Tissue Engineering for Damaged Surface and Lining Epithelia: Stem Cells, Current Clinical Applications, and Available Engineered Tissues

Tissue engineering is an important tool for the treatment of damaged surface and lining epithelia. A source of cells and biocompatible substrates upon which cells can grow and differentiate are key components of this technology. Cultured normal human epithelial cells reconstitute sheets of stratified epithelia that retain biochemical and histological characteristics as well as specific differentiation features of the original donor site. Maintenance of epithelial stem cells in culture and a well-prepared receiving wound bed allow to permanently regenerate full-thickness wounds by means of in vitro reconstituted epithelia. Further, cultured cells produce growth factors and extracellular matrix (ECM) components that help resident cells to contribute to the wound-healing process. Biological matrices enhance the performance of the in vitro reconstituted epithelia. Owing to their similarity to the ECM, natural polymers offer the advantage of being similar to macromolecules that the human environment is prepared to recognize. They also maintain biological information and physical and chemical features that are instructive for cells used to populate them. This article discusses the developments of tissues engineered for cutaneous and mucosal regeneration. Native tissues and their stem cells are also considered, to enhance understanding of the extensive field of tissue reconstruction.