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Badv M, Alonso-Cantu C, Shakeri A, Hosseinidoust Z, Weitz JI, Didar TF. Biofunctional Lubricant-Infused Vascular Grafts Functionalized with Silanized Bio-Inks Suppress Thrombin Generation and Promote Endothelialization. ACS Biomater Sci Eng 2019; 5:6485-6496. [DOI: 10.1021/acsbiomaterials.9b01062] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | | | | | | | - Jeffrey I. Weitz
- Thrombosis & Atherosclerosis Research Institute (TaARI), 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada
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52
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Wang W, Liu D, Li D, Du H, Zhang J, You Z, Li M, He C. Nanofibrous vascular scaffold prepared from miscible polymer blend with heparin/stromal cell-derived factor-1 alpha for enhancing anticoagulation and endothelialization. Colloids Surf B Biointerfaces 2019; 181:963-972. [DOI: 10.1016/j.colsurfb.2019.06.065] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 01/21/2023]
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53
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Min S, Ko IK, Yoo JJ. State-of-the-Art Strategies for the Vascularization of Three-Dimensional Engineered Organs. Vasc Specialist Int 2019; 35:77-89. [PMID: 31297357 PMCID: PMC6609020 DOI: 10.5758/vsi.2019.35.2.77] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/03/2019] [Accepted: 06/05/2019] [Indexed: 02/07/2023] Open
Abstract
Engineering three-dimensional (3D) implantable tissue constructs is a promising strategy for replacing damaged or diseased tissues and organs with functional replacements. However, the efficient vascularization of new 3D organs is a major scientific and technical challenge since large tissue constructs or organs require a constant blood supply to survive in vivo. Current approaches to solving this problem generally fall into the following three major categories: (a) cell-based, (b) angiogenic factor-based, and (c) scaffold-based. In this review, we summarize state-of-the-art technologies that are used to develop complex, stable, and functional vasculature for engineered 3D tissue constructs and organs; additionally, we have suggested directions for future research.
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Affiliation(s)
- Sangil Min
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - In Kap Ko
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - James J Yoo
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Jin X, Geng X, Jia L, Xu Z, Ye L, Gu Y, Zhang AY, Feng ZG. Preparation of Small-Diameter Tissue-Engineered Vascular Grafts Electrospun from Heparin End-Capped PCL and Evaluation in a Rabbit Carotid Artery Replacement Model. Macromol Biosci 2019; 19:e1900114. [PMID: 31222914 DOI: 10.1002/mabi.201900114] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/23/2019] [Indexed: 12/14/2022]
Abstract
Aiming to construct small diameter (ID <6 mm) off-the-shelf tissue-engineered vascular grafts, the end-group heparinizd poly(ε-caprolactone) (PCL) is synthesized by a three-step process and then electrospun into an inner layer of double-layer vascular scaffolds (DLVSs) showing a hierarchical double distribution of nano- and microfibers. Afterward, PCL without the end-group heparinization is electrospun into an outer layer. A steady release of grafted heparin and the existence of a glycocalyx structure give the grafts anticoagulation activity and the conjugation of heparin also improves hydrophilicity and accelerates degradation of the scaffolds. The DLVSs are evaluated in six rabbits via a carotid artery interpositional model for a period of three months. All the grafts are patent until explantation, and meanwhile smooth endothelialization and fine revascularization are observed in the grafts. The composition of the outer layer of scaffolds exhibits a significant effect on the aneurysm dilation after implantation. Only one aneurysm dilation is detected at two months and no calcification is formed in the follow-up term. How to prevent aneurysms remains a challenging topic.
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Affiliation(s)
- Xin Jin
- School of Materials Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China
| | - Xue Geng
- School of Materials Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China
| | - Liujun Jia
- Beijing Key Laboratory of Pre-clinic Research and Evaluation for Cardiovascular Implant Materials, Fuwai Hospital National Cardiovascular Center, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100037, China
| | - Zeqin Xu
- Department of Vascular Surgery, Xuanwu Hospital and Institute of Vascular Surgery, Capital Medical University, Beijing, 100053, China
| | - Lin Ye
- School of Materials Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China
| | - Yongquan Gu
- Department of Vascular Surgery, Xuanwu Hospital and Institute of Vascular Surgery, Capital Medical University, Beijing, 100053, China
| | - Ai-Ying Zhang
- School of Materials Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China
| | - Zeng-Guo Feng
- School of Materials Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China
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55
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Shi P, Zhang L, Tian W, Li H, Wang Q, Yi H, Yin Y, Wang A, Ning P, Dong F, Wang J. Preparation and anticoagulant activity of functionalised silk fibroin. Chem Eng Sci 2019. [DOI: 10.1016/j.ces.2019.01.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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56
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Sphingosine-1-phosphate in Endothelial Cell Recellularization Improves Patency and Endothelialization of Decellularized Vascular Grafts In Vivo. Int J Mol Sci 2019; 20:ijms20071641. [PMID: 30987025 PMCID: PMC6480112 DOI: 10.3390/ijms20071641] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/25/2019] [Accepted: 03/29/2019] [Indexed: 12/17/2022] Open
Abstract
Background: S1P has been shown to improve the endothelialization of decellularized vascular grafts in vitro. Here, we evaluated the potential of tissue-engineered vascular grafts (TEVGs) constructed by ECs and S1P on decellularized vascular scaffolds in a rat model. Methods: Rat aorta was decellularized mainly by 0.1% SDS and characterized by histology. Rat ECs, were seeded onto decellularized scaffolds, and the viability of the ECs was evaluated by biochemical assays. Then, we investigated the in vivo patency rate and endothelialization for five groups of decellularized vascular grafts (each n = 6) in a rat abdominal aorta model for 14 days. The five groups included (1) rat allogenic aorta (RAA); (2) decellularized RAA (DRAA); (3) DRAA with S1P (DRAA/S1P); (4) DRAA with EC recellularization (DRAA/EC); and (5) DRAA with S1P and EC recellularization (DRAA/EC/S1P). Results: In vitro, ECs were identified by the uptake of Dil-Ac-LDL. S1P enhanced the expression of syndecan-1 on ECs and supported the proliferation of ECs on decellularized vascular grafts. In vivo, RAA and DRAA/EC/S1P both had 100% patency without thrombus formation within 14 days. Better endothelialization, more wall structure maintenance and less inflammation were noted in the DRAA/EC/S1P group. In contrast, there was thrombus formation in the DRAA, DRAA/S1P and DRAA/EC groups. Conclusion: S1P could inhibit thrombus formation to improve the patency rate of EC-covered decellularized vascular grafts in vivo and may play an important role in the construction of TEVGs.
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57
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Weidenbacher L, Müller E, Guex AG, Zündel M, Schweizer P, Marina V, Adlhart C, Vejsadová L, Pauer R, Spiecker E, Maniura-Weber K, Ferguson SJ, Rossi RM, Rottmar M, Fortunato G. In Vitro Endothelialization of Surface-Integrated Nanofiber Networks for Stretchable Blood Interfaces. ACS APPLIED MATERIALS & INTERFACES 2019; 11:5740-5751. [PMID: 30668107 DOI: 10.1021/acsami.8b18121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite major technological advances within the field of cardiovascular engineering, the risk of thromboembolic events on artificial surfaces in contact with blood remains a major challenge and limits the functionality of ventricular assist devices (VADs) during mid- or long-term therapy. Here, a biomimetic blood-material interface is created via a nanofiber-based approach that promotes the endothelialization capability of elastic silicone surfaces for next-generation VADs under elevated hemodynamic loads. A blend fiber membrane made of elastic polyurethane and low-thrombogenic poly(vinylidene fluoride- co-hexafluoropropylene) was partially embedded into the surface of silicone films. These blend membranes resist fundamental irreversible deformation of the internal structure and are stably attached to the surface, while also exhibiting enhanced antithrombotic properties when compared to bare silicone. The composite material supports the formation of a stable monolayer of endothelial cells within a pulsatile flow bioreactor, resembling the physiological in vivo situation in a VAD. The nanofiber surface modification concept thus presents a promising approach for the future design of advanced elastic composite materials that are particularly interesting for applications in contact with blood.
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Affiliation(s)
| | | | | | | | - Peter Schweizer
- Department of Materials Science and Engineering, Institute of Micro- and Nanostructure Research & Center for Nanoanalysis and Electron Microscopy , Friedrich-Alexander-Universität Erlangen-Nürnberg , 91058 Erlangen , Germany
| | | | - Christian Adlhart
- Institute of Chemistry and Biotechnology , Zurich University of Applied Sciences ZHAW , 8820 Wädenswil , Switzerland
| | - Lucie Vejsadová
- Institute of Chemistry and Biotechnology , Zurich University of Applied Sciences ZHAW , 8820 Wädenswil , Switzerland
| | - Robin Pauer
- Electron Microscopy Center , Empa, Swiss Federal Laboratories for Materials Science and Technology , 8600 Dübendorf , Switzerland
| | - Erdmann Spiecker
- Department of Materials Science and Engineering, Institute of Micro- and Nanostructure Research & Center for Nanoanalysis and Electron Microscopy , Friedrich-Alexander-Universität Erlangen-Nürnberg , 91058 Erlangen , Germany
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58
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Hall ML, Ogle BM. Cardiac Extracellular Matrix Modification as a Therapeutic Approach. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1098:131-150. [PMID: 30238369 PMCID: PMC6584040 DOI: 10.1007/978-3-319-97421-7_7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The cardiac extracellular matrix (cECM) is comprised of proteins and polysaccharides secreted by cardiac cell types, which provide structural and biochemical support to cardiovascular tissue. The roles of cECM proteins and the associated family of cell surface receptor, integrins, have been explored in vivo via the generation of knockout experimental animal models. However, the complexity of tissues makes it difficult to isolate the effects of individual cECM proteins on a particular cell process or disease state. The desire to further dissect the role of cECM has led to the development of a variety of in vitro model systems, which are now being used not only for basic studies but also for testing drug efficacy and toxicity and for generating therapeutic scaffolds. These systems began with 2D coatings of cECM derived from tissue and have developed to include recombinant ECM proteins, ECM fragments, and ECM mimics. Most recently 3D model systems have emerged, made possible by several developing technologies including, and most notably, 3D bioprinting. This chapter will attempt to track the evolution of our understanding of the relationship between cECM and cell behavior from in vivo model to in vitro control systems. We end the chapter with a summary of how basic studies such as these have informed the use of cECM as a direct therapy.
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Affiliation(s)
- Mikayla L Hall
- Department of Biomedical Engineering, University of Minnesota - Twin Cities, Minneapolis, MN, USA
- Stem Cell Institute, University of Minnesota - Twin Cities, Minneapolis, MN, USA
| | - Brenda M Ogle
- Department of Biomedical Engineering, University of Minnesota - Twin Cities, Minneapolis, MN, USA.
- Stem Cell Institute, University of Minnesota - Twin Cities, Minneapolis, MN, USA.
- Masonic Cancer Center, University of Minnesota - Twin Cities, Minneapolis, MN, USA.
- Lillehei Heart Institute, University of Minnesota - Twin Cities, Minneapolis, MN, USA.
- Institute for Engineering in Medicine, University of Minnesota - Twin Cities, Minneapolis, MN, USA.
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59
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Munisso MC, Yamaoka T. Peptide with endothelial cell affinity and antiplatelet adhesion property to improve hemocompatibility of blood‐contacting biomaterials. Pept Sci (Hoboken) 2019. [DOI: 10.1002/pep2.24114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Maria Chiara Munisso
- Department of Biomedical EngineeringNational Cerebral and Cardiovascular Center Research Institute Suita Osaka Japan
| | - Tetsuji Yamaoka
- Department of Biomedical EngineeringNational Cerebral and Cardiovascular Center Research Institute Suita Osaka Japan
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60
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Ardila DC, Liou JJ, Maestas D, Slepian MJ, Badowski M, Wagner WR, Harris D, Vande Geest JP. Surface Modification of Electrospun Scaffolds for Endothelialization of Tissue-Engineered Vascular Grafts Using Human Cord Blood-Derived Endothelial Cells. J Clin Med 2019; 8:E185. [PMID: 30720769 PMCID: PMC6416564 DOI: 10.3390/jcm8020185] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/22/2019] [Accepted: 02/01/2019] [Indexed: 01/09/2023] Open
Abstract
Tissue engineering has gained attention as an alternative approach for developing small diameter tissue-engineered vascular grafts intended for bypass surgery, as an option to treat coronary heart disease. To promote the formation of a healthy endothelial cell monolayer in the lumen of the graft, polycaprolactone/gelatin/fibrinogen scaffolds were developed, and the surface was modified using thermoforming and coating with collagen IV and fibronectin. Human cord blood-derived endothelial cells (hCB-ECs) were seeded onto the scaffolds and the important characteristics of a healthy endothelial cell layer were evaluated under static conditions using human umbilical vein endothelial cells as a control. We found that polycaprolactone/gelatin/fibrinogen scaffolds that were thermoformed and coated are the most suitable for endothelial cell growth. hCB-ECs can proliferate, produce endothelial nitric oxide synthase, respond to interleukin 1 beta, and reduce platelet deposition.
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Affiliation(s)
| | - Jr-Jiun Liou
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA.
| | - David Maestas
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21231, USA.
| | - Marvin J Slepian
- Sarver Heart Center, The University of Arizona, Tucson, AZ 85721, USA.
- The Arizona Center for Accelerated BioMedical Innovation, University of Arizona, Tucson, AZ 85721, USA.
- BIO5 Institute for Biocollaborative Research, The University of Arizona, Tucson, AZ 85721, USA.
- Interventional Cardiology, University of Arizona, Tucson, AZ 85721, USA.
| | - Michael Badowski
- Arizona Health Science Center Biorepository, University of Arizona, Tucson, AZ 85724, USA.
| | - William R. Wagner
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA.
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA.
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA.
| | - David Harris
- Arizona Health Science Center Biorepository, University of Arizona, Tucson, AZ 85724, USA.
- Department of Immunobiology, Arizona Health Science Center Biorepository, University of Arizona, Tucson, AZ 85724, USA.
| | - Jonathan P Vande Geest
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15219, USA.
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA.
- Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA 15219, USA.
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61
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Beyond RGD; nanoclusters of syndecan- and integrin-binding ligands synergistically enhance cell/material interactions. Biomaterials 2018; 187:81-92. [DOI: 10.1016/j.biomaterials.2018.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 09/19/2018] [Accepted: 10/02/2018] [Indexed: 12/22/2022]
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62
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Cui C, Wen M, Zhou F, Zhao Y, Yuan X. Target regulation of both VECs and VSMCs by dual-loading miRNA-126 and miRNA-145 in the bilayered electrospun membrane for small-diameter vascular regeneration. J Biomed Mater Res A 2018; 107:371-382. [PMID: 30461189 DOI: 10.1002/jbm.a.36548] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 08/18/2018] [Accepted: 08/29/2018] [Indexed: 11/10/2022]
Abstract
Clinical utility of small-diameter vascular grafts is still challenging in blood vessel regeneration owing to thrombosis and intimal hyperplasia. To cope with the issues, modulation of gene expression via microRNAs (miRNAs) could be a feasible approach by rational regulating physiological activities of both vascular endothelial cells (VECs) and vascular smooth muscle cells (VSMCs). Our previous studies demonstrated that individually loaded miRNA-126 (miR-126) or miRNA-145 (miR-145) in the electrospun membranes showed the tendency to promote vascular regeneration. In this work, the bilayered electrospun graft in 1.5-mm diameter was developed by emulsion electrospinning to dual-load miR-126 and miR-145 for target regulation of both VECs and VSMCs, respectively. Accelerated release of miR-126 was achieved by introducing poly(ethylene glycol) in the inner electrospun poly(ethylene glycol)-b-poly(l-lactide-co-caprolactone) ultrafine fibrous membrane, reaching 61.3 ± 1.2% of the cumulative release in the initial 10 days, whereas the outer electrospun poly(l-lactide-co-glycolide) membrane composed of microfibers fulfilled prolonged release of miR-145 for about 56 days. In vivo tests suggested that dual-loading with miR-126 and miR-145 in the bilayered electrospun membranes could modulate both VECs and VSMCs for rapid endothelialization and hyperplasia inhibition as well. It is reasonably expected that dual target-delivery of miR-126 and miR-145 in the electrospun vascular grafts has effective potential for small-diameter vascular regeneration. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 371-382, 2019.
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Affiliation(s)
- Ce Cui
- School of Materials Science and Engineering, and Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin, 300350, China
| | - Meiling Wen
- School of Materials Science and Engineering, and Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin, 300350, China
| | - Fang Zhou
- School of Materials Science and Engineering, and Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin, 300350, China
| | - Yunhui Zhao
- School of Materials Science and Engineering, and Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin, 300350, China
| | - Xiaoyan Yuan
- School of Materials Science and Engineering, and Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin, 300350, China
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63
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Bao BQ, Le NH, Nguyen DHT, Tran TV, Pham LPT, Bach LG, Ho HM, Nguyen TH, Nguyen DH. Evolution and present scenario of multifunctionalized mesoporous nanosilica platform: A mini review. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 91:912-928. [DOI: 10.1016/j.msec.2018.07.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 06/06/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
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In Vivo Performance of Decellularized Vascular Grafts: A Review Article. Int J Mol Sci 2018; 19:ijms19072101. [PMID: 30029536 PMCID: PMC6073319 DOI: 10.3390/ijms19072101] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 07/16/2018] [Accepted: 07/16/2018] [Indexed: 12/12/2022] Open
Abstract
Due to poor vessel quality in patients with cardiovascular diseases, there has been an increased demand for small-diameter tissue-engineered blood vessels that can be used as replacement grafts in bypass surgery. Decellularization techniques to minimize cellular inflammation have been applied in tissue engineering research for the development of small-diameter vascular grafts. The biocompatibility of allogenic or xenogenic decellularized matrices has been evaluated in vitro and in vivo. Both short-term and long-term preclinical studies are crucial for evaluation of the in vivo performance of decellularized vascular grafts. This review offers insight into the various preclinical studies that have been performed using decellularized vascular grafts. Different strategies, such as surface-modified, recellularized, or hybrid vascular grafts, used to improve neoendothelialization and vascular wall remodeling, are also highlighted. This review provides information on the current status and the future development of decellularized vascular grafts.
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65
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Zhao Q, Cui H, Wang J, Chen H, Wang Y, Zhang L, Du X, Wang M. Regulation Effects of Biomimetic Hybrid Scaffolds on Vascular Endothelium Remodeling. ACS APPLIED MATERIALS & INTERFACES 2018; 10:23583-23594. [PMID: 29943973 DOI: 10.1021/acsami.8b06205] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The formation of complete and well-functioning endothelium is critical for the success of tissue-engineered vascular grafts yet remaining a fundamental challenge. Endothelium remodeling onto the lumen of tissue-engineered vascular grafts is affected by their topographical, mechanical, and biochemical characteristics. For meeting multiple requirements, composite strategies have recently emerged for fabricating hybrid scaffolds, where the integrated properties are tuned by varying their compositions. However, the underlying principle how the integrated properties of hybrid scaffolds regulate vascular endothelium remodeling remains unclear. To uncover the regulation effects of hybrid scaffolds on vascular endothelium remodeling, we prepared different biomimetic hybrid scaffolds using gelatin methacrylamide (GelMA) and poly-ε-caprolactone (PCL) and then investigated vascular endothelial cell responses on them. GelMA and PCL, respectively, conferred the resulting scaffolds with biomimetic bioactivity and mechanical properties, which were tuned by varying GelMA/PCL mass ratios (3:1, 1:1, or 1:3). On different GelMA/PCL hybrid scaffolds, distinct vascular endothelial cell responses were observed. Firm cell-scaffold/cell-cell interactions were rapidly established on the hybrid scaffolds with the highest mass ratio of bioactive GelMA. However, they were mechanically insufficient as vascular grafts. On the contrary, the scaffolds with the highest mass ratio of PCL showed significantly reinforced mechanical properties but poor biological performance. Between the two extremes, the scaffolds with the same GelMA/PCL mass ratio balanced the pros and cons of two materials. Therefore, they could meet the mechanical requirements of vascular grafts and support the early-stage vascular endothelial cell remodeling by appropriate biological signaling and mechanotransduction. This investigation experimentally proves that scaffold bioactivity is the dominant factor affecting vascular endothelial cell adhesion and remodeling, whereas mechanical properties are crucial factors for the integrity of endothelium. This work offers a universal design strategy for desirable vascular grafts for improved endothelium remodeling.
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Affiliation(s)
- Qilong Zhao
- Institute of Biomedical & Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT) , Chinese Academy of Sciences (CAS) , Shenzhen 518055 , China
| | - Huanqing Cui
- Institute of Biomedical & Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT) , Chinese Academy of Sciences (CAS) , Shenzhen 518055 , China
| | - Juan Wang
- Institute of Biomedical & Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT) , Chinese Academy of Sciences (CAS) , Shenzhen 518055 , China
| | - Hongxu Chen
- Institute of Biomedical & Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT) , Chinese Academy of Sciences (CAS) , Shenzhen 518055 , China
| | - Yunlong Wang
- Institute of Biomedical & Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT) , Chinese Academy of Sciences (CAS) , Shenzhen 518055 , China
| | - Lidong Zhang
- Department of Chemistry and Molecular Engineering , East China Normal University , Shanghai 200062 , China
| | - Xuemin Du
- Institute of Biomedical & Health Engineering, Shenzhen Institutes of Advanced Technology (SIAT) , Chinese Academy of Sciences (CAS) , Shenzhen 518055 , China
| | - Min Wang
- Department of Mechanical Engineering , The University of Hong Kong , Hong Kong , China
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66
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Shafiq M, Zhang Q, Zhi D, Wang K, Kong D, Kim DH, Kim SH. In Situ Blood Vessel Regeneration Using SP (Substance P) and SDF (Stromal Cell-Derived Factor)-1α Peptide Eluting Vascular Grafts. Arterioscler Thromb Vasc Biol 2018; 38:e117-e134. [PMID: 29853570 PMCID: PMC6039427 DOI: 10.1161/atvbaha.118.310934] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 05/16/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The objective of this study was to develop small-diameter vascular grafts capable of eluting SDF (stromal cell-derived factor)-1α-derived peptide and SP (substance P) for in situ vascular regeneration. APPROACH AND RESULTS Polycaprolactone (PCL)/collagen grafts containing SP or SDF-1α-derived peptide were fabricated by electrospinning. SP and SDF-1α peptide-loaded grafts recruited significantly higher numbers of mesenchymal stem cells than that of the control group. The in vivo potential of PCL/collagen, SDF-1, and SP grafts was assessed by implanting them in a rat abdominal aorta for up to 4 weeks. All grafts remained patent as observed using color Doppler and stereomicroscope. Host cells infiltrated into the graft wall and the neointima was formed in peptides-eluting grafts. The lumen of the SP grafts was covered by the endothelial cells with cobblestone-like morphology, which were elongated in the direction of the blood flow, as discerned using scanning electron microscopy. Moreover, SDF-1α and SP grafts led to the formation of a confluent endothelium as evaluated using immunofluorescence staining with von Willebrand factor antibody. SP and SDF-1α grafts also promoted smooth muscle cell regeneration, endogenous stem cell recruitment, and blood vessel formation, which was the most prominent in the SP grafts. Evaluation of inflammatory response showed that 3 groups did not significantly differ in terms of the numbers of proinflammatory macrophages, whereas SP grafts showed significantly higher numbers of proremodeling macrophages than that of the control and SDF-1α grafts. CONCLUSIONS SDF-1α and SP grafts can be potential candidates for in situ vascular regeneration and are worthy for future investigations.
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MESH Headings
- Angiogenesis Inducing Agents/chemistry
- Angiogenesis Inducing Agents/pharmacology
- Animals
- Aorta, Abdominal/diagnostic imaging
- Aorta, Abdominal/pathology
- Aorta, Abdominal/physiopathology
- Aorta, Abdominal/surgery
- Blood Vessel Prosthesis
- Blood Vessel Prosthesis Implantation/instrumentation
- Cell Movement/drug effects
- Cell Proliferation/drug effects
- Cells, Cultured
- Chemokine CXCL12/chemistry
- Chemokine CXCL12/pharmacology
- Coated Materials, Biocompatible
- Collagen Type I/chemistry
- Humans
- Male
- Mesenchymal Stem Cells/drug effects
- Neointima
- Neovascularization, Physiologic/drug effects
- Peptide Fragments/chemistry
- Peptide Fragments/pharmacology
- Polyesters/chemistry
- Prosthesis Design
- Rats, Sprague-Dawley
- Substance P/chemistry
- Substance P/pharmacology
- Time Factors
- Ultrasonography, Doppler, Color
- Vascular Patency
- Vascular Remodeling
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Affiliation(s)
- Muhammad Shafiq
- From the Department of Biomedical Engineering, Korea University of Science and Technology, Daejeon (M.S., S.H.K.)
- Center for Biomaterials, Biomedical Research Institute, Department of Biomedical Engineering, Korea Institute of Science and Technology, Seoul, Republic of Korea (M.S., S.H.K.)
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials of Ministry of Education, Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), College of Life Science, Department of Biochemistry and Molecular Biology, Nankai University, China (M.S., Q.Z., D.Z., K.W., D.K.)
| | - Qiuying Zhang
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials of Ministry of Education, Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), College of Life Science, Department of Biochemistry and Molecular Biology, Nankai University, China (M.S., Q.Z., D.Z., K.W., D.K.)
| | - Dengke Zhi
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials of Ministry of Education, Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), College of Life Science, Department of Biochemistry and Molecular Biology, Nankai University, China (M.S., Q.Z., D.Z., K.W., D.K.)
| | - Kai Wang
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials of Ministry of Education, Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), College of Life Science, Department of Biochemistry and Molecular Biology, Nankai University, China (M.S., Q.Z., D.Z., K.W., D.K.)
| | - Deling Kong
- State Key Laboratory of Medicinal Chemical Biology, Key Laboratory of Bioactive Materials of Ministry of Education, Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), College of Life Science, Department of Biochemistry and Molecular Biology, Nankai University, China (M.S., Q.Z., D.Z., K.W., D.K.)
| | - Dong-Hwee Kim
- Tianjin Key Laboratory of Biomedical Materials, Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, China (D.K.)
- Department of Nano-Bio-Information Technology (NBIT), KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul (D.-H.K., S.H.K.)
| | - Soo Hyun Kim
- From the Department of Biomedical Engineering, Korea University of Science and Technology, Daejeon (M.S., S.H.K.)
- Center for Biomaterials, Biomedical Research Institute, Department of Biomedical Engineering, Korea Institute of Science and Technology, Seoul, Republic of Korea (M.S., S.H.K.)
- Department of Nano-Bio-Information Technology (NBIT), KU-KIST Graduate School of Converging Science and Technology, Korea University, Seoul (D.-H.K., S.H.K.)
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Mi HY, Jing X, Thomsom JA, Turng LS. Promoting Endothelial Cell Affinity and Antithrombogenicity of Polytetrafluoroethylene (PTFE) by Mussel-Inspired Modification and RGD/Heparin Grafting. J Mater Chem B 2018; 6:3475-3485. [PMID: 30455952 PMCID: PMC6238965 DOI: 10.1039/c8tb00654g] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
When used as small-diameter vascular grafts (SDVGs), synthetic biomedical materials like polytetrafluoroethylene (PTFE) may induce thrombosis and intimal hyperplasia due to the lack of an endothelial cell layer. Modification of the PTFE in an aqueous solution is difficult because of its hydrophobicity. Herein, aiming to simultaneously promote endothelial cell affinity and antithrombogenicity, a mussel-inspired modification approach was employed to enable the grafting of various bioactive molecules like RGD and heparin. This approach involves a series of pragmatic steps including oxygen plasma treatment, dopamine (DA) coating, polyethylenimine (PEI) grafting, and RGD or RGD/heparin immobilization. Successful modification in each step was verified via Fourier transform infrared (FTIR) spectroscopy and X-ray photoelectron spectroscopy (XPS). Plasma treatment increased the hydrophilicity of PTFE, thereby allowing it to be efficiently coated with dopamine. Grafting of dopamine, RGD, and heparin led to an increase in surface roughness and a decrease in water contact angle due to increased surface energy. Platelet adhesion increased after dopamine and RGD modification, but it dramatically decreased when heparin was introduced. All of these modifications, especially the incorporation of RGD, showed favorable effects on endothelial cell attachment, viability, and proliferation. Due to strong cell-substrate interactions between endothelial cells and RGD, the RGD/heparin-grafted PTFE demonstrated high endothelial cell affinity. This facile modification method is highly suitable for all hydrophobic surfaces and provides a promising technique for SDVG modification to stimulate fast endothelialization and effective antithrombosis.
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Affiliation(s)
- Hao-Yang Mi
- Wisconsin Institute for Discovery, University of Wisconsin–Madison, WI, 53715, USA
- Department of Industrial Equipment and Control Engineering, South China University of Technology, Guangzhou, 510640, China
- Department of Mechanical Engineering, University of Wisconsin–Madison, WI, 53706, USA
| | - Xin Jing
- Wisconsin Institute for Discovery, University of Wisconsin–Madison, WI, 53715, USA
- Department of Industrial Equipment and Control Engineering, South China University of Technology, Guangzhou, 510640, China
- Department of Mechanical Engineering, University of Wisconsin–Madison, WI, 53706, USA
| | - James A. Thomsom
- Morgridge Institute for Research, University of Wisconsin–Madison, WI, 53715, USA
| | - Lih-Sheng Turng
- Wisconsin Institute for Discovery, University of Wisconsin–Madison, WI, 53715, USA
- Department of Mechanical Engineering, University of Wisconsin–Madison, WI, 53706, USA
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68
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Tasiopoulos CP, Widhe M, Hedhammar M. Recombinant Spider Silk Functionalized with a Motif from Fibronectin Mediates Cell Adhesion and Growth on Polymeric Substrates by Entrapping Cells During Self-Assembly. ACS APPLIED MATERIALS & INTERFACES 2018; 10:14531-14539. [PMID: 29641180 DOI: 10.1021/acsami.8b02647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In vitro endothelialization of synthetic grafts or engineered vascular constructs is considered a promising alternative to overcome shortcomings in the availability of autologous vessels and in-graft complications with synthetics. A number of cell-seeding techniques have been implemented to render vascular grafts accessible for cells to attach, proliferate, and spread over the surface area. Nonetheless, seeding efficiency and the time needed for cells to adhere varies dramatically. Herein, we investigated a novel cell-seeding approach (denoted co-seeding) that enables cells to bind to a motif from fibronectin included in a recombinant spider silk protein. Entrapment of cells occurs at the same time as the silk assembles into a nanofibrillar coating on various substrates. Cell adhesion analysis showed that the technique can markedly improve cell-seeding efficiency to nonfunctionalized polystyrene surfaces, as well as establish cell attachment and growth of human dermal microvascular endothelial cells on bare polyethylene terephthalate and polytetrafluoroethylene (PTFE) substrates. Scanning electron microscopy images revealed a uniform endothelial cell layer and cell-substratum compliance with the functionalized silk protein to PTFE surfaces. The co-seeding technique holds a great promise as a method to reliably and quickly cellularize engineered vascular constructs as well as to in vitro endothelialize commercially available cardiovascular grafts.
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Affiliation(s)
- Christos Panagiotis Tasiopoulos
- School of Engineering Sciences in Chemistry, Biotechnology and Health, Division of Protein Science , AlbaNova University Center, KTH-Royal Institute of Technology , Stockholm 114 21 , Sweden
| | - Mona Widhe
- School of Engineering Sciences in Chemistry, Biotechnology and Health, Division of Protein Science , AlbaNova University Center, KTH-Royal Institute of Technology , Stockholm 114 21 , Sweden
| | - My Hedhammar
- School of Engineering Sciences in Chemistry, Biotechnology and Health, Division of Protein Science , AlbaNova University Center, KTH-Royal Institute of Technology , Stockholm 114 21 , Sweden
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69
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Adipurnama I, Yang MC, Ciach T, Butruk-Raszeja B. Surface modification and endothelialization of polyurethane for vascular tissue engineering applications: a review. Biomater Sci 2018; 5:22-37. [PMID: 27942617 DOI: 10.1039/c6bm00618c] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Cardiovascular implants, especially vascular grafts made of synthetic polymers, find wide clinical applications in the treatment of cardiovascular diseases. However, cases of failure still exist, notably caused by restenosis and thrombus formation. Aiming to solve these problems, various approaches to surface modification of synthetic vascular grafts have been used to improve both the hemocompatibility and long-term patency of artificial vascular grafts. Surface modification using hydrophilic molecules can enhance hemocompatibility, but this may limit the initial vascular endothelial cell adhesion. Therefore, the improvement of endothelialization on these grafts with specific peptides and biomolecules is now an exciting field of research. In this review, several techniques to improve surface modification and endothelialization on vascular grafts, mainly polyurethane (PU) grafts, are summarized, together with the recent development and evolution of the different strategies: from the use of PEG, zwitterions, and polysaccharides to peptides and other biomolecules and genes; from in vitro endothelialization to in vivo endothelialization; and from bio-inert and bio-active to bio-mimetic approaches.
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Affiliation(s)
- Iman Adipurnama
- Department of Materials Science and Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan.
| | - Ming-Chien Yang
- Department of Materials Science and Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan.
| | - Tomasz Ciach
- Faculty of Chemical and Process Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Beata Butruk-Raszeja
- Faculty of Chemical and Process Engineering, Warsaw University of Technology, Warsaw, Poland
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70
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Novel approach for a PTX/VEGF dual drug delivery system in cardiovascular applications—an innovative bulk and surface drug immobilization. Drug Deliv Transl Res 2018. [DOI: 10.1007/s13346-018-0507-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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71
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Ding X, Chin W, Lee CN, Hedrick JL, Yang YY. Peptide-Functionalized Polyurethane Coatings Prepared via Grafting-To Strategy to Selectively Promote Endothelialization. Adv Healthc Mater 2018; 7. [PMID: 29205938 DOI: 10.1002/adhm.201700944] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 09/06/2017] [Indexed: 01/02/2023]
Abstract
Endothelialization, formation of endothelial cells (ECs) layer on cardiovascular implant surface, is considered an ideal approach to prevent restenosis (renarrowing of blood vessel mainly due to the accumulation of proliferated vascular smooth muscle cells, SMCs) and thrombosis. In this study, the possibility of using polyurethane (PU) as a coating platform for functionalization with peptide to enhance endothelialization on implants is explored. PUs are synthesized through metal-free organocatalytic polymerization followed by chemical conjugation with an EC-specific REDV peptide through thiol-ene reaction. Meanwhile, the free isocyanate groups of PU allow for covalent grafting of REDV-functionalized PU (PU/REDV) to silanize implant materials (nitinol and PET). PU/REDV coating with peptide grafting density of ≈2 nmol cm-2 selectively accommodates primary human umbilical vein ECs (HUVECs) and retards spreading of primary human umbilical artery SMCs (HUASMCs). In addition, a layer of HUVECs is formed within 3 d on PU/REDV-coated surfaces, while proliferation of HUASMCs is inhibited. The selectivity is further confirmed by coculture of HUVECs and HUASMCs. Moreover, the PU/REDV-coated surfaces are less thrombogenic as evidenced by reduced number and activity of adhered platelets. Therefore, PU/REDV can be potentially used as a coating of cardiovascular implants to prevent restenosis and thrombosis by promoting endothelialization.
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Affiliation(s)
- Xin Ding
- Institute of Bioengineering and Nanotechnology; 31 Biopolis Way, The Nanos 138669 Singapore Singapore
| | - Willy Chin
- Institute of Bioengineering and Nanotechnology; 31 Biopolis Way, The Nanos 138669 Singapore Singapore
| | - Chuen Neng Lee
- Department of Cardiac, Thoracic and Vascular Surgery; National University Hospital Singapore; 5 Lower Kent Ridge Road 119074 Singapore Singapore
- Department of Surgery; Yong Loo Lin School of Medicine; National University of Singapore; 5 Lower Kent Ridge Road 119074 Singapore Singapore
| | - James L. Hedrick
- IBM Almaden Research Center; 650 Harry Road San Jose CA 95120 USA
| | - Yi Yan Yang
- Institute of Bioengineering and Nanotechnology; 31 Biopolis Way, The Nanos 138669 Singapore Singapore
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72
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Elastic polyurethane bearing pendant TGF-β1 affinity peptide for potential tissue engineering applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 83:67-77. [DOI: 10.1016/j.msec.2017.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 09/05/2017] [Accepted: 10/11/2017] [Indexed: 12/18/2022]
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73
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Hong SJ, Ahn MH, Sangshetti J, Choung PH, Arote RB. Sugar-based gene delivery systems: Current knowledge and new perspectives. Carbohydr Polym 2018; 181:1180-1193. [DOI: 10.1016/j.carbpol.2017.11.105] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/26/2017] [Accepted: 11/28/2017] [Indexed: 12/11/2022]
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Chen X, Gu H, Lyu Z, Liu X, Wang L, Chen H, Brash JL. Sulfonate Groups and Saccharides as Essential Structural Elements in Heparin-Mimicking Polymers Used as Surface Modifiers: Optimization of Relative Contents for Antithrombogenic Properties. ACS APPLIED MATERIALS & INTERFACES 2018; 10:1440-1449. [PMID: 29231707 DOI: 10.1021/acsami.7b16723] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Blood compatibility is a long sought-after goal in biomaterials research, but remains an elusive one, and in spite of extensive work in this area, there is still no definitive information on the relationship between material properties and blood responses such as coagulation and thrombus formation. Materials modified with heparin-mimicking polymers have shown promise and indeed may be seen as comparable to materials modified with heparin itself. In this work, heparin was conceptualized as consisting of two major structural elements: saccharide- and sulfonate-containing units, and polymers based on this concept were developed. Copolymers of 2-methacrylamido glucopyranose, containing saccharide groups, and sodium 4-vinylbenzenesulfonate, containing sulfonate groups, were graft-polymerized on vinyl-functionalized polyurethane (PU) surfaces by free radical polymerization. This graft polymerization method is simple, and the saccharide and sulfonate contents are tunable by regulating the feed ratio of the monomers. Homopolymer-grafted materials, containing only sulfonate or saccharide groups, showed different effects on cell-surface interactions including platelet adhesion, adhesion and proliferation of vascular endothelial cells, and adhesion and proliferation of smooth muscle cells. The copolymer-grafted materials showed effects due to both sulfonate and saccharide elements with respect to blood responses, and the optimum composition was obtained at a 2:1 ratio of sulfonate to saccharide units (material designated as PU-PS1M1). In cell adhesion experiments, this material showed the lowest platelet and human umbilical vein smooth muscle cell density and the highest human umbilical vein endothelial cell density. Among the materials investigated, PU-PS1M1 also had the longest plasma clotting time. This material was thus shown to be multifunctional with a combination of properties, suggesting thromboresistant behavior in blood contact.
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Affiliation(s)
- Xianshuang Chen
- State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, College of Chemistry, Chemical Engineering and Materials Science, Soochow University , 199 Ren'ai Road, Suzhou 215123, P. R. China
| | - Hao Gu
- State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, College of Chemistry, Chemical Engineering and Materials Science, Soochow University , 199 Ren'ai Road, Suzhou 215123, P. R. China
| | - Zhonglin Lyu
- State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, College of Chemistry, Chemical Engineering and Materials Science, Soochow University , 199 Ren'ai Road, Suzhou 215123, P. R. China
| | - Xiaoli Liu
- State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, College of Chemistry, Chemical Engineering and Materials Science, Soochow University , 199 Ren'ai Road, Suzhou 215123, P. R. China
| | - Lei Wang
- State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, College of Chemistry, Chemical Engineering and Materials Science, Soochow University , 199 Ren'ai Road, Suzhou 215123, P. R. China
| | - Hong Chen
- State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, College of Chemistry, Chemical Engineering and Materials Science, Soochow University , 199 Ren'ai Road, Suzhou 215123, P. R. China
| | - John L Brash
- State and Local Joint Engineering Laboratory for Novel Functional Polymeric Materials, College of Chemistry, Chemical Engineering and Materials Science, Soochow University , 199 Ren'ai Road, Suzhou 215123, P. R. China
- Department of Chemical Engineering and School of Biomedical Engineering, McMaster University , Hamilton, Ontario L8S4L7, Canada
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Madhavan K, Frid MG, Hunter K, Shandas R, Stenmark KR, Park D. Development of an electrospun biomimetic polyurea scaffold suitable for vascular grafting. J Biomed Mater Res B Appl Biomater 2018; 106:278-290. [PMID: 28130878 PMCID: PMC6080858 DOI: 10.1002/jbm.b.33853] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 11/15/2016] [Accepted: 01/01/2017] [Indexed: 12/19/2022]
Abstract
The optimization of biomechanical and biochemical properties of a vascular graft to render properties relevant to physiological environments is a major challenge today. These critical properties of a vascular graft not only regulate its stability and integrity, but also control invasion of cells for scaffold remodeling permitting its integration with native tissue. In this work, we have synthesized a biomimetic scaffold by electrospinning a blend of a polyurea, poly(serinol hexamethylene urea) (PSHU), and, a polyester, poly-ε-caprolactone (PCL). Mechanical properties of the scaffold were varied by varying polymer blending ratio and electrospinning flow rate. Mechanical characterization revealed that scaffolds with lower PSHU content relative to PCL content resulted in elasticity close to native mammalian arteries. We also found that increasing electrospinning flow rates also increased the elasticity of the matrix. Optimization of elasticity generated scaffolds that enabled vascular smooth muscle cells (SMCs) to adhere, grow and maintain a SMC phenotype. The 30/70 scaffold also underwent slower degradation than scaffolds with higher PSHU content, thereby, providing the best option for in vivo remodeling. Further, Gly-Arg-Gly-Asp-Ser (RGD) covalently conjugated to the polyurea backbone in 30/70 scaffold resulted in significantly increased clotting times. Reducing surface thrombogenicity by the conjugation of RGD is critical to avoiding intimal hyperplasia. Hence, biomechanical and biochemical properties of a vascular graft can be balanced by optimizing synthesis parameters and constituent components. For these reasons, the optimized RGD-conjugated 30/70 scaffold electrospun at 2.5 or 5 mL/h has great potential as a suitable material for vascular grafting applications. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 278-290, 2018.
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Affiliation(s)
- Krishna Madhavan
- Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cardiovascular Pulmonary Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Maria G. Frid
- Department of Pediatrics, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cardiovascular Pulmonary Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Kendall Hunter
- Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cardiovascular Pulmonary Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Robin Shandas
- Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Department of Pediatrics, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Department of Surgery, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cardiovascular Pulmonary Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Kurt R. Stenmark
- Department of Pediatrics, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Cardiovascular Pulmonary Group, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Daewon Park
- Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, 80045, USA
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Ippel BD, Dankers PYW. Introduction of Nature's Complexity in Engineered Blood-compatible Biomaterials. Adv Healthc Mater 2018; 7. [PMID: 28841771 DOI: 10.1002/adhm.201700505] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/04/2017] [Indexed: 01/07/2023]
Abstract
Biomaterials with excellent blood-compatibility are needed for applications in vascular replacement therapies, such as vascular grafts, heart valves and stents, and in extracorporeal devices such as hemodialysis machines and blood-storage bags. The modification of materials that are being used for blood-contacting devices has advanced from passive surface modifications to the design of more complex, smart biomaterials that respond to relevant stimuli from blood to counteract coagulation. Logically, the main source of inspiration for the design of new biomaterials has been the endogenous endothelium. Endothelial regulation of hemostasis is complex and involves a delicate interplay of structural components and feedback mechanisms. Thus, challenges to develop new strategies for blood-compatible biomaterials now lie in incorporating true feedback controlled mechanisms that can regulate blood compatibility in a dynamic way. Here, supramolecular material systems are highlighted as they provide a promising platform to introduce dynamic reciprocity, due to their inherent dynamic nature.
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Affiliation(s)
- Bastiaan D. Ippel
- Institute for Complex Molecular Systems; Laboratory for Chemical Biology; and Laboratory for Cell and Tissue Engineering; Eindhoven University of Technology; P.O. Box 513 5600 MB Eindhoven The Netherlands
| | - Patricia Y. W. Dankers
- Institute for Complex Molecular Systems; Laboratory for Chemical Biology; and Laboratory for Cell and Tissue Engineering; Eindhoven University of Technology; P.O. Box 513 5600 MB Eindhoven The Netherlands
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Transmural capillary ingrowth is essential for confluent vascular graft healing. Acta Biomater 2018; 65:237-247. [PMID: 29111372 DOI: 10.1016/j.actbio.2017.10.038] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 10/24/2017] [Accepted: 10/26/2017] [Indexed: 01/10/2023]
Abstract
Spontaneous endothelialization of synthetic vascular grafts may occur via three independent or concurrent modalities: transanastomotic (TA) outgrowth, transmural (TM) ingrowth or fallout (FO) from the blood. The limited TA and FO endothelialization, which occurs in humans, results in poor long-term patency in the small diameter position, where TM ingrowth may offer a clinically relevant alternative. To achieve sequential analysis of each mode of healing, loop grafts comprising anastomotically isolated angiopermissive polyurethane control grafts were abluminally sealed using either ePTFE wraps or solid polyurethane skins and implanted in the rat infrarenal aortic loop model for twelve weeks. Positive control grafts showed improved endothelialization and patency compared to the abluminally isolated mid-grafts. Furthermore, the mid-graft healing was accelerated with surface heparin and heparin-growth factor (VEGF, PDGF) modification in a three-week sub-study. We are thus able to distinguish between the three vascular graft endothelialization modes, and conclude that fallout plays a secondary role to TM healing. The increased endothelialisation for growth factor presenting grafts indicates the promise of this simple approach but further optimization is required. STATEMENT OF SIGNIFICANCE In addition to the full elucidation of, and differentiation between, the three healing/endothelialisation modes of vascular grafts, the significance of the work relates to the near-complete lack of endothelialisation of small diameter vascular grafts in humans (1-2 cm transanastomotic outgrowth on a graft that may be 60 cm long) even after decades of implantation. The concomitant retained midgraft thrombogenicity leads, together with anastomotic hyperplastic responses, to poor long-term outcomes. The large impact of successful translation of the current research to the achievement of full endothelialisation of long peripheral grafts in humans via transmural ingrowth (half a millimetre distance; thickness of the graft wall), is evident, and supported by the large improvements in clinical patencies achievable in by pre-seeding of ePTFE grafts with confluent endothelia.
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Regulation of macrophage polarization and promotion of endothelialization by NO generating and PEG-YIGSR modified vascular graft. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017. [PMID: 29519417 DOI: 10.1016/j.msec.2017.11.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
As an effective clinic treatment for cardiovascular disease, vascular transplantation gains much acceptance recently. However, due to the acute thrombosis and intimal hyperplasia, long-term failure of synthetic grafts after implanted in small diameter blood vessel decelerates its commercial use. The continued acute inflammation and delayed endothelialization have been considered as fundamental reasons. To enhance the adhesion and organization of endothelial cells (ECs) and improve the vascular remodeling process, we have constructed a vascular graft based on electrospun polycaprolactone (PCL) matrix, on which organoselenium-immobilized polyethyleneimine (SePEI) for in situ nitric oxide (NO) generation and hyaluronic acid (HA) grafted with poly (ethylene glycol) (PEG) modified Tyr-Ile-Gly-Ser-Arg (YIGSR) for antifouling and EC adhesion were deposited through electrostatic layer-by-layer assembly. The in vitro results showed that SePEI deposited on the grafts could catalyze stable generation of NO. After in situ implantation in rats for 4 and 8weeks, the graft promoted the transformation of macrophages into an anti-inflammatory phenotype (M2), which helped endothelium remodeling. YIGSR on the outmost layer facilitated more rapid and organized EC adhesion compared to PCL and non-modified grafts. PEG polymer chain on the outmost layer mitigated nonspecific adsorption of undesirable blood components. In our study, we first demonstrated the regulation of macrophage polarization by an NO-generating vascular graft. The results indicated that the approach of anti-inflammatory macrophage polarization and enhanced endothelialization through NO generation and PEG-modified YIGSR in our study may provide a new perspective for the clinic application of cell-free small-diameter vascular grafts.
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Hu YT, Pan XD, Zheng J, Ma WG, Sun LZ. In vitro and in vivo evaluation of a small-caliber coaxial electrospun vascular graft loaded with heparin and VEGF. Int J Surg 2017. [PMID: 28648794 DOI: 10.1016/j.ijsu.2017.06.077] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION To date, clinically available expanded polytetrafluoro-ethylene (ePTFE) vascular grafts are suboptimal for reconstructing small caliber (D < 6 mm) arteries, owing to thrombosis in early and restenosis in late stage. Our aim in this preliminary study was to fabricate a nano-fibrous vascular graft which was biofunctionalized with VEGF165 and heparin. The short term performance was evaluated both in vitro and in vivo. METHOD Four-mm caliber grafts were prepared by the coaxial-elctrospun technique, which consisted of poly(l-lactide-co-caprolactone) [P(LLA-CL)] collagen and elastin. Heparin and endothelial cell growth factor-165 (VEGF165) were encapsulated in the core of the fibrous. Controlled release of the heparin and VEGF165 were evaluated for 28 days. Endothelial cells were cultured on the electrospun grafts or ePTFE grafts as controls. The cellular adhesion, proliferation and morphology were examined. Electrospun or ePTFE grafts were randomly implanted into a rabbit infrarenal aortic replacement model (n = 30) for 28 days without any antiplatelet therapy. At the termination, all grafts were examined by Doppler ultrasound and then evaluated with histology and scanning electron microscopy. RESULTS The cumulative release amount of heparin (6.93 ± 1.03 mg) and VEGF165 (22.17 ± 5.56 μg) during 28 days were measured. Endothelial cells cultured on electrospun grafts showed significantly higher attachment efficiency and proliferation compared to the ePTFE ones (P < 0.001). At 2 h more ECs had attached to the P(LLA-CL)/Collagen/Elatin grafts (83.26 ± 8.02%) compared to P(LLA-CL) (67.07 ± 4.16%) and ePTFE (46.87 ± 8.85%). ECs proliferated faster on VEGF loaded grafts (O.D = 2.9 ± 1.2, n = 12) compared to ePTFE (O.D = 1.7 ± 1.0, n = 12). The patency was significantly higher in electrospun grafts (86.6%) than ePTFE grafts (40.0%) (P = 0.021). Correspondingly, the microscope images of electrospun implants showed little thrombus when compared with the ePTFE implants. CONCLUSION Biofunctionalized electrospun graft showed surgical properties, hemocompatibility and higher short-term patency compared with the ePTFE grafts. Despite good early performances, profound study should be designed for long-term evaluation.
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Affiliation(s)
- Yun-Tao Hu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vascular Diseases, Beijing, China
| | - Xu-Dong Pan
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vascular Diseases, Beijing, China
| | - Jun Zheng
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vascular Diseases, Beijing, China
| | - Wei-Guo Ma
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vascular Diseases, Beijing, China
| | - Li-Zhong Sun
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vascular Diseases, Beijing, China.
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80
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Influence of Micropatterned Silk Fibroin Films on Human Umbilical Endothelial Cell Behaviors. J Med Biol Eng 2017. [DOI: 10.1007/s40846-017-0249-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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81
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Caracciolo PC, Rial-Hermida MI, Montini-Ballarin F, Abraham GA, Concheiro A, Alvarez-Lorenzo C. Surface-modified bioresorbable electrospun scaffolds for improving hemocompatibility of vascular grafts. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 75:1115-1127. [DOI: 10.1016/j.msec.2017.02.151] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/13/2016] [Accepted: 02/24/2017] [Indexed: 12/25/2022]
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82
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The effect of hirudin modification of silk fibroin on cell growth and antithrombogenicity. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2017; 75:237-246. [DOI: 10.1016/j.msec.2017.02.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/15/2016] [Accepted: 02/08/2017] [Indexed: 01/14/2023]
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83
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Wang X, Jiang C, Qin Y, Peng Y, Wen G, Liang A, Jiang Z. SERS spectral study of HAuCl 4-cysteine nanocatalytic reaction and its application for detection of heparin sodium with label-free VB4r molecular probe. Sci Rep 2017; 7:45979. [PMID: 28378828 PMCID: PMC5380991 DOI: 10.1038/srep45979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 03/07/2017] [Indexed: 12/23/2022] Open
Abstract
In the presence of nanocatalyst, L-cysteine reduce HAuCl4 rapidly to form gold nanoparticles (AuNP), and a quick nanocatalytic preparation procedure was established for Au/AuNP sol with highly active surface enhanced Raman scattering (SERS) effect and good stability. The nanoreaction was also studied by absorption, resonance Rayleigh scattering (RRS), transmission electron microscopy (TEM) and energy spectra. In the selected conditions, the analyte heparin sodium (HS) could react with victoria blue 4 R (VB4r) to form associated complexes which have very weak SERS effect to make the SERS signals decrease. The SERS signals at 1617 cm−1 reduced linearly with HS concentration increasing. Upon addition of FeCl3, it hydrolyzed to form stable Fe(OH)3 sol platform that carried SERS active Au/AuNPs to enhance the sensitivity. Accordingly, we established a SERS quantitative analysis method in the sol substrate of Fe(OH)3-Au/AuNPs, with a linear range of 0.5–75 ng/mL HS and a detection limit of 0.2 ng/mL. HS in real samples was determined, with a relative standard deviation of 2.65–7.63% and a recovery of 99.3–101%.
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Affiliation(s)
- Xiaoliang Wang
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection of Ministry Education, Guangxi Key Laboratory of Environmental Pollution Control Theory and Technology, Guangxi Normal University, Guilin 541004, China
| | - Caina Jiang
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection of Ministry Education, Guangxi Key Laboratory of Environmental Pollution Control Theory and Technology, Guangxi Normal University, Guilin 541004, China
| | - Yanna Qin
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection of Ministry Education, Guangxi Key Laboratory of Environmental Pollution Control Theory and Technology, Guangxi Normal University, Guilin 541004, China
| | - Yutao Peng
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection of Ministry Education, Guangxi Key Laboratory of Environmental Pollution Control Theory and Technology, Guangxi Normal University, Guilin 541004, China
| | - Guiqing Wen
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection of Ministry Education, Guangxi Key Laboratory of Environmental Pollution Control Theory and Technology, Guangxi Normal University, Guilin 541004, China
| | - Aihui Liang
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection of Ministry Education, Guangxi Key Laboratory of Environmental Pollution Control Theory and Technology, Guangxi Normal University, Guilin 541004, China
| | - Zhiliang Jiang
- Key Laboratory of Ecology of Rare and Endangered Species and Environmental Protection of Ministry Education, Guangxi Key Laboratory of Environmental Pollution Control Theory and Technology, Guangxi Normal University, Guilin 541004, China
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84
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Simon-Yarza T, Bataille I, Letourneur D. Cardiovascular Bio-Engineering: Current State of the Art. J Cardiovasc Transl Res 2017; 10:180-193. [DOI: 10.1007/s12265-017-9740-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/24/2017] [Indexed: 12/15/2022]
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85
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Munisso MC, Yamaoka T. Novel peptides for small-caliber graft functionalization selected by a phage display of endothelial-positive/platelet-negative combined selection. J Mater Chem B 2017; 5:9354-9364. [DOI: 10.1039/c7tb02652h] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A new protocol to identify peptides with EPCs high affinity and at the same time the ability to suppress the interaction with platelets was presented.
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Affiliation(s)
- Maria Chiara Munisso
- Department of Biomedical Engineering
- National Cerebral and Cardiovascular Center Research Institute
- Suita
- Japan
| | - Tetsuji Yamaoka
- Department of Biomedical Engineering
- National Cerebral and Cardiovascular Center Research Institute
- Suita
- Japan
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86
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Karimi F, McKenzie TG, O'Connor AJ, Qiao GG, Heath DE. Nano-scale clustering of integrin-binding ligands regulates endothelial cell adhesion, migration, and endothelialization rate: novel materials for small diameter vascular graft applications. J Mater Chem B 2017; 5:5942-5953. [DOI: 10.1039/c7tb01298e] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Blood contacting devices are commonly used in today's medical landscape.
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Affiliation(s)
- Fatemeh Karimi
- School of Chemical and Biomedical Engineering
- Particulate Fluids Processing Centre
- University of Melbourne
- Melbourne
- Australia
| | - Thomas G. McKenzie
- Polymer Science Group
- Department of Chemical Engineering
- Particulate Fluids Processing Centre
- University of Melbourne
- Melbourne
| | - Andrea J. O'Connor
- School of Chemical and Biomedical Engineering
- Particulate Fluids Processing Centre
- University of Melbourne
- Melbourne
- Australia
| | - Greg G. Qiao
- Polymer Science Group
- Department of Chemical Engineering
- Particulate Fluids Processing Centre
- University of Melbourne
- Melbourne
| | - Daniel E. Heath
- School of Chemical and Biomedical Engineering
- Particulate Fluids Processing Centre
- University of Melbourne
- Melbourne
- Australia
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87
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Boire TC, Balikov DA, Lee Y, Guth CM, Cheung-Flynn J, Sung HJ. Biomaterial-Based Approaches to Address Vein Graft and Hemodialysis Access Failures. Macromol Rapid Commun 2016; 37:1860-1880. [PMID: 27673474 PMCID: PMC5156561 DOI: 10.1002/marc.201600412] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 08/15/2016] [Indexed: 12/19/2022]
Abstract
Veins used as grafts in heart bypass or as access points in hemodialysis exhibit high failure rates, thereby causing significant morbidity and mortality for patients. Interventional or revisional surgeries required to correct these failures have been met with limited success and exorbitant costs, particularly for the US Centers for Medicare & Medicaid Services. Vein stenosis or occlusion leading to failure is primarily the result of neointimal hyperplasia. Systemic therapies have achieved little long-term success, indicating the need for more localized, sustained, biomaterial-based solutions. Numerous studies have demonstrated the ability of external stents to reduce neointimal hyperplasia. However, successful results from animal models have failed to translate to the clinic thus far, and no external stent is currently approved for use in the US to prevent vein graft or hemodialysis access failures. This review discusses current progress in the field, design considerations, and future perspectives for biomaterial-based external stents. More comparative studies iteratively modulating biomaterial and biomaterial-drug approaches are critical in addressing mechanistic knowledge gaps associated with external stent application to the arteriovenous environment. Addressing these gaps will ultimately lead to more viable solutions that prevent vein graft and hemodialysis access failures.
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Affiliation(s)
- Timothy C Boire
- Department of Biomedical Engineering, Vanderbilt University, 37235, Nashville, TN, USA
| | - Daniel A Balikov
- Department of Biomedical Engineering, Vanderbilt University, 37235, Nashville, TN, USA
| | - Yunki Lee
- Department of Biomedical Engineering, Vanderbilt University, 37235, Nashville, TN, USA
| | - Christy M Guth
- Division of Vascular Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, 37235, USA
| | - Joyce Cheung-Flynn
- Division of Vascular Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, 37235, USA
| | - Hak-Joon Sung
- Department of Biomedical Engineering, Vanderbilt University, 37235, Nashville, TN, USA
- Severance Biomedical Science Institute, College of Medicine, Yonsei University, Seoul, 120-752, Republic of Korea
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