4.7 Review

Building gut from scratch - progress and update of intestinal tissue engineering

Journal

NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY
Volume 19, Issue 7, Pages 417-431

Publisher

NATURE PORTFOLIO
DOI: 10.1038/s41575-022-00586-x

Keywords

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Funding

  1. Horizon 2020 grant [INTENS 668294]
  2. Francis Crick Institute from Cancer Research UK [FC001105]
  3. UK Medical Research Council [FC001105]
  4. Wellcome Trust [FC001105]
  5. NIHR Professorship
  6. NIHR UCL BRC-GOSH
  7. Great Ormond Street Hospital Children's Charity
  8. Oak Foundation
  9. NIHR UCL BRC-GOSH Crick Clinical Research Training Fellowship
  10. General Sir John Monash Foundation, Australia
  11. University College London

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Short bowel syndrome is a rare but highly morbid and mortal condition. Exciting advances have been made in the field of intestinal tissue engineering as a potential therapeutic option to address this unmet clinical need. This review summarizes the progress in intestinal tissue engineering and discusses the key factors and challenges in transitioning it towards clinical translation.
Short bowel syndrome (SBS), a condition defined by insufficient absorptive intestinal epithelium, is a rare disease, with an estimated prevalence up to 0.4 in 10,000 people. However, it has substantial morbidity and mortality for affected patients. The mainstay of treatment in SBS is supportive, in the form of intravenous parenteral nutrition, with the aim of achieving intestinal autonomy. The lack of a definitive curative therapy has led to attempts to harness innate developmental and regenerative mechanisms to engineer neo-intestine as an alternative approach to addressing this unmet clinical need. Exciting advances have been made in the field of intestinal tissue engineering (ITE) over the past decade, making a review in this field timely. In this Review, we discuss the latest advances in the components required to engineer intestinal grafts and summarize the progress of ITE. We also explore some key factors to consider and challenges to overcome when transitioning tissue-engineered intestine towards clinical translation, and provide the future outlook of ITE in therapeutic applications and beyond. Intestinal tissue engineering offers a potential therapeutic option for short bowel syndrome. This Review examines the progress in intestinal tissue engineering, discusses the components required for engineered intestinal grafts, preclinical progress and efforts towards clinical translation, including challenges to overcome.

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