Cryopreservation of ovarian tissue and its subsequent transplantation represent a big hope to preserve fertility in young women who have defeated cancer. Ovary revascularization is a crucial factor impacting the outcome of the engraftment. Limited oxygenation may have severe consequences on the ovarian reserve, with a significant loss of follicles. New frontiers in reproductive technology aim to reduce the ischemic/hypoxic window following auto-transplantation procedures. Biomaterials supplemented with ovarian-derived endothelial cells could be the solution to enhance vascular regeneration in the transplanted tissue.
In this study, we propose a combined Advanced Therapeutic Medicinal Product (ATMP) obtained from the association of cryopreserved ovarian tissue with a 3D dermal substitute — a biocompatible and bioactive scaffold employed in regenerative medicine — pre-seeded with vascular system cells previously isolated from the same ovarian tissue. This pre-seeding, known as inosculation, is a bioengineering approach aimed at enhancing revascularization by promoting the formation of novel vascular networks within the scaffold prior to implantation. The goal of the research is to demonstrate that a such graft can boost the growth of new vessels (Fig. 1), potentially improving the ovary survival and functionality.
To evaluate the effectiveness of this approach, several techniques were employed including synchrotron radiation-based X-ray phase-contrast microtomography (SR PC-microCT). As a volumetric imaging technique, SR PC-microCT enables three-dimensional visualization of the inner anatomical structures of the proposed ATMP at high spatial and contrast resolution, with the additional advantage of being non-destructive. Scans were carried out at the SYRMEP Imaging beamline of Elettra. The findings obtained by the X-ray images were complemented by histology and immunohistochemical analyses, adhesion and proliferation assays, gene expression and immunofluorescence.
A bovine collagen-based scaffold, Integra®, was selected among various dermal substitute materials tested and was used as a support for ovarian transplantation in subsequent in vivo experiments on mouse models. Histology clearly demonstrates the presence of endothelial cells within the Integra® matrix, exhibiting a tendency to form vascular structures. Red-blood cells can be also observed inside the developing vessels (Fig. 2a). Similarly, Fig. 2b shows a virtual slice obtained by X-ray PC microCT of a sample region at the interface between the ovarian tissue and the Integra® support. In agreement with the histological data, the X-ray image shows a massive accumulation of dense structures within the scaffold, which may be attributed to a high concentration of endothelial cells. Notably, SR PC microCT enables the cells distribution within the scanned blocks to be tracked, revealing a migration of the endothelial cells from the matrix into the tissue with a preferential side of accumulation. Supplementary videos are available on the full paper website (please follow the link at bottom of this page).
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