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Bladder Tissue Engineering: The Past and the Future

  • Anthony Atala
    Correspondence
    Address correspondence to: Anthony Atala, Wake Forest Institute for Regenerative Medicine, Department of Urology, Wake Forest School of Medicine, Winston Salem, NC.
    Affiliations
    Wake Forest Institute for Regenerative Medicine, Department of Urology, Wake Forest School of Medicine, Winston Salem, NC
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      The paper “Bladder Augmentation using Allogenic Bladder Submucosa Seeded with Cells,” published in 1998, is the first journal article in the biomedical field describing the replacement of bladder tissue with a scaffold with and without seeded cells.
      • Yoo JJ
      • Meng J
      • Oberpenning F
      • Atala A
      Bladder augmentation using allogenic bladder submucosa seeded with cells.
      At the time of this publication, the term “regenerative medicine” had not been coined, and the first description of human embryonic stem cells had not yet occurred; however, the promising concept of regenerating tissue had been front and center for a number of investigators worldwide. Many articles, some dating back to the 1950s, described the use of materials alone, without cells, to replace bladder tissue in animals. Some of these materials included polyvinyl sponge, gelatin sponge, silicone, Teflon, lyophilized human dura, small intestinal submucosa, and even silk paper.
      • Yoo JJ
      • Meng J
      • Oberpenning F
      • Atala A
      Bladder augmentation using allogenic bladder submucosa seeded with cells.
      Interestingly many of these materials uniformly regenerated bladders adequately in rodents, but larger animal models tended to fail. The ability for rodents to regenerate is well known. For example, rodents with a complete spinal cord transection start to walk a few weeks later.
      • Seitz A.
      • Aglow E.
      • Heber-Katz E
      Recovery from spinal cord injury: a new transection model in the C57Bl/6 mouse.
      It is also important to note that despite decades of publications showing that materials without added cells could regenerate bladder tissue in animal models, there was a glaring paucity of data in humans when our article was published.
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