Tissue Engineering in the Gut: Developments in Neuromusculature

• Published in: Gastroenterology (New York, N.Y. 1943) Vol. 146; no. 7; pp. 1614 - 1624
• Main Authors: Bitar, Khalil N, Raghavan, Shreya, Zakhem, Elie
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2014
• Subjects: Animals; Cell Survival; Enteric Nervous System; Enteric Nervous System - pathology; Enteric Nervous System - physiopathology; Enteric Nervous System - surgery; Gastroenterology and Hepatology; Gastrointestinal Diseases - pathology; Gastrointestinal Diseases - physiopathology; Gastrointestinal Diseases - surgery; Gastrointestinal Motility; Gastrointestinal Tract - innervation; Gastrointestinal Tract - pathology; Gastrointestinal Tract - surgery; Humans; Intestinal Tissue Engineering; Muscle, Smooth - innervation; Muscle, Smooth - pathology; Muscle, Smooth - transplantation; Neoinnervation; Nerve Regeneration; Recovery of Function; Regenerative Medicine - methods; Smooth Muscle; Tissue Engineering; Tissue Scaffolds; GI; Intestinal Tissue Engineering; Neoinnervation; ICC; CNS; ENS; Smooth Muscle; Enteric Nervous System; interstitial cells of Cajal; central nervous system; gastrointestinal; lower esophageal sphincter; vasoactive intestinal peptide; internal anal sphincter; IAS; LES; VIP
• ISSN: 0016-5085; 1528-0012
• DOI: 10.1053/j.gastro.2014.03.044

The complexity of the gastrointestinal (GI) tract lies in its anatomy as well as in its physiology. Several different cell types populate the GI tract, adding to the complexity of cell sourcing for regenerative medicine. Each cell layer has a specialized function in mediating digestion, absorption, secretion, motility, and excretion. Tissue engineering and regenerative medicine aim to regenerate the specific layers mimicking architecture and recapitulating function. Gastrointestinal motility is the underlying program that mediates the diverse functions of the intestines, as an organ. Hence, the first logical step in GI regenerative medicine is the reconstruction of the tubular smooth musculature along with the drivers of their input, the enteric nervous system. Recent advances in the field of GI tissue engineering have focused on the use of scaffolding biomaterials in combination with cells and bioactive factors. The ability to innervate the bioengineered muscle is a critical step to ensure proper functionality. Finally, in vivo studies are essential to evaluate implant integration with host tissue, survival, and functionality. In this review, we focus on the tubular structure of the GI tract, tools for innervation, and, finally, evaluation of in vivo strategies for GI replacements.