Bioengineered vocal fold mucosa for functional voice restoration
An engineered vocal fold mucosa, including an engineered lamina propria layer and an engineered squamous epithelium layer, is disclosed. The engineered lamina propria is made by seeding and culturing human vocal fold fibroblasts within a polymerized collagen scaffold, and the engineered squamous epithelium is made by culturing human vocal fold epithelial cells on the scaffold surface. The resulting engineered vocal fold mucosa is not immunogenic, and is capable of exhibiting the vibratory function and acoustic output of a native vocal fold mucosa. Accordingly, the engineered vocal fold mucosa may be implanted into the larynx to treat voice impairment.
1. An engineered vocal fold mucosa comprising:
(a) an engineered non-vascularized lamina propria comprising a scaffold comprising polymerized collagen populated by a plurality of human vocal fold fibroblasts (VFFs); and
(b) an engineered stratified squamous epithelium in contact with the engineered non-vascularized lamina propria of (a), the stratified squamous epithelium comprising a plurality of human vocal fold epithelial cells (VFEs);
wherein the engineered vocal fold mucosa, when implanted into a larynx, exhibits vibratory function and acoustic output of a native human vocal fold mucosa.
2. The engineered vocal fold mucosa of claim 1 , wherein the polymerized collagen is polymerized collagen, type I.
3. The engineered vocal fold mucosa of claim 1 , wherein VFF density of the engineered non-vascularized lamina propria is 100-300 cells/mm 2 .
4. The engineered vocal fold mucosa of claim 3 , wherein VFF density of the engineered non-vascularized lamina propria is 130-270 cells/mm 2 .
5. The engineered vocal fold mucosa of claim 1 , wherein the engineered stratified squamous epithelium is between 30 and 70 μm thick.
6. The engineered vocal fold mucosa of claim 1 , wherein one or more VFEs at basal and epithelial surfaces of the engineered stratified squamous epithelium express the basement membrane marker collagen, type IV.
7. The engineered vocal fold mucosa of claim 1 , wherein the engineered stratified squamous epithelium comprises one or more Keratin 5 + VFEs, and wherein a basal surface of the engineered stratified squamous epithelium does not have a higher percentage of Keratin 5 + VFEs than the stratified squamous epithelium as a whole.
8. The engineered vocal fold mucosa of claim 1 , further comprising one or more proteins listed in Table 1.
9. The engineered vocal fold mucosa of claim 8 , wherein at least one of the one or more proteins listed in Table 1 is a protein that is not present in native vocal fold mucosa.
10. An engineered vocal fold mucosa according to claim 1 for use in treating voice impairment caused by vocal fold fibrosis or vocal fold mucosal tissue damage or loss.
11. An engineered vocal fold mucosa according to claim 1 for use in manufacturing a composition for treating voice impairment caused by vocal fold fibrosis or vocal fold mucosal tissue damage or loss.
12. A method of treating voice impairment caused by vocal fold fibrosis or vocal fold mucosal tissue damage or loss, comprising implanting an engineered vocal fold mucosa according to claim 1 into a larynx of a human subject in need thereof, whereby the voice impairment is reduced.
13. An engineered vocal fold mucosa as made by
(a) culturing a plurality of human vocal fold fibroblasts (VFFs) within a scaffold comprising polymerized collagen; and
(b) culturing a plurality of human vocal fold epithelial cells (VFEs) on the scaffold surface;
thereby forming an engineered vocal fold mucosa comprising an engineered stratified squamous epithelium in contact with an engineered non-vascularized lamina propria comprising a scaffold comprising polymerized collagen and populated by a plurality of human VFFs.