The use of bi-layer silk fibroin scaffolds and small intestinal submucosa matrices to support bladder tissue regeneration in a rat model of spinal cord injury

Biomaterials, 2014 · DOI: 10.1016/j.biomaterials.2014.05.044 · Published: August 1, 2014

Simple Explanation

This study explores alternative graft substitutes for bladder reconstruction due to the adverse effects of enterocystoplasty. It investigates the ability of bi-layer silk fibroin (SF) scaffolds and small intestinal submucosa (SIS) matrices to support bladder tissue regeneration. Bladder augmentation was performed using these scaffolds in rats with spinal cord injury (SCI) for 10 weeks. The study compared these augmented groups to non-augmented control groups to assess tissue regeneration and bladder function. The results showed that both SF and SIS scaffolds supported the formation of new smooth muscle and urothelial tissues. This suggests that these materials could be viable options for bladder reconstruction in patients with spinal cord injuries.

Study Duration

10 weeks

Participants

Forty-two female Sprague–Dawley rats

Evidence Level

Not specified

Key Findings

1
Both bi-layer SF and SIS scaffolds supported the formation of new smooth muscle layers with contractile protein expression and maturation of multi-layer urothelia.
2
SCI rats receiving SIS and bi-layer SF scaffolds displayed respective survival rates of 83% and 75% over the course of the study period.
3
SCI animals implanted with both matrix configurations also experienced improvements in certain urodynamic parameters, such as decreased peak intravesical pressure.

Research Summary

The study evaluated bi-layer silk fibroin (SF) scaffolds and small intestinal submucosa (SIS) matrices for bladder tissue regeneration in a rat model of spinal cord injury (SCI). Both SF and SIS scaffolds supported the formation of innervated, vascularized smooth muscle and urothelial tissues in the neurogenic bladder model, suggesting their potential as graft substitutes. SCI animals implanted with both matrix configurations also experienced improvements in certain urodynamic parameters, such as decreased peak intravesical pressure, providing indications that these biomaterials may be useful in mitigating the risk of upper urinary tract damage

Practical Implications

Alternative Graft Substitutes

The study provides evidence for the use of SF and SIS scaffolds as alternatives to enterocystoplasty for bladder reconstruction, potentially reducing associated complications.

Mitigating Urinary Tract Damage

The observed decrease in peak intravesical pressure suggests that these biomaterials may help mitigate the risk of upper urinary tract damage in patients with neurogenic bladder.

Platform for Further Optimization

The flexibility in modulating the properties of bi-layer SF scaffolds suggests potential for optimizing future designs to reduce stone formation and increase organ compliance.

Study Limitations

1
High frequency of intravesical stones in scaffold groups may have masked volumetric gains.
2
Lack of significant reductions in post-void residual volumes or SNVC.
3
The neurogenic bladder environment limited the restoration of normal neuronal circuitry during defect consolidation.

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