graft loss and in some cases, death. Relevant variables to assess the risk of TB infection in a transplant recipient include the donor's and recipient's medical histories, imaging results, microbiology and tuberculin skin test(TST) and interferon-gamma release assays(IGRA). TST is routinely performed in the donor and recipient before transplantation. If TST is > 5 mm in the recipient or > 10 mm in the donor, it is necessary to exclude active TB(pulmonary and renal). Chemopro-phylaxis is recommended in TST(+) recipients and in recipients with recent seroconversion, in donors with a history of untreated TB or in contact with an individual with active TB, if radiological images are suspicious and the IGRA is(+). The drug of choice is isoniazid. These topics are herewith reviewed.
文摘The long term consequence of immunosuppressive therapy in kidney transplantation has prompted investigation of alternative means to modify the immune response to the allograft. Cell based therapies are potentially attractive as they may provide a long lasting immunomodulatory effect, may repair tissues and reduce the necessity to take immunosuppressive drug therapy. Of the current cell therapies, mesenchymal stem cells have now been trialled in small numbers of human kidney transplantation with apparent safety and potential efficacy. Many issues however need to be resolved before these cells will become mainstays of transplant immunosuppression including ex vivo modification to enhance immunomodulatory properties, cell number, route and frequency of administration as well as cellular source of origin.
