Reverse Thermal Gel for In Utero Coverage of Spina Bifida Defects: An Innovative Bioengineering Alternative to Open Fetal Repair

Macromol Biosci. 2017 Jun;17(6). doi: 10.1002/mabi.201600473. Epub 2017 Jan 30.

Abstract

Current state-of-the-art management of open spina bifida defects entails an open fetal surgery approach associated with significant morbidities. In an attempt to reduce these risks and provide for an earlier minimally invasive repair, it is aimed to develop and characterize an innovative alternative using a unique reverse thermal gel. This study focuses on characterization of the physical and biological properties of the polymer and its in vivo applicability. Based on the knowledge and benchmarking, the "ideal" biomaterial should have the following characteristics: stability in amniotic fluid, limited permeability, biocompatibility, biologically functional, nontoxic, ability to support cellular functions, and in vivo applicability. The results demonstrate that the polymer possesses a unique ultrastructure, is stable in amniotic fluid, possesses limited yet predictable permeability, biocompatible with cells exposed in neural tube defects, is nontoxic, and can support cellular migration. These characteristics make it a potential novel alternative to open fetal repairs.

Keywords: fetal surgery; gels; myelomeningocele; reverse thermal gel; tissue engineering.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amniotic Fluid / drug effects*
  • Amniotic Fluid / physiology
  • Biocompatible Materials / chemistry
  • Biocompatible Materials / therapeutic use*
  • Biomedical Engineering
  • Cell Movement / drug effects
  • Female
  • Fetus / drug effects
  • Fetus / pathology
  • Fetus / surgery
  • Humans
  • Minimally Invasive Surgical Procedures*
  • Neural Tube Defects / surgery
  • Polymers / chemistry
  • Polymers / therapeutic use*
  • Spina Bifida Cystica / pathology
  • Spina Bifida Cystica / therapy*

Substances

  • Biocompatible Materials
  • Polymers