Sustained Postnatal Skin Regeneration upon Prenatal Application of Functionalized Collagen Scaffolds

C Oostendorp, PJ Geutjes, F Smit, DM Tiemessen, S Polman, A Abbawi, KM Brouwer, Alex Eggink, WF Feitz, WF Daamen, TH van Kuppevelt

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3 Citations (Scopus)


Primary closure of fetal skin in spina bifida protects the spinal cord and improves clinical outcome, but is also associated with postnatal growth malformations and spinal cord tethering. In this study, we evaluated the postnatal effects of prenatally closed full-Thickness skin defects in sheep applying collagen scaffolds with and without heparin/vascular endothelial growth factor/fibroblast growth factor 2, focusing on skin regeneration and growth. At 6 months, collagen scaffold functionalized with heparin, VEGF, and FGF2 (COL-HEP/GF) resulted in a 6.9-fold increase of the surface area of the regenerated skin opposed to 1.7 × for collagen only. Epidermal thickness increased 5.7-fold at 1 month, in line with high gene expression of S100 proteins, and decreased to 2.1 at 6 months. Increased adipose tissue and reduced scaffold degradation and number of myofibroblasts were observed for COL-HEP/GF. Gene ontology terms related to extracellular matrix (ECM) organization were enriched for both scaffold treatments. In COL-HEP/GF, ECM gene expression resembled native skin. Expression of hair follicle-related genes in COL-HEP/GF was comparable to native skin, and de novo hair follicle generation was indicated. In conclusion, in utero closure of skin defects using functionalized collagen scaffolds resulted in long-Term skin regeneration and growth. Functionalized collagen scaffolds that grow with the child may be useful for prenatal treatment of closure defects like spina bifida.

Original languageEnglish
Pages (from-to)10-25
Number of pages16
JournalTissue Engineering - Part A
Issue number1-2
Publication statusPublished - 1 Jan 2021

Bibliographical note

Funding Information:
This work was financially supported by EU-FP7 project EuroSkinGraft (grant agreement no. 279024) and the EU-FP6 project EuroSTEC (grant agreement no.: LSHB-CT-2006-037409).

Publisher Copyright:
© 2021, Mary Ann Liebert, Inc., publishers 2021.

Research programs

  • EMC OR-01


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