Decellularized Human Dermis to Treat Massive Rotator Cuff Tears: In Vitro Evaluations

Abstract

Interest is increasing in biological scaffolds for tissue regeneration such as extracellular matrix membranes, developed through soft tissue decellularization. Extracellular matrix membranes were developed to heal different tendon and soft tissue lesions that are very frequent in the general population with high health-care costs and patient morbidity. The aim of this research was to evaluate a human dermal matrix (HDM) decellularized by a chemico-physical method. A primary culture of rat tenocytes was performed: tenocytes were seeded on HDM samples and on polystyrene wells as controls (CTR). Cell viability and synthetic activity were evaluated at 3 and 7 days. An in vitro microwound model was used to evaluate HDM bioactivity: after tenocyte expansion, artificial wounds were created, HDM extracts were added, and closure time and decorin synthesis were monitored histomorphometrically at 1, 4, 24, and 72 hr. A significant higher amount of collagen I was observed when cells were cultured on HDM in comparison with that on CTR (3 days: p < 0.0001; 7 days: p < 0.05). In HDM group, fibronectin synthesis was significantly higher at both experimental times (p < 0.0001). At 3 days, proteoglycans and transforming growth factor-β1 releases were significantly higher on HDM (p < 0.0001 and p < 0.005, respectively). The artificial microwound closure time and decorin expression were significantly enhanced by the addition of 50% HDM extract (p < 0.05). In vitro data showed that the decellularization technique enabled the development of a matrix with adequate biological and biomechanical properties.

• tenocytes
• tendons
• decellularization technique
• dermis
• in vitro microwound model

Acknowledgments

We gratefully acknowledge the assistance provided by Drs. Roberto Orioli, Alessandro Benini, and Carmine D’Acunto of the Burn Intensive Care Unit “Banca Regionale della Cute Emilia Romagna” Cesena, Italy. This work was supported by the Project “Regione Emilia Romagna Programma di Ricerca Regione-Università 2007–2009” (Regenerative Medicine in Osteoarticular Disease), WP3 Regenerative Medicine for Tendon Repair: Clinical Studies.

Declaration of interest

The authors MF, EB, DM, and RG patented the decellularization technique. No benefits in any form have been or will be received from a commercial party directly or indirectly related to the subject of this article.