A tissue-engineered construct based on polydioxanone and multipotent stromal cells for plastic surgery repair of abdominal cavity and pelvic floor defects

Objective. To study the safety and efficiency of transplantation of the developed tissue-engineered prosthesis based on polydioxanone and cultured multipotent stromal cells (MSC) from the umbilical cord. Material and methods. In vivo biocompatibility of prostheses was evaluated in outbred rats, by modeling a full-layer defect of the anterior abdominal wall, the edges of which was sutured with a polydioxanone prosthesis that was unpopulated and populated by the cultured cells. A prosthesis based on the decellularized dermis (Permacol) was used in the comparison group. The animals were withdrawn from the experiment at 3, 10, 30, 60, and 180 days after surgery. Macroscopic, tensiometric, histomorphometric, and immunohistochemical studies were conducted. Results. The polydioxanone-based prostheses were found to be more effectively integrated and grow their own tissues. The biomechanical properties of tissues in the field of transplantation in the long-term periods did not differ between the groups and the native tissue of the anterior abdominal wall. When a tissue-engineered construct was transplanted, there was a lower inflammatory response due to macrophage M2 polarization, as well as a more pronounced angiogenesis. The transplanted cells did not differentiate into blood vessel cells and were totally eliminated by a recipient’s macrophages. The registered effects appeared to be shown via paracrine mechanisms. Conclusion. The addition of cultured MSCs to the prosthesis could substantially reduce the severity of an inflammatory response to rejection of a foreign body and stimulate angiogenesis and the rate of replacement by the recipient’s own tissues.

mesh resorbable prosthesis, polydioxanone, tissue engineering, multipotent stromal cells, biocompatibility, macrophages, giant foreign body cells, angiogenesis