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Sierra-Sánchez Á, Cabañas-Penagos J, Igual-Roger S, Martínez-Heredia L, Espinosa-Ibáñez O, Sanabria-de la Torre R, Quiñones-Vico MI, Ubago-Rodríguez A, Lizana-Moreno A, Fernández-González A, Guerrero-Calvo J, Fernández-Porcel N, Ramírez-Muñoz A, Arias-Santiago S. Biological properties and characterization of several variations of a clinical human plasma-based skin substitute model and its manufacturing process. Regen Biomater 2024; 11:rbae115. [PMID: 39469583 PMCID: PMC11513639 DOI: 10.1093/rb/rbae115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 08/07/2024] [Accepted: 09/11/2024] [Indexed: 10/30/2024] Open
Abstract
Human plasma is a natural biomaterial that due to their protein composition is widely used for the development of clinical products, especially in the field of dermatology. In this context, this biomaterial has been used as a scaffold alone or combined with others for the development of cellular human plasma-based skin substitutes (HPSSs). Herein, the biological properties (cell viability, cell metabolic activity, protein secretion profile and histology) of several variations of a clinical HPSS model, regarding the biomaterial composition (alone or combined with six secondary biomaterials - serine, fibronectin, collagen, two types of laminins and hyaluronic acid), the cellular structure (trilayer, bilayer, monolayer and control without cells) and their skin tissue of origin (abdominal or foreskin cells) and the manufacturing process [effect of partial dehydration process in cell viability and comparison between submerged (SUB) and air/liquid interface (ALI) methodologies] have been evaluated and compared. Results reveal that the use of human plasma as a main biomaterial determines the in vitro properties, rather than the secondary biomaterials added. Moreover, the characteristics are similar regardless of the skin cells used (from abdomen or foreskin). However, the manufacture of more complex cellular substitutes (trilayer and bilayer) has been demonstrated to be better in terms of cell viability, metabolic activity and wound healing protein secretion (bFGF, EGF, VEGF-A, CCL5) than monolayer HPSSs, especially when ALI culture methodology is applied. Moreover, the application of the dehydration, although required to achieve an appropriate clinical structure, reduce cell viability in all cases. These data indicate that this HPSS model is robust and reliable and that the several subtypes here analysed could be promising clinical approaches depending on the target dermatological disease.
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Affiliation(s)
- Álvaro Sierra-Sánchez
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, 18012, Spain
| | - Jorge Cabañas-Penagos
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
| | - Sandra Igual-Roger
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
| | - Luis Martínez-Heredia
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
| | - Olga Espinosa-Ibáñez
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
| | - Raquel Sanabria-de la Torre
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- Department of Biochemistry and Molecular Biology III and Immunology, University of Granada, Granada, 18071, Spain
| | - María I Quiñones-Vico
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- Department of Dermatology, University of Granada, Granada, 18016, Spain
| | - Ana Ubago-Rodríguez
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
| | - Antonio Lizana-Moreno
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
| | - Ana Fernández-González
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
| | - Jorge Guerrero-Calvo
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
| | - Natividad Fernández-Porcel
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
| | - Arena Ramírez-Muñoz
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
| | - Salvador Arias-Santiago
- Andalusian Network of Design and Translation of Advanced Therapies, Unidad de Producción Celular e Ingeniería Tisular, Virgen de las Nieves University Hospital, Granada, 18014, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, 18012, Spain
- Department of Dermatology, University of Granada, Granada, 18016, Spain
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2
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Ghosal D, Majumder N, Das P, Chaudhary S, Dey S, Banerjee P, Tiwari P, Das P, Basak P, Nandi SK, Ghosh S, Kumar S. Enhancing Wound Healing With Sprayable Hydrogel Releasing Multi Metallic Ions: Inspired by the Body's Endogenous Healing Mechanism. Adv Healthc Mater 2024:e2402024. [PMID: 39226530 DOI: 10.1002/adhm.202402024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/31/2024] [Indexed: 09/05/2024]
Abstract
In the pursuit of new wound care products, researchers are exploring methods to improve wound healing through exogenous wound healing products. However, diverging from this conventional approach, this work has developed an endogenous support system for wound healing, drawing inspiration from the body's innate healing mechanisms governed by the sequential release of metal ions by body at wound site to promote different stages of wound healing. This work engineers a multi-ion-releasing sprayable hydrogel system, to mimic this intricate process, representing the next evolutionary step in wound care products. It comprises Alginate (Alg) and Fibrin (Fib) hydrogel infused with Polylactic acid (PLA) polymeric microcarriers encapsulating multi (calcium, copper, and zinc) nanoparticles (Alg-Fib-PLA-nCMB). Developed sprayable Alg-Fib-PLA-nCMB hydrogel show sustained release of beneficial multi metallic ions at wound site, offering a range of advantages including enhanced cellular function, antibacterial properties, and promotion of crucial wound healing processes like cell migration, ROS mitigation, macrophage polarization, collagen deposition, and vascular regeneration. In a comparative study with a commercial product (Midstress spray), developed Alg-Fib-PLA-nCMB hydrogel demonstrates superior wound healing outcomes in a rat model, indicating its potential for next generation wound care product, addressing critical challenges and offering a promising avenue for future advancements in the wound management.
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Affiliation(s)
- Doyel Ghosal
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India
| | - Nilotpal Majumder
- Department of Textile and Fibre Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India
| | - Pratik Das
- School of Bioscience and Engineering, Jadavpur University, Kolkata, 700032, India
- Department of Veterinary Surgery & Radiology, West Bengal University of Animal & Fishery Sciences, Kolkata, 700037, India
| | - Shivani Chaudhary
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India
| | - Sovan Dey
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India
| | - Priya Banerjee
- Department of Textile and Fibre Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India
| | - Preeti Tiwari
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India
| | - Piyali Das
- Department of Microbiology, School of Life Science and Biotechnology, Adamas University, Kolkata, 700126, India
| | - Piyali Basak
- School of Bioscience and Engineering, Jadavpur University, Kolkata, 700032, India
| | - Samit K Nandi
- Department of Veterinary Surgery & Radiology, West Bengal University of Animal & Fishery Sciences, Kolkata, 700037, India
| | - Sourabh Ghosh
- Department of Textile and Fibre Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India
| | - Sachin Kumar
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, 110016, India
- Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, 110029, India
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Ismayilzada N, Tarar C, Dabbagh SR, Tokyay BK, Dilmani SA, Sokullu E, Abaci HE, Tasoglu S. Skin-on-a-chip technologies towards clinical translation and commercialization. Biofabrication 2024; 16:042001. [PMID: 38964314 DOI: 10.1088/1758-5090/ad5f55] [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: 09/19/2023] [Accepted: 07/04/2024] [Indexed: 07/06/2024]
Abstract
Skin is the largest organ of the human body which plays a critical role in thermoregulation, metabolism (e.g. synthesis of vitamin D), and protection of other organs from environmental threats, such as infections, microorganisms, ultraviolet radiation, and physical damage. Even though skin diseases are considered to be less fatal, the ubiquity of skin diseases and irritation caused by them highlights the importance of skin studies. Furthermore, skin is a promising means for transdermal drug delivery, which requires a thorough understanding of human skin structure. Current animal andin vitrotwo/three-dimensional skin models provide a platform for disease studies and drug testing, whereas they face challenges in the complete recapitulation of the dynamic and complex structure of actual skin tissue. One of the most effective methods for testing pharmaceuticals and modeling skin diseases are skin-on-a-chip (SoC) platforms. SoC technologies provide a non-invasive approach for examining 3D skin layers and artificially creating disease models in order to develop diagnostic or therapeutic methods. In addition, SoC models enable dynamic perfusion of culture medium with nutrients and facilitate the continuous removal of cellular waste to further mimic thein vivocondition. Here, the article reviews the most recent advances in the design and applications of SoC platforms for disease modeling as well as the analysis of drugs and cosmetics. By examining the contributions of different patents to the physiological relevance of skin models, the review underscores the significant shift towards more ethical and efficient alternatives to animal testing. Furthermore, it explores the market dynamics ofin vitroskin models and organ-on-a-chip platforms, discussing the impact of legislative changes and market demand on the development and adoption of these advanced research tools. This article also identifies the existing obstacles that hinder the advancement of SoC platforms, proposing directions for future improvements, particularly focusing on the journey towards clinical adoption.
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Affiliation(s)
- Nilufar Ismayilzada
- Department of Mechanical Engineering, Koç University, Istanbul 34450, Turkey
| | - Ceren Tarar
- Department of Mechanical Engineering, Koç University, Istanbul 34450, Turkey
| | | | - Begüm Kübra Tokyay
- Koç University Research Center for Translational Medicine, Koç University, Istanbul 34450, Turkey
| | - Sara Asghari Dilmani
- Koç University Research Center for Translational Medicine, Koç University, Istanbul 34450, Turkey
| | - Emel Sokullu
- School of Medicine, Koç University, Istanbul 34450, Turkey
| | - Hasan Erbil Abaci
- Department of Dermatology, Columbia University, New York City, NY, United States of America
| | - Savas Tasoglu
- Department of Mechanical Engineering, Koç University, Istanbul 34450, Turkey
- Boğaziçi Institute of Biomedical Engineering, Boğaziçi University, Istanbul 34684, Turkey
- Koç University Research Center for Translational Medicine, Koç University, Istanbul 34450, Turkey
- Koç University Arçelik Research Center for Creative Industries (KUAR), Koç University, Istanbul 34450, Turkey
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4
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Tong D, Gobert S, Reuzeau A, Farges JC, Leveque M, Bolon M, Costantini A, Pasdeloup M, Lafont J, Ducret M, Bekhouche M. Dental pulp mesenchymal stem cells-response to fibrin hydrogel reveals ITGA2 and MMPs expression. Heliyon 2024; 10:e32891. [PMID: 39027533 PMCID: PMC11255596 DOI: 10.1016/j.heliyon.2024.e32891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 07/20/2024] Open
Abstract
Regenerative endodontic procedures (REP) aim at reestablishing tooth vitality by replacing the irreversibly damaged dental pulp removed by the dental practitioner with a new functional one. The current treatment of advanced caries relies on the replacement of the inflamed or necrosed dental pulp with an inert filling material. This leads to a functional but non-vital tooth, which lacks the ability to sense dental tissue damage, and to protect from further bacterial attack. Therapeutic strategies inspired by tissue engineering called REP propose to regenerate a fully functional dental pulp directly in the canal space. Promising results were obtained using dental pulp mesenchymal stem cells (DP-MSCs) in combination with bio-inspired artificial and temporary 3D hydrogels made of extracellular matrix molecules such as collagen and fibrin biomacromolecules. However, the uncontrolled mechanisms of DP regeneration from DP-MSCs in 3D biomacromolecules fail to regenerate a fully functional DP and can induce fibrotic scarring or mineralized tissue formation to a non-negligible extent. The lack of knowledge regarding the early molecular mechanisms initiated by DP-MSCs seeded in ECM-made hydrogels is a scientific lock for REP. In this study, we investigated the early DP-MSC-response in a 3D fibrin hydrogel. DP-MSCs isolated from human third molars were cultured for 24 h in the fibrin hydrogel. The differential transcript levels of extracellular and cell surface genes were screened with 84-gene PCR array. Out of the 84 genes screened, 9 were found to be overexpressed, including those coding for the integrin alpha 2 subunit, the collagenase MMP1 and stromelysins MMP3, MMP10 and MMP12. Over-expression of ITGA2 was confirmed by RT-qPCR. The expression of alpha 2 integrin subunit protein was assessed over time by immunoblot and immunofluorescence staining. The increase in the transcript level of MMP1, MMP3, MM10 and MMP12 was confirmed by RT-qPCR. The overexpression of MMP1 and 3 at the protein level was assessed by immunoblot. MMP3 expression by DP-MSCs was observed by immunofluorescence staining. This work demonstrates overexpression of ITGA2 and of MMP1, 3, 10 and 12 by DP-MSCs cultured in a fibrin hydrogel. The main preliminary extracellular and cell surface response of the DP-MSCs to fibrin hydrogel seems to rely on a ITGA2/MMP3 axis. Further investigations are needed to precisely decipher the role of this axis in dental pulp tissue building. Nevertheless, this work identifies extracellular and cell surface molecules that could be potential checkpoints to be targeted to guide proper dental pulp tissue regeneration.
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Affiliation(s)
- David Tong
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Stéphanie Gobert
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Alicia Reuzeau
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Jean-Christophe Farges
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
- Odontology Faculty of Lyon, University Lyon 1, France
- Hospices Civils de Lyon, France
| | - Marianne Leveque
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Marie Bolon
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Arthur Costantini
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
- Hospices Civils de Lyon, France
| | - Marielle Pasdeloup
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Jérôme Lafont
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
| | - Maxime Ducret
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
- Odontology Faculty of Lyon, University Lyon 1, France
| | - Mourad Bekhouche
- LBTI - Tissue Biology and Therapeutic Engineering Laboratory, UMR5305, CNRS/Université, Claude Bernard Lyon 1, France
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Phuphanitcharoenkun S, Louis F, Sowa Y, Matsusaki M, Palaga T. Improving stability of human three dimensional skin equivalents using plasma surface treatment. Biotechnol Bioeng 2024; 121:1950-1960. [PMID: 38470332 DOI: 10.1002/bit.28690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/10/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
In developing three-dimensional (3D) human skin equivalents (HSEs), preventing dermis and epidermis layer distortion due to the contraction of hydrogels by fibroblasts is a challenging issue. Previously, a fabrication method of HSEs was tested using a modified solid scaffold or a hydrogel matrix in combination with the natural polymer coated onto the tissue culture surface, but the obtained HSEs exhibited skin layer contraction and loss of the skin integrity and barrier functions. In this study, we investigated the method of HSE fabrication that enhances the stability of the skin model by using surface plasma treatment. The results showed that plasma treatment of the tissue culture surface prevented dermal layer shrinkage of HSEs, in contrast to the HSE fabrication using fibronectin coating. The HSEs from plasma-treated surface showed significantly higher transepithelial electrical resistance compared to the fibronectin-coated model. They also expressed markers of epidermal differentiation (keratin 10, keratin 14 and loricrin), epidermal tight junctions (claudin 1 and zonula occludens-1), and extracellular matrix proteins (collagen IV), and exhibited morphological characteristics of the primary human skins. Taken together, the use of plasma surface treatment significantly improves the stability of 3D HSEs with well-defined dermis and epidermis layers and enhanced skin integrity and the barrier functions.
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Affiliation(s)
- Suphanun Phuphanitcharoenkun
- Graduate Program in Biotechnology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Materials and Bio-Interfaces, Chulalongkorn University, Bangkok, Thailand
| | - Fiona Louis
- Joint Research Laboratory (TOPPAN) for Advanced Cell Regulatory Chemistry, Graduate School of Engineering, Osaka University, Osaka, Japan
| | - Yoshihiro Sowa
- Department of Plastic and Reconstructive Surgery, Graduate School of Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Plastic Surgery, Jichi Medical University, Tochigi, Japan
| | - Michiya Matsusaki
- Joint Research Laboratory (TOPPAN) for Advanced Cell Regulatory Chemistry, Graduate School of Engineering, Osaka University, Osaka, Japan
- Department of Applied Chemistry, Graduate School of Engineering, Osaka University, Osaka, Japan
| | - Tanapat Palaga
- Center of Excellence in Materials and Bio-Interfaces, Chulalongkorn University, Bangkok, Thailand
- Department of Microbiology, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
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Liu S, Bahmani A, Ghezelbash F, Li J. Fibrin clot fracture under cyclic fatigue and variable rate loading. Acta Biomater 2024; 177:265-277. [PMID: 38336270 DOI: 10.1016/j.actbio.2024.01.046] [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: 10/05/2023] [Revised: 01/23/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024]
Abstract
Fibrin clot is a vital class of fibrous materials, governing the mechanical response of blood clots. Fracture behavior of fibrin clots under complex physiological load is relevant for hemostasis and thrombosis. But how they fracture under cyclic and variable rate loading has not been reported. Here we conduct cyclic fatigue and monotonic variable rate loading tests on fibrin clots to characterize their fracture properties in terms of fatigue threshold and rate-dependent fracture toughness. We demonstrate that the fracture behavior of fibrin clots is sensitive to the amplitude of cyclic load and the loading rate. The cyclic fatigue tests show the fatigue threshold of fibrin clots at 1.66 J/m2, compared to the overall fracture toughness 15.8 J/m2. Furthermore, we rationalize the fatigue threshold using a semi-empirical model parameterized by 3D morphometric quantification to account for the hierarchical molecular structure of fibrin fibers. The variable loading tests reveal rate dependence of the overall fracture toughness of fibrin clots. Our analysis with a viscoelastic fracture model suggests the viscoelastic origin of the rate-dependent fracture toughness. The toughening mechanism of fibrin clots is further compared with biological tissues and hydrogels. This study advances the understanding and modeling of fatigue and fracture of blood clots and would motivate further investigation on the mechanics of fibrous materials. STATEMENT OF SIGNIFICANCE: Fibrin clot is a soft fibrous gel, exhibiting nonlinear mechanical responses under complex physiological loads. It is the main load-bearing constituent of blood clots where red blood cells, platelets and other cells are trapped. How the fibrin clot fractures under complex mechanical loads is critical for hemostasis and thrombosis. We study the fracture behavior of fibrin clots under cyclic fatigue and monotonic variable rate loads. We characterize the fatigue-threshold and viscous energy dissipation of fibrin clots. We compare the toughness enhancement of fibrin clots with hydrogels. The findings offer new insights into the fatigue and fracture of blood clots and fibrous materials, which could improve design guidelines for bioengineered materials.
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Affiliation(s)
- Shiyu Liu
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada
| | - Aram Bahmani
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada
| | - Farshid Ghezelbash
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada
| | - Jianyu Li
- Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada; Department of Biomedical Engineering, McGill University, 817 Sherbrooke St W, Montreal, QC H3A 0C3, Canada.
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7
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Quílez C, Valencia L, González‐Rico J, Suárez‐Cabrera L, Amigo‐Morán L, Jorcano JL, Velasco D. In vitro induction of hair follicle signatures using human dermal papilla cells encapsulated in fibrin microgels. Cell Prolif 2024; 57:e13528. [PMID: 37539497 PMCID: PMC10771113 DOI: 10.1111/cpr.13528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/13/2023] [Accepted: 06/27/2023] [Indexed: 08/05/2023] Open
Abstract
Cellular spheroids have been described as an appropriate culture system to restore human follicle dermal papilla cells (hFDPc) intrinsic properties; however, they show a low and variable efficiency to promote complete hair follicle formation in in vivo experiments. In this work, a conscientious analysis revealed a 25% cell viability in the surface of the dermal papilla spheroid (DPS) for all culture conditions, questioning whether it is an appropriate culture system for hFDPc. To overcome this problem, we propose the use of human blood plasma for the generation of fibrin microgels (FM) with encapsulated hFDPc to restore its inductive signature, either in the presence or in the absence of blood platelets. FM showed a morphology and extracellular matrix composition similar to the native dermal papilla, including Versican and Collagen IV and increasing cell viability up to 85%. While both systems induce epidermal invaginations expressing hair-specific keratins K14, K15, K71, and K75 in in vitro skin cultures, the number of generated structures increases from 17% to 49% when DPS and FM were used, respectively. These data show the potential of our experimental setting for in vitro hair follicle neogenesis with wild adult hFDPc using FM, being a crucial step in the pursuit of human hair follicle regeneration therapies.
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Affiliation(s)
- Cristina Quílez
- Department of BioengineeringUniversidad Carlos III de MadridLeganésSpain
- Fundación Instituto de Investigación Sanitaria de la Fundación Jiménez DíazMadridSpain
| | - Leticia Valencia
- Department of BioengineeringUniversidad Carlos III de MadridLeganésSpain
| | - Jorge González‐Rico
- Department of Continuum Mechanics and Structural AnalysisUniversidad Carlos III de MadridLeganésSpain
| | | | - Lidia Amigo‐Morán
- Department of BioengineeringUniversidad Carlos III de MadridLeganésSpain
| | - José Luis Jorcano
- Department of BioengineeringUniversidad Carlos III de MadridLeganésSpain
- Instituto De Investigacion Sanitaria Gregorio MarañonMadridSpain
| | - Diego Velasco
- Department of BioengineeringUniversidad Carlos III de MadridLeganésSpain
- Fundación Instituto de Investigación Sanitaria de la Fundación Jiménez DíazMadridSpain
- Instituto De Investigacion Sanitaria Gregorio MarañonMadridSpain
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8
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de Rijk SR, Boys AJ, Roberts IV, Jiang C, Garcia C, Owens RM, Bance M. Tissue-Engineered Cochlear Fibrosis Model Links Complex Impedance to Fibrosis Formation for Cochlear Implant Patients. Adv Healthc Mater 2023; 12:e2300732. [PMID: 37310792 PMCID: PMC11468547 DOI: 10.1002/adhm.202300732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/30/2023] [Indexed: 06/15/2023]
Abstract
Cochlear implants are a life-changing technology for those with severe sensorineural hearing loss, partially restoring hearing through direct electrical stimulation of the auditory nerve. However, they are known to elicit an immune response resulting in fibrotic tissue formation in the cochlea that is linked to residual hearing loss and suboptimal outcomes. Intracochlear fibrosis is difficult to track without postmortem histology, and no specific electrical marker for fibrosis exists. In this study, a tissue-engineered model of cochlear fibrosis is developed following implant placement to examine the electrical characteristics associated with fibrotic tissue formation around electrodes. The model is characterized using electrochemical impedance spectroscopy and an increase in the resistance and a decrease in capacitance of the tissue using a representative circuit are found. This result informs a new marker of fibrosis progression over time that is extractable from voltage waveform responses, which can be directly measured in cochlear implant patients. This marker is tested in a small sample size of recently implanted cochlear implant patients, showing a significant increase over two postoperative timepoints. Using this system, complex impedance is demonstrated as a marker of fibrosis progression that is directly measurable from cochlear implants to enable real-time tracking of fibrosis formation in patients, creating opportunities for earlier treatment intervention to improve cochlear implant efficacy.
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Affiliation(s)
- Simone R. de Rijk
- Cambridge Hearing GroupCambridgeCB2 8AFUK
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeCB2 3 EBUK
| | - Alexander J. Boys
- Cambridge Hearing GroupCambridgeCB2 8AFUK
- Department of Chemical Engineering and BiotechnologyUniversity of CambridgeCambridgeCB3 0ASUK
| | - Iwan V. Roberts
- Cambridge Hearing GroupCambridgeCB2 8AFUK
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeCB2 3 EBUK
| | - Chen Jiang
- Cambridge Hearing GroupCambridgeCB2 8AFUK
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeCB2 3 EBUK
- Department of Electronic EngineeringTsinghua UniversityBeijing100190P. R. China
| | - Charlotte Garcia
- Cambridge Hearing GroupCambridgeCB2 8AFUK
- Medical Research Council Cognition and Brain Sciences UnitUniversity of CambridgeCambridgeCB2 7EFUK
| | - Róisín M. Owens
- Cambridge Hearing GroupCambridgeCB2 8AFUK
- Department of Chemical Engineering and BiotechnologyUniversity of CambridgeCambridgeCB3 0ASUK
| | - Manohar Bance
- Cambridge Hearing GroupCambridgeCB2 8AFUK
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeCB2 3 EBUK
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9
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Angelidakis E, Chen S, Zhang S, Wan Z, Kamm RD, Shelton SE. Impact of Fibrinogen, Fibrin Thrombi, and Thrombin on Cancer Cell Extravasation Using In Vitro Microvascular Networks. Adv Healthc Mater 2023; 12:e2202984. [PMID: 37119127 PMCID: PMC10524192 DOI: 10.1002/adhm.202202984] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/25/2023] [Indexed: 04/30/2023]
Abstract
A bidirectional association exists between metastatic dissemination and the hypercoagulable state associated with many types of cancer. As such, clinical studies have provided evidence that markers associated with elevated levels of coagulation and fibrinolysis correlate with decreased patient survival. However, elucidating the mechanisms underpinning the effects of different components of the coagulation system on metastasis formation is challenging both in animal models and 2D models lacking the complex cellular interactions necessary to model both thrombosis and metastasis. Here, an in vitro, 3D, microvascular model for observing the formation of fibrin thrombi is described, which is in turn used to study how different aspects of the hypercoagulable state associated with cancer affect the endothelium. Using this platform, cancer cells expressing ICAM-1 are shown to form a fibrinogen-dependent bridge and transmigrate through the endothelium more effectively. Cancer cells are also demonstrated to interact with fibrin thrombi, using them to adhere, spread, and enhance their extravasation efficiency. Finally, thrombin is also shown to enhance cancer cell extravasation. This system presents a physiologically relevant model of fibrin clot formation in the human microvasculature, enabling in-depth investigation of the cellular interactions between cancer cells and the coagulation system affecting cancer cell extravasation.
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Affiliation(s)
- Emmanouil Angelidakis
- Department of Biological EngineeringMassachusetts Institute of TechnologyCambridgeMA02139USA
| | - Sophia Chen
- Department of Biological EngineeringMassachusetts Institute of TechnologyCambridgeMA02139USA
| | - Shun Zhang
- Department of Biological EngineeringMassachusetts Institute of TechnologyCambridgeMA02139USA
| | - Zhengpeng Wan
- Department of Biological EngineeringMassachusetts Institute of TechnologyCambridgeMA02139USA
| | - Roger D. Kamm
- Department of Biological EngineeringMassachusetts Institute of TechnologyCambridgeMA02139USA
- Department of Mechanical EngineeringMassachusetts Institute of TechnologyCambridgeMA02139USA
| | - Sarah E. Shelton
- Department of Biological EngineeringMassachusetts Institute of TechnologyCambridgeMA02139USA
- Department of Medical OncologyDana Farber Cancer InstituteBostonMA02215USA
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10
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Jung SH, Jang BH, Kwon S, Park SJ, Park TE, Kang JH. Nematic Fibrin Fibers Enabling Vascularized Thrombus Implants Facilitate Scarless Cutaneous Wound Healing. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023:e2211149. [PMID: 37052392 DOI: 10.1002/adma.202211149] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Autologous implantable scaffolds that induce vasculogenesis have shown great potential in tissue regeneration; however, previous attempts mainly relied on cell-laden hydrogel patches using fat tissues or platelet-rich plasma, which are insufficient for generating a uniform vasculature in a scalable manner. Here, implantable vascularized engineered thrombi (IVETs) are presented using autologous whole blood, which potentiate effective skin wound healing by constructing robust microcapillary vessel networks at the wound site. Microfluidic shear stresses enable the alignment of bundled fibrin fibers along the direction of the blood flow streamlines and the activation of platelets, both of which offer moderate stiffness of the microenvironment optimal for facilitating endothelial cell maturation and vascularization. Rodent dorsal skin wounds patched with IVET present superior wound closure rates (96.08 ± 1.58%), epidermis thickness, collagen deposition, hair follicle numbers, and neutrophil infiltration, which are permitted by enhanced microvascular circulation. Moreover, IVET treatment accelerates wound healing by recruiting M2 phenotype macrophages.
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Affiliation(s)
- Su Hyun Jung
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology (UNIST), UNIST gil 50, Ulsan, 44919, Republic of Korea
| | - Bong Hwan Jang
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology (UNIST), UNIST gil 50, Ulsan, 44919, Republic of Korea
| | - Seyong Kwon
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology (UNIST), UNIST gil 50, Ulsan, 44919, Republic of Korea
| | - Sung Jin Park
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology (UNIST), UNIST gil 50, Ulsan, 44919, Republic of Korea
| | - Tae-Eun Park
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology (UNIST), UNIST gil 50, Ulsan, 44919, Republic of Korea
| | - Joo H Kang
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology (UNIST), UNIST gil 50, Ulsan, 44919, Republic of Korea
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11
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Martín C, Bachiller A, Fernández-Blázquez JP, Nishina Y, Jorcano JL. Plasma-Derived Fibrin Hydrogels Containing Graphene Oxide for Infections Treatment. ACS MATERIALS LETTERS 2023; 5:1245-1255. [PMID: 38323142 PMCID: PMC10842975 DOI: 10.1021/acsmaterialslett.2c01044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/20/2023] [Indexed: 02/08/2024]
Abstract
Wound infection is inevitable in most patients suffering from extensive burns or chronic ulcers, and there is an urgent demand for the production of bactericidal dressings to be used as grafts to restore skin functionalities. In this context, the present study explores the fabrication of plasma-derived fibrin hydrogels containing bactericidal hybrids based on graphene oxide (GO). The hydrogels were fully characterized regarding gelation kinetics, mechanical properties, and internal hydrogel structures by disruptive cryo scanning electron microscopies (cryo-SEMs). The gelation kinetic experiments revealed an acceleration of the gel formation when GO was added to the hydrogels in a concentration of up to 0.2 mg/mL. The cryo-SEM studies showed up a decrease of the pore size when GO was added to the network, which agreed with a faster area contraction and a higher compression modulus of the hydrogels that contained GO, pointing out the critical structural role of the nanomaterial. Afterward, to study the bactericidal ability of the gels, GO was used as a carrier, loading streptomycin (STREP) on its surface. The loading content of the drug to form the hybrid (GO/STREP) resulted in 50.2% ± 4.7%, and the presence of the antibiotic was also demonstrated by Raman spectroscopy, Z-potential studies, and thermogravimetric analyses. The fibrin-derived hydrogels containing GO/STREP showed a dose-response behavior according to the bactericidal hybrid concentration and allowed a sustained release of the antibiotic at a programmed rate, leading to drug delivery over a prolonged period of time.
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Affiliation(s)
- Cristina Martín
- Department
of Bioengineering, Universidad Carlos III
de Madrid, Leganés 28911, Spain
| | - Ariadna Bachiller
- Department
of Bioengineering, Universidad Carlos III
de Madrid, Leganés 28911, Spain
| | | | - Yuta Nishina
- Graduate
School of Natural Science and Technology, Okayama University, Okayama 700-8530, Japan
- Research
Core for Interdisciplinary Sciences, Okayama
University, Okayama 700-8530, Japan
| | - José L. Jorcano
- Department
of Bioengineering, Universidad Carlos III
de Madrid, Leganés 28911, Spain
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12
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Bakulina AA, Musina GR, Gavdush AA, Efremov YM, Komandin GA, Vosough M, Shpichka AI, Zaytsev KI, Timashev PS. PEG-fibrin conjugates: the PEG impact on the polymerization dynamics. SOFT MATTER 2023; 19:2430-2437. [PMID: 36930054 DOI: 10.1039/d2sm01504h] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Fibrin and its modifications, particularly those with functionalized polyethylene glycol (PEG), remain highly attractive as a biomaterial in drug delivery and regenerative medicine. Despite the extensive knowledge of fibrinogenesis, there is little information on the processes occurring after its modification. Previously, we found structural differences between native fibrin and its conjugates with PEG that allows us to hypothesize that a combination of methods such as terahertz (THz) pulsed spectroscopy and rheology may contribute to the characterization of gelation and reveal the effect of PEG on the polymerization dynamics. Compared to native fibrin, PEGylated fibrins had a homogenously soft surface; PEGylation also led to a significant decrease in the gelation time: from 42.75 min for native fibrin to 31.26 min and 35.09 min for 5 : 1 and 10 : 1 PEGylated fibrin, respectively. It is worth noting that THz pulsed spectroscopy makes it possible to reliably investigate only the polymerization process itself, while it does not allow us to observe statistically significant differences between the distinct PEGylated fibrin gels. The polymerization time constant of native fibrin measured by THz pulsed spectroscopy was 14.4 ± 2.8 min. However, it could not be calculated for PEGylated fibrin because the structural changes were too rapid. These results, together with those previously reported, led us to speculate that PEG-fibrin conjugates formed homogenously distributed highly water-shelled aggregates without bundling compared to native fibrin, ensuring rapid gelation and stabilization of the system without increasing its complexity.
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Affiliation(s)
- Alesia A Bakulina
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia.
| | - Guzel R Musina
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia.
| | - Arsenii A Gavdush
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia.
| | - Yuri M Efremov
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia.
| | - Gennady A Komandin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia.
| | - Massoud Vosough
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Anastasia I Shpichka
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia.
- World-Class Research Center "Digital Biodesign and Personalized Healthcare", Sechenov University, Moscow, Russia
- Chemistry Department, Lomonosov Moscow State University, Moscow, Russia
| | - Kirill I Zaytsev
- Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia.
| | - Peter S Timashev
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russia.
- World-Class Research Center "Digital Biodesign and Personalized Healthcare", Sechenov University, Moscow, Russia
- Chemistry Department, Lomonosov Moscow State University, Moscow, Russia
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13
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Sanz-Horta R, Matesanz A, Gallardo A, Reinecke H, Jorcano JL, Acedo P, Velasco D, Elvira C. Technological advances in fibrin for tissue engineering. J Tissue Eng 2023; 14:20417314231190288. [PMID: 37588339 PMCID: PMC10426312 DOI: 10.1177/20417314231190288] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/11/2023] [Indexed: 08/18/2023] Open
Abstract
Fibrin is a promising natural polymer that is widely used for diverse applications, such as hemostatic glue, carrier for drug and cell delivery, and matrix for tissue engineering. Despite the significant advances in the use of fibrin for bioengineering and biomedical applications, some of its characteristics must be improved for suitability for general use. For example, fibrin hydrogels tend to shrink and degrade quickly after polymerization, particularly when they contain embedded cells. In addition, their poor mechanical properties and batch-to-batch variability affect their handling, long-term stability, standardization, and reliability. One of the most widely used approaches to improve their properties has been modification of the structure and composition of fibrin hydrogels. In this review, recent advances in composite fibrin scaffolds, chemically modified fibrin hydrogels, interpenetrated polymer network (IPN) hydrogels composed of fibrin and other synthetic or natural polymers are critically reviewed, focusing on their use for tissue engineering.
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Affiliation(s)
- Raúl Sanz-Horta
- Department of Applied Macromolecular Chemistry, Institute of Polymer Science and Technology, Spanish National Research Council (ICTP-CSIC), Madrid, Spain
| | - Ana Matesanz
- Department of Bioengineering, Universidad Carlos III de Madrid (UC3M), Madrid, Spain
- Department of Electronic Technology, Universidad Carlos III de Madrid (UC3M), Madrid, Spain
| | - Alberto Gallardo
- Department of Applied Macromolecular Chemistry, Institute of Polymer Science and Technology, Spanish National Research Council (ICTP-CSIC), Madrid, Spain
| | - Helmut Reinecke
- Department of Applied Macromolecular Chemistry, Institute of Polymer Science and Technology, Spanish National Research Council (ICTP-CSIC), Madrid, Spain
| | - José Luis Jorcano
- Department of Bioengineering, Universidad Carlos III de Madrid (UC3M), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Pablo Acedo
- Department of Electronic Technology, Universidad Carlos III de Madrid (UC3M), Madrid, Spain
| | - Diego Velasco
- Department of Bioengineering, Universidad Carlos III de Madrid (UC3M), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Fundación Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, Madrid, Spain
| | - Carlos Elvira
- Department of Applied Macromolecular Chemistry, Institute of Polymer Science and Technology, Spanish National Research Council (ICTP-CSIC), Madrid, Spain
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14
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Gomez-Cruz C, Laguna S, Bachiller-Pulido A, Quilez C, Cañadas-Ortega M, Albert-Smet I, Ripoll J, Muñoz-Barrutia A. Single Plane Illumination Microscopy for Microfluidic Device Imaging. BIOSENSORS 2022; 12:1110. [PMID: 36551076 PMCID: PMC9775991 DOI: 10.3390/bios12121110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Three-dimensional imaging of live processes at a cellular level is a challenging task. It requires high-speed acquisition capabilities, low phototoxicity, and low mechanical disturbances. Three-dimensional imaging in microfluidic devices poses additional challenges as a deep penetration of the light source is required, along with a stationary setting, so the flows are not perturbed. Different types of fluorescence microscopy techniques have been used to address these limitations; particularly, confocal microscopy and light sheet fluorescence microscopy (LSFM). This manuscript proposes a novel architecture of a type of LSFM, single-plane illumination microscopy (SPIM). This custom-made microscope includes two mirror galvanometers to scan the sample vertically and reduce shadowing artifacts while avoiding unnecessary movement. In addition, two electro-tunable lenses fine-tune the focus position and reduce the scattering caused by the microfluidic devices. The microscope has been fully set up and characterized, achieving a resolution of 1.50 μm in the x-y plane and 7.93 μm in the z-direction. The proposed architecture has risen to the challenges posed when imaging microfluidic devices and live processes, as it can successfully acquire 3D volumetric images together with time-lapse recordings, and it is thus a suitable microscopic technique for live tracking miniaturized tissue and disease models.
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Affiliation(s)
- Clara Gomez-Cruz
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain
| | - Sonia Laguna
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain
| | - Ariadna Bachiller-Pulido
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain
| | - Cristina Quilez
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain
| | - Marina Cañadas-Ortega
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain
| | - Ignacio Albert-Smet
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain
| | - Jorge Ripoll
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, 28009 Madrid, Spain
| | - Arrate Muñoz-Barrutia
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Leganés, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, 28009 Madrid, Spain
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15
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Detwiler A, Polkoff K, Gaffney L, Freytes DO, Piedrahita JA. Donor Age and Time in Culture Affect Dermal Fibroblast Contraction in an In Vitro Hydrogel Model. Tissue Eng Part A 2022; 28:833-844. [PMID: 35925753 PMCID: PMC9595626 DOI: 10.1089/ten.tea.2021.0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/31/2022] [Indexed: 11/12/2022] Open
Abstract
Current cellular hydrogel-based skin grafts composed of human dermal fibroblasts and a hydrogel scaffold tend to minimize contraction of full-thickness skin wounds and support skin regeneration. However, there has been no comparison between the sources of the dermal fibroblast used. Products using human adult or neonatal foreskin dermal fibroblasts are often expanded in vitro and used after multiple passages without a clear understanding of the effects of this initial production step on the quality and reproducibility of the cellular behavior. Based on the known effects of 2D tissue culture expansion on cellular proliferation and gene expression, we hypothesized that differences in donor age and time in culture may influence cellular properties and contractile behavior in a fibroblast-populated collagen matrix. Using porcine skin as a model based on its similarity to human skin in structure and wound healing properties, we isolated porcine dermal fibroblasts of three different donor ages for use in a 2D proliferation assay and in a 3D cell-populated collagen matrix contractility assay. In 2D cell culture, doubling time remained relatively consistent between all age groups from passage 1 to 6. In the contractility assays, fetal and neonatal groups contracted faster and generated more contractile force than the adult group at passage 1 in vitro. However, after five passages in culture, there was no difference in contractility between ages. These results show how cellular responses in a hydrogel scaffold differ based on donor age and time in culture in vitro, and suggest that consistency in the cellular component of bioengineered skin products could be beneficial in the biomanufacturing of consistent, reliable skin grafts and graft in vivo models. Future research and therapies using bioengineered skin grafts should consider how results may vary based on donor age and time in culture before seeding. Impact statement Little is known about the impact of donor cell age and time in culture on the contraction of cellular, hydrogel-based skin grafts. These results show how cellular phenotypes of porcine fibroblasts differ based on donor age and time in culture. This information is beneficial when addressing important inconsistencies in biomanufacturing of bioengineered skin grafts and in vitro models. These findings are relevant to research and therapies using bioengineered skin graft models and the results can be used to increase reproducibility and consistency during the production of bioengineered skin constructs. The information from this study can be extrapolated to future in vivo studies using human dermal fibroblasts in an in vivo model to help determine the best donor age and time in culture for optimal wound healing outcomes or more reproducible in vitro testing constructs.
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Affiliation(s)
- Amber Detwiler
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
- Joint Department of Biomedical Engineering, North Carolina State University/University of North Carolina-Chapel Hill, Raleigh, North Carolina, USA
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Kathryn Polkoff
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Lewis Gaffney
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
- Joint Department of Biomedical Engineering, North Carolina State University/University of North Carolina-Chapel Hill, Raleigh, North Carolina, USA
| | - Donald O. Freytes
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
- Joint Department of Biomedical Engineering, North Carolina State University/University of North Carolina-Chapel Hill, Raleigh, North Carolina, USA
| | - Jorge A. Piedrahita
- Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, USA
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
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16
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Tan SH, Chua DAC, Tang JRJ, Bonnard C, Leavesley D, Liang K. Design of Hydrogel-based Scaffolds for in vitro Three-dimensional Human Skin Model Reconstruction. Acta Biomater 2022; 153:13-37. [DOI: 10.1016/j.actbio.2022.09.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/01/2022] [Accepted: 09/26/2022] [Indexed: 11/01/2022]
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17
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Patiño Vargas MI, Martinez-Garcia FD, Offens F, Becerra NY, Restrepo LM, van der Mei HC, Harmsen MC, van Kooten TG, Sharma PK. Viscoelastic properties of plasma-agarose hydrogels dictate favorable fibroblast responses for skin tissue engineering applications. BIOMATERIALS ADVANCES 2022; 139:212967. [PMID: 35882126 DOI: 10.1016/j.bioadv.2022.212967] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 12/17/2022]
Abstract
Dermal wound healing relies on the properties of the extracellular matrix (ECM). Thus, hydrogels that replicate skin ECM have reached clinical application. After a dermal injury, a transient, biodegradable fibrin clot is instrumental in wound healing. Human plasma, and its main constituent, fibrin would make a suitable biomaterial for improving wound healing and processed as hydrogels albeit with limited mechanical strength. To overcome this, plasma-agarose (PA) composite hydrogels have been developed and used to prepare diverse bioengineered tissues. To date, little is known about the influence of variable agarose concentrations on the viscoelastic properties of PA hydrogels and their correlation to cell biology. This study reports the characterization of the viscoelastic properties of different concentrations of agarose in PA hydrogels: 0 %, 0.5 %, 1 %, 1.5 %, and 2 % (w/v), and their influence on the cell number and mitochondrial activity of human dermal fibroblasts. Results show that agarose addition increased the stiffness, relaxation time constants 1 (τ1) and 2 (τ2), and fiber diameter, whereas the porosity decreased. Changes in cell metabolism occurred at the early stages of culturing and correlated to the displacement of fast (τ1) and intermediate (τ2) Maxwell elements. Fibroblasts seeded in low PA concentrations spread faster during 14 d than cells cultured in higher agarose concentrations. Collectively, these results confirm that PA viscoelasticity and hydrogel architecture strongly influenced cell behavior. Therefore, viscoelasticity is a key parameter in the design of PA-based implants.
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Affiliation(s)
- Maria Isabel Patiño Vargas
- University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, Groningen, the Netherlands; Tissue Engineering and Cell Therapy Group, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Francisco Drusso Martinez-Garcia
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
| | - Freya Offens
- University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, Groningen, the Netherlands
| | - Natalia Y Becerra
- Tissue Engineering and Cell Therapy Group, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Luz M Restrepo
- Tissue Engineering and Cell Therapy Group, Faculty of Medicine, University of Antioquia, Medellín, Colombia
| | - Henny C van der Mei
- University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, Groningen, the Netherlands
| | - Martin C Harmsen
- University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
| | - Theo G van Kooten
- University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, Groningen, the Netherlands
| | - Prashant K Sharma
- University of Groningen, University Medical Center Groningen, Department of Biomedical Engineering, Groningen, the Netherlands.
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18
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El Maachi I, Kyriakou S, Rütten S, Kopp A, Köpf M, Jockenhoevel S, Fernández-Colino A. Silk Fibroin as Adjuvant in the Fabrication of Mechanically Stable Fibrin Biocomposites. Polymers (Basel) 2022; 14:2251. [PMID: 35683920 PMCID: PMC9183065 DOI: 10.3390/polym14112251] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 11/17/2022] Open
Abstract
Fibrin is a very attractive material for the development of tissue-engineered scaffolds due to its exceptional bioactivity, versatility in the fabrication, affinity to cell mediators; and the possibility to isolate it from blood plasma, making it autologous. However, fibrin application is greatly limited due to its low mechanical properties, fast degradation, and strong contraction in the presence of cells. In this study, we present a new strategy to overcome these drawbacks by combining it with another natural polymer: silk fibroin. Specifically, we fabricated biocomposites of fibrin (5 mg/mL) and silk fibroin (0.1, 0.5 and 1% w/w) by using a dual injection system, followed by ethanol annealing. The shear elastic modulus increased from 23 ± 5 Pa from fibrin alone, to 67 ± 22 Pa for fibrin/silk fibroin 0.1%, 241 ± 67 Pa for fibrin/silk fibroin 0.5% and 456 ± 32 Pa for fibrin/silk fibroin 1%. After culturing for 27 days with strong contractile cells (primary human arterial smooth muscle cells), fibrin/silk fibroin 0.5% and fibrin/silk fibroin 1% featured minimal cell-mediated contraction (ca. 15 and 5% respectively) in contrast with the large surface loss of the pure fibrin scaffolds (ca. 95%). Additionally, the composites enabled the formation of a proper endothelial cell layer after culturing with human primary endothelial cells under standard culture conditions. Overall, the fibrin/silk fibroin composites, manufactured within this study by a simple and scalable biofabrication approach, offer a promising avenue to boost the applicability of fibrin in tissue engineering.
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Affiliation(s)
- Ikram El Maachi
- Department of Biohybrid & Medical Textiles (BioTex), AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, D-52074 Aachen, Germany; (I.E.M.); (S.K.)
| | - Stavroula Kyriakou
- Department of Biohybrid & Medical Textiles (BioTex), AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, D-52074 Aachen, Germany; (I.E.M.); (S.K.)
| | - Stephan Rütten
- Electron Microscopy Facility, Uniklinik RWTH Aachen, D-52074 Aachen, Germany;
| | - Alexander Kopp
- Fibrothelium GmbH, D-52068 Aachen, Germany; (A.K.); (M.K.)
| | - Marius Köpf
- Fibrothelium GmbH, D-52068 Aachen, Germany; (A.K.); (M.K.)
| | - Stefan Jockenhoevel
- Department of Biohybrid & Medical Textiles (BioTex), AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, D-52074 Aachen, Germany; (I.E.M.); (S.K.)
- AMIBM-Aachen-Maastricht-Institute for Biobased Materials, Faculty of Science and Engineering, Brightlands Chemelot Campus, Maastricht University, 6167 RD Geleen, The Netherlands
| | - Alicia Fernández-Colino
- Department of Biohybrid & Medical Textiles (BioTex), AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, D-52074 Aachen, Germany; (I.E.M.); (S.K.)
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Preparation and Characterization of Plasma-Derived Fibrin Hydrogels Modified by Alginate di-Aldehyde. Int J Mol Sci 2022; 23:ijms23084296. [PMID: 35457113 PMCID: PMC9029004 DOI: 10.3390/ijms23084296] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/07/2022] [Accepted: 04/12/2022] [Indexed: 12/04/2022] Open
Abstract
Fibrin hydrogels are one of the most popular scaffolds used in tissue engineering due to their excellent biological properties. Special attention should be paid to the use of human plasma-derived fibrin hydrogels as a 3D scaffold in the production of autologous skin grafts, skeletal muscle regeneration and bone tissue repair. However, mechanical weakness and rapid degradation, which causes plasma-derived fibrin matrices to shrink significantly, prompted us to improve their stability. In our study, plasma-derived fibrin was chemically bonded to oxidized alginate (alginate di-aldehyde, ADA) at 10%, 20%, 50% and 80% oxidation, by Schiff base formation, to produce natural hydrogels for tissue engineering applications. First, gelling time studies showed that the degree of ADA oxidation inhibits fibrin polymerization, which we associate with fiber increment and decreased fiber density; moreover, the storage modulus increased when increasing the final volume of CaCl2 (1% w/v) from 80 µL to 200 µL per milliliter of hydrogel. The contraction was similar in matrices with and without human primary fibroblasts (hFBs). In addition, proliferation studies with encapsulated hFBs showed an increment in cell viability in hydrogels with ADA at 10% oxidation at days 1 and 3 with 80 µL of CaCl2; by increasing this compound (CaCl2), the proliferation does not significantly increase until day 7. In the presence of 10% alginate oxidation, the proliferation results are similar to the control, in contrast to the sample with 20% oxidation whose proliferation decreases. Finally, the viability studies showed that the hFB morphology was maintained regardless of the degree of oxidation used; however, the quantity of CaCl2 influences the spread of the hFBs.
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Montero A, Atienza C, Elvira C, Jorcano JL, Velasco D. Hyaluronic acid-fibrin hydrogels show improved mechanical stability in dermo-epidermal skin substitutes. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 128:112352. [PMID: 34474900 DOI: 10.1016/j.msec.2021.112352] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 07/15/2021] [Accepted: 07/29/2021] [Indexed: 12/16/2022]
Abstract
Human plasma-derived bilayered skin substitutes have been successfully used by our group in different skin tissue engineering applications. However, several issues associated with their poor mechanical properties were observed, and they often resulted in rapid contraction and degradation. In this sense, hydrogels composed of plasma-derived fibrin and thiolated-hyaluronic acid (HA-SH, 0.05-0.2% w/v) crosslinked with poly(ethylene glycol) diacrylate (PEGDA, 2:1, 6:1, 10:1 and 14:1 mol of thiol to moles of acrylate) were developed to reduce the shrinking rates and enhance the mechanical properties of the plasma-derived matrices. Plasma/HA-SH-PEGDA hydrogels showed a decrease in the contraction behaviour ranging from 5% to 25% and an increase in Young's modulus. Furthermore, the results showed that a minimal amount of the added HA-SH was able to escape the plasma/HA-SH-PEGDA hydrogels after incubation in PBS. The results showed that the increase in rigidity of the matrices as well as the absence of adhesion cellular moieties in the second network of HA-SH/PEGDA, resulted in a decrease in contraction in the presence of the encapsulated primary human fibroblasts (hFBs), which may have been related to an overall decrease in proliferation of hFBs found for all hydrogels after 7 days with respect to the plasma control. The metabolic activity of hFB returned to the control levels at 14 days except for the 2:1 PEGDA crosslinking ratio. The metabolic activity of primary human keratinocytes (hKCs) seeded on the hydrogels showed a decrease when high amounts of HA-SH and PEGDA crosslinker were incorporated. Organotypic skins formed in vitro after 21 days with plasma/HA-SH-PEGDA hydrogels with an HA content of 0.05% w/v and a 2:1 crosslinking ratio were up to three times thicker than the plasma controls, evidencing a reduction in contraction, while they also showed better and more homogeneous keratin 10 (K10) expression in the supra-basal layer of the epidermis. Furthermore, filaggrin expression showed the formation of an enhanced stratum corneum for the constructs containing HA. These promising results indicate the potential of using these biomimetic hydrogels as in vitro skin models for pharmaceutical products and cosmetics and future work will elucidate their potential functionality for clinical treatment.
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Affiliation(s)
- Andrés Montero
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), Spain
| | - Clara Atienza
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), Spain
| | - Carlos Elvira
- Institute of Polymer Science and Technology, CSIC, Juan de la Cierva 3, Madrid 28006, Spain
| | - José Luis Jorcano
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - Diego Velasco
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
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Cardiac Extracellular Matrix Hydrogel Enriched with Polyethylene Glycol Presents Improved Gelation Time and Increased On-Target Site Retention of Extracellular Vesicles. Int J Mol Sci 2021; 22:ijms22179226. [PMID: 34502146 PMCID: PMC8431142 DOI: 10.3390/ijms22179226] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/19/2021] [Accepted: 08/22/2021] [Indexed: 12/17/2022] Open
Abstract
Stem-cell-derived extracellular vesicles (EVs) have demonstrated multiple beneficial effects in preclinical models of cardiac diseases. However, poor retention at the target site may limit their therapeutic efficacy. Cardiac extracellular matrix hydrogels (cECMH) seem promising as drug-delivery materials and could improve the retention of EVs, but may be limited by their long gelation time and soft mechanical properties. Our objective was to develop and characterize an optimized product combining cECMH, polyethylene glycol (PEG), and EVs (EVs–PEG–cECMH) in an attempt to overcome their individual limitations: long gelation time of the cECMH and poor retention of the EVs. The new combined product presented improved physicochemical properties (60% reduction in half gelation time, p < 0.001, and threefold increase in storage modulus, p < 0.01, vs. cECMH alone), while preserving injectability and biodegradability. It also maintained in vitro bioactivity of its individual components (55% reduction in cellular senescence vs. serum-free medium, p < 0.001, similar to EVs and cECMH alone) and increased on-site retention in vivo (fourfold increase vs. EVs alone, p < 0.05). In conclusion, the combination of EVs–PEG–cECMH is a potential multipronged product with improved gelation time and mechanical properties, increased on-site retention, and maintained bioactivity that, all together, may translate into boosted therapeutic efficacy.
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Elastin-Plasma Hybrid Hydrogels for Skin Tissue Engineering. Polymers (Basel) 2021; 13:polym13132114. [PMID: 34203144 PMCID: PMC8271496 DOI: 10.3390/polym13132114] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/20/2021] [Accepted: 06/22/2021] [Indexed: 11/23/2022] Open
Abstract
Dermo-epidermal equivalents based on plasma-derived fibrin hydrogels have been extensively studied for skin engineering. However, they showed rapid degradation and contraction over time and low mechanical properties which limit their reproducibility and lifespan. In order to achieve better mechanical properties, elasticity and biological properties, we incorporated a elastin-like recombinamer (ELR) network, based on two types of ELR, one modified with azide (SKS-N3) and other with cyclooctyne (SKS-Cyclo) chemical groups at molar ratio 1:1 at three different SKS (serine-lysine-serine sequence) concentrations (1, 3, and 5 wt.%), into plasma-derived fibrin hydrogels. Our results showed a decrease in gelation time and contraction, both in the absence and presence of the encapsulated human primary fibroblasts (hFBs), higher mechanical properties and increase in elasticity when SKSs content is equal or higher than 3%. However, hFBs proliferation showed an improvement when the lowest SKS content (1 wt.%) was used but started decreasing when increasing SKS concentration at day 14 with respect to the plasma control. Proliferation of human primary keratinocytes (hKCs) seeded on top of the hybrid-plasma hydrogels containing 1 and 3% of SKS showed no differences to plasma control and an increase in hKCs proliferation was observed for hybrid-plasma hydrogels containing 5 wt.% of SKS. These promising results showed the need to achieve a balance between the reduced contraction, the better mechanical properties and biological properties and indicate the potential of using this type of hydrogel as a testing platform for pharmaceutical products and cosmetics, and future work will elucidate their potential.
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Montero A, Quílez C, Valencia L, Girón P, Jorcano JL, Velasco D. Effect of Fibrin Concentration on the In Vitro Production of Dermo-Epidermal Equivalents. Int J Mol Sci 2021; 22:ijms22136746. [PMID: 34201667 PMCID: PMC8269027 DOI: 10.3390/ijms22136746] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/10/2021] [Accepted: 06/17/2021] [Indexed: 01/18/2023] Open
Abstract
Human plasma-derived bilayered skin substitutes were successfully used by our group to produce human-based in vitro skin models for toxicity, cosmetic, and pharmaceutical testing. However, mechanical weakness, which causes the plasma-derived fibrin matrices to contract significantly, led us to attempt to improve their stability. In this work, we studied whether an increase in fibrin concentration from 1.2 to 2.4 mg/mL (which is the useful fibrinogen concentration range that can be obtained from plasma) improves the matrix and, hence, the performance of the in vitro skin cultures. The results show that this increase in fibrin concentration indeed affected the mechanical properties by doubling the elastic moduli and the maximum load. A structural analysis indicated a decreased porosity for the 2.4 mg/mL hydrogels, which can help explain this mechanical behavior. The contraction was clearly reduced for the 2.4 mg/mL matrices, which also allowed for the growth and proliferation of primary fibroblasts and keratinocytes, although at a somewhat reduced rate compared to the 1.2 mg/mL gels. Finally, both concentrations of fibrin gave rise to organotypic skin cultures with a fully differentiated epidermis, although their lifespans were longer (25–35%) in cultures with more concentrated matrices, which improves their usefulness. These systems will allow the generation of much better in vitro skin models for the testing of drugs, cosmetics and chemicals, or even to “personalized” skin for the diagnosis or determination of the most effective treatment possible.
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Affiliation(s)
- Andrés Montero
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
| | - Cristina Quílez
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
| | - Leticia Valencia
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
| | - Paula Girón
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
| | - José Luis Jorcano
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Correspondence: (J.L.J.); (D.V.)
| | - Diego Velasco
- Department of Bioengineering and Aerospace Engineering, Universidad Carlos III de Madrid (UC3M), 28903 Madrid, Spain; (A.M.); (C.Q.); (L.V.); (P.G.)
- Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
- Correspondence: (J.L.J.); (D.V.)
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