1
|
Deepak T, Bajhaiya D, Babu AR. Impact of the Different Chemical-Based Decellularization Protocols on the Properties of the Caprine Pericardium. Cardiovasc Eng Technol 2024; 15:279-289. [PMID: 38347340 DOI: 10.1007/s13239-024-00712-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 01/02/2024] [Indexed: 07/13/2024]
Abstract
PURPOSE This study aims to decellularized caprine pericardium tissue with varied non-ionic surfactant and anionic detergent concentrations. METHODS Protocol A consists of 1%, 0.5%, and 0.25% (w/v) sodium dodecyl sulphate (SDS). Protocol B uses 1%, 0.5%, and 0.25% (w/v) Triton X-100. Protocol C comprised 0.5% SDS + 0.5% Triton X-100, 0.5% + 0.25%, and 0.25% SDS + 0.5% Triton X-100. RESULTS Protocol B left a few countable cells in the pericardium tissue, but treatments A and C removed all cells. DNA quantification also demonstrated that protocol B had the most leftover DNA after decellularization. The pericardium tissue treated with an equal combination of anionic detergent and non-ionic surfactant preserves the matrix. However, changing the anionic detergent-non-ionic surfactant ratio disrupted the microstructure. Protocol A decreased pericardium tissue secant modulus (p < 0.05). Protocol B-treated pericardium tissue matched native tissue secant modulus and ultimate tensile stress. Protocol C strengthened pericardium tissue. CONCLUSION The intact extracellular matrix and biomechanical properties like native tissues require optimal chemical doses and combinations.
Collapse
Affiliation(s)
- Thirumalai Deepak
- Department of Biotechnology and Medical Engineering, National Institute of Technology, Rourkela, Odisha, 769008, India
| | - Deepak Bajhaiya
- Department of Biotechnology and Medical Engineering, National Institute of Technology, Rourkela, Odisha, 769008, India
| | - Anju R Babu
- Department of Biotechnology and Medical Engineering, National Institute of Technology, Rourkela, Odisha, 769008, India.
| |
Collapse
|
2
|
Jafari Sorkhdehi MM, Doostmohammadi A, Talebi A, Alizadeh A. Decellularization and characterization of camel pericardium as a new scaffold for tissue engineering and regenerative medicine. Asian Cardiovasc Thorac Ann 2024; 32:194-199. [PMID: 38767039 DOI: 10.1177/02184923241255720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
BACKGROUND Valvular heart diseases (VHDs) have become prevalent in populations due to aging. Application of different biomaterials for cardiac valve regeneration and repair holds a great promise for treatment of VHD. Aortic valve replacement using tissue-engineered xenografts is a considered approach, and the pericardium of different species such as porcine and bovine has been studied over the last few years. It has been suggested that the animal origin can affect the outcomes of replacement. METHODS So, herein, we at first decellularized and characterized the camel pericardium (dCP), then characterized dCP with H&E staining, in vitro and in vivo biocompatibility and mechanical tests and compared it with decellularized bovine pericardium (dBP), to describe the potency of dCP as a new xenograft and bio scaffold. RESULTS The histological assays indicated less decluttering and extracellular matrix damage in dCP after decellularization compared to the dBP also dCP had higher Young Modulus (105.11), and yield stress (1.57 ± 0.45). We observed more blood vessels and also less inflammatory cells in the dCP sections after implantation. CONCLUSIONS In conclusion, the results of this study showed that the dCP has good capabilities not only for use in VHD treatment but also for other applications in tissue engineering and regenerative medicine.
Collapse
Affiliation(s)
| | - Ali Doostmohammadi
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Athar Talebi
- Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Akram Alizadeh
- Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran
- Department of Tissue Engineering and Applied Cell Sciences, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| |
Collapse
|
3
|
Dittfeld C, Bähring S, Welzel C, Jannasch A, Matschke K, Tugtekin SM, Alexiou K. Tissue requirements for the application of aortic valve neocuspidization - appropriate pericardium properties and homogeneity? JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2024; 35:26. [PMID: 38683259 PMCID: PMC11058761 DOI: 10.1007/s10856-024-06790-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 03/05/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE Aortic valve neocuspidization (AVNeo) using autologous pericardium is a promising technique. Expected advantages are reduced immune response, appropriate biomechanics and lower treatment expenses. Nevertheless, autologous pericardium can be affected by patient's age and comorbidities. Usually, glutaraldehyde (GA) - fixed bovine pericardium is the basic material for aortic valve prostheses, easy available and carefully pre-examined in a standardized fabrication process. Aim of the study is the verification of autologous pericardial tissue homogeneity by analysing tissue thickness, biomechanics and extracellular matrix (ECM) composition. METHODS Segments of human GA-fixed pericardium selected by the surgeon based on visual criteria for cusp pre-cut and remaining after surgical AV replacement were investigated in comparison to bovine standard tissue treated equivalently. Pericardium sampling was performed at up to three positions of each sutured cusp for histological or biomechanical analysis, according to tissue availability. RESULTS AND CONCLUSIONS Human pericardia exhibited a higher heterogeneity in collagen content, density of vessel structures and elastic moduli. Thickness, vessel density and collagen and elastin content differed significantly between the species. In contrast, significant interindividual differences were detected in most properties investigated for human pericardial samples but only for tissue thickness in bovine tissues. Higher heterogeneity of human pericardium, differing vessel and collagen content compared to bovine state-of-the-art material might be detrimental for long term AV functionality or deterioration and have to be intensely investigated in patients follow up after autologous cusp replacement.
Collapse
Affiliation(s)
- Claudia Dittfeld
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Dresden, Germany.
| | - Sophia Bähring
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Dresden, Germany
| | - Cindy Welzel
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Dresden, Germany
| | - Anett Jannasch
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Dresden, Germany
| | - Klaus Matschke
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Dresden, Germany
| | - Sems-Malte Tugtekin
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Dresden, Germany
| | - Konstantin Alexiou
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Dresden, Germany
| |
Collapse
|
4
|
Jing W, Huang Y, Feng J, Li H, Yu X, Zhao B, Wei P. The clinical effectiveness of staple line reinforcement with different matrix used in surgery. Front Bioeng Biotechnol 2023; 11:1178619. [PMID: 37351469 PMCID: PMC10282759 DOI: 10.3389/fbioe.2023.1178619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/24/2023] [Indexed: 06/24/2023] Open
Abstract
Staplers are widely used in clinics; however, complications such as bleeding and leakage remain a challenge for surgeons. To tackle this issue, buttress materials are recommended to reinforce the staple line. This Review provides a systematic summary of the characteristics and applications of the buttress materials. First, the physical and chemical properties of synthetic polymer materials and extracellular matrix used for the buttress materials are introduced, as well as their pros and cons in clinical applications. Second, we review the clinical effects of reinforcement mesh in pneumonectomy, sleeve gastrectomy, pancreatectomy, and colorectal resection. Based on the analysis of numerous research data, we believe that buttress materials play a crucial role in increasing staple line strength and reducing the probability of complications, such as bleeding and leakage. However, considering the requirements of bioactivity, degradability, and biosafety, non-crosslinked small intestinal submucosa (SIS) matrix material is the preferred candidate. It has high research and application value, but further studies are required to confirm this. The aim of this Review is to provide comprehensive guidance on the selection of materials for staple line reinforcement.
Collapse
Affiliation(s)
| | | | | | | | | | - Bo Zhao
- *Correspondence: Bo Zhao, ; Pengfei Wei,
| | | |
Collapse
|
5
|
Dittfeld C, Welzel C, König U, Jannasch A, Alexiou K, Blum E, Bronder S, Sperling C, Maitz MF, Tugtekin SM. Hemocompatibility tuning of an innovative glutaraldehyde-free preparation strategy using riboflavin/UV crosslinking and electron irradiation of bovine pericardium for cardiac substitutes. BIOMATERIALS ADVANCES 2023; 147:213328. [PMID: 36764200 DOI: 10.1016/j.bioadv.2023.213328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/17/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023]
Abstract
Hemocompatibility tuning was adopted to explore and refine an innovative, GA-free preparation strategy combining decellularization, riboflavin/UV crosslinking, and low-energy electron irradiation (SULEEI) procedure. A SULEEI-protocol was established to avoid GA-dependent deterioration that results in insufficient long-term aortic valve bioprosthesis durability. Final SULEEI-pericardium, intermediate steps and GA-fixed reference pericardium were exposed in vitro to fresh human whole blood to elucidate effects of preparation parameters on coagulation and inflammation activation and tissue histology. The riboflavin/UV crosslinking step showed to be less efficient in inactivating extracellular matrix (ECM) protein activity than the GA fixation, leading to tissue-factor mediated blood clotting. Intensifying the riboflavin/UV crosslinking with elevated riboflavin concentration and dextran caused an enhanced activation of the complement system. Yet activation processes induced by the previous protocol steps were quenched with the final electron beam treatment step. An optimized SULEEI protocol was developed using an intense and extended, trypsin-containing decellularization step to inactivate tissue factor and a dextran-free, low riboflavin, high UV crosslinking step. The innovative and improved GA-free SULEEI-preparation protocol results in low coagulant and low inflammatory bovine pericardium for surgical application.
Collapse
Affiliation(s)
- Claudia Dittfeld
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Germany.
| | - Cindy Welzel
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Germany
| | - Ulla König
- Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, Dresden, Germany
| | - Anett Jannasch
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Germany
| | - Konstantin Alexiou
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Germany
| | - Ekaterina Blum
- Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, Dresden, Germany
| | - Saskia Bronder
- Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, Dresden, Germany
| | - Claudia Sperling
- Leibniz-Institut für Polymerforschung Dresden e.V., Institute Biofunctional Polymer Materials, Dresden, Germany
| | - Manfred F Maitz
- Leibniz-Institut für Polymerforschung Dresden e.V., Institute Biofunctional Polymer Materials, Dresden, Germany
| | - Sems-Malte Tugtekin
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, Germany
| |
Collapse
|
6
|
Kasravi M, Ahmadi A, Babajani A, Mazloomnejad R, Hatamnejad MR, Shariatzadeh S, Bahrami S, Niknejad H. Immunogenicity of decellularized extracellular matrix scaffolds: a bottleneck in tissue engineering and regenerative medicine. Biomater Res 2023; 27:10. [PMID: 36759929 PMCID: PMC9912640 DOI: 10.1186/s40824-023-00348-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
Tissue-engineered decellularized extracellular matrix (ECM) scaffolds hold great potential to address the donor shortage as well as immunologic rejection attributed to cells in conventional tissue/organ transplantation. Decellularization, as the key process in manufacturing ECM scaffolds, removes immunogen cell materials and significantly alleviates the immunogenicity and biocompatibility of derived scaffolds. However, the application of these bioscaffolds still confronts major immunologic challenges. This review discusses the interplay between damage-associated molecular patterns (DAMPs) and antigens as the main inducers of innate and adaptive immunity to aid in manufacturing biocompatible grafts with desirable immunogenicity. It also appraises the impact of various decellularization methodologies (i.e., apoptosis-assisted techniques) on provoking immune responses that participate in rejecting allogenic and xenogeneic decellularized scaffolds. In addition, the key research findings regarding the contribution of ECM alterations, cytotoxicity issues, graft sourcing, and implantation site to the immunogenicity of decellularized tissues/organs are comprehensively considered. Finally, it discusses practical solutions to overcome immunogenicity, including antigen masking by crosslinking, sterilization optimization, and antigen removal techniques such as selective antigen removal and sequential antigen solubilization.
Collapse
Affiliation(s)
- Mohammadreza Kasravi
- grid.411600.2Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, 1985711151 Iran ,grid.411600.2Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Armin Ahmadi
- grid.411600.2Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, 1985711151 Iran
| | - Amirhesam Babajani
- grid.411600.2Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, 1985711151 Iran
| | - Radman Mazloomnejad
- grid.411600.2Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, 1985711151 Iran
| | - Mohammad Reza Hatamnejad
- grid.411600.2Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Siavash Shariatzadeh
- grid.19006.3e0000 0000 9632 6718Department of Surgery, University of California Los Angeles, Los Angeles, California USA
| | - Soheyl Bahrami
- grid.454388.60000 0004 6047 9906Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in AUVA Research Center, Vienna, Austria
| | - Hassan Niknejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, 1985711151, Iran.
| |
Collapse
|
7
|
Mazloomnejad R, Babajani A, Kasravi M, Ahmadi A, Shariatzadeh S, Bahrami S, Niknejad H. Angiogenesis and Re-endothelialization in decellularized scaffolds: Recent advances and current challenges in tissue engineering. Front Bioeng Biotechnol 2023; 11:1103727. [PMID: 36873356 PMCID: PMC9978201 DOI: 10.3389/fbioe.2023.1103727] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/09/2023] [Indexed: 02/18/2023] Open
Abstract
Decellularization of tissues and organs has recently become a promising approach in tissue engineering and regenerative medicine to circumvent the challenges of organ donation and complications of transplantations. However, one main obstacle to reaching this goal is acellular vasculature angiogenesis and endothelialization. Achieving an intact and functional vascular structure as a vital pathway for supplying oxygen and nutrients remains the decisive challenge in the decellularization/re-endothelialization procedure. In order to better understand and overcome this issue, complete and appropriate knowledge of endothelialization and its determining variables is required. Decellularization methods and their effectiveness, biological and mechanical characteristics of acellular scaffolds, artificial and biological bioreactors, and their possible applications, extracellular matrix surface modification, and different types of utilized cells are factors affecting endothelialization consequences. This review focuses on the characteristics of endothelialization and how to optimize them, as well as discussing recent developments in the process of re-endothelialization.
Collapse
Affiliation(s)
- Radman Mazloomnejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhesam Babajani
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Kasravi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Armin Ahmadi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Siavash Shariatzadeh
- Department of Surgery, University of California Los Angeles, Los Angeles, CA, United States
| | - Soheyl Bahrami
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in AUVA Research Center, Vienna, Austria
| | - Hassan Niknejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Redox-Activation of Neutrophils Induced by Pericardium Scaffolds. Int J Mol Sci 2022; 23:ijms232415468. [PMID: 36555108 PMCID: PMC9779008 DOI: 10.3390/ijms232415468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/24/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Implantation of scaffolds causes a local inflammatory response whereby the early recruitment of neutrophils is of great importance not only for fighting the infection, but also for facilitating effective regeneration. We used luminol-dependent chemiluminescence, flow cytometry, ELISA, and confocal microscopy to assess the responses of neutrophils after the exposure to the scaffold-decellularized bovine pericardium (collagen type I) crosslinked with genipin (DBPG). We demonstrated that DBPG activated neutrophils in whole blood causing respiratory burst, myeloperoxidase (MPO) secretion, and formation of neutrophil extracellular trap-like structures (NETs). In addition, we studied platelets, another important player of the immediate immune host response. We found that platelets triggered redox-activation of isolated neutrophils by the pericardium scaffold, and likely participate in the NETs formation. Free radicals generated by neutrophils and hypochlorous acid produced by MPO are potent oxidizing agents which can oxidatively degrade biological structures. Understanding the mechanisms and consequences of redox activation of neutrophils by pericardium scaffolds is important for the development of new approaches to increase the efficiency of tissue regeneration.
Collapse
|
9
|
Welzel C, König U, Jannasch A, Matschke K, Tugtekin SM, Dittfeld C, Steiner G. Infrared Spectroscopic Verification of a α-Helical Collagen Structure in Glutaraldehyde-Free Crosslinked Bovine Pericardium for Cardiac Implants. LIFE (BASEL, SWITZERLAND) 2022; 12:life12122035. [PMID: 36556400 PMCID: PMC9785276 DOI: 10.3390/life12122035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
The degeneration of heart valve bioprostheses due to calcification processes is caused by the intercalation of calciumhydroxyapatite in pericardium collagen bundles. Variations of the protein secondary structure of biomaterials according to preparation are relevant for this mineralization process and thus the structural characterization of innovative bioprostheses materials is of great importance. The gold standard for prostheses preparation is glutaraldehyde (GA)-fixation of bovine pericardium that adversely promotes calcification. The novel GA-free SULEEI-treatment of bovine pericardium includes decellularization, UV-crosslinking, and electron beam sterilization. The aim of this study is the structural characterization of SULEEI-treated and GA-fixed bovine pericardium. IR spectroscopic imaging combined with multivariate data and curve fit analysis was applied to investigate the amide I and amide II regions of SULEEI-treated and GA-fixed samples. The spectroscopic images of GA-fixed pericardial tissue exhibited a generally high content of amine groups and side chains providing nucleation points for calcification processes. In contrast, in SULEEI-treated tissue, the typical α-helical structure was retained and was supposed to be less prone to deterioration.
Collapse
Affiliation(s)
- Cindy Welzel
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, 01307 Dresden, Germany
- Correspondence:
| | - Ulla König
- Department of Medical and Biotechnological Applications, Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology, 01277 Dresden, Germany
| | - Anett Jannasch
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, 01307 Dresden, Germany
| | - Klaus Matschke
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, 01307 Dresden, Germany
| | - Sems-Malte Tugtekin
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, 01307 Dresden, Germany
| | - Claudia Dittfeld
- Department of Cardiac Surgery, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Heart Centre Dresden, 01307 Dresden, Germany
| | - Gerald Steiner
- Department of Anaesthesiology and Critical Care Medicine, Clinical Sensoring and Monitoring, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| |
Collapse
|
10
|
Human P, Bezuidenhout D, Aikawa E, Zilla P. Residual Bioprosthetic Valve Immunogenicity: Forgotten, Not Lost. Front Cardiovasc Med 2022; 8:760635. [PMID: 35059444 PMCID: PMC8764456 DOI: 10.3389/fcvm.2021.760635] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/13/2021] [Indexed: 12/02/2022] Open
Abstract
Despite early realization of the need to control inherent immunogenicity of bioprosthetic replacement heart valves and thereby mitigate the ensuing host response and its associated pathology, including dystrophic calcification, the problem remains unresolved to this day. Concerns over mechanical stiffness associated with prerequisite high cross-link density to effect abrogation of this response, together with the insinuated role of leaching glutaraldehyde monomer in subsequent dystrophic mineralization, have understandably introduced compromises. These have become so entrenched as a benchmark standard that residual immunogenicity of the extracellular matrix has seemingly been relegated to a very subordinate role. Instead, focus has shifted toward the removal of cellular compartment antigens renowned for their implication in the failure of vascularized organ xenotransplants. While decellularization certainly offers advantages, this review aims to refocus attention on the unresolved matter of the host response to the extracellular matrix. Furthermore, by implicating remnant immune and inflammatory processes to bioprosthetic valve pathology, including pannus overgrowth and mineralization, the validity of a preeminent focus on decellularization, in the context of inefficient antigen and possible residual microbial remnant removal, is questioned.
Collapse
Affiliation(s)
- Paul Human
- Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.,Cardiovascular Research Unit, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Deon Bezuidenhout
- Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.,Cardiovascular Research Unit, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Elena Aikawa
- Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Peter Zilla
- Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.,Cardiovascular Research Unit, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Faculty of Health Sciences, Cape Heart Institute, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
11
|
Noble C, Morse D, Lerman A, Young M. Evaluation of Pericardial Tissues from Assorted Species as a Tissue-Engineered Heart Valve Material. Med Biol Eng Comput 2022; 60:393-406. [PMID: 34984601 DOI: 10.1007/s11517-021-02498-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/17/2021] [Indexed: 11/25/2022]
Abstract
Decellularized pericardial tissue is a strong candidate for a TEHV material as ECM is present to guide cellular infiltration and fixed porcine and bovine pericardial tissue have existing use in bioprosthetic heart valves. In this work, we compare the mechanical and microstructural properties of decellularized-sterilized (DS) porcine, bovine, and bison pericardial tissues with respect to use as a TEHV. H&E staining was used to verify removal of cellular content post-decellularization and to evaluate collagen fiber structure. Additionally, uniaxial and biaxial tension testing were used to compare mechanical performance and, for the latter, acquire constitutive model parameters for subsequent finite element (FE) modeling. H&E staining revealed complete removal of cellular content and good collagen fiber structure. Tensile testing showed comparable mechanical strength between the three DS pericardial tissues and considerably stronger mechanical properties compared to native tissues. Bovine and bison DS pericardial tissues showed the strongest mechanical performance in the FE models with bison demonstrating the overall best mechanical characteristics. The increased thickness of bovine and bison tissues coupled with the strong mechanical behavior and ECM structure indicates that these materials will be resistant to damage until sufficient cellular infiltration has occurred such that damaged tissue can be repaired.
Collapse
Affiliation(s)
- Christopher Noble
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - David Morse
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Amir Lerman
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Melissa Young
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
12
|
Poelmann RE, Gittenberger-de Groot AC, Goerdajal C, Grewal N, De Bakker MAG, Richardson MK. Ventricular Septation and Outflow Tract Development in Crocodilians Result in Two Aortas with Bicuspid Semilunar Valves. J Cardiovasc Dev Dis 2021; 8:jcdd8100132. [PMID: 34677201 PMCID: PMC8537894 DOI: 10.3390/jcdd8100132] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/14/2021] [Accepted: 09/27/2021] [Indexed: 02/07/2023] Open
Abstract
Background: The outflow tract of crocodilians resembles that of birds and mammals as ventricular septation is complete. The arterial anatomy, however, presents with a pulmonary trunk originating from the right ventricular cavum, and two aortas originating from either the right or left ventricular cavity. Mixing of blood in crocodilians cannot occur at the ventricular level as in other reptiles but instead takes place at the aortic root level by a shunt, the foramen of Panizza, the opening of which is guarded by two facing semilunar leaflets of both bicuspid aortic valves. Methods: Developmental stages of Alligator mississipiensis, Crocodilus niloticus and Caiman latirostris were studied histologically. Results and Conclusions: The outflow tract septation complex can be divided into two components. The aorto-pulmonary septum divides the pulmonary trunk from both aortas, whereas the interaortic septum divides the systemic from the visceral aorta. Neural crest cells are most likely involved in the formation of both components. Remodeling of the endocardial cushions and both septa results in the formation of bicuspid valves in all three arterial trunks. The foramen of Panizza originates intracardially as a channel in the septal endocardial cushion.
Collapse
Affiliation(s)
- Robert E. Poelmann
- Sylvius Laboratory, Department of Animal Sciences and Health, Institute of Biology, University of Leiden, Sylvi-usweg 72, 2333BE Leiden, The Netherlands; (C.G.); (M.A.G.D.B.); (M.K.R.)
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300RC Leiden, The Netherlands;
- Correspondence: ; Tel.: +31-652695875
| | | | - Charissa Goerdajal
- Sylvius Laboratory, Department of Animal Sciences and Health, Institute of Biology, University of Leiden, Sylvi-usweg 72, 2333BE Leiden, The Netherlands; (C.G.); (M.A.G.D.B.); (M.K.R.)
| | - Nimrat Grewal
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300RC Leiden, The Netherlands;
| | - Merijn A. G. De Bakker
- Sylvius Laboratory, Department of Animal Sciences and Health, Institute of Biology, University of Leiden, Sylvi-usweg 72, 2333BE Leiden, The Netherlands; (C.G.); (M.A.G.D.B.); (M.K.R.)
| | - Michael K. Richardson
- Sylvius Laboratory, Department of Animal Sciences and Health, Institute of Biology, University of Leiden, Sylvi-usweg 72, 2333BE Leiden, The Netherlands; (C.G.); (M.A.G.D.B.); (M.K.R.)
| |
Collapse
|
13
|
Williams DF, Bezuidenhout D, de Villiers J, Human P, Zilla P. Long-Term Stability and Biocompatibility of Pericardial Bioprosthetic Heart Valves. Front Cardiovasc Med 2021; 8:728577. [PMID: 34589529 PMCID: PMC8473620 DOI: 10.3389/fcvm.2021.728577] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/19/2021] [Indexed: 01/15/2023] Open
Abstract
The use of bioprostheses for heart valve therapy has gradually evolved over several decades and both surgical and transcatheter devices are now highly successful. The rapid expansion of the transcatheter concept has clearly placed a significant onus on the need for improved production methods, particularly the pre-treatment of bovine pericardium. Two of the difficulties associated with the biocompatibility of bioprosthetic valves are the possibilities of immune responses and calcification, which have led to either catastrophic failure or slow dystrophic changes. These have been addressed by evolutionary trends in cross-linking and decellularization techniques and, over the last two decades, the improvements have resulted in somewhat greater durability. However, as the need to consider the use of bioprosthetic valves in younger patients has become an important clinical and sociological issue, the requirement for even greater longevity and safety is now paramount. This is especially true with respect to potential therapies for young people who are afflicted by rheumatic heart disease, mostly in low- to middle-income countries, for whom no clinically acceptable and cost-effective treatments currently exist. To extend longevity to this new level, it has been necessary to evaluate the mechanisms of pericardium biocompatibility, with special emphasis on the interplay between cross-linking, decellularization and anti-immunogenicity processes. These mechanisms are reviewed in this paper. On the basis of a better understanding of these mechanisms, a few alternative treatment protocols have been developed in the last few years. The most promising protocol here is based on a carefully designed combination of phases of tissue-protective decellularization with a finely-titrated cross-linking sequence. Such refined protocols offer considerable potential in the progress toward superior longevity of pericardial heart valves and introduce a scientific dimension beyond the largely disappointing 'anti-calcification' treatments of past decades.
Collapse
Affiliation(s)
- David F. Williams
- Strait Access Technologies Ltd. Pty., Cape Town, South Africa
- Wake Forest Institute of Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Deon Bezuidenhout
- Strait Access Technologies Ltd. Pty., Cape Town, South Africa
- Cardiovascular Research Unit, Cape Heart Institute, University of Cape Town, Cape Town, South Africa
| | | | - Paul Human
- Christiaan Barnard Department of Cardiothoracic Surgery, University of Cape Town, Cape Town, South Africa
| | - Peter Zilla
- Strait Access Technologies Ltd. Pty., Cape Town, South Africa
- Cardiovascular Research Unit, Cape Heart Institute, University of Cape Town, Cape Town, South Africa
- Christiaan Barnard Department of Cardiothoracic Surgery, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
14
|
Musina GR, Chernomyrdin NV, Gafarova ER, Gavdush AA, Shpichka AJ, Komandin GA, Anzin VB, Grebenik EA, Kravchik MV, Istranova EV, Dolganova IN, Zaytsev KI, Timashev PS. Moisture adsorption by decellularized bovine pericardium collagen matrices studied by terahertz pulsed spectroscopy and solid immersion microscopy. BIOMEDICAL OPTICS EXPRESS 2021; 12:5368-5386. [PMID: 34692188 PMCID: PMC8515980 DOI: 10.1364/boe.433216] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 05/03/2023]
Abstract
In this paper, terahertz (THz) pulsed spectroscopy and solid immersion microscopy were applied to study interactions between water vapor and tissue scaffolds-the decellularized bovine pericardium (DBP) collagen matrices, in intact form, cross-linked with the glutaraldehyde or treated by plasma. The water-absorbing properties of biomaterials are prognostic for future cell-mediated reactions of the recipient tissue with the scaffold. Complex dielectric permittivity of DBPs was measured in the 0.4-2.0 THz frequency range, while the samples were first dehydrated and then exposed to water vapor atmosphere with 80.0 ± 5.0% relative humidity. These THz dielectric measurements of DBPs and the results of their weighting allowed to estimate the adsorption time constants, an increase of tissue mass, as well as dispersion of these parameters. During the adsorption process, changes in the DBPs' dielectric permittivity feature an exponential character, with the typical time constant of =8-10 min, the transient process saturation at =30 min, and the tissue mass improvement by =1-3%. No statistically-relevant differences between the measured properties of the intact and treated DBPs were observed. Then, contact angles of wettability were measured for the considered DBPs using a recumbent drop method, while the observed results showed that treatments of DBP somewhat affects their surface energies, polarity, and hydrophilicity. Thus, our studies revealed that glutaraldehyde and plasma treatment overall impact the DBP-water interactions, but the resultant effects appear to be quite complex and comparable to the natural variability of the tissue properties. Such a variability was attributed to the natural heterogeneity of tissues, which was confirmed by the THz microscopy data. Our findings are important for further optimization of the scaffolds' preparation and treatment technologies. They pave the way for THz technology use as a non-invasive diagnosis tool in tissue engineering and regenerative medicine.
Collapse
Affiliation(s)
- G R Musina
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
- Bauman Moscow State Technical University, Russia
| | - N V Chernomyrdin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Russia
- World-Class Research Center "Digital Biodesign & Personalized Healthcare", Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - E R Gafarova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Russia
- World-Class Research Center "Digital Biodesign & Personalized Healthcare", Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - A A Gavdush
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
- Bauman Moscow State Technical University, Russia
| | - A J Shpichka
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Russia
- World-Class Research Center "Digital Biodesign & Personalized Healthcare", Sechenov First Moscow State Medical University (Sechenov University), Russia
- Chemistry Department, Lomonosov Moscow State University, Russia
| | - G A Komandin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
- Bauman Moscow State Technical University, Russia
| | - V B Anzin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
| | - E A Grebenik
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - M V Kravchik
- Scientific Research Institute of Eye Diseases, Russia
| | - E V Istranova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - I N Dolganova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Russia
- World-Class Research Center "Digital Biodesign & Personalized Healthcare", Sechenov First Moscow State Medical University (Sechenov University), Russia
- Institute of Solid State Physics of the Russian Academy of Sciences, Russia
| | - K I Zaytsev
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Russia
- Bauman Moscow State Technical University, Russia
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - P S Timashev
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Russia
- World-Class Research Center "Digital Biodesign & Personalized Healthcare", Sechenov First Moscow State Medical University (Sechenov University), Russia
- Chemistry Department, Lomonosov Moscow State University, Russia
- Department of Polymers and Composites, N. N. Semenov Institute of Chemical Physics, Russia
| |
Collapse
|
15
|
Gafarova ER, Grebenik EA, Lazhko AE, Frolova AA, Kuryanova AS, Kurkov AV, Bazhanov IA, Kapomba BS, Kosheleva NV, Novikov IA, Shekhter AB, Golubeva EN, Soloviova AB, Timashev PS. Evaluation of Supercritical CO 2-Assisted Protocols in a Model of Ovine Aortic Root Decellularization. Molecules 2020; 25:molecules25173923. [PMID: 32867356 PMCID: PMC7504408 DOI: 10.3390/molecules25173923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/26/2020] [Accepted: 08/26/2020] [Indexed: 01/03/2023] Open
Abstract
One of the leading trends in the modern tissue engineering is the development of new effective methods of decellularization aimed at the removal of cellular components from a donor tissue, reducing its immunogenicity and the risk of rejection. Supercritical CO2 (scCO2)-assisted processing has been proposed to improve the outcome of decellularization, reduce contamination and time costs. The resulting products can serve as personalized tools for tissue-engineering therapy of various somatic pathologies. However, the decellularization of heterogeneous 3D structures, such as the aortic root, requires optimization of the parameters, including preconditioning medium composition, the type of co-solvent, values of pressure and temperature inside the scCO2 reactor, etc. In our work, using an ovine aortic root model, we performed a comparative analysis of the effectiveness of decellularization approaches based on various combinations of these parameters. The protocols were based on the combinations of treatments in alkaline, ethanol or detergent solutions with scCO2-assisted processing at different modes. Histological analysis demonstrated favorable effects of the preconditioning in a detergent solution. Following processing in scCO2 medium provided a high decellularization degree, reduced cytotoxicity, and increased ultimate tensile strength and Young’s modulus of the aortic valve leaflets, while the integrity of the extracellular matrix was preserved.
Collapse
Affiliation(s)
- Elvira R. Gafarova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
- Correspondence: ; Tel.: +7-917-372-5217
| | - Ekaterina A. Grebenik
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Alexey E. Lazhko
- Kurnakov Institute of General and Inorganic Chemistry, Russian Academy of Sciences, 119991 Moscow, Russia;
| | - Anastasia A. Frolova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Anastasia S. Kuryanova
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
- N. N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, 117977 Moscow, Russia;
| | - Alexandr V. Kurkov
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Ilya A. Bazhanov
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Byron S. Kapomba
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Nastasia V. Kosheleva
- FSBSI “Institute of General Pathology and Pathophysiology”, 125315 Moscow, Russia;
- Faculty of Biology, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - Ivan A. Novikov
- Scientific Research Institute of Eye Diseases, 119021 Moscow, Russia;
| | - Anatoly B. Shekhter
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
| | - Elena N. Golubeva
- Faculty of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia;
| | - Anna B. Soloviova
- N. N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, 117977 Moscow, Russia;
| | - Peter S. Timashev
- Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia; (E.A.G.); (A.A.F.); (A.S.K.); (A.V.K.); (I.A.B.); (B.S.K.); (A.B.S.); (P.S.T.)
- N. N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences, 117977 Moscow, Russia;
- Faculty of Chemistry, Lomonosov Moscow State University, 119991 Moscow, Russia;
| |
Collapse
|