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Cell and organ bioengineering technology as applied to gastrointestinal diseases
  1. Giuseppe Orlando1,2,
  2. Juan Domínguez Bendala3,4,
  3. Thomas Shupe1,
  4. Christopher Bergman1,
  5. Khalil N Bitar1,
  6. Christopher Booth1,
  7. Marco Carbone5,
  8. Kenneth L Koch1,
  9. Jan P Lerut6,
  10. James M Neuberger5,
  11. Bryon Petersen1,
  12. Camillo Ricordi3,4,
  13. Anthony Atala1,7,
  14. Robert J Stratta2,
  15. Shay Soker1
  1. 1Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
  2. 2Department of General Surgery, Section of Transplantation, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
  3. 3Diabetes Research Institute, University of Miami Leonard M Miller School of Medicine, Miami, Florida, USA
  4. 4Department of Surgery, University of Miami Leonard M Miller School of Medicine, Miami, Florida, USA
  5. 5Liver Unit, Queen Elizabeth Hospital, Birmingham, UK
  6. 6Abdominal Transplant Unit, Department of Abdominal and Transplant Surgery, University Hospitals St Luc, Université Catholique de Louvain, Belgium, Brussels
  7. 7Department of Urology, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA
  1. Correspondence to Dr Giuseppe Orlando, Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston Salem, NC, USA; gorlando{at}wakehealth.edu

Abstract

This review illustrates promising regenerative medicine technologies that are being developed for the treatment of gastrointestinal diseases. The main strategies under validation to bioengineer or regenerate liver, pancreas, or parts of the digestive tract are twofold: engineering of progenitor cells and seeding of cells on supporting scaffold material. In the first case, stem cells are initially expanded under standard tissue culture conditions. Thereafter, these cells may either be delivered directly to the tissue or organ of interest, or they may be loaded onto a synthetic or natural three-dimensional scaffold that is capable of enhancing cell viability and function. The new construct harbouring the cells usually undergoes a maturation phase within a bioreactor. Within the bioreactor, cells are conditioned to adopt a phenotype similar to that displayed in the native organ. The specific nature of the scaffold within the bioreactor is critical for the development of this high-function phenotype. Efforts to bioengineer or regenerate gastrointestinal tract, liver and pancreas have yielded promising results and have demonstrated the immense potential of regenerative medicine. However, a myriad of technical hurdles must be overcome before transplantable, engineered organs become a reality.

  • Regenerative medicine
  • tissue engineering
  • extracellular matrix
  • scaffold
  • stem cells
  • liver regeneration
  • liver transplantation
  • pancreatic islet cell
  • liver cirrhosis
  • primary biliary cirrhosis
  • hepatitis C
  • hepatobiliary disease

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Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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    BMJ Publishing Group Ltd and British Society of Gastroenterology