Intrauterine Correction of Neural Tube Defects Using Smart Biomimetic Patches: Systematic Review and Computational Model
DOI:
https://doi.org/10.70577/asce.v5i4.1114Keywords:
Myelomeningocele; Intrauterine surgery; Biomimetic patch; Mesenchymal stem cells; Motor function; Psychosocial developmentAbstract
Introduction: Myelomeningocele (MMC) is the most severe neural tube defect, associated with motor disability, urological dysfunction, and impaired psychosocial development. Smart biomimetic patches incorporating mesenchymal stromal cells (MSCs) and neurotrophic factors could enhance regeneration. Objective: To assess, through a systematic review and a computational model, the feasibility and potential effects of a polycaprolactone (PCL) biomimetic patch functionalized with allogeneic MSCs and sustained‑release brain‑derived neurotrophic factor (BDNF) for intrauterine MMC repair. Methods: A PRISMA 2020 systematic review was conducted (PubMed, EMBASE, Cochrane, Scopus; 2015‑2025). In addition, an in silico simulation of BDNF release and the mechanical behavior of the patch was developed using the finite element method (COMSOL Multiphysics). Results: The systematic review (25 studies, n=1,862 patients) showed that intrauterine surgery reduces the need for ventriculoperitoneal shunt (RR=0.51; 95%CI:0.42‑0.62) and improves independent ambulation (RR=2.10; 95%CI:1.58‑2.79). Predictive simulation indicated that the biomimetic patch releases BDNF sustainably for 60 days (effective half‑life 18.5 days), with a maximum concentration of 28.4 ng/mL in adjacent tissue. The patch's elastic modulus (8.2 MPa) matches that of the fetal spinal cord (7.5‑9.0 MPa). Conclusions: The systematized evidence and computational models support the safety and potential benefit of the smart biomimetic patch. Preclinical studies and clinical trials are required to confirm these findings.
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