Research Article | Open Access
Rebecca Stark, James C. Y. Dunn, "Mechanical Enterogenesis - A Review", Journal of Healthcare Engineering, vol. 3, Article ID 274254, 14 pages, 2012. https://doi.org/10.1260/2040-2218.104.22.168
Mechanical Enterogenesis - A Review
Mechanical enterogenesis is a novel method of lengthening pre-existing intestine with distractive force. The application of mechanical force on small intestine aims to induce cellular proliferation and ultimately increase bowel length. This has been investigated primarily for the treatment of short bowel syndrome (SBS). Research has been ongoing for well over a decade in this arena and a multitude of advances have been made, both in the understanding of the biology behind force induced cellular proliferation and in the basic mechanics of force delivery systems. Important experimental models have been developed for studying this phenomenon and the collaboration of engineers and medical researchers has lead to the design of several devices that successfully lengthen small intestine. This has catapulted the field forward and there may soon be a device suitable for medical use in humans. This review analyses the past, present and future of mechanical enterogenesis.
- A. L. Buchman, “Etiology and Initial Management of Short Bowel Syndrome,” Gastroenterology, vol. 130, pp. s5–s15, 2006.
- D. Duro, D. Kamin, and C. Duggan, “Overview of Pediatric Short Bowel Syndrome,” Journal of Pediatric Gastroenterology and Nutrition, vol. 47, pp. s33–s36, 2008.
- A. U. Spencer, A. Neaga, B. West et al., “Pediatric Short Bowel Syndrome: redefining predictors of success,” Annals of Surgery, vol. 242, pp. 403–412, 2005.
- A. U. Spencer, D. Kovacevich, M. McKinney-Barnett et al., “Pediatric Short Bowel Syndrome: the cost of comprehensive care,” American Journal of Clinical Nutrition, vol. 88, pp. 1153–9, 2008.
- M. H. Galea, H. Holiday, R. Carachi, and L. Kapila, “Short Bowel Syndrome: a collective review,” Journal of Pediatric Surgery, vol. 27, pp. 592–596, 1992.
- P. W. Wales, A. Nasr, N. de Silva, and J. Yamada, “Human growth hormone and glutamine for patients with short bowel syndrome. The Cochrane Library,” The Cochrane Library, no. 6, 2010.
- D. Sudan, J. Thompson, J. Botha et al., “Comparison of Intestinal Lengthening Procedures for Patients with Short Bowel Syndrome,” Annals of Surgery, vol. 246, pp. 593–604, 2007.
- K. M. Abu-elmagd, “Intestinal transplantation for short bowel syndrome and gastrointestinal failure: current consensus, rewarding outcomes, and practical guidelines,” Gastroenterology, vol. 130, pp. s132–s137, 2006.
- J. C. Dunn, “Is the tissue-engineered intestine clinically viable?” Nature Clinical Practice Gastroenterology and Hepatology, vol. 5, pp. 366–367, 2008.
- P. C. Chang, J. Mendoza, J. Park et al., “Sustainability of mechanically lengthened bowel in rats,” Journal of Pediatric Surgery, vol. 41, pp. 2019–2022, 2006.
- J. Park, D. P. Puapong, B. Wu, J. Atkinson, and J. C. Y. Dunn, “Enterogenesis by Mechanical Lengthening: Morphology and Function of the Lengthened Small Intestine,” Journal of Pediatric Surgery, vol. 39, pp. 1823–1827, 2004.
- R. E. De Filippo and A. Atala, “Stretch and growth: the molecular and physiologic influences of tissue expansion,” Plastic and Reconstructive Surgery, vol. 109, pp. 2450–2462, 2002.
- G. A. Illizarov, “The tension-stress effect on the genesis and growth of tissue,” Clinical Orthopedic Related Research, vol. 238, pp. 249–281, 1989.
- L. K. Cheung and H. D. Chua, “A meta-analysis of cleft maxillary osteotomy and distraction osteogenesis,” International Journal of Oral Maxillofacial Surgery, vol. 35, pp. 14–24, 2006.
- H. H. Chang, H. Tseng, T. M. Hsieh et al., “The effects of distraction osteogenesis on mandibular growth in growing minipigs: a report on three dimensional morphologic changes,” Plastic Reconstructive Surgery, vol. 115, pp. 2014–24, 2005.
- N. G. Lailas, B. Cilento, and A. Atala, “Progressive ureteral dilation for subsequent ureterocystoplasty,” Journal of Urology, vol. 156:1151, 1996.
- N. Satar, J. J. Yoo, and A. Atala, “Progressive dilation for bladder tissue expansion,” Journal of Urology, vol. 162:829, 1999.
- D. G. Young, “Successful primary anastamosis in oesophageal atresia after reduction of long gap between the bind ends by bougenage of the upper pouch,” The British Journal of Surgery, vol. 54, pp. 321–324, 1967.
- B. E. Sumpio, S. R. Banes, W. G. Link, and G. Johnson Jr., “Enhanced collagen production by smooth muscle cells during repetitive mechanical stretching,” Archives of Surgery, vol. 123:1233, 1988.
- J. E. Foker, B. C. Linden, E. M. Boyle Jr., and C. Marquardt, “Development of a true primary repair for the full spectrum of esophageal atresia,” Ann Surg, vol. 226, no. 4, pp. 533–543, 1997.
- A. V. Cybulsky, J. V. Bonventre, R. J. Quigg, L. S. Wolf, and D. J. Salant, “Extracellular matric regulates proliferation and phospholipids turnover in glomerular epithelial cells,” American Journal of Physiology, vol. 259:326, 1990.
- P. R. Kollros, S. R. Bates, M. B. Matthews, A. L. Horwitz, and S. Glagov, “Cyclic AMP inhibits increased collagen production by cyclically stretched smooth muscle cells,” Laboratory Investigations, vol. 56:410, 1987.
- H. H. Vandenburgh and P. Karlisch, “Longitudinal growth of skeletal myotubes in vitro in a new horizontal mechanical stimulator,” In Vitro Cellular Developmental Biology, vol. 25:607, 1989.
- D. Critchley, “Focal adhesions: the cytoskeletal connection,” Current Opinions in Cell Biology, vol. 12:133, 2000.
- M. Lee, B. M. Wu, M. Stelzner, H. Reichardt, and J. C. Y. Dunn, “Intestinal smooth muscle cell maintenance by Basic Fibroblast Growth Factor,” Tissue Engineering, vol. 14, pp. 1395–1402, 2008.
- L. Vinter-Jensen, B. U. Duch, J. A. Petersen, A. Ryslev, and H. Gregersen, “Systemic treatment with epidermal growth factor in the rat. Biomechanical properties of the growing small intestine,” Regulatory Peptides, vol. 51, pp. 135–142, 1996.
- J. C. Dunn, M. M. Lam, and E. Lee, “Increased expression of insulin-like growth factor in intestinal lengthening by mechanical force in rats,” Journal of Pediatric Surgery, vol. 42, pp. 2057–2061, 2007.
- M. Davis, G. Meininger, and D. Zawieja, “Stretch-induced increases in extracellular calcium of isolated vascular smooth muscle cells,” American Journal of Physiology, vol. 263:1292, 1992.
- S. Diamond, F. Sachs, and W. Sigurdson, “Mechanically induced calcium mobilization in cultures endothelial cells s dependent on actin and phospholipase,” Athersclerotic Thormbosis, vol. 14:2000, 1994.
- H. H. Vandenburgh, “Mechanical forces and their second messengers in stimulating cell growth in vitro,” American Journal of Physiology, vol. 262:350, 1992.
- E. A. Miyasaka, M. Okawada, B. Utter et al., “Application of distractive forces to the small intestine: defining safe limits,” Journal of Surgical Research, vol. 163, pp. 169–175, 2010.
- J. Mendoza, C. Chang, C. Blalock, J. B. Atkinson, B. Wu, and J. C. Y. Dunn, “Contractile function of the mechanically lengthened intestine,” Journal of Surgical Research, vol. 136, pp. 8–12, 2006.
- A. U. Spencer, X. Sun, M. El-Sawaf et al., “Enterogenesis in a clinically feasible model of mechanical small bowel lengthening,” Surgery, vol. 140, pp. 212–220, 2006.
- D. P. Puapong, B. M. Wu, M. Lam, J. Atkinson, and J. C. Y. Dunn, “Distension enterogenesis: Increasing the size and function of small intestine,” Journal of Pediatric Surgery, vol. 41, pp. 763–767, 2006.
- S. D. Safford, A. J. Freemerman, K. M. Safford, R. Bentley, and M. A. Skinner, “Longitudinal mechanical tension induces growth in the small bowel of juvenile rats,” Gut, vol. 54, pp. 1085–1090, 2005.
- Y. Chen, J. Zhang, R. Qu, J. Wang, and Y. Xie, “An animal experiment on short gut lengthening,” Chinese Medical Journal, vol. 110, pp. 354–357, 1997.
- H. Printz, R. Schlenzka, P. Requadt et al., “Small bowel lengthening by mechanical distraction,” Digestion, vol. 58, pp. 240–248, 1997.
- S. Shekherdimian, A. Scott, A. Chan, and J. C. Y. Dunn, “Intestinal Lengthening in rats after massive small intestinal resection,” Surgery, vol. 146, pp. 291–295, 2009.
- J. Luntz, D. Brei, D. H. Teitelbaum, and A. U. Spencer, “Mechanical extension implants for short-bowel syndrome,” in Proc Soc Photo Opt Intrum Eng, vol. 6173, pp. 1–24.
- S. Shekherdimian, M. Panduranga, G. P. Carman, and J. C. Y. Dunn, “The feasibility of using an endoluminal device for intestinal lengthening,” Journal of Pediatric Surgery, vol. 45, pp. 1575–1580, 2010.
- A. R. Pelton, D. Stoeckel, and T. W. Duerig, “Medical uses of Nitinol,” Material Sciences Forum, vol. 327-328, pp. 63–70, 2000.
- R. Stark, M. Panduranga, G. Carman, and J. C. Dunn, “Development of an endoluminal intestinal lengthening capsule,” Journal of Pediatric Surgery, vol. 47, pp. 136–141, 2012.
- R. Stark, T. Zupekan, S. Bondada, and J. C. Dunn, “Restoration of mechanically lengthened jejunum into intestinal continuity in rats,” Journal of Pediatric Surgery, vol. 46, pp. 2321–6, 2011.
- B. Utter, Luntz, D. Brei, M. Okawada, E. Miyasaka, and D. H. Teitelbaum, “Preliminary in vivo experimental validation of SMA based bowel extender for short bowel syndrome,” in ASME SMASIS Conference, 2009.
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