Biomaterials from Decellularized Tissues

The field of tissue engineering/regenerative medicine is based upon the following fundamental strategies to promote functional tissue replacement: cell-based therapies, scaffold-based approaches, provision of bioactive molecules, or combinations of these strategies. The majority of work to date has focused upon cell-based therapies. Synthetic materials are manufactured with high precision and generally have an identified and expected tissue response. In contrast, biologic scaffolds consist of either the intact extracellular matrix (ECM) following tissue decellularization or individual components of the ECM such as Collagen Type I, laminin, or hyaluronic acid. Biologic scaffolds tend to elicit a friendlier host response than synthetic materials but are subject to biologic variability in their natural composition and mechanical properties. This chapter discusses the clinical use of naturally occurring scaffolds and explores the pros and cons of such biologic materials. The process of tissue remodeling following biomaterial implantation is invariably associated with an innate immune response.