Airway tissue engineering for congenital laryngotracheal disease

• Published in: Seminars in pediatric surgery Vol. 25; no. 3; pp. 186 - 190
• Main Authors: Maughan, Elizabeth, Lesage, Flore, Butler, Colin R, Hynds, Robert E, Hewitt, Richard, Janes, Sam M, Deprest, Jan A, Coppi, Paolo De
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2016
• Subjects: Congenital disease; Fetal Therapies - methods; Fetal therapy; Guided Tissue Regeneration; Humans; Infant, Newborn; Laryngeal Diseases - congenital; Laryngeal Diseases - surgery; Larynx - abnormalities; Larynx - surgery; Pediatrics; Perinatal surgery; Respiratory System Abnormalities - surgery; Stem cell; Surgery; Tissue engineering; Tissue Engineering - methods; Tissue Transplantation; Trachea; Trachea - abnormalities; Trachea - surgery; Tracheal Diseases - congenital; Tracheal Diseases - surgery; Transplantation; Tissue engineering; Stem cell; Transplantation; Perinatal surgery; Fetal therapy; Trachea; Congenital disease
• ISSN: 1055-8586; 1532-9453
• DOI: 10.1053/j.sempedsurg.2016.02.012

Regenerative medicine offers hope of a sustainable solution for severe airway disease by the creation of functional, immunocompatible organ replacements. When considering fetuses and newborns, there is a specific spectrum of airway pathologies that could benefit from cell therapy and tissue engineering applications. While hypoplastic lungs associated with congenital diaphragmatic hernia (CDH) could benefit from cellular based treatments aimed at ameliorating lung function, patients with upper airway obstruction could take advantage from a de novo tissue engineering approach. Moreover, the international acceptance of the EXIT procedure as a means of securing the precarious neonatal airway, together with the advent of fetal surgery as a method of heading off postnatal co-morbidities, offers the revolutionary possibility of extending the clinical indication for tissue-engineered airway transplantation to infants affected by diverse severe congenital laryngotracheal malformations. This chapter outlines the necessary basic components for regenerative medicine solutions in this potential clinical niche.