Primary human epithelium on nitinol stents to improve mucociliary function.

BACKGROUND: Current airway stents treat tracheobronchial stenosis effectively but lack native respiratory epithelium. This deficiency impairs mucociliary clearance, leading to complications such as mucus accumulation, infection, and granulation tissue formation. The objective of this study was to evaluate if the direct explant culture of human bronchial tissue on silicone-coated nitinol stents supports epithelial adhesion and preserves functional ciliary activity. METHODS: Primary bronchial epithelial tissues from lung cancer patients (n=4) were cultured directly on silicone-coated nitinol stents using an explant technique, with conventional dishes as controls. Cellular viability and density were evaluated, and ciliary differentiation and function were quantified by measuring ciliary beating frequency (CBF) on days 5, 10, and 15 via high-speed video analysis. Cell density and phenotype were verified immunohistochemically on day 20. RESULTS: Human bronchial epithelial cells successfully adhered and proliferated on nitinol stents, forming a differentiated ciliated architecture. Functional ciliary activity was detected in both groups at all time points. On stents, mean CBF increased from 7.38±0.67 Hz (day 5) to 8.60±1.78 Hz (day 10). Immunohistochemistry confirmed the presence of ciliated structures. CBF values on stents were comparable to control groups (p>0.05), indicating physiological functional equivalence and excellent biocompatibility on the biomaterial surface. CONCLUSION: These findings demonstrate the feasibility of engineering a biologically active airway stent by culturing patient-derived bronchial epithelium on nitinol surfaces. Epithelialized stents may support mucociliary function and improve biological performance. Further preclinical validation is warranted to evaluate the therapeutic benefit of this approach.