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Tissue-engineering with muscle fiber fragments improves the strength of a weak abdominal wall in rats

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Abstract

Introduction and hypothesis

Alternative approaches to reinforce the native tissue in patients with pelvic organ prolapse (POP) are needed to improve surgical outcome. Our aims were to develop a weakened abdominal wall in a rat model to mimic the weakened vaginal wall in women with POP and then evaluate the regenerative potential of a quickly biodegradable synthetic scaffold, methoxypolyethylene glycol polylactic-co-glycolic acid (MPEG-PLGA), seeded with autologous muscle fiber fragments (MFFs) using this model.

Methods

In an initial pilot study with 15 animals, significant weakening of the abdominal wall and a feasible technique was established by creating a partial defect with removal of one abdominal muscle layer. Subsequently, 18 rats were evenly divided into three groups: (1) unrepaired partial defect; (2) partial defect repaired with MPEG-PLGA; (3) partial defect repaired with MPEG-PLGA and MFFs labeled with PKH26-fluorescence dye. After 8 weeks, we performed histopathological and immunohistochemical testing, fluorescence analysis, and uniaxial biomechanical testing.

Results

Both macroscopically and microscopically, the MPEG-PLGA scaffold was fully degraded, with no signs of an inflammatory or foreign-body response. PKH26-positive cells were found in all animals from the group with added MFFs. Analysis of variance (ANOVA) showed a significant difference between groups with respect to load at failure (p = 0.028), and post hoc testing revealed that the group with MPEG-PLGA and MFFs showed a significantly higher strength than the group with MPEG-PLGA alone (p = 0.034).

Conclusion

Tissue-engineering with MFFs seeded on a scaffold of biodegradable MPEG-PLGA might be an interesting adjunct to future POP repair.

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Abbreviations

POP:

Pelvic organ prolapse

MFFs:

Muscle fiber fragments

MPEG-PLGA:

Methoxypolyethylene glycol polylactic-co-glycolic acid

SD:

Standard deviation

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Copenhagen University Hospital Herlev, Herlev Ringvej 75, DK - 2730, Herlev, Denmark

    Hanna Jangö, Søren Gräs & Gunnar Lose

  2. Department of Pathology, Copenhagen University Hospital Herlev, Herlev, Denmark

    Lise Christensen

Authors
  1. Hanna Jangö
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  2. Søren Gräs
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  3. Lise Christensen
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  4. Gunnar Lose
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Corresponding author

Correspondence to Hanna Jangö.

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Financial disclaimers

The Danish National Advanced Technology Foundation and the Nordic Urogynecological Association have supported this study. Coloplast A/S provided scaffolds and facilities for biomechanical and histological testing.

Conflicts of interest

G. Lose has received compensation as a consultant for Astellas. H. Jangö, S. Gräs, and L. Christensen have no conflicts of interest.

Additional information

Some preliminary results were presented at the 29th Bi-Annual Meeting of Nordic Urogynecological Association 29–31 January 2015, Stockholm, Sweden

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Jangö, H., Gräs, S., Christensen, L. et al. Tissue-engineering with muscle fiber fragments improves the strength of a weak abdominal wall in rats. Int Urogynecol J 28, 223–229 (2017). https://doi.org/10.1007/s00192-016-3091-8

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  • DOI: https://doi.org/10.1007/s00192-016-3091-8

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