Esophageal Tissue Engineering

The focus of the chapter is to review current novel tissue engineering approaches for the esophagus. Patients suffering from esophageal defects and disease are commonly treated with surgical intervention, which can lead to a host of short and long term complications including the need for repeated surgery. The diseased segment or defect is replaced with either stomach, colon or small intestine from that patient, which lacks the motility to function as an esophageal replacement. Therefore, a new surgical therapeutic option is needed that can be tailored to each patient and be comprised of autologous cells. Many researchers have evaluated the use of native or synthetic matrix as a scaffold for bridging the gap. The cells used on these scaffolds have ranged from cells isolated from the native esophagus, pluripotent stem cells, mesenchymal stem cells and even fibroblasts. When these scaffolds and cells have been introduced in animal models, those scaffolds seeded with cells show a positive outcome with integration into host tissue and lack of a large immune response. The opposite was seen when scaffolds were implanted without any cells seeded on them. These implantation studies have also been done in larger animals and allowed to incubate for months and demonstrate anatomy similar to that of native esophagus but further studies are needed to better understand the mechanism for this result as well as what combinations of cells and scaffolding yield a positive result for the patient.

Keywords: Atresia, Autologous cells, Biopsy, Caustic injury, Decellularized, Digestive system, Eosinophilic esophagitis, Epithelial cells, Epithelial reprogramming, Esophageal cancer, Esophagus, Extracellular matrix, Fistula, Implantation, Mesenchymal stem cells, Pluripotent stem cells, Recellularized, Regenerative, Smooth muscle, Synthetic scaffold, Tissue engineering.