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Urethral Repair Using Bone Marrow Stem Cells Shows Encouraging Results

Health In Focus   - G J E 4
Highlights
  • Hypospadias is a congenital defect where the urethral opening is on the underside of the penis, instead of being at the tip.
  • It causes abnormal curvature of the penis (chordee) and spraying of urine while passing
  • Presently, treatment involves surgical repair with an autograft employing tissue from the inner aspect of the cheek
  • Research shows that graft made from the patient's bone marrow stem cells are effective in urethral repair, with minimal complications
Graft made from patient's own bone marrow stem cells have proven to be effective in repair of hypospadias, with better healing and minimal scarring, says a recent study.
Urethral Repair Using Bone Marrow Stem Cells Shows Encouraging Results
Urethral Repair Using Bone Marrow Stem Cells Shows Encouraging Results
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Results of the Study

Scientists have shown in the study using an animal model, that it is possible and effective to employ a graft made from the patient's own bone marrow stem cells, for repair of urethra in hypospadias.

‘Novel urethral repair for treatment of hypospadias, using bone marrow stem cells appears promising with lesser complications.’
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The stem cells were then seeded on a new synthetic scaffold which is non-toxic, biodegradable and can expand and contract. The graft thus obtained, promoted regeneration of the damaged tissue at many biological levels.

"Using two unique populations of stem cells derived from the bone marrow, we were able to temper the inflammatory response and avoid scar tissue," said Dr. Arun Sharma, PhD, senior author and Director of Pediatric Urological Regenerative Medicine/Surgical Research, Stanley Manne Children's Research Institute at Ann & Robert H. Lurie Children's Hospital of Chicago. "We also saw that new blood vessels were sprouting after the graft, which is important for tissue healing and growth."

The novel use of stem cells and synthetic scaffolding material in this study follows Dr Sharma's earlier work in bladder tissue repair and regeneration.

"With this approach, a child would no longer need to suffer from complications of the current treatment for hypospadias," said Sharma, a sentiment echoed by Joceline Liu, MD, first author and Urology Resident, Northwestern Memorial Hospital.

About Hypospadias

Hypospadias is a congenital defect occurring in boys with the urethral opening on the underside of the penis, instead of being at the tip. It happens in 1 out of every 200 births.

Symptoms include
  • Downward curvature of the penis (chordee)
  • Abnormal spraying while passing urine
  • Inability to urinate while standing
If untreated, it can cause complications during adult life, with difficulty in sustaining an erection and difficulties during intercourse.

Hypospadias is usually diagnosed at birth, and surgical correction is performed between 3 to 18 months of age. Reconstruction is undertaken using graft tissue taken from the inner aspect of the child's cheek. This method may be associated with various complications, occasionally necessitating multiple operations.

Recent Advances in Urethral Repair Surgery - Tissue Engineering

Congenital disorders such as hypospadias, malignancy, and trauma, of the genitourinary tract may cause considerable structural damage to the organ or functional loss, that needs correction by reconstruction or replacement of the damaged tissue.

Tissue engineering involves the generation of biological substitutes that have the potential to restore normal structure and function. Most of the tissue regeneration research has taken place in the past decade, and has found application in the field of urologic reconstruction surgery.

Urethral repair typically involves the use of a scaffolding on which cells are seeded. The current study used a synthetic scaffolding material that satisfied the criteria of an ideal scaffold such as being bioresorbable and biodegradable, and having favorable physical and mechanical properties. In addition, it should aid the proliferation of seeded stem cells and also ingrowth of native cells following implantation.

Stem cells are capable of self-renewal and differentiation into a variety of cellular types. Due to the ethical issues involving the use of embryos to obtain stem cells, stem cells are being harvested from adult organs such as the bone marrow.

Future Research Plans

Initial studies on animal models have yielded favorable results. The authors plan enlarge upon their initial research, and conduct animal testing followed by clinical trials before it can be tried on children.

"Before we can use it in children, however, we will need to conduct more studies in animal models, followed by future clinical trials. The findings of this study lay a promising foundation for continued research."

References
  1. Facts About Hypospadias - (http://www.cdc.gov/ncbddd/birthdefects/hypospadias.html)
  2. Hypospadias - (http://www.mayoclinic.org/diseases-conditions/hypospadias/basics/symptoms/con-20031354)
  3. Tissue Engineering of the Penis - (https:www.ncbi.nlm.nih.gov/pmc/articles/PMC3253692/)
Source: Medindia
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