In vitro regeneration of tissue engineered cartilage and its clinical application for nasal reconstruction_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

REN Pengjie , XU Yihao ,  FAN Fei , TIAN Le , LU Xiaona , YOU Jianjun , WANG Huan , ZHENG Ruobing

Center of Rhinoplasty and Nasal Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100043, P.R.China;

Corresponding?author：

FAN Fei, Email: fanfei1962@gmail.com

Keywords：

Tissue engineered cartilage; nasal reconstruction; nasal defect; nasal deformity

DOI：

10.7507/1002-1892.202009053

Video：

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Objective To explore the clinical application and effectiveness of a personalized tissue engineered cartilage with seed cells derived from ear or nasal septal cartilage and poly-glycolic acid (PGA)/poly-lactic acid (PLA) as scaffold in patients with nasal reconstruction. Methods Between March 2014 and October 2015, 4 cases of acquired nasal defects and 1 case of congenital nasal deformity were admitted. The patient with congenital nasal deformity was a 4-year-old boy, and the source of seed cells was nasal septal cartilage. The other 4 patients were 3 males and 1 female, aged 24-33 years, with an average of 28.5 years. They all had multiple nasal subunit defects caused by trauma and the source of seed cells was auricular cartilage. The tissue engineered cartilage framework was constructed in the shape of normal human nasal alar cartilage and L-shaped silicone prosthesis with seed cells from cartilage and PGA-PLA compound biodegradable scaffold. The boy underwent nasal deformity correction and silicone prosthesis implantation in the first stage, and the prosthesis was removed and implanted with tissue engineered cartilage in the second stage; the remaining 4 adult patients all used expanded forehead flaps for nasal reconstruction. All 5 patients underwent 1-4 nasal revisions. The implanted tissue engineered cartilage was observed during the operation and taken from 2 patients for histological examination.Results All the incisions healed by first intention after the tissue engineered cartilage implantation, and the expanded forehead flaps survived. Postoperative low fever occurred in 3 patients. No complications such as infection, obvious immune rejection response, and tissue engineered cartilage protrusion were found in all patients. All patients were followed up 9-74 months (mean, 54.8 months). During follow-up, the patients had no obvious discomfort in the nose and the ventilation function were good. All patients were satisfied with the nasal contour. Early-stage histological examination showed the typical cartilage characteristics in 1 patient after the implantation of tissue engineered cartilage. Late-stage histological examination in 1 patient of tissue engineered cartilage showed the characteristics of fibrous connective tissue; and the other showed there was remaining cartilage.Conclusion The safety of tissue engineered cartilage constructed in vitro for reconstruction is preliminarily confirmed, but the effectiveness still needs further verification.

Citation： REN Pengjie, XU Yihao, FAN Fei, TIAN Le, LU Xiaona, YOU Jianjun, WANG Huan, ZHENG Ruobing. In vitro regeneration of tissue engineered cartilage and its clinical application for nasal reconstruction. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(2): 221-226. doi: 10.7507/1002-1892.202009053 Copy

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10.	Kusuhara H, Isogai N, Enjo M, et al. Tissue engineering a model for the human ear: assessment of size, shape, morphology, and gene expression following seeding of different chondrocytes. Wound Repair Regen, 2009, 17(1): 136-146.
11.	丁金萍. 組織工程軟骨在大動物體內構建穩定性的研究. 北京: 北京協和醫學院中國醫學科學院, 2016.
12.	余一凡, 王婷, 金石峰, 等. 細胞膜片技術在組織修復中的研究進展. 中國美容整形外科雜志, 2020, 31(5): 318-320, 后插1.
13.	曹誼林. “耳郭軟骨組織工程的研究進展”點評. 中國眼耳鼻喉科雜志, 2018, 18(4): 238-239.
14.	王為. 三維培養體系中周期性壓力對骨髓間充質干細胞與殼聚糖/絲素蛋白/納米羥基磷灰石多層支架復合體的促成軟骨分化效應. 武漢: 華中科技大學, 2019.
15.	Theodoridis K, Aggelidou E, Manthou M, et al. Assessment of cartilage regeneration on 3D collagen-polycaprolactone scaffolds: evaluation of growth media in static and in perfusion bioreactor dynamic culture. Colloids Surf B Biointerfaces, 2019, 183: 110403.
16.	陸曉娜, 徐奕昊, 王歡, 等. 一種組合式組織工程動態培養儀. 中華損傷與修復雜志 (電子版), 2018, 13(3): 172-175.

1. 陸曉娜, 王歡, 尤建軍, 等. 鼻再造術中肋軟骨支架結構的構建. 中華整形外科雜志, 2017, 33(1): 72-76.
2. Xu Y, Fan F, Kang N, et al. Tissue engineering of human nasal alar cartilage precisely by using three-dimensional printing. Plast Reconstr Surg, 2015, 135(2): 451-458.
3. 鄭萬玲, 王蘋蘋, 溫敏敏, 等. 三維技術聯合術后血流監測輔助完成全鼻再造. 中華整形外科雜志, 2018, 34(11): 912-918.
4. Fulco I, Miot S, Haug MD, et al. Engineered autologous cartilage tissue for nasal reconstruction after tumour resection: an observational first-in-human trial. Lancet, 2014, 384(9940): 337-346.
5. 李雪盛, 孫建軍. 再生醫學之鼻軟骨組織工程研究進展. 臨床耳鼻咽喉頭頸外科雜志, 2019, 33(12): 1217-1220.
6. Lu X, Wang H, You J, et al. A decade’s experience: a sound framework as the foundation to nasal reconstruction. J Craniofac Surg, 2018, 29(8): 2032-2037.
7. 蔣海越團隊. “組織工程耳” 離我們還有多遠?—3 例組織工程軟骨支架耳廓再造術的臨床報告. 中華整形外科雜志, 2018, 34(3): 165-171.
8. Zhou G, Jiang H, Yin Z, et al. In vitro regeneration of patient-specific ear-shaped cartilage and its first clinical application for auricular reconstruction. EBioMedicine, 2018, 28: 287-302.
9. 張雪. 軟骨微環境及細胞起源對再生軟骨類型的調控作用. 北京: 北京協和醫學院中國醫學科學院, 2016.
10. Kusuhara H, Isogai N, Enjo M, et al. Tissue engineering a model for the human ear: assessment of size, shape, morphology, and gene expression following seeding of different chondrocytes. Wound Repair Regen, 2009, 17(1): 136-146.
11. 丁金萍. 組織工程軟骨在大動物體內構建穩定性的研究. 北京: 北京協和醫學院中國醫學科學院, 2016.
12. 余一凡, 王婷, 金石峰, 等. 細胞膜片技術在組織修復中的研究進展. 中國美容整形外科雜志, 2020, 31(5): 318-320, 后插1.
13. 曹誼林. “耳郭軟骨組織工程的研究進展”點評. 中國眼耳鼻喉科雜志, 2018, 18(4): 238-239.
14. 王為. 三維培養體系中周期性壓力對骨髓間充質干細胞與殼聚糖/絲素蛋白/納米羥基磷灰石多層支架復合體的促成軟骨分化效應. 武漢: 華中科技大學, 2019.
15. Theodoridis K, Aggelidou E, Manthou M, et al. Assessment of cartilage regeneration on 3D collagen-polycaprolactone scaffolds: evaluation of growth media in static and in perfusion bioreactor dynamic culture. Colloids Surf B Biointerfaces, 2019, 183: 110403.
16. 陸曉娜, 徐奕昊, 王歡, 等. 一種組合式組織工程動態培養儀. 中華損傷與修復雜志 (電子版), 2018, 13(3): 172-175.

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