Regeneration and bioengineering of the gastrointestinal tract: current status and future perspectives

The present review aims to illustrate the strategies that are being implemented in regenerative medicine to treat diseases that affect the digestive tract. Possible avenues are twofold: organ bioengineering, where cells are seeded on biological or synthetic scaffolding materials ex vivo and allowed to either mature in bioreactors or be implanted without undergoing any maturation; and regeneration per se, where the diseased tissue or organ is regenerated by recapitulation of its multi-step ontogenesis. This latter avenue may be induced either in vivo or ex vivo. While bioengineering technology has already manufactured segments of the digestive tract and sphincters, pure regeneration of any segment of the digestive tract has not yet been described. However, models of regeneration extrapolated from simple organisms are elucidating the complex yet fascinating mechanisms that regulate the ontogenesis of the digestive tract and are paving the way for the development of new regenerative technologies and methods.