Preclinical study for treatment of hypospadias by advanced therapy medicinal products

World J Urol. 2020 Sep;38(9):2115-2122. doi: 10.1007/s00345-019-02864-x. Epub 2019 Jul 9.

Abstract

Purpose: This paper explores the feasibility of a new therapy for the treatment of hypospadias patients. Hypospadias is a very common congenital malformation of male genitals, with very high rate of recurrences after surgery. The field of regenerative medicine, which offers innovative solutions for many pathologies, still does not offer reliable solution for this pathology. Here, we propose quality, safety, and clinical feasibility assessment for an oral mucosa advanced therapy medicinal product (ATMP) grown on a biocompatible scaffold for a clinical study on urethral reconstruction of hypospadias patients.

Methods: Urethral and oral mucosal epithelia from donor biopsies were cultivated between two fibrin layers, under clinical-grade conditions for cell and tissue characterization and comparison, aimed at tissue engineering. In addition, single-clone analyses were performed to analyze gene expression profiles of the two epithelia by microarray technology.

Results: Oral mucosa appeared suitable for urethral reconstruction. The resulting ATMP was proven to maintain stem cells and regenerative potency. The preclinical safety studies were performed on human tissues to assess abnormalities and tumorigenicity, and confirmed the safety of the ATMP. Finally, the patient selection and the clinical protocol for the upcoming clinical trial were defined.

Conclusions: Against this backdrop, in this paper, we are proposing a new reproducible and reliable ATMP for the treatment of hypospadias.

Keywords: Clinical trial; Hypospadias; Oral mucosa; Regenerative medicine; Stem cells; Tissue engineering.

MeSH terms

  • Animals
  • Disease Models, Animal
  • Feasibility Studies
  • Humans
  • Hypospadias / surgery*
  • In Vitro Techniques
  • Male
  • Mouth Mucosa / transplantation*
  • Swine
  • Tissue Engineering
  • Tissue Scaffolds
  • Urethra / surgery*
  • Urologic Surgical Procedures, Male / methods