Editorial
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World J Gastroenterol. Oct 7, 2012; 18(37): 5145-5150
Published online Oct 7, 2012. doi: 10.3748/wjg.v18.i37.5145
Cell sheet technology for regeneration of esophageal mucosa
Ryo Takagi, Masayuki Yamato, Nobuo Kanai, Daisuke Murakami, Makoto Kondo, Takaaki Ishii, Takeshi Ohki, Hideo Namiki, Masakazu Yamamoto, Teruo Okano
Ryo Takagi, Masayuki Yamato, Nobuo Kanai, Daisuke Murakami, Makoto Kondo, Takaaki Ishii, Takeshi Ohki, Teruo Okano, Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
Nobuo Kanai, Takeshi Ohki, Masakazu Yamamoto, Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, Tokyo 162-8666, Japan
Daisuke Murakami, Makoto Kondo, Takaaki Ishii, Hideo Namiki, Graduate School of Science and Engineering, Waseda University, Tokyo 162-8480, Japan
Author contributions: Yamato M, Ohki T, Namiki H, Yamamoto M and Okano T designed this research; Takagi R, Kanai N, Murakami D, Kondo M and Ishii T fabricated cell sheets; Kanai N and Ohki T performed endoscopic surgery; and Takagi R and Yamato M wrote this manuscript.
Supported by The Formation of Innovation Center for Fusion of Advanced Technologies in the Special Coordination Funds for Promoting Science and Technology from the Ministry of Education, Culture, Sports, Science, and Technology, Japan
Correspondence to: Teruo Okano, PhD, Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, TWIns, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan. tokano@abmes.twmu.ac.jp
Telephone: +81-3-53679945 Fax: +81-3-33596046
Received: December 24, 2011
Revised: April 18, 2012
Accepted: April 27, 2012
Published online: October 7, 2012
Abstract

The progress of tissue-engineering technology has realized development of new therapies to treat various disorders by using cultured cells. Cell- and tissue-based therapies have been successfully applied to human patients, and several tissue-engineered products have been approved by the regulatory agencies and are commercially available. In the review article, we describe our experience of development and clinical application of cell sheet-based regenerative medicine. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have been shown to be useful for removal of gastrointestinal neoplasms with less invasiveness compared with open surgery, especially in esophageal surgery. However, postoperative inflammation and stenosis are major complications observed after intensive mucosal resection. Therefore, we have developed novel regenerative medicine to prevent such complications and promote wound healing of esophageal mucosa after EMR or ESD. Transplantable oral mucosal epithelial cell sheets were fabricated from patients’ own oral mucosa. Immediately after EMR or ESD, fabricated autologous cell sheets were endoscopically transplanted to the ulcer sites. We performed a preclinical study with a canine model. In human clinical settings, cell culture and cell sheet fabrication were performed in clean rooms according to good manufacturing practice guidelines, and pharmaceutical drugs were used as supplements to culture medium in place of research regents used in animal study. We believe that cell-based regenerative medicine would be useful to improve quality of life of patients after EMR or ESD.

Keywords: Cell sheet; Endoscopic resection; Esophageal stenosis; Oral mucosa; Good manufacturing practice