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Byun WY, Liu L, Palutsis A, Tan ZH, Herster R, VanKoevering K, Manning A, Chiang T. Dynamic flow for efficient partial decellularization of tracheal grafts: A preliminary rabbit study. Laryngoscope Investig Otolaryngol 2024; 9:e1247. [PMID: 38618643 PMCID: PMC11015388 DOI: 10.1002/lio2.1247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/15/2024] [Accepted: 02/29/2024] [Indexed: 04/16/2024] Open
Abstract
Objective Bioengineered tracheal grafts are a potential solution for the repair of long-segment tracheal defects. A recent advancement is partially decellularized tracheal grafts (PDTGs) which enable regeneration of host epithelium and retain viable donor chondrocytes for hypothesized benefits to mechanical properties. We propose a novel and tunable 3D-printed bioreactor for creating large animal PDTG that brings this technology closer to the bedside. Methods Conventional agitated immersion with surfactant and enzymatic activity was used to partially decellularize New Zealand white rabbit (Oryctolagus cuniculus) tracheal segments (n = 3). In parallel, tracheal segments (n = 3) were decellularized in the bioreactor with continuous extraluminal flow of medium and alternating intraluminal flow of surfactant and medium. Unprocessed tracheal segments (n = 3) were also collected as a control. The grafts were assessed using the H&E stain, tissue DNA content, live/dead assay, Masson's trichrome stain, and mechanical testing. Results Conventional processing required 10 h to achieve decellularization of the epithelium and submucosa with poor chondrocyte viability and mechanical strength. Using the bioreactor reduced processing time by 6 h and resulted in chondrocyte viability and mechanical strength similar to that of native trachea. Conclusion Large animal PDTG created using our novel 3D printed bioreactor is a promising approach to efficiently produce tracheal grafts. The bioreactor offers flexibility and adjustability favorable to creating PDTG for clinical research and use. Future research includes optimizing flow conditions and transplantation to assess post-implant regeneration and mechanical properties. Level of Evidence NA.
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Affiliation(s)
- Woo Yul Byun
- College of MedicineThe Ohio State UniversityColumbusOhioUSA
- Center for Regenerative MedicineAbigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
| | - Lumei Liu
- Center for Regenerative MedicineAbigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
| | - Amanda Palutsis
- Center for Regenerative MedicineAbigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
- College of EngineeringThe Ohio State UniversityColumbusOhioUSA
| | - Zheng Hong Tan
- College of MedicineThe Ohio State UniversityColumbusOhioUSA
- Center for Regenerative MedicineAbigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
| | - Rachel Herster
- College of EngineeringThe Ohio State UniversityColumbusOhioUSA
- Department of Otolaryngology–Head & Neck SurgeryThe Ohio State University Medical CenterColumbusOhioUSA
| | - Kyle VanKoevering
- Department of Otolaryngology–Head & Neck SurgeryThe Ohio State University Medical CenterColumbusOhioUSA
| | - Amy Manning
- Center for Regenerative MedicineAbigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
- Department of Pediatric OtolaryngologyNationwide Children's HospitalColumbusOhioUSA
| | - Tendy Chiang
- Center for Regenerative MedicineAbigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
- Department of Pediatric OtolaryngologyNationwide Children's HospitalColumbusOhioUSA
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Sissoko C, Walker V, Dion GR. Biomechanical Evaluation of Tracheal Needle Puncture Forces: Comparative Analysis of Annular Ligaments and Tracheal Cartilage. J Biomech Eng 2024; 146:011008. [PMID: 37851532 DOI: 10.1115/1.4063821] [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: 03/31/2023] [Accepted: 10/13/2023] [Indexed: 10/20/2023]
Abstract
Percutaneous tracheotomies (PCT) are commonly performed minimally invasive procedures involving the creation of an airway opening through an incision or puncture of the tracheal wall. While the medical intervention is crucial for critical care and the management of acute respiratory failure, tracheostomy complications can lead to severe clinical symptoms due to the alterations of the airways biomechanical properties/structures. The causes and mechanisms underlaying the development of these post-tracheotomy complications remain largely unknown. In this study, we aimed to investigate the needle puncture process and its biomechanical characteristics by using a well establish porcine ex vivo trachea to simulate the forces involved in accessing airways during PCT at varying angular approaches. Given that many procedures involve inserting a needle into the trachea without direct visualization of the tracheal wall, concerns have been raised over the needle punctures through the cartilaginous rings as compared to the space between them may result in fractured cartilage and post-tracheostomy airway complications. We report a difference in puncture force between piercing the cartilage and the annular ligaments and observe that the angle of puncture does not significantly alter the puncture forces. The data collected in this study can guide the design of relevant biomechanical feedback system during airway access procedures and ultimately help refine and optimize PCT.
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Affiliation(s)
- Cheick Sissoko
- Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0528, Cincinnati, OH 45267
| | - Victoria Walker
- University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0528, Cincinnati, OH 45267
| | - Gregory R Dion
- Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0528, Cincinnati, OH 45267
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3
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Liu Y, Zheng K, Meng Z, Wang L, Liu X, Guo B, He J, Tang X, Liu M, Ma N, Li X, Zhao J. A cell-free tissue-engineered tracheal substitute with sequential cytokine release maintained airway opening in a rabbit tracheal full circumferential defect model. Biomaterials 2023; 300:122208. [PMID: 37352607 DOI: 10.1016/j.biomaterials.2023.122208] [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: 09/25/2022] [Revised: 05/21/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023]
Abstract
In this study, a cell-free tissue-engineered tracheal substitute was developed, which is based on a 3D-printed polycaprolactone scaffold coated with a gelatin-methacryloyl (GelMA) hydrogel, with transforming growth factor-β1 (TGF-β) and stromal cell-derived factor-1α (SDF-1) sequentially embedded, to facilitate cell recruitment and differentiation toward chondrocyte-phenotype. TGF-β was loaded onto polydopamine particles, and then encapsulated into the GelMA together with SDF-1, and called G/S/P@T, which was used to coat 3D-printed PCL scaffold to form the tracheal substitute. A rapid release of SDF-1 was observed during the first week, followed by a slow and sustained release of TGF-β for approximately four weeks. The tracheal substitute significantly promoted the recruitment of mesenchymal stromal cells (MSCs) or human bronchial epithelial cells in vitro, and enhanced the ability of MSCs to differentiate towards chondrocyte phenotype. Implantation of the tissue-engineered tracheal substitute with a rabbit tracheal anterior defect model improved regeneration of airway epithelium, recruitment of endogenous MSCs and expression of markers of chondrocytes at the tracheal defect site. Moreover, the tracheal substitute maintained airway opening for 4 weeks in a tracheal full circumferential defect model with airway epithelium coverage at the defect sites without granulation tissue accumulation in the tracheal lumen or underneath. The promising results suggest that this simple, cell-free tissue-engineered tracheal substitute can be used directly after tracheal defect removal and should be further developed towards clinical application.
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Affiliation(s)
- Yujian Liu
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China; Department of Cardiothoracic Surgery, Central Theater Command General Hospital of Chinese People's Liberation Army, Wuhan, Hubei, 430070, China
| | - Kaifu Zheng
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China; Department of General Surgery, The 991st Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Xiangyang, Hubei, 441000, China
| | - Zijie Meng
- State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China
| | - Lei Wang
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Xi Liu
- Department of Cardiothoracic Surgery, The 980th Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Shijiazhuang, Hebei, 052460, China
| | - Baolin Guo
- State Key Laboratory for Mechanical Behavior of Materials, And Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China
| | - Jiankang He
- State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China
| | - Xiyang Tang
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China
| | - Mingyao Liu
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Nan Ma
- Department of Ophthalmology, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China.
| | - Xiaofei Li
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China.
| | - Jinbo Zhao
- Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, 710038, China.
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4
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Kandi R, Sachdeva K, Choudhury SD, Pandey PM, Mohanty S. A facile 3D bio-fabrication of customized tubular scaffolds using solvent-based extrusion printing for tissue-engineered tracheal grafts. J Biomed Mater Res A 2023; 111:278-293. [PMID: 36210769 DOI: 10.1002/jbm.a.37458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 09/17/2022] [Accepted: 09/28/2022] [Indexed: 12/13/2022]
Abstract
Tracheal implantation remains a major therapeutic challenge due to the unavailability of donors and the lack of biomimetic tubular grafts. Fabrication of biomimetic tracheal scaffolds of suitable materials with matched rigidity, enhanced flexibility and biocompatibility has been a major challenge in the field of tracheal reconstruction. In this study, customized tubular grafts made up of FDA-approved polycaprolactone ( PCL ) and polyurethane ( PU ) were fabricated using a novel solvent-based extrusion 3D printing. The printed scaffolds were investigated by various physical, thermal, and mechanical characterizations such as contact angle measurement, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), radial compression, longitudinal compression, and cyclic radial compression. In this study, the native goat trachea was used as a reference for the fabrication of different types of scaffolds (cylindrical, bellow-shaped, and spiral-shaped). The mechanical properties of the goat trachea were also compared to find suitable formulations of PCL / PU . Spiral-shaped scaffolds were found to be an ideal shape based on longitudinal compression and torsion load maintaining clear patency. To check the long-term implantation, in vitro degradation test was performed for all the 3D printed scaffolds and it was found that blending of PU with PCL reduced the degradation behavior. The printed scaffolds were further evaluated for biocompatibility assay, live/dead assay, and cell adhesion assay using bone marrow-derived human mesenchymal stem cells (hMSCs). From biomechanical and biological assessments, PCL 70 / PU 30 of spiral-shaped scaffolds could be a suitable candidate for the development of tracheal regenerative applications.
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Affiliation(s)
- Rudranarayan Kandi
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Kunj Sachdeva
- Stem Cell Facility, DBT-Centre of Excellence for Stem cell Research, All India Institute of Medical Sciences, New Delhi, India
| | - Saumitra Dey Choudhury
- Confocal Facility, Centralized Core Research Facility, All India Institute of Medical Sciences, New Delhi, India
| | - Pulak Mohan Pandey
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India.,Bundelkhand Institute of Engineering & Technology, Jhansi, Uttar Pradesh, India
| | - Sujata Mohanty
- Stem Cell Facility, DBT-Centre of Excellence for Stem cell Research, All India Institute of Medical Sciences, New Delhi, India
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5
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Cao A, Kaye R, Goldstein T, Grande DA, Zeltsman D, Smith LP. In response to compression property of trachea: A key mechanical property for artificial trachea graft. Am J Otolaryngol 2022; 43:103412. [PMID: 35210112 DOI: 10.1016/j.amjoto.2022.103412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Angela Cao
- Department of Otolaryngology-Head and Neck Surgery, Albert Einstein School of Medicine/Montefiore Medical Center, Bronx, NY, United States of America
| | - Rachel Kaye
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, United States of America.
| | - Todd Goldstein
- The Feinstein Institute for Medical Research, Manhasset, NY, United States of America; The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, United States of America
| | - Daniel A Grande
- The Feinstein Institute for Medical Research, Manhasset, NY, United States of America; The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, United States of America
| | - David Zeltsman
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, United States of America; Division of Thoracic Surgery, Northwell Health System, New Hyde Park, NY, United States of America
| | - Lee P Smith
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, United States of America; Division of Pediatric Otolaryngology, Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, NY, United States of America
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6
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Kaye R, Cao A, Goldstein T, Grande DA, Zeltsman D, Smith LP. Biomechanical properties of the ex vivo porcine trachea: A benchmark for three-dimensional bioprinted airway replacements. Am J Otolaryngol 2022; 43:103217. [PMID: 34537505 DOI: 10.1016/j.amjoto.2021.103217] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/05/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Combining tissue engineering and three-dimensional (3D) printing may allow for the introduction of a living functional tracheal replacement graft. However, defining the biomechanical properties of the native trachea is a key prerequisite to clinical translation. To achieve this, we set out to define the rotation, axial stretch capacity, and positive intraluminal pressure capabilities for ex vivo porcine tracheas. STUDY DESIGN Animal study. MATERIALS AND METHODS Six full-length ex vivo porcine tracheas were bisected into 5.5 cm segments. Maximal positive intraluminal pressure was measured by sealing segment ends with custom designed 3D printed caps through which a pressure transducer was introduced. Axial stretch capacity and rotation were evaluated by stretching and rotating the segments along their axis between two clamps, respectively. RESULTS Six segments were tested for axial lengthening and the average post-stretch length percentage was 148.92% (range 136.81-163.48%, 95% CI 153-143%). The mean amount of length gain achieved per cartilaginous ring was 7.82% (range 4.71-10.95%, 95% CI 6.3-9.35%). Four tracheal segments were tested for maximal positive intraluminal pressure, which was over 400 mmHg. Degree of rotation testing found that the tracheal segments easily transformed 180° in anterior-posterior bending, lateral bending, and axial rotational twisting. CONCLUSIONS We define several biomechanical properties of the ex vivo porcine trachea by reporting the rotation, axial stretch capacity, and positive intraluminal pressure capabilities. We hope that this will aid future work in the clinical translation of 3D bioprinted airway replacement grafts and ensure their compatibility with native tracheal properties.
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Affiliation(s)
- Rachel Kaye
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, United States of America.
| | - Angela Cao
- Department of Otolaryngology-Head and Neck Surgery, Albert Einstein School of Medicine/Montefiore Medical Center, Bronx, NY, United States of America
| | - Todd Goldstein
- The Feinstein Institute for Medical Research, Manhasset, NY, United States of America; The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, United States of America
| | - Daniel A Grande
- The Feinstein Institute for Medical Research, Manhasset, NY, United States of America; The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, United States of America
| | - David Zeltsman
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, United States of America; Division of Thoracic Surgery, Northwell Health System, New Hyde Park, NY, United States of America
| | - Lee P Smith
- The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Hempstead, NY, United States of America; Division of Pediatric Otolaryngology, Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, NY, United States of America
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7
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A Standardised Approach to the Biomechanical Evaluation of Tracheal Grafts. Biomolecules 2021; 11:biom11101461. [PMID: 34680094 PMCID: PMC8533576 DOI: 10.3390/biom11101461] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/28/2021] [Accepted: 10/04/2021] [Indexed: 11/17/2022] Open
Abstract
The ideal tracheal substitute must have biomechanical properties comparable to the native trachea, but currently there is no standardised approach to evaluating these properties. Here we propose a novel method for evaluating and comparing the properties of tracheal substitutes, thus systematising both measurement and data curation. This system was tested by comparing native rabbit tracheas to frozen and decellularised specimens and determining the histological characteristics of those specimens. We performed radial compression tests on the anteroposterior tracheal axis and longitudinal axial tensile tests with the specimens anastomosed to the jaw connected to a measuring system. All calculations and results were adjusted according to tracheal size, always using variables relative to the tracheal dimensions, thus permitting comparison of different sized organs. The biomechanical properties of the decellularised specimens were only slightly reduced compared to controls and significant in regard to the maximum stress withstood in the longitudinal axis (-0.246 MPa CI [-0.248, -0.145] MPa) and the energy stored per volume unit (-0.124 mJ·mm-3 CI [-0.195, -0.055] mJ·mm-3). The proposed method is suitable for the systematic characterisation of the biomechanical properties of different tracheal substitutes, regardless of the size or nature of the substitute, thus allowing for direct comparisons.
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8
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Martínez-Hernández NJ, Díaz-Cuevas A, Milián-Medina L, Sancho-Tello M, Roselló-Ferrando J, Morcillo-Aixelá A, Campo-Cañaveral JL, Roig-Bataller A, Mata-Roig M. Decellularized tracheal prelamination implant: A proposed bilateral double organ technique. Artif Organs 2021; 45:1491-1500. [PMID: 34310703 DOI: 10.1111/aor.14043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 01/08/2023]
Abstract
In tracheal replacement transplantation, prelamination is a critical stage. Nowadays, the most widely used prelamination technique is the prethoracic fascia flap with lateral thoracic artery. We propose a flap based on the internal thoracic artery, which allows a relatively non-aggressive double organ implant, and we have tested its efficacy in decellularized tracheas. Tracheas of albino New Zealand rabbits were decellularized following a protocol that uses detergents and cryogenization, sterilized with 1kGy gamma radiation, and tutorized with a stent. Bilateral pedicled flaps made of pectoral fascia and a muscular component were harvested through a longitudinal 3-cm central thoracic incision, wrapping the tracheas with them in 16 rabbits, remaining them implanted for 2, 4, 8, and 12 weeks. The tracheas were then studied histologically using standard stainings plus immunohistochemistry (CD31). The models were adjusted with Bayesian statistics using ordinal regression; results as odds ratios and credibility intervals. All analysis were performed using R software. Acute inflammatory cell invasion was observed at 2 weeks, which almost disappeared at week 8 after implant. Only macrophages and giant cells increased between Weeks 8 and 12 (OR 10.487, CI [1.603-97.327]). The cartilage maintained its structure, with slight signs of ischemia in a few cases. New CD31-positive vessels were observed from Week 2 and increasing thereafter, reaching a maximum peak at Week 8. We propose a bilateral implant technique that is viable and effective as a prelamination option for two concurrent tracheas, achieving perfect vascularization and integration of the organ with hardly any inflammatory response in the medium or long term.
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Affiliation(s)
| | | | - Lara Milián-Medina
- Pathology Department, Medicine and Odontology Faculty, Universitat de València, València, Spain
| | | | | | | | | | | | - Manuel Mata-Roig
- Pathology Department, Medicine and Odontology Faculty, Universitat de València, València, Spain.,Networking Research Center on Respiratory Diseases (CIBERER), ISCIII, Madrid, Spain
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9
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Paunović N, Bao Y, Coulter FB, Masania K, Geks AK, Klein K, Rafsanjani A, Cadalbert J, Kronen PW, Kleger N, Karol A, Luo Z, Rüber F, Brambilla D, von Rechenberg B, Franzen D, Studart AR, Leroux JC. Digital light 3D printing of customized bioresorbable airway stents with elastomeric properties. SCIENCE ADVANCES 2021; 7:7/6/eabe9499. [PMID: 33536222 PMCID: PMC7857684 DOI: 10.1126/sciadv.abe9499] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/17/2020] [Indexed: 05/19/2023]
Abstract
Central airway obstruction is a life-threatening disorder causing a high physical and psychological burden to patients. Standard-of-care airway stents are silicone tubes, which provide immediate relief but are prone to migration. Thus, they require additional surgeries to be removed, which may cause tissue damage. Customized bioresorbable airway stents produced by 3D printing would be highly needed in the management of this disorder. However, biocompatible and biodegradable materials for 3D printing of elastic medical implants are still lacking. Here, we report dual-polymer photoinks for digital light 3D printing of customized and bioresorbable airway stents. These stents exhibit tunable elastomeric properties with suitable biodegradability. In vivo study in healthy rabbits confirmed biocompatibility and showed that the stents stayed in place for 7 weeks after which they became radiographically invisible. This work opens promising perspectives for the rapid manufacturing of the customized medical devices for which high precision, elasticity, and degradability are sought.
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Affiliation(s)
- Nevena Paunović
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| | - Yinyin Bao
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| | | | - Kunal Masania
- Complex Materials, Department of Materials, ETH Zurich, Zurich, Switzerland
- Shaping Matter Lab, Faculty of Aerospace Engineering, TU Delft, Delft, Netherlands
| | - Anna Karoline Geks
- Musculoskeletal Research Unit, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Karina Klein
- Musculoskeletal Research Unit, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Ahmad Rafsanjani
- Complex Materials, Department of Materials, ETH Zurich, Zurich, Switzerland
- SDU Biorobotics, The Mærsk Mc-Kinney Møller Institute, University of Southern Denmark, Odense, Denmark
| | - Jasmin Cadalbert
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| | - Peter W Kronen
- Musculoskeletal Research Unit, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Veterinary Anaesthesia Services-International, Winterthur, Switzerland
- Center for Applied Biotechnology and Molecular Medicine, University of Zurich, Zurich, Switzerland
| | - Nicole Kleger
- Complex Materials, Department of Materials, ETH Zurich, Zurich, Switzerland
| | - Agnieszka Karol
- Musculoskeletal Research Unit, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Zhi Luo
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| | - Fabienne Rüber
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Davide Brambilla
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
- Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | | | - Daniel Franzen
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.
| | - André R Studart
- Complex Materials, Department of Materials, ETH Zurich, Zurich, Switzerland.
| | - Jean-Christophe Leroux
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland.
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10
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Huang Z, Wang L, Zhang CX, Cai ZH, Liu WH, Li WM, Ye SG, Li XF, Zhao JB. Biomechanical strength dependence on mammalian airway length. J Thorac Dis 2021; 13:918-926. [PMID: 33717564 PMCID: PMC7947550 DOI: 10.21037/jtd-20-2970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background The trachea is the uppermost respiratory airway element connecting the larynx to the bronchi Airway reconstructions in humans are often developed from animal models but there is limited knowledge comparing tracheal biomechanics between species. We aimed to assess the structure and biomechanics of porcine, canine, caprine and human airways. Methods Tracheas from pigs (n=15), goats (n=9) and canines (n=9) were divided into three groups (4, 6 and 8-ringswhile human left principal brochi (n=12) were divided into two groups (3and-rings). Airway structures were compared using histology and scanning electron microscopy. Biomechanical properties were measured subjecting samples to uniaxial tension and compression, recording the elastic modulus and (tensile and compressive) strengths. Results The structures of animal tracheal and human bronchia appeared similar. Biomechanical testing revealed that the elastic modulus of 8-ring tracheas was 1,190.48±363.68, 2,572.00±608.19 and 1,771.27±145.54 kPa, for porcine, canine and caprine samples, respectively, while corresponding tensile strengths were 437.63±191.41, 808.38±223.48 and 445.76±44.00 kPa. Comparable measures of anterior-posterior (A-P) compression strengths were 7.94±0.82, 7.54±0.07 and 8.10±1.87 N, respectively, whereas lateral compression strengths were 8.75±0.82, 14.55±2.29 and 11.12±0.40 N. Compression testing of human samples showed significant differences (P<0.05) between the 3-ring (A-P, 1.06±0.02 N; lateral, 0.55±0.06 N) and 5-ring groups (A-P, 1.08±0.64 N; lateral, 2.32±1.95 N). Conclusions The tensile and compressive strengths of mammalian airways show positive correlations with the cartilage ring number (length). On the basis of structural and biomechanical comparisons, porcine, canine and caprine species appear suitable models for the study of airway reconstruction in human.
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Affiliation(s)
- Zhao Huang
- The Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University (The Fourth Military Medical University), Xi'an, China.,Department of Cardiothoracic Surgery, Jingling Hospital, Medical School of Nanjing University, Nanjing, China.,The Department of Thoracic Surgery, The 960th PLA Hospital, Ji'nan, China
| | - Lei Wang
- The Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University (The Fourth Military Medical University), Xi'an, China
| | - Chen-Xi Zhang
- The Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University (The Fourth Military Medical University), Xi'an, China
| | - Zhi-Hao Cai
- State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Wen-Hao Liu
- The Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University (The Fourth Military Medical University), Xi'an, China
| | - Wei-Miao Li
- The Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University (The Fourth Military Medical University), Xi'an, China
| | - Shu-Gao Ye
- Lung Transplant Group, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Xiao-Fei Li
- The Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University (The Fourth Military Medical University), Xi'an, China
| | - Jin-Bo Zhao
- The Department of Thoracic Surgery, Tangdu Hospital, Air Force Medical University (The Fourth Military Medical University), Xi'an, China
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11
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Liu L, Stephens B, Bergman M, May A, Chiang T. Role of Collagen in Airway Mechanics. Bioengineering (Basel) 2021; 8:13. [PMID: 33467161 PMCID: PMC7830870 DOI: 10.3390/bioengineering8010013] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 01/06/2021] [Accepted: 01/09/2021] [Indexed: 12/13/2022] Open
Abstract
Collagen is the most abundant airway extracellular matrix component and is the primary determinant of mechanical airway properties. Abnormal airway collagen deposition is associated with the pathogenesis and progression of airway disease. Thus, understanding how collagen affects healthy airway tissue mechanics is essential. The impact of abnormal collagen deposition and tissue stiffness has been an area of interest in pulmonary diseases such as cystic fibrosis, asthma, and chronic obstructive pulmonary disease. In this review, we discuss (1) the role of collagen in airway mechanics, (2) macro- and micro-scale approaches to quantify airway mechanics, and (3) pathologic changes associated with collagen deposition in airway diseases. These studies provide important insights into the role of collagen in airway mechanics. We summarize their achievements and seek to provide biomechanical clues for targeted therapies and regenerative medicine to treat airway pathology and address airway defects.
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Affiliation(s)
- Lumei Liu
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA;
| | - Brooke Stephens
- College of Medicine, The Ohio State University, Columbus, OH 43210, USA;
| | - Maxwell Bergman
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA;
| | - Anne May
- Section of Pulmonary Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USA;
- Department of Pediatrics, The Ohio State University Wexner Medical Center, Columbus, OH 43205, USA
| | - Tendy Chiang
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH 43215, USA;
- Department of Pediatric Otolaryngology, Nationwide Children’s Hospital, Columbus, OH 43205, USA
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12
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Kaye R, Goldstein T, Grande DA, Zeltsman D, Smith LP. A 3-dimensional bioprinted tracheal segment implant pilot study: Rabbit tracheal resection with graft implantation. Int J Pediatr Otorhinolaryngol 2019; 117:175-178. [PMID: 30579077 DOI: 10.1016/j.ijporl.2018.11.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Surgical reconstruction of tracheal disease has expanded to include bioengineering and three dimensional (3D) printing. This pilot study investigates the viability of introducing a living functional tracheal replacement graft in a rabbit animal model. METHODS Seven New Zealand White rabbits were enrolled and six completed participation (one intraoperative mortality). Tracheal replacement grafts were created by impregnating 3D printed biodegradable polycaprolactone (PCL) tracheal scaffolds with rabbit tracheal hyaline chondrocytes. 2 cm of native trachea was resected and the tracheal replacement graft implanted. Subjects were divided into two equal groups (n = 3) that differed in their time of harvest following implantation (three or six weeks). Tracheal specimens were analyzed with intraluminal telescopic visualization and histopathology. RESULTS The two groups did not significantly differ in histopathology or intraluminal diameter. All sections wherein the implant telescoped over native trachea (anastomotic ends) contained adequate hyaline cartilage formation (i.e. chondrocytes within lacuna, surrounding extracellular matrix, and strong Safranin O staining). Furthermore, the PCL scaffold was surrounded by a thin layer of fibrous tissue. All areas without membranous coverage contained inadequate or immature cartilage formation with inflammation. The average intraluminal stenosis was 83.4% (range 34.2-95%). CONCLUSIONS We report normal cartilage growth in a tracheal replacement graft when chondrocytes are separated from the tracheal lumen by an intervening membrane. When no such membrane exists there is a propensity for inflammation and stenosis. These findings are important for future construction and implantation of tracheal replacement grafts. LEVEL OF EVIDENCE Not applicable: this is an in vivo animal trial.
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Affiliation(s)
- Rachel Kaye
- Rutgers New Jersey Medical School, Newark, NJ, USA.
| | - Todd Goldstein
- The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Daniel A Grande
- The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - David Zeltsman
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Division of Thoracic Surgery, Northwell Health System, New Hyde Park, NY, USA
| | - Lee P Smith
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Division of Pediatric Otolaryngology, Steven and Alexandra Cohen Children's Medical Center, New Hyde Park, NY, USA
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13
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Lee JSJ, Park J, Shin DA, Ryu YJ, Kim HC, Lee JC, Kwon SK. Characterization of the biomechanical properties of canine trachea using a customized 3D-printed apparatus. Auris Nasus Larynx 2018; 46:407-416. [PMID: 30392980 DOI: 10.1016/j.anl.2018.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/04/2018] [Accepted: 10/17/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The canine trachea is considered to be an excellent preclinical model for tracheal research due to its similar mechanical and dimensional characteristics to the human trachea. However, normative biomechanical properties have yet to be defined and it is one of the main reasons tracheal reconstruction has not succeeded in animal models at large scale. Variation and inaccurate measurement due to a lack of proper apparatus for mechanical tests further prevent determination of normative mechanical data of the trachea. The goal of this study was to overcome these shortcomings by designing the measuring apparatus using 3D-printing technology. Using this apparatus, we determined the normative biomechanical properties of the canine trachea. METHODS Whole tracheas were obtained from thirteen mongrel dogs. Biomechanical measurements were performed to determine the radial compressive strength and tensile strength of the intact trachea, and the elastic modulus of the tracheal cartilage. RESULTS Structural parameter data indicated the canine trachea to have inner-diameters similar to those of the human trachea and other widely used animal models. The compressive strength was 4.24N while the tensile strength was 29.96N. The elastic modulus of the cartilage portion of the trachea was 1.58N without showing a significant difference in value based on the location of the trachea. CONCLUSIONS This study delineates a comprehensive and foundational characterization of the biomechanical properties of both the intact and cartilage portion of the canine trachea. The parameters were in agreement with those of the human trachea, confirming the canine trachea to be an excellent preclinical model for tracheal research.
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Affiliation(s)
- Jennifer Sang-Jee Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea
| | - Jonghyun Park
- Interdisciplinary Program for Bioengineering, Seoul National University Graduate School, 1 Gwanak-ro, Gwanak-gu Seoul 08826, Republic of Korea
| | - Dong-A Shin
- Interdisciplinary Program for Bioengineering, Seoul National University Graduate School, 1 Gwanak-ro, Gwanak-gu Seoul 08826, Republic of Korea
| | - Yoon-Jong Ryu
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea
| | - Hee Chan Kim
- Department of Biomedical Engineering, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-Gu, Seoul, 03080 Republic of Korea; Department of Biomedical Engineering, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, 1 Gwanak-ro, Gwanak-gu Seoul, 08826 Republic of Korea
| | - Jung Chan Lee
- Department of Biomedical Engineering, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-Gu, Seoul, 03080 Republic of Korea; Department of Biomedical Engineering, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, 1 Gwanak-ro, Gwanak-gu Seoul, 08826 Republic of Korea.
| | - Seong Keun Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, 101 Daehak-Ro Jongno-Gu, Seoul, 03080 Republic of Korea.
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Peloquin JM, Santare MH, Elliott DM. Short cracks in knee meniscus tissue cause strain concentrations, but do not reduce ultimate stress, in single-cycle uniaxial tension. ROYAL SOCIETY OPEN SCIENCE 2018; 5:181166. [PMID: 30564409 PMCID: PMC6281910 DOI: 10.1098/rsos.181166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 10/19/2018] [Indexed: 05/15/2023]
Abstract
Tears are central to knee meniscus pathology and, from a mechanical perspective, are crack-like defects (cracks). In many materials, cracks create stress concentrations that cause progressive local rupture and reduce effective strength. It is currently unknown if cracks in meniscus have these consequences; if they do, this would have repercussions for management of meniscus pathology. The objective of this study was to determine if a short crack in meniscus tissue, which mimics a preclinical meniscus tear, (a) causes crack growth and reduces effective strength, (b) creates a near-tip strain concentration and (c) creates unloaded regions on either side of the crack. Specimens with and without cracks were tested in uniaxial tension and compared in terms of macroscopic stress-strain curves and digital image correlation strain fields. The strain fields were used as an indicator of stress concentrations and unloaded regions. Effective strength was found to be insensitive to the presence of a crack (potential effect < 0.86 s.d.; β = 0.2), but significant strain concentrations, which have the potential to lead to long-term accumulation of tissue or cell damage, were observed near the crack tip.
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Affiliation(s)
- John M. Peloquin
- Department of Biomedical Engineering, University of Delaware, Newark, DE, USA
| | - Michael H. Santare
- Department of Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - Dawn M. Elliott
- Department of Biomedical Engineering, University of Delaware, Newark, DE, USA
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De Wolf J, Brieu M, Zawadzki C, Ung A, Kipnis E, Jashari R, Hubert T, Fayoux P, Mariette C, Copin MC, Wurtz A. Successful immunosuppressant-free heterotopic transplantation of tracheal allografts in the pig. Eur J Cardiothorac Surg 2018; 52:248-255. [PMID: 28472471 DOI: 10.1093/ejcts/ezx116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/04/2017] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES It has been demonstrated that both heterotopic and orthotopic transplants of epithelium-denuded cryopreserved tracheal allografts are feasible in immunosuppressant-free rabbits. Validation of these results in large animals is required before considering clinical applications. We evaluated the viability, immune tolerance and strain properties of such tracheal allografts heterotopically transplanted in a pig model. METHODS Ten tracheal segments, 5 short (5 rings) and 5 long (10 rings), were obtained from male Landrace pigs. The tracheal segments were surgically denuded of their epithelium, then cryopreserved and stored in a tissue bank for 33 to 232 days. After thawing, tracheal segments stented with a silicone tube were wrapped in the omentum in 2 groups of 5 female recipients. The animals did not receive any immunosuppressive drugs. The animals were euthanized from Day 6 to Day 90 in both groups. RESULTS An effective revascularization of allografts regardless of length was observed. Lymphocyte infiltrate was shown in the early postoperative period and became non-significant after 30 days. Allografts displayed high levels of neoangiogenesis and viable cartilage rings with islets of calcification. Biomechanical measurements demonstrated strain properties similar to those of a fresh tracheal segment from Day 58. CONCLUSIONS Our results demonstrate the acceptability and satisfactory stiffness of epithelium-denuded cryopreserved tracheal allografts implanted in the omentum, despite the absence of immunosuppressive drugs. Since the omentum has the capability to reach the tracheal region, this approach should be investigated in the setting of orthotopic transplants in a pig model before considering clinical applications.
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Affiliation(s)
- Julien De Wolf
- Department of Thoracic Surgery, CHU Lille, Lille, France.,Environnement Périnatal et Santé (EA 4489), Université Lille, Lille, France
| | - Mathias Brieu
- Laboratoire de Mécanique de Lille, UMR CNRS 8107, Centrale Lille, Villeneuve d'Ascq, France
| | | | - Alexandre Ung
- Environnement Périnatal et Santé (EA 4489), Université Lille, Lille, France
| | - Eric Kipnis
- Department of Surgical Critical Care, CHU Lille, Lille, France
| | | | - Thomas Hubert
- Environnement Périnatal et Santé (EA 4489), Université Lille, Lille, France
| | - Pierre Fayoux
- Department of Otolaryngology-Head and Neck Surgery, CHU Lille, Lille, France
| | | | | | - Alain Wurtz
- Department of Thoracic Surgery, CHU Lille, Lille, France.,Environnement Périnatal et Santé (EA 4489), Université Lille, Lille, France
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16
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Linkov G, Hanifi A, Yousefi F, Tint D, Bolla S, Marchetti N, Soliman AMS, Pleshko N. Compositional Assessment of Human Tracheal Cartilage by Infrared Spectroscopy. Otolaryngol Head Neck Surg 2018; 158:688-694. [PMID: 29337647 DOI: 10.1177/0194599817752310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/15/2017] [Indexed: 10/15/2023]
Abstract
Objectives To assess the potential of infrared fiber-optic spectroscopy to evaluate the compositional properties of human tracheal cartilage. Study Design Laboratory-based study. Methods Twenty human cadaveric distal tracheas were harvested (age range 20-78 years; 6 females, 14 males) for compositional analysis. Histologic staining, Fourier transform infrared imaging spectroscopy data on collagen and proteoglycan (PG) content, and near-infrared (NIR) fiber-optic probe spectroscopic data that reflect protein and water content were evaluated. NIR fiber-optic probe data were also obtained from the proximal trachea in 4 human cadavers (age range 51-65 years; 2 females, 2 males) in situ for comparison to distal trachea spectral data. Results In the distal trachea cohort, the spectroscopic-determined ratio of PG/amide I, indicative of the relative amount of PG, was significantly higher in the tissues from the younger group compared to the older group (0.37 ± 0.08 vs 0.32 ± 0.05, P = .05). A principal component analysis of the NIR spectral data enabled separation of spectra based on tracheal location, likely due to differences in both protein and water content. The NIR-determined water content based on the 5200-cm-1 peak was significantly higher in the distal trachea compared to the proximal trachea ( P < .001). Conclusions Establishment of normative compositional values and further elucidating differences between the segments of trachea will enable more directed research toward appropriate compositional end points in regenerative medicine for tracheal repair.
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Affiliation(s)
- Gary Linkov
- 1 Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Arash Hanifi
- 2 Tissue Imaging and Spectroscopy Laboratory, Department of Bioengineer-ing, Temple University, Philadelphia, Pennsylvania, USA
| | - Farzad Yousefi
- 2 Tissue Imaging and Spectroscopy Laboratory, Department of Bioengineer-ing, Temple University, Philadelphia, Pennsylvania, USA
| | - Derrick Tint
- 1 Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Sudheer Bolla
- 3 Department of Thoracic Medicine & Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Nathanial Marchetti
- 3 Department of Thoracic Medicine & Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Ahmed M S Soliman
- 1 Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Nancy Pleshko
- 2 Tissue Imaging and Spectroscopy Laboratory, Department of Bioengineer-ing, Temple University, Philadelphia, Pennsylvania, USA
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17
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Tran VN, Lee HS, Truong VG, Rhee YH, Kang HW. Concentric photothermal coagulation with basket-integrated optical device for treatment of tracheal stenosis. JOURNAL OF BIOPHOTONICS 2018; 11:e201700073. [PMID: 28731623 DOI: 10.1002/jbio.201700073] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/19/2017] [Accepted: 07/19/2017] [Indexed: 05/20/2023]
Abstract
A basket-integrated optical device is developed to consistently treat tubular tissue by centering an optical diffuser in the lumen. Four nitinol arms in conjunction with the optical diffusing applicator are deployed to induce homogeneous circumferential light emission and concentric photothermal coagulation on tracheal tissue. A 1470-nm laser light is employed for the tissue testing at various irradiation conditions and evaluated in terms of thermal gradient and temperature evolution. Preliminary experiments on liver tissue demonstrate the concentric development of the radial thermal coagulation in the tissue (eccentric ratio = ~5.5%). The interstitial tissue temperature increases with the total amount of energy delivery (around 65°C). Ex vivo trachea testing yields up to 16.5% tissue shrinkage due to dehydration as well as uniform ablation of the cilia and goblet cells in a mucosa layer under 7-W irradiation for 10 s. The proposed optical device may be a feasible therapeutic method to entail the circumferential coagulation in the tubular tissues in a reliable manner.
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Affiliation(s)
- Van N Tran
- Department of Biomedical Engineering, Pukyong National University, Busan, South Korea
| | - Hyoung Shin Lee
- Department of Otolaryngology Head and Neck Surgery, Kosin University, Busan, South Korea
| | - Van G Truong
- Department of Biomedical Engineering, Pukyong National University, Busan, South Korea
| | - Yun-Hee Rhee
- Beckman Laser Institute Korea, Dankook University, Cheonan, South Korea
| | - Hyun Wook Kang
- Department of Biomedical Engineering, Pukyong National University, Busan, South Korea
- Center for Marine-Integrated Biomedical Technology, Pukyong National University, Busan, South Korea
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18
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Aoki FG, Moriya HT. Mechanical Evaluation of Tracheal Grafts on Different Scales. Artif Organs 2017; 42:476-483. [PMID: 29226358 DOI: 10.1111/aor.13063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/18/2017] [Accepted: 09/28/2017] [Indexed: 12/12/2022]
Abstract
Tissue engineered (or bioengineered) tracheas are alternative options under investigation when the resection with end-to-end anastomosis cannot be performed. One approach to develop bioengineered tracheas is a complex process that involves the use of decellularized tissue scaffolds, followed by recellularization in custom-made tracheal bioreactors. Tracheas withstand pressure variations and their biomechanics are of great importance so that they do not collapse during respiration, although there has been no preferred method of mechanical assay of tracheas among several laboratories over the years. These methods have been performed in segments or whole tracheas and in different species of mammals. This article aims to present some methods used by different research laboratories to evaluate the mechanics of tracheal grafts and presents the importance of the tracheal biomechanics in both macro and micro scales. If bioengineered tracheas become a reality in hospitals in the next few years, the standardization of biomechanical parameters will be necessary for greater consistency of results before transplantations.
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Affiliation(s)
- Fabio Gava Aoki
- Biomedical Engineering Laboratory, University of São Paulo, Escola Politécnica, São Paulo, Brazil
| | - Henrique Takachi Moriya
- Biomedical Engineering Laboratory, University of São Paulo, Escola Politécnica, São Paulo, Brazil
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Peloquin JM, Santare MH, Elliott DM. Advances in Quantification of Meniscus Tensile Mechanics Including Nonlinearity, Yield, and Failure. J Biomech Eng 2016; 138:021002. [PMID: 26720401 DOI: 10.1115/1.4032354] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Indexed: 11/08/2022]
Abstract
The meniscus provides crucial knee function and damage to it leads to osteoarthritis of the articular cartilage. Accurate measurement of its mechanical properties is therefore important, but there is uncertainty about how the test procedure affects the results, and some key mechanical properties are reported using ad hoc criteria (modulus) or not reported at all (yield). This study quantifies the meniscus' stress-strain curve in circumferential and radial uniaxial tension. A fiber recruitment model was used to represent the toe region of the stress-strain curve, and new reproducible and objective procedures were implemented for identifying the yield point and measuring the elastic modulus. Patterns of strain heterogeneity were identified using strain field measurements. To resolve uncertainty regarding whether rupture location (i.e., midsubstance rupture versus at-grip rupture) influences the measured mechanical properties, types of rupture were classified in detail and compared. Dogbone (DB)-shaped specimens are often used to promote midsubstance rupture; to determine if this is effective, we compared DB and rectangle (R) specimens in both the radial and circumferential directions. In circumferential testing, we also compared expanded tab (ET) specimens under the hypothesis that this shape would more effectively secure the meniscus' curved fibers and thus produce a stiffer response. The fiber recruitment model produced excellent fits to the data. Full fiber recruitment occurred approximately at the yield point, strongly supporting the model's physical interpretation. The strain fields, especially shear and transverse strain, were extremely heterogeneous. The shear strain field was arranged in pronounced bands of alternating positive and negative strain in a pattern similar to the fascicle structure. The site and extent of failure showed great variation, but did not affect the measured mechanical properties. In circumferential tension, ET specimens underwent earlier and more rapid fiber recruitment, had less stretch at yield, and had greater elastic modulus and peak stress. No significant differences were observed between R and DB specimens in either circumferential or radial tension. Based on these results, ET specimens are recommended for circumferential tests and R specimens for radial tests. In addition to the data obtained, the procedural and modeling advances made in this study are a significant step forward for meniscus research and are applicable to other fibrous soft tissues.
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Karkhanis T, Rao M, Zafar F, Simon Morales DL, Haridas B. Tracheal Cartilage Ring Biomechanical Properties for Pediatric Exostent Design1. J Med Device 2016. [DOI: 10.1115/1.4033248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Teja Karkhanis
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843
| | - Marepalli Rao
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45221
| | - Farhan Zafar
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229
| | | | - Balakrishna Haridas
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843
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21
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Den Hondt M, Vanaudenaerde BM, Verbeken EK, Vranckx JJ. Tracheal tissue-engineering: in-vivo biocompatibility of mechanically-stripped allogenic rabbit trachea with autologous epithelial covering. Acta Chir Belg 2016; 116:164-174. [PMID: 27696973 DOI: 10.1080/00015458.2016.1210844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Successful trachea transplantation comprises the use of biocompatible constructs with little immune-reactivity, submucosal revascularization and creation of an epithelial covering. Allogenic chondrocytes might be protected from an overt immune-response due to physical isolation. Our aim was to evaluate in-vivo biocompatibility of allotracheae, stripped of their highly-immunogenic inner lining. Secondly, we established whether these constructs might serve as suitable scaffolds for autologous epithelial grafting. METHODS Mucosa and submucosa of 12 rabbit donor tracheae were mechanically peeled off. Cartilage was covered with Integra™ regeneration-template. Constructs were implanted within the recipient's lateral thoracic artery flap. Integra of 6 revascularized allotracheae was grafted with autologous buccal mucosa. Macroscopical, histological analysis and immunohistochemistry were performed. RESULTS Revascularization and buccal grafting was incomplete in the first 2 circular constructs. To enhance blood-vessel outgrowth, the following 10 transplants were opened longitudinally before implantation. Integra revascularized well. Grafted tracheae showed satisfactory mucosa-adherence, albeit with invasion of migrating epithelium within the Integra-scaffold. CONCLUSIONS Mechanically-stripped allotracheae exhibited beneficial biocompatibility up to two months. This approach might open doors in the treatment of long-segment tracheal pathologies of which immunosuppression is contra-indicated. Thickness of this layered construct limited practical feasibility of orthotopic transfer, though with further refinements, a clinically-useful transplant could be created.
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Ott LM, Zabel TA, Walker NK, Farris AL, Chakroff JT, Ohst DG, Johnson JK, Gehrke SH, Weatherly RA, Detamore MS. Mechanical evaluation of gradient electrospun scaffolds with 3D printed ring reinforcements for tracheal defect repair. ACTA ACUST UNITED AC 2016; 11:025020. [PMID: 27097554 DOI: 10.1088/1748-6041/11/2/025020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Tracheal stenosis can become a fatal condition, and current treatments include augmentation of the airway with autologous tissue. A tissue-engineered approach would not require a donor source, while providing an implant that meets both surgeons' and patients' needs. A fibrous, polymeric scaffold organized in gradient bilayers of polycaprolactone (PCL) and poly-lactic-co-glycolic acid (PLGA) with 3D printed structural ring supports, inspired by the native trachea rings, could meet this need. The purpose of the current study was to characterize the tracheal scaffolds with mechanical testing models to determine the design most suitable for maintaining a patent airway. Degradation over 12 weeks revealed that scaffolds with the 3D printed rings had superior properties in tensile and radial compression, with at least a three fold improvement and 8.5-fold improvement, respectively, relative to the other scaffold groups. The ringed scaffolds produced tensile moduli, radial compressive forces, and burst pressures similar to or exceeding physiological forces and native tissue data. Scaffolds with a thicker PCL component had better suture retention and tube flattening recovery properties, with the monolayer of PCL (PCL-only group) exhibiting a 2.3-fold increase in suture retention strength (SRS). Tracheal scaffolds with ring reinforcements have improved mechanical properties, while the fibrous component increased porosity and cell infiltration potential. These scaffolds may be used to treat various trachea defects (patch or circumferential) and have the potential to be employed in other tissue engineering applications.
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Affiliation(s)
- Lindsey M Ott
- Bioengineering Program, University of Kansas, Lawrence, KS 66045, USA
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Hoffman B, Martin M, Brown BN, Bonassar LJ, Cheetham J. Biomechanical and biochemical characterization of porcine tracheal cartilage. Laryngoscope 2016; 126:E325-31. [DOI: 10.1002/lary.25861] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 12/11/2015] [Accepted: 12/15/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Benjamin Hoffman
- Department of Clinical Sciences; College of Veterinary Medicine, Cornell University; Ithaca New York
| | - Matthew Martin
- Department of Clinical Sciences; College of Veterinary Medicine, Cornell University; Ithaca New York
| | - Bryan N. Brown
- Department of Clinical Sciences; College of Veterinary Medicine, Cornell University; Ithaca New York
- McGowan Institute for Regenerative Medicine, University of Pittsburgh; Pittsburgh Pennsylvania U.S.A
| | | | - Jonathan Cheetham
- Department of Clinical Sciences; College of Veterinary Medicine, Cornell University; Ithaca New York
- McGowan Institute for Regenerative Medicine, University of Pittsburgh; Pittsburgh Pennsylvania U.S.A
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On Studying the Interaction Between Different Stent Models and Rabbit Tracheal Tissue: Numerical, Endoscopic and Histological Comparison. Ann Biomed Eng 2015; 44:368-81. [DOI: 10.1007/s10439-015-1504-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 11/05/2015] [Indexed: 12/14/2022]
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Ott LM, Vu CH, Farris AL, Fox KD, Galbraith RA, Weiss ML, Weatherly RA, Detamore MS. Functional Reconstruction of Tracheal Defects by Protein-Loaded, Cell-Seeded, Fibrous Constructs in Rabbits. Tissue Eng Part A 2015; 21:2390-403. [PMID: 26094554 DOI: 10.1089/ten.tea.2015.0157] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Tracheal stenosis is a life-threatening disease and current treatments include surgical reconstruction with autologous rib cartilage and the highly complex slide tracheoplasty surgical technique. We propose using a sustainable implant, composed of a tunable, fibrous scaffold with encapsulated chondrogenic growth factor (transforming growth factor-beta3 [TGF-β3]) or seeded allogeneic rabbit bone marrow mesenchymal stromal cells (BMSCs). In vivo functionality of these constructs was determined by implanting them in induced tracheal defects in rabbits for 6 or 12 weeks. The scaffolds maintained functional airways in a majority of the cases, with the BMSC-seeded group having an improved survival rate and the Scaffold-only group having a higher occurrence of more patent airways as determined by microcomputed tomography. The BMSC group had a greater accumulation of inflammatory cells over the graft, while also exhibiting normal epithelium, subepithelium, and cartilage formation. Overall, it was concluded that a simple, acellular scaffold is a viable option for tracheal tissue engineering, with the intraoperative addition of cells being an optional variation to the scaffolds.
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Affiliation(s)
- Lindsey M Ott
- 1 Bioengineering Program, University of Kansas , Lawrence, Kansas
| | - Cindy H Vu
- 2 School of Medicine, University of Kansas , Kansas City, Kansas
| | - Ashley L Farris
- 3 Department of Molecular Biosciences, University of Kansas , Lawrence, Kansas
| | - Katrina D Fox
- 4 College of Veterinary Medicine, Kansas State University , Manhattan, Kansas
| | - Richard A Galbraith
- 5 Anatomic and Clinical Pathology, Lawrence Memorial Hospital , Lawrence, Kansas
| | - Mark L Weiss
- 4 College of Veterinary Medicine, Kansas State University , Manhattan, Kansas
| | - Robert A Weatherly
- 6 Section of Otolaryngology, Children's Mercy Hospital , Kansas City, Missouri
| | - Michael S Detamore
- 1 Bioengineering Program, University of Kansas , Lawrence, Kansas
- 7 Department of Chemical and Petroleum Engineering, University of Kansas , Lawrence, Kansas
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Jones MC, Rueggeberg FA, Cunningham AJ, Faircloth HA, Jana T, Mettenburg D, Waller JL, Postma GN, Weinberger PM. Biomechanical changes from long-term freezer storage and cellular reduction of tracheal scaffoldings. Laryngoscope 2014; 125:E16-22. [PMID: 25092543 DOI: 10.1002/lary.24853] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 07/02/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine structural biomechanical changes in tracheal scaffolds resulting from cellular reduction and storage at -80(o) C. STUDY DESIGN Laboratory-based study. METHODS Forty-four rabbit tracheal segments were separated into four treatment groups: untreated (group A, control), cellular-reduced (group B), storage at -80(o) C followed by cellular reduction (group C), and cellular-reduced followed by storage at -80(o) C (group D). Tracheal segments were subjected to uniaxial tension (n = 21) or compression (n = 23) using a universal testing machine to determine sutured tensile yield load and radial compressive strengths at 50% lumen occlusion. Mean differences among groups for tension and compression were compared by analysis of variance with post-hoc Tukey-Kramer test. RESULTS The untreated trachea (group A) demonstrated mean yield strength of 5.93 (± 1.65) N and compressive strength of 2.10 (± 0.51) N. Following treatment/storage, the tensile yield strength was not impaired (group B = 6.79 [± 1.58] N, C = 6.21 [± 1.40] N, D = 6.26 [± 1.18]; P > 0.10 each). Following cellular reduction, there was a significant reduction in compressive strength (group B = 0.44 N [± 0.13], P < 0.0001), but no further reduction due to storage (group C = 0.39 N [± 0.10]; P = 0.97 compared to group B). CONCLUSION The data suggest cellular reduction leads to loss of compressive strength. Freezing at -80°C (either before, or subsequent to cellular reduction) may be a viable storage method for tracheal grafts.
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Affiliation(s)
- Matthew C Jones
- Center for Voice, Airway and Swallowing, Department of Otolaryngology, Augusta, Georgia, U.S.A
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