A Triple-Layered Composite Scaffold of Silk Fibroin and Decellularized Amniotic Membrane for Bladder Tissue Engineering.

Augmentation cystoplasty has different side effects in urinary bladder reconstruction. Accordingly, it is necessary to develop substitutes using natural and synthetic biomaterials to address current problems. This study evaluates the potential of a triple-layered composite scaffold for bladder regeneration. The triple-layered scaffold consists of a silk fibroin (SF) film blended with polyethylene oxide (PEO), a decellularized human amniotic membrane (DHAM), and a lyophilized SF sponge, which is seeded with adipose tissue-derived stem cells (ADSCs) encapsulated in collagen hydrogel. The mechanical properties of the triple-layered scaffolds closely resemble those of human bladder tissue. The cell survival, proliferation, and viability of the different layers of the scaffold are assessed. The results show that DHAM and silk sponge at a concentration of 4% wt v achieve a high level of biocompatibility. To study potential stone formation, scaffolds either with DHAM or without DHAM are exposed to human urine. Field emission scanning electron microscopy (FESEM) and X-ray diffraction analyses indicate that the scaffolds with DHAM do not exhibit any signs of erosion or the creation of crystalline particles after 7 days. In conclusion, the data presented in this study highlight a new triple-layered scaffold for the purpose of bladder tissue engineering.