Tissue Eng Regen Med.  2017 Oct;14(5):631-639. 10.1007/s13770-017-0057-y.

Serial Analysis of Tracheal Restenosis After 3D-Printed Scaffold Implantation: Recruited Inflammatory Cells and Associated Tissue Changes

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongnogu, Seoul 03080, Korea. charlie@snu.ac.kr, otolarynx@snuh.org
  • 2Obstructive Upper Airway Research (OUaR) Laboratory, Department of Pharmacology, Seoul National University College of Medicine, 103 Daehak-ro, Seoul 03080, Korea.
  • 3Department of Nature-Inspired Nanoconvergence Systems, Korea Institute of Machinery and Materials, Gajeongbuk-ro 156, Daejeon 34103, Korea.
  • 4Department of Biomedical Sciences, Seoul National University Graduate School, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea.
  • 5Cancer Research Institute and Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea.

Abstract

Tracheal restenosis is a major obstacle to successful tracheal replacement, and remains the greatest challenge in tracheal regeneration. However, there have been no detailed investigations of restenosis. The present study was performed to analyze the serial changes in recruited inflammatory cells and associated histological changes after tracheal scaffold implantation. Asymmetrically porous scaffolds, which successfully prevented tracheal stenosis in a partial trachea defect model, designed with a tubular shape by electrospinning and reinforced by 3D-printing to reconstruct 2-cm circumferential tracheal defect. Serial rigid bronchoscopy, micro-computed tomography, and histology [H&E, Masson's Trichrome, IHC against a-smooth muscle actin (α-SMA)] were performed 1, 4, and 8 weeks after transplantation. Progressive stenosis developed especially at the site of anastomosis. Neutrophils were the main inflammatory cells recruited in the early stage, while macrophage infiltration increased with time. Recruitment of fibroblasts peaked at 4 weeks and deposition of a-SMA increased from 4 weeks and was maintained through 8 weeks. During the first 8 weeks post-transplantation, neutrophils and macrophages played significant roles in restenosis of the trachea. Antagonists to these would be ideal targets to reduce restenosis and thus play a pivotal role in successful tracheal regeneration.

Keyword

Trachea; Restenosis; Inflammation; 3D-printing; Scaffold

MeSH Terms

Actins
Bronchoscopy
Constriction, Pathologic
Fibroblasts
Inflammation
Macrophages
Neutrophils
Regeneration
Trachea
Tracheal Stenosis
Actins
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