2018 Fiscal Year Final Research Report

Study on pediatric airway reconstruction using implant autolougous cell regeneration cartilage

Research Project

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Project/Area Number	16K11359
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Pediatric surgery
Research Institution	Keio University
Principal Investigator	FUCHIMOTO YASUSHI 慶應義塾大学, 医学部(信濃町), 特任教授 (40219077)
Co-Investigator(Kenkyū-buntansha)	古村眞埼玉医科大学, 医学部, 教授 (10422289) 黒田達夫慶應義塾大学, 医学部(信濃町), 教授 (60170130)
Research Collaborator	ENOSAWA Shin OHNO Michinobu HIGUCHI Masataka
Project Period (FY)	2016-04-01 – 2019-03-31
Keywords	気管再生 / 組織工学 / 軟骨細胞 / PLLA / インプラント型 / ブタ / FGF
Outline of Final Research Achievements	Chondrocytes collected from porcine auricular cartilage were cultured, and implanted in the subcutaneous of pig using PLLA as a scaffold, we succeeded in creating an implanted regenerated cartilage in several weeks. At this time, it was confirmed that it is better to implant subcutaneously in the abdomen than in the auricle, and that injection of bFGF at the time of transplantation promotes implanted chondrogenesis. Half of tracheal circumference diameter was excised and transplanted an implant type cartilage as a patch graft. After 11 weeks of transplantation, bronchoscopy revealed a narrowing of the lumen around the patch area, and in the pathological tissue, scattered cartilage and small cartilage were found, but inflammatory cell infiltration and scar formation were also observed. The above findings suggest that foreign body reaction was induced to PLLA used for scaffolding and scar fibrosis occurred.
Free Research Field	小児外科、再生医療、腫瘍免疫
Academic Significance and Societal Importance of the Research Achievements	長期気管内挿管や気管切開後に生じる抜管困難症や先天性声門下狭窄症に対して、再生軟骨のパッチ移植は有効であると思われる。当該研究では軟骨細胞を吸収性素材のポリ乳酸多孔体（PLLA）を足場とした組織工学手法を利用して小児の成長に即応したインプラント型再生軟骨を形成することが確認された。しかし、インプラント型再生軟骨を気管孔にパッチ移植するとPLLAに対する反応性から気管内腔の狭窄をきたした。反応性の少ない足場素材を開発すれば、患児の成長とともに大きくなる再生気管軟骨を作成することができる可能性が期待される。