Bioengineering and regeneration of gastrointestinal tissue: where are we now and what comes next?

ABSTRACT

Introduction: The field of tissue engineering and regenerative medicine has been applied to the gastrointestinal (GI) tract for a couple decades. Several achievements have been accomplished that provide promising tools for treating diseases of the GI tract.

Areas covered: The work described in this review covers the traditional aspect of using cells and scaffolds to replace parts of the tract. Several studies investigated different types of biomaterials and different types of cells. A more recent approach involved the use of gut-derived organoid units that can differentiate into all gut cell layers. The most recent approach introduced the use of organ-on-a-chip concept to understand the physiology and pathophysiology of the GI system.

Expert opinion: The different approaches tackle the diseases of the GI tract from different perspectives. While all these different approaches provide a promising and encouraging future for this field, the translational aspect is yet to be studied.

KEYWORDS:

• Gastrointestinal tract
• scaffolds
• biomaterials
• organoids
• organ-on-a-chip

Article highlights

• This review covers recent advances in the field of GI regeneration using cells and scaffolds. A lot of work has been performed in this area which focused on regenerating the musculature and the epithelium. Studying phenotype and function are key factors for success.

• Different biomaterials have been studied and optimized to promote cell survival and differentiation. In vitro results do not necessarily translate into in vivo, therefore, animal studies are necessary to confirm the results in the correct animal models.

• Extracellular matrices and their decellularization is a technique that has been applied to regenerate all organs of the body. The GI tract benefited from this technique by using decellularized tissue-specific and other tissues for gut reconstruction. ECM maintains the architecture and proteins needed for a reconstructive remodeling.

• Organoid units have gained special attention due to their ability of differentiating in vivo into the different cell layers of the gut. Those units can be isolated from various parts of the gut and seeded onto scaffolds for implantation.

• Organ-on-a-chip technique has been introduced to the field of GI regeneration. This highly sophisticated technique allows studying the physiology and pathophysiology of the system. Absorption of drugs, interaction of epithelium with the microbiome and the barrier function of the epithelium can be studied through this system.

This box summarizes the key points contained in the article.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

The work of the authors was supported by STTR NIH/NIDDK R42DK105593 to Cellf-Bio, LLC and by NIH/NIDCR T32DE00007057-41, 42 (SR).