Tracheal cartilage regeneration by slow release of basic fibroblast growth factor from a gelatin sponge

Objective: We investigated whether implantation of a gelatin sponge, releasing basic fibroblast growth factor slowly (b-FGF) into a tracheal cartilage defect, would induce regeneration of autologous tracheal cartilage. Methods: We created a 1-cm defect in the midventral portion of each of 10 consecutive cervical tracheal cartilage rings in 12 experimental dogs. In the control group (n = 4), the resulting defects were left untreated. In the gelatin group (n = 4), empty gelatin sponges were implanted in the defects. In the basic fibroblast growth factor group (n = 4), gelatin sponges incorporating 100 mu g of b-FGF solution were implanted in the defects. We killed the 4 dogs in each group at 1, 3, 6, and 12 months after implantation, respectively, and examined the implant sites macro- and microscopically. Results: In the control and gelatin groups, no regenerated cartilage was observed in the tracheal cartilage defects, and the width of the gap between the host cartilage stumps had shrunk. In the b-FGF group, regenerated cartilage was observed in all dogs. The proportion of the defect in the host cartilage occupied by regenerated cartilage was 13%, 84%, 75%, and 69% at 1, 3, 6, and 12 months, respectively. The regenerated cartilage was fibrous cartilage covered with perichondrium, which grew from the host perichondrium and showed continuity with the host cartilage stumps. Conclusions: Implantation of a gelatin sponge slowly releasing basic fibroblast growth factor induces tracheal cartilage regeneration, which subsequently fills a large proportion of experimentally created tracheal cartilage defects within 12 months after implantation.