Feasibility study of a novel urinary bladder bioreactor.

We have devised a bioreactor to simulate normal urinary bladder dynamics. The design permits a cell-seeded scaffold made from a modified porcine acellular matrix to be placed between 2 closed chambers filled with culture medium and be mechanically stimulated in a physiologically relevant manner. Specifically designed software increased hydrostatic pressure from 0 to 10 cm of water in a linear fashion in 1 chamber, resulting in mechanical stretch and strain on the scaffold. Pressure was increased over 55 min (filling) and then decreased to 0 over 10 s (voiding). Commercially available small intestinal submucosa scaffolds were used to test the mechanical capabilities of the bioreactor, and pressure waveforms were generated for up to 18 h. Scaffolds were seeded with bladder smooth muscle or urothelial cells and incubated in the bioreactor, which generated pressure waveforms for 6 h. Scaffold integrity was preserved as seen through Masson's trichrome staining. No obvious contamination of the system was noted. Hematoxylin and eosin staining showed presence of cells after incubation in the bioreactor, and immunohistochemistry and real-time reverse transcriptase polymerase chain reaction suggested continued cellular activity. Cellular orientation tended to be perpendicular to the applied pressure. Preliminary results suggest that our bioreactor is a suitable model for simulating normal physiological conditions of bladder cycling in an ex vivo system.

Quantifying angiogenesis in VEGF-enhanced tissue-engineered bladder constructs by dynamic contrast-enhanced MRI using contrast agents of different molecular weights.

PURPOSE: To compare Gadomer, a macromolecular magnetic resonance (MR) contrast agent, and gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) for quantifying angiogenesis in tissue-engineered bladder constructs. MATERIALS AND METHODS: Constructs enhanced with vascular endothelial growth factor (VEGF) were grafted onto the bladder of 12 rabbits (N= 3/VEGF, VEGF = 0,10,15,20 ng/g tissue). After eight days dynamic contrast-enhanced MRI (DCE-MRI) was performed in each animal using Gadomer and Gd-DTPA, separated by a one-hour interval. DCE-MRI parameters were calculated from two-compartment pharmacokinetics (plasma volume fraction, v(p); transfer constant, K(trans)) and model-free analysis, area under the concentration-time curve (AUC). Histology assessment of microvessel density (MVD) and Evans blue permeability were compared to DCE-MRI. RESULTS: MVD was elevated (P < 0.05) at the highest VEGF but not among lower levels; permeability differences were absent. Contrast enhancement increased with VEGF and was better resolved with Gadomer than Gd-DTPA. Gadomer was the better assay for estimating plasma volume: v(p) provided the best distinction (P < 0.005), but both v(p) and AUC were correlated to MVD. With Gd-DTPA, only AUC distinguished MVD differences (P< 0.05). Changes in K(trans) were insignificant. CONCLUSION: Macromolecular contrast agents are valuable for monitoring angiogenesis in tissue-engineered bladder grafts. Compared to Gd-DTPA, Gadomer provides more accurate and precise quantification of microvessel function, and is better suited to pharmacokinetic analysis for accurate physiological quantification.

Porcine bladder acellular matrix porosity: impact of hyaluronic acid and lyophilization.

Bladder acellular matrix (ACM) is being investigated as a urinary bladder replacement scaffold. We have demonstrated that ACM is porous and theorized that this contributes to ACM fibrosis and contracture over time in vivo and may preclude uptake and retention of molecules, which may aid cellular repopulation. We sought to determine if hyaluronic acid (HA) would decrease ACM porosity. Porcine ACM was lyophilized and rehydrated in HA (SIGMA) to form the hybrid HA-ACM construct. Three groups (n = 15/group: HA-ACM, ACM, and lyophilized/rehydrated ACM) were tested for porosity to a 10 cm column of distilled water, measuring the effluent hourly for 3 h. A porosity index was determined as the total effluent divided by time and area (cc/cm2 hr). Alcian blue staining and fluorophore-assisted carbohydrate electrophoresis qualitatively and quantitatively confirmed the uptake of HA. HA-ACM and lyophilized/rehydrated ACM were significantly less porous to water than untreated ACM [mean (+/-SE): 0.09 (+/-0.02), 0.74 (+/-0.4), and 9.8 (+/-1.6) cc/cm2 hr, respectively; Mann Whitney p < 0.0001 (HA) and p < 0.0001 (lyo)]. The difference between HA-ACM and lyophilized ACM was also statistically significant (p = 0.014). ACM hybridization with HA decreases ACM porosity, in part because of ACM lyophilization during the hybridization process. In future applications, HA may function as a carrier for smaller molecules such as growth factors, and as a bioactive molecule to improve wound healing and decrease fibrosis in tissue-engineered bladder constructs.