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Marinaro F, Sánchez-Margallo FM, Álvarez V, López E, Tarazona R, Brun MV, Blázquez R, Casado JG. Meshes in a mess: Mesenchymal stem cell-based therapies for soft tissue reinforcement. Acta Biomater 2019; 85:60-74. [PMID: 30500445 DOI: 10.1016/j.actbio.2018.11.042] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 11/21/2018] [Accepted: 11/26/2018] [Indexed: 12/19/2022]
Abstract
Surgical meshes are frequently used for the treatment of abdominal hernias, pelvic organ prolapse, and stress urinary incontinence. Though these meshes are designed for tissue reinforcement, many complications have been reported. Both differentiated cell- and mesenchymal stem cell-based therapies have become attractive tools to improve their biocompatibility and tissue integration, minimizing adverse inflammatory reactions. However, current studies are highly heterogeneous, making it difficult to establish comparisons between cell types or cell coating methodologies. Moreover, only a few studies have been performed in clinically relevant animal models, leading to contradictory results. Finally, a thorough understanding of the biological mechanisms of mesenchymal stem cells in the context of foreign body reaction is lacking. This review aims to summarize in vitro and in vivo studies involving the use of differentiated and mesenchymal stem cells in combination with surgical meshes. According to preclinical and clinical studies and considering the therapeutic potential of mesenchymal stem cells, it is expected that these cells will become valuable tools in the treatment of pathologies requiring tissue reinforcement. STATEMENT OF SIGNIFICANCE: The implantation of surgical meshes is the standard procedure to reinforce tissue defects such as hernias. However, an adverse inflammatory response secondary to this implantation is frequently observed, leading to a strong discomfort and chronic pain in the patients. In many cases, an additional surgical intervention is needed to remove the mesh. Both differentiated cell- and stem cell-based therapies have become attractive tools to improve biocompatibility and tissue integration, minimizing adverse inflammatory reactions. However, current studies are incredibly heterogeneous and it is difficult to establish a comparison between cell types or cell coating methodologies. This review aims to summarize in vitro and in vivo studies where differentiated and stem cells have been combined with surgical meshes.
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Affiliation(s)
- F Marinaro
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Ctra. N-521, km 41.8, 10071 Cáceres, Spain
| | - F M Sánchez-Margallo
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Ctra. N-521, km 41.8, 10071 Cáceres, Spain; CIBER de Enfermedades Cardiovasculares, Avenida Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - V Álvarez
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Ctra. N-521, km 41.8, 10071 Cáceres, Spain
| | - E López
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Ctra. N-521, km 41.8, 10071 Cáceres, Spain
| | - R Tarazona
- Immunology Unit, Department of Physiology, University of Extremadura, 10071 Caceres, Spain
| | - M V Brun
- Department of Small Animal Medicine, Federal University of Santa Maria (UFSM), Av. Roraima, 1000 - 7 - Camobi, Santa Maria, 97105-900 Rio Grande do Sul, Brazil
| | - R Blázquez
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Ctra. N-521, km 41.8, 10071 Cáceres, Spain; CIBER de Enfermedades Cardiovasculares, Avenida Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain.
| | - J G Casado
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, Ctra. N-521, km 41.8, 10071 Cáceres, Spain; CIBER de Enfermedades Cardiovasculares, Avenida Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
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Lachaux J, Alcaine C, Gómez-Escoda B, Perrault CM, Duplan DO, Wu PYJ, Ochoa I, Fernandez L, Mercier O, Coudreuse D, Roy E. Thermoplastic elastomer with advanced hydrophilization and bonding performances for rapid (30 s) and easy molding of microfluidic devices. LAB ON A CHIP 2017; 17:2581-2594. [PMID: 28656191 DOI: 10.1039/c7lc00488e] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
One of the most important areas of research on microfluidic technologies focuses on the identification and characterisation of novel materials with enhanced properties and versatility. Here we present a fast, easy and inexpensive microstructuration method for the fabrication of novel, flexible, transparent and biocompatible microfluidic devices. Using a simple hot press, we demonstrate the rapid (30 s) production of various microfluidic prototypes embossed in a commercially available soft thermoplastic elastomer (sTPE). This styrenic block copolymer (BCP) material is as flexible as PDMS and as thermoformable as classical thermoplastics. It exhibits high fidelity of replication using SU-8 and epoxy master molds in a highly convenient low-isobar (0.4 bar) and iso-thermal process. Microfluidic devices can then be easily sealed using either a simple hot plate or even a room-temperature assembly, allowing them to sustain liquid pressures of 2 and 0.6 bar, respectively. The excellent sorption and biocompatibility properties of the microchips were validated via a standard rhodamine dye assay as well as a sensitive yeast cell-based assay. The morphology and composition of the surface area after plasma treatment for hydrophilization purposes are stable and show constant and homogenous distribution of block nanodomains (∼22° after 4 days). These domains, which are evenly distributed on the nanoscale, therefore account for the uniform and convenient surface of a "microfluidic scale device". To our knowledge, this is the first thermoplastic elastomer material that can be used for fast and reliable fabrication and assembly of microdevices while maintaining a high and stable hydrophilicity.
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Affiliation(s)
- Julie Lachaux
- Centre Nanosciences et Nanotechnologies, CNRS UMR9001, Paris-Saclay University, 91460 Marcoussis, France.
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Islam A, Chapin K, Younesi M, Akkus O. Computer aided biomanufacturing of mechanically robust pure collagen meshes with controlled macroporosity. Biofabrication 2015. [PMID: 26200002 DOI: 10.1088/1758-5090/7/3/035005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Reconciliation of high strength and high porosity in pure collagen based structures is a major barrier in collagen's use in load-bearing applications. The current study developed a CAD/CAM based electrocompaction method to manufacture highly porous patterned scaffolds using pure collagen. Utilization of computerized scaffold design and fabrication allows the integration of mesh-scaffolds with controlled pore size, shape and spacing. Mechanical properties of fabricated collagen meshes were investigated as a function of number of patterned layers, and with different pore geometries. The tensile stiffness, tensile strength and modulus ranges from 10-50 N cm(-1), 1-6 MPa and 5-40 MPa respectively for all the scaffold groups. These results are within the range of practical usability of different tissue engineering application such as tendon, hernia, stress urinary incontinence or thoracic wall reconstruction. Moreover, 3-fold increase in the layer number resulted in more than 5-fold increases in failure load, toughness and stiffness which suggests that by changing the number of layers and shape of the structure, mechanical properties can be modulated for the aforementioned tissue engineering application. These patterned scaffolds offer a porosity ranging from 0.8 to 1.5 mm in size, a range that is commensurate with pore sizes of repair meshes in the market. The connected macroporosity of the scaffolds facilitated cell-seeding such that cells populated the entire scaffold at the time of seeding. After 3 d of culture, cell nuclei became elongated. These results indicate that the patterned electrochemical deposition method in this study was able to develop mechanically robust, highly porous collagen scaffolds with controlled porosity which not only tries to solve one of the major tissue engineering problems at a fundamental level but also has a significant potential to be used in different tissue engineering applications.
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Affiliation(s)
- Anowarul Islam
- Department of Mechanical and Aerospace Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
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Spelzini F, Manodoro S, Frigerio M, Nicolini G, Maggioni D, Donzelli E, Altomare L, Farè S, Veneziano F, Avezza F, Tredici G, Milani R. Stem cell augmented mesh materials: an in vitro and in vivo study. Int Urogynecol J 2014; 26:675-83. [PMID: 25416022 DOI: 10.1007/s00192-014-2570-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 11/04/2014] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND HYPOTHESIS To test in vitro and in vivo the capability of mesh materials to act as scaffolds for rat-derived mesenchymal stem cells (rMSCs) and to compare inflammatory response and collagen characteristics of implant materials, either seeded or not with rMSCs. METHODS rMSCs isolated from rat bone marrow were seeded and cultured in vitro on four different implant materials. Implants showing the best rMSC proliferation rate were selected for the in vivo experiment. Forty-eight adult female Sprague-Dawley rats were randomly divided into two treatment groups. The implant of interest-either seeded or not with rMSCs-was laid and fixed over the muscular abdominal wall. Main outcome measures were: in vitro, proliferation of rMSCs on selected materials; in vivo, the occurrence of topical complications, the evaluation of systemic and local inflammatory response and examination of the biomechanical properties of explants. RESULTS Surgisis and Pelvitex displayed the best cell growth in vitro. At 90 days in the rat model, rMSCs were related to a lower count of neutrophil cells for Pelvitex and a greater organisation and collagen amount for Surgisis. At 7 days Surgisis samples seeded with rMSCs displayed higher breaking force and stiffness. CONCLUSIONS The presence of rMSCs reduced the systemic inflammatory response on synthetic implants and improved collagen characteristics at the interface between biological grafts and native tissues. rMSCs enhanced the stripping force on biological explants.
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Affiliation(s)
- Federico Spelzini
- Department of Obstetrics and Gynaecology, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
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Lane FL, Jacobs S. Stem cells in gynecology. Am J Obstet Gynecol 2012; 207:149-56. [PMID: 22464292 DOI: 10.1016/j.ajog.2012.01.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2011] [Revised: 01/12/2012] [Accepted: 01/31/2012] [Indexed: 12/14/2022]
Abstract
Stem cell based therapies hold promise for the obstetrician and gynecologist. This article reviews the history of stem cells and some of their current applications in gynecology. Currently, mesenchymal and muscle-derived stem cells are being explored for the treatment of urinary and anal incontinence. Potential stem cell treatments include fistula repair, vaginal tissue engineering, and graft material enhancement. Published animal and human pilot studies demonstrate improved histologic and functional outcomes in those receiving stem cells. Transplanted cells may improve function by local engraftment, trophic factors, or modulation of inflammation. Further clinical and safety studies are needed before clinical application.
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Chandler EM, Seo BR, Califano JP, Andresen Eguiluz RC, Lee JS, Yoon CJ, Tims DT, Wang JX, Cheng L, Mohanan S, Buckley MR, Cohen I, Nikitin AY, Williams RM, Gourdon D, Reinhart-King CA, Fischbach C. Implanted adipose progenitor cells as physicochemical regulators of breast cancer. Proc Natl Acad Sci U S A 2012; 109:9786-91. [PMID: 22665775 PMCID: PMC3382522 DOI: 10.1073/pnas.1121160109] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Multipotent adipose-derived stem cells (ASCs) are increasingly used for regenerative purposes such as soft tissue reconstruction following mastectomy; however, the ability of tumors to commandeer ASC functions to advance tumor progression is not well understood. Through the integration of physical sciences and oncology approaches we investigated the capability of tumor-derived chemical and mechanical cues to enhance ASC-mediated contributions to tumor stroma formation. Our results indicate that soluble factors from breast cancer cells inhibit adipogenic differentiation while increasing proliferation, proangiogenic factor secretion, and myofibroblastic differentiation of ASCs. This altered ASC phenotype led to varied extracellular matrix (ECM) deposition and contraction thereby enhancing tissue stiffness, a characteristic feature of breast tumors. Increased stiffness, in turn, facilitated changes in ASC behavior similar to those observed with tumor-derived chemical cues. Orthotopic mouse studies further confirmed the pathological relevance of ASCs in tumor progression and stiffness in vivo. In summary, altered ASC behavior can promote tumorigenesis and, thus, their implementation for regenerative therapy should be carefully considered in patients previously treated for cancer.
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Affiliation(s)
- Emily M. Chandler
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853
| | - Bo Ri Seo
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853
| | - Joseph P. Califano
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853
| | | | - Jason S. Lee
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853
| | - Christine J. Yoon
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853
| | - David T. Tims
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853
| | - James X. Wang
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853
| | - Le Cheng
- Department of Biomedical Sciences, Cornell University, Ithaca, NY 14853; and
| | - Sunish Mohanan
- Department of Biomedical Sciences, Cornell University, Ithaca, NY 14853; and
| | | | - Itai Cohen
- Department of Physics, Cornell University, Ithaca, NY 14853
| | | | | | - Delphine Gourdon
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY 14853
| | | | - Claudia Fischbach
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853
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Current world literature. Curr Opin Urol 2012; 22:336-45. [PMID: 22677776 DOI: 10.1097/mou.0b013e3283551cbf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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