Development of a Prophylaxis for Postoperative Bronchial Fistula Using Multilayered Fibroblast Sheets

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K09165
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55040:Respiratory surgery-related
• Research Institution: Yamaguchi University
• Principal Investigator: Murakami Junichi 山口大学, 医学部附属病院, 助教 (10725683)
• Co-Investigator(Kenkyū-buntansha): 田中 俊樹 山口大学, 医学部附属病院, 講師 (50457305) ; 溝口 高弘 山口大学, 医学部附属病院, 助教 (90844796)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 気管支断端瘻 / 積層線維芽細胞シート / 再生医療 / 肺切除術

Outline of Final Research Achievements

The effect of multilayered fibroblast sheets in reinforcing bronchial breaks was verified in a large animal experiment. Fibroblasts were isolated from canine oral mucosa, and laminated fibroblast sheets were prepared. The cell sheets were found to have 6-8 layers of stacked cell structures, some of which contained myofibroblasts, and to secrete high levels of growth factors such as VEGF, HGF, and TGF-β. Fibroblast cell sheets prepared from the oral mucosa were transplanted into the bronchial stump after resection of the posterior lobe of the left lung. No adverse events due to the implantation of the cell sheets were observed. Histological evaluation is currently underway. Soft tissue adhesion to the bronchial stump and pleural coverage was observed in the cell sheet transplantation group compared to the control group, suggesting that the cell sheets may have contributed to accelerated tissue repair.

Free Research Field

呼吸器外科

Academic Significance and Societal Importance of the Research Achievements

細胞シート移植によって肺切除後の気管支断端瘻を予防できれば、死亡率が高く、治療に難渋する気管支断端瘻治療に苦しむ患者や悩む医療者を激減させ、長期にわたる医療コストをも削減することができる。呼吸器外科手術における気管-気管や気管支-気管支吻合における縫合不全の予防、既に発症した気管支断端瘻に対する治療への適応拡大も見込まれる。さらに我々が最終的に目指す積層線維芽細胞シートの他家移植が可能となれば、自己の細胞・組織採取が不要な新規バイオマテリアルとして、外科他領域における術後合併症(術後出血、腸管縫合不全、術後膵液漏、胆汁漏、髄液漏、乳糜漏、神経損傷など)の予防への応用が期待できる。