Hence, a major recellularization hurdle has been overcome with the improved recellularization strategies and in vitro platforms described herein. However, the recellularization efficiency in scaffolds preconditioned with matrix metalloproteinases was 200–300% better than the other strategies evaluated herein, independent of decellularization protocol. The recellularization efficiency was improved short-term when transwells were used compared with standard culturing conditions. Extensive recellularization optimization was conducted using multipotent sheep fetal stem cells and we report results from the following three in vitro conditions (a) standard cell culturing conditions, (b) constructs cultured in transwells, and (c) scaffolds preconditioned with matrix metalloproteinase 2 and 9. Scaffolds were then assessed for bioactivity using the dorsal root ganglion and chorioallantoic membrane assays, and we found that all the uterus scaffolds exhibited growth factor activity that promoted neurogenesis and angiogenesis. In this study, we decellularized whole sheep uterus with three different protocols using 0.5% sodium dodecyl sulfate, 2% sodium deoxycholate (SDC) or 2% SDC, and 1% Triton X-100. For example, transplanted recellularized constructs derived from decellularized tissue restored fertility in rodent models and mandate translational studies. However, risky donor surgery and immunosuppressive therapy are factors that may be avoided with bioengineering. Uterine factor infertility was considered incurable until recently when we reported the first successful live birth after uterus transplantation.
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