Bladder regeneration: great potential but challenges remain.

摘要

The review article by Arun Sharma in this issue of Regenerative Medicine [1] highlights the successes of the different disciplines involved in regenerative medicine for the purpose of urinary bladder tissue engineering. It is rich and diverse in presenting the multiple facets that we need to address to have a successful outcome (i.e., a compliant and contractile urinary bladder). The authors present a clear, detailed summary of all the aspects that we need to take into account when we attempt to regenerate or tissue engineer a bladder. However, while it is evident that this task has resulted in many breakthrough findings [2,3], they have yet to culminate in an effective and clinically tested tissue engineered construct that meets the expectations of healthcare providers and surgeons. The key reason for the multiple failures encountered in this field could be related to the fact that we are still in some ways simplistic in our approach; the bladder may be forgiving but it is not a simple organ that can be easily replaced and regenerated. Much can be learned from bladder development, injury and the remodeling to help understand how to rebuild the bladder in vitro. The signaling pathways involved in the cellular and molecular mechanisms underlying bladder development and injury-induced regenerative response may have immense potential in designing strategies for urinary bladder regeneration [4]. Unfortunately, none of the lessons learned in this area have been translated into tissue engineering research.