Autologous Multilayered Fibroblast Sheets Can Reinforce Bronchial Stump in a Rat Model

Semin Thorac Cardiovasc Surg. 2022 Spring;34(1):349-358. doi: 10.1053/j.semtcvs.2021.03.010. Epub 2021 Mar 10.

Abstract

Bronchopleural fistula is one of the most serious postoperative complications caused by the incomplete healing of a bronchial stump. Fibroblasts play an important role in wound healing by facilitating connective tissue formation and inducing angiogenesis. We developed a method for production of multilayered fibroblast sheets that secreted some growth factors and promoted wound healing. The present study aimed to assess the treatment effect of multilayered fibroblast sheets on bronchial stump healing. In this rat model, left pneumonectomy was performed, and multilayered fibroblast sheets derived from autologous oral mucosal tissues were transplanted to the bronchial stump. The changes in the bronchial stump were examined macroscopically, histologically, and mechanically. The fibroblast sheets promoted the formation of thick connective tissues around the bronchial stump. The formed connective tissues were accompanied by new blood vessels, and fibrosis was observed over time. Then, 7 days after the transplantation of the fibroblast sheets, the bronchial wall became significantly thicker, and the area of the blood vessels for the bronchial wall tissues was significantly larger in the experimental group than in the control group. In addition, the burst pressure in the bronchial stump was significantly higher in the experimental group than in the control group. Bronchial stumps were reinforced by the transplantation of multilayered fibroblast sheets derived from autologous oral mucosal tissues.

Keywords: Angiogenesis; Bronchial stump; Bronchopleural fistula; Cell sheet; Fibroblast; Tissue formation.

MeSH terms

  • Animals
  • Bronchi / surgery
  • Bronchial Fistula* / etiology
  • Fibroblasts
  • Humans
  • Pneumonectomy / adverse effects
  • Rats
  • Treatment Outcome