Tissue engineering for compensating short bowel syndrome
Short bowel syndrome is an important clinical problem characterized by a high incidence of serious complications, deaths and socioeconomic consequences. Parenteral nutrition provides only a temporary solution without reducing the risk of complications. This applies equally to surgical treatment, in particular to small intestine transplantation and related concomitant interventions, which only facilitate the adaptation of the intestine to new conditions. Potential approaches have been analyzed in the treatment of the syndrome of the small intestine, which can be offered by dynamically developing tissue engineering. Various types of carriers and cell types that are used in experiments for obtaining tissue engineering designs of the intestine are discussed. A wide range of variants of such constructions is analyzed that can lead to obtaining an organ prosthesis with a cellular organization and mechanical stability similar to those of the native small intestine, which will ensure the necessary biocompatibility. It is established that one of the optimal carriers for today are extracellular matrices obtained by decellularization of the native small intestine. This process allows to preserve the microarchitecture of the small intestine, which greatly facilitates the process of filling the matrix with cells both in vitro and in vivo. It has also been established that mesenchymal stromal multipotent cells and organoid units obtained from the tissue of the native small intestine are particularly prominent among the most promising participants in the cellular ensemble.