人工組織は、食道の一部が欠損した状態で生まれた赤ちゃんに希望をもたらす(Engineered tissue offers hope for babies born with missing food pipe section)

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2026-03-20  ユニバーシティ・カレッジ・ロンドン(UCL)

英ユニバーシティ・カレッジ・ロンドン(UCL)の研究チームは、食道の一部が欠損して生まれる先天性疾患(食道閉鎖症)に対し、再生医療による新たな治療法の可能性を示した。研究では、患者由来細胞を用いて人工的に食道組織を作製し、実験モデルで機能的に動作することを確認。これにより従来の外科手術に頼る治療の限界を補い、より自然な形での組織再建が期待される。特に成長に伴う適応や合併症リスクの低減に寄与する可能性がある。本成果は、先天性疾患の治療や小児外科、再生医療分野における重要な前進とされる。

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大型動物モデルにおける自家組織化食道の機能的統合 Functional integration of an autologous engineered esophagus in a large-animal model

Natalie Durkin,George T. Hall,Roberto Lutman,Marianna Scuglia,Theodoros Xenakis,Giulia Patera,Daniele Di Biagio,Koji Yamada,Lucinda Tullie,Dominic Scaglioni,Soichi Shibuya,Kornilia Nikaki,Max Arran Beesley,Tarek Saleh,Matias Garrido Flores,Dominika Borselle,Valerija Karaluka,J. Ciaran Hutchinson,Sahira Khalaf,Olumide Ogunbiyi,Lei Wu,Xia Huang,Wenhui Song,Stavros Loukogeorgakis,… Paolo De Coppi
Nature Biotechnology  Published:20 March 2026
DOI:https://doi.org/10.1038/s41587-026-03043-1

人工組織は、食道の一部が欠損した状態で生まれた赤ちゃんに希望をもたらす(Engineered tissue offers hope for babies born with missing food pipe section)

Abstract

Tissue engineering of the esophagus has been limited by stent dependance and poor muscle regeneration. Here we report an integrated strategy to engineer a 2.5-cm esophageal segment by microinjecting autologous pericyte-like myogenic precursors and fibroblasts in a decellularized porcine scaffold to repair circumferential defects in 10-kg minipigs (n = 8), modeling pediatric use. Bioreactor maturation induced a proangiogenic phenotype, with in vivo support from biodegradable intraluminal stents and a vascularizing pleural wrap. This coordinated approach yielded safe and effective esophageal conduits; oral feeding supported normal growth, morbidity resembled that of clinical esophageal replacement and was endoscopically manageable, and 63% (5/8) survived to the 6-month endpoint. Comprehensive multimodal analyses demonstrated progressive recapitulation of native architecture, with increasing neuromuscular regeneration and vascularization, correlating with functional recovery, absence of symptomatic stricture and the presence of secondary peristalsis by 6 months. These results demonstrate that the combination of complementary regenerative, conditioning and surgical strategies enables a functionally integrated, contractile esophageal graft with ongoing structural maturation without immunosuppression.

医療・健康
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