Tissue Eng Regen Med.  2024 Feb;21(2):277-290. 10.1007/s13770-023-00604-2.

Alternative Biological Material for Tissue Engineering of the Vagina: Porcine-Derived Acellular Vaginal Matrix

• Tian Y
• Liu Y
• Xiao Y
• Li Z
• Zhang M
• Chen L
• Li Z
• Zhang W
• Zhang Z
• Kong D
• Meng L
• Du Y
• Zhang J
• Gao J
• Huang X

• KMID: 2553247
• DOI: http://doi.org/10.1007/s13770-023-00604-2

Abstract

BACKGROUND
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a severe congenital disorder characterized by vaginal hypoplasia caused by dysplasia of the Müllerian duct. Patients with MRKH syndrome often require nonsurgical or surgical treatment to achieve satisfactory vaginal length and sexual outcomes. The extracellular matrix has been successfully used for vaginal reconstruction.
METHODS
In this study, we developed a new biological material derived from porcine vagina (acellular vaginal matrix, AVM) to reconstruct the vagina in Bama miniature pigs. The histological characteristics and efficacy of acellularization of AVM were evaluated, and AVM was subsequently transplanted into Bama miniature pigs to reconstruct the vaginas.
RESULTS
Macroscopic analysis showed that the neovaginas functioned well in all Bama miniature pigs with AVM implants. Histological analysis and electrophysiological evidence indicated that morphological and functional recovery was restored in normal vaginal tissues. Scanning electron microscopy showed that the neovaginas had mucosal folds characteristics of normal vagina. No significant differences were observed in the expression of CK14, HSP47, and a-actin between the neovaginas and normal vaginal tissues. However, the expression of estrogen receptor (ER) was significantly lower in the neovaginas than in normal vaginal tissues. In addition, AVM promoted the expression of b-catenin, c-Myc, and cyclin D1. These results suggest that AVM might promotes vaginal regeneration by activating the b-catenin/cMyc/cyclin D1 pathway.
CONCLUSION
This study reveals that porcine-derived AVM has potential application for vaginal regeneration.

Keyword

Acellular vaginal matrix; Vaginal reconstruction; Bama miniature pigs; Wnt/b-catenin signaling; Tissue engineering