Journal
NPJ REGENERATIVE MEDICINE
Volume 6, Issue 1, Pages -Publisher
NATURE RESEARCH
DOI: 10.1038/s41536-021-00136-0
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Funding
- Knut and Alice Wallenberg Foundation
- Swedish research council [VR: 116008]
- Adlerbertska foundation
- Hjalmar Svensson foundation
- Wilhelm & Martina Lundgrens research foundation
- Swedish-Korean International Cooperation in Research and Higher Education (STINT)
- International Research and Development Program of the NRF of Korea - Ministry of Science and ICT of Korea [NRF-2018K2A9A2A12000216, NRF-2018R1D1A1B07049059]
- Swedish government
- NMI [VR-RFI 2016-00968]
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Uterine factor infertility was long considered incurable, until the successful live birth after uterus transplantation was reported. Through bioengineering approaches, risky donor surgery and immunosuppressive therapy can potentially be avoided. By decellularizing and recellularizing sheep uterus scaffolds with different protocols, it was found that matrix metalloproteinase preconditioned scaffolds showed significantly better recellularization efficiency, paving the way for potential future clinical applications.
Uterine factor infertility was considered incurable until recently when we reported the first successful live birth after uterus transplantation. However, risky donor surgery and immunosuppressive therapy are factors that may be avoided with bioengineering. For example, transplanted recellularized constructs derived from decellularized tissue restored fertility in rodent models and mandate translational studies. In this study, we decellularized whole sheep uterus with three different protocols using 0.5% sodium dodecyl sulfate, 2% sodium deoxycholate (SDC) or 2% SDC, and 1% Triton X-100. Scaffolds were then assessed for bioactivity using the dorsal root ganglion and chorioallantoic membrane assays, and we found that all the uterus scaffolds exhibited growth factor activity that promoted neurogenesis and angiogenesis. Extensive recellularization optimization was conducted using multipotent sheep fetal stem cells and we report results from the following three in vitro conditions; (a) standard cell culturing conditions, (b) constructs cultured in transwells, and (c) scaffolds preconditioned with matrix metalloproteinase 2 and 9. The recellularization efficiency was improved short-term when transwells were used compared with standard culturing conditions. However, the recellularization efficiency in scaffolds preconditioned with matrix metalloproteinases was 200-300% better than the other strategies evaluated herein, independent of decellularization protocol. Hence, a major recellularization hurdle has been overcome with the improved recellularization strategies and in vitro platforms described herein. These results are an important milestone and should facilitate the production of large bioengineered grafts suitable for future in vivo applications in the sheep, which is an essential step before considering these principles in a clinical setting.
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