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Prenatal Neural Tube Anomalies: A Decade of Intrauterine Stem Cell Transplantation Using Advanced Tissue Engineering Methods

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Abstract

Neural tube defects (NTDs) are among the most common congenital defects during neurulation. Spina bifida is a type of NTD that can occur in different forms. Since myelomeningocele (MMC) is the most severe form of spina bifida, finding a satisfactory treatment for MMC is a gold standard for the treatment of spina bifida. The Management of Myelomeningocele Study (MOMS) demonstrated that intrauterine treatment of spina bifida could ameliorate the complications associated with spina bifida and would also reduce the placement of ventriculoperitoneal (VP) shunt by 50%. Recently developed tissue engineering (TE) approaches using scaffolds, stem cells, and growth factors allow treatment of the fetus with minimally invasive methods and promising outcomes. The application of novel patches with appropriate stem cells and growth factors leads to better coverage of the defect with fewer complications. These approaches with less invasive surgical procedures, even in animal models with similar characteristics as the human MMC defect, paves the way for the modern application of less invasive surgical methods. Significantly, the early detection of these problems and applying these approaches can increase the potential efficacy of MMC treatment with fewer complications. However, further studies should be conducted to find the most suitable scaffolds and stem cells, and their application should be evaluated in animal models. This review intends to discuss advanced TE methods for treating MMC and recent successes in increasing the efficacy of the treatment.

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Data Availability

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Abbreviations

NTD:

Neural tube defect

MMC:

Myelomeningocele

MOMS:

Management of Myelomeningocele Study

VP:

Ventriculoperitoneal

TE:

Tissue engineering

TRASCET:

Trans-amniotic stem cell therapy

CSF:

Cerebrospinal fluid

ADM:

Acellular dermal matrix

bFGF:

Basic fibroblast growth factor

AM:

Amniotic membrane

PMSC:

Placenta-derived mesenchymal stem cell

HUC:

Human umbilical cord

BCF:

Biocellulose film

PLA:

Polylactic acid

PCL:

Polycaprolactone

MSC:

Mesenchymal stem cell

AFMSC:

Amniotic fluid-derived mesenchymal stem cell

MHC:

Major Histocompatibility Complex

BDNF:

Brain-derived neurotropic factor

BMSC:

Bone marrow-derived mesenchymal stem cell

ECM:

Extracellular matrix

SLR:

Sheep Locomotor Rating

NGF:

Nerve growth factor

PDGF:

Platelet-derived growth factor

EGF:

Epithelial growth factor

TGF- α:

Transforming growth factor-α

FGF:

Fibroblast growth factor

iPSC:

Induced pluripotent stem cell

VEGF:

Vascular endothelial growth factor

MRI:

Magnetic resonance imaging

PROM:

Prelabor rupture of membrane

RTG:

Reverse thermal gel

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Authors and Affiliations

  1. Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children’s Hospital Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Gharib’s Street, Keshavarz Boulevard, Tehran, 1419433151, Iran

    Alireza Soltani Khaboushan, Abdol-Mohammad Kajbafzadeh & Masoumeh Majidi Zolbin

  2. Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Alireza Soltani Khaboushan

  3. Musculoskeletal Research Group and Tumor Biology, Chair of Vegetative Anatomy, Institute of Anatomy, Faculty of Medicine, Ludwig-Maximilian-University Munich, Pettenkoferstrasse 11, D-80336, Munich, Germany

    Mehdi Shakibaei

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Soltani Khaboushan, A., Shakibaei, M., Kajbafzadeh, AM. et al. Prenatal Neural Tube Anomalies: A Decade of Intrauterine Stem Cell Transplantation Using Advanced Tissue Engineering Methods. Stem Cell Rev and Rep 18, 752–767 (2022). https://doi.org/10.1007/s12015-021-10150-w

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