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Tsukada J, Mela P, Jinzaki M, Tsukada H, Schmitz-Rode T, Vogt F. Development of In Vitro Endothelialised Stents - Review. Stem Cell Rev Rep 2021; 18:179-197. [PMID: 34403073 DOI: 10.1007/s12015-021-10238-3] [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] [Accepted: 08/06/2021] [Indexed: 01/12/2023]
Abstract
Endovascular treatment is prevalent as a primary treatment for coronary and peripheral arterial diseases. Although the introduction of drug-eluting stents (DES) dramatically reduced the risk of in-stent restenosis, stent thrombosis persists as an issue. Notwithstanding improvements in newer generation DES, they are yet to address the urgent clinical need to abolish the late stent complications that result from in-stent restenosis and are associated with late thrombus formation. These often lead to acute coronary syndromes with high mortality in coronary artery disease and acute limb ischemia with a high risk of limb amputation in peripheral arterial disease. Recently, a significant amount of research has focused on alternative solutions to improve stent biocompatibility by using tissue engineering. There are two types of tissue engineering endothelialisation methods: in vitro and in vivo. To date, commercially available in vivo endothelialised stents have failed to demonstrate antithrombotic or anti-stenosis efficacy in clinical trials. In contrast, the in vitro endothelialisation methods exhibit the advantage of monitoring cell type and growth prior to implantation, enabling better quality control. The present review discusses tissue-engineered candidate stents constructed by distinct in vitro endothelialisation approaches, with a particular focus on fabrication processes, including cell source selection, stent material composition, stent surface modifications, efficacy and safety evidence from in vitro and in vivo studies, and future directions.
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Affiliation(s)
- Jitsuro Tsukada
- Department of Diagnostic Radiology, Nihon University School of Medicine, 30-1, Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan. .,Department of Diagnostic Radiology, Keio University School of Medicine, 35, Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan.
| | - P Mela
- Department of Mechanical Engineering and Munich School of BioEngineering, Technical University of Munich, Boltzmannstr. 15, Garching, Munich, 85748, Germany
| | - M Jinzaki
- Department of Diagnostic Radiology, Keio University School of Medicine, 35, Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - H Tsukada
- Department of Surgery II, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - T Schmitz-Rode
- AME - Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Pauwelsstrasse 30, Aachen, 52074, Germany
| | - F Vogt
- Department of Cardiology, University Hospital RWTH Aachen, Pauwelsstrasse 30, Aachen, 52074, Germany
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Park KS, Kang SN, Kim DH, Kim HB, Im KS, Park W, Hong YJ, Han DK, Joung YK. Late endothelial progenitor cell-capture stents with CD146 antibody and nanostructure reduce in-stent restenosis and thrombosis. Acta Biomater 2020; 111:91-101. [PMID: 32434081 DOI: 10.1016/j.actbio.2020.05.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/08/2020] [Accepted: 05/08/2020] [Indexed: 12/13/2022]
Abstract
The restoration of damaged endothelium is promising to reduce side effects, including restenosis and thrombosis, in the stent treatment for vascular diseases. Current technologies based on drug delivery for these complications still do not satisfy patients due to invariant recurrence rate. Recently, even if one approach was applied to clinical trial to develop the firstly commercialized stent employing circulating endothelial progenitor cells (EPCs) in blood vessels, it resulted in failure in clinical trial. Based on instruction of the failed case, we designed an advanced EPC-capture stent covered with anti-CD146 antibody (Ab) immobilized silicone nanofilament (SiNf) for the highly efficient and specific capture of not early but late stage of EPCs. In vitro cell capture test demonstrates enhanced capture efficiency and adhesion morphology of late EPCs on the modified substrate. The modified substrates could capture 8 times more late EPCs and even 3 times more mesenchymal stem cells (MSCs) as compared to unmodified one. A porcine model with high similarity to human reproduced in vivo results ideally translated from in vitro cell capture results. As restenosis indicators, lumen area, neointimal rate and stenosis area for modified stents were reduced at the range of 30-60% as compared to those for bare metal stent (BMS). Fibrin score indicating thrombosis was lowered less than half as comparing to that on BMS. These inspiring results are attributed to ~2-fold increased endothelial coverage, determined by immuno-histological staining. Taken together, the CD146 Ab-armed nanofilamentous stent could show great performance in the reduction of thrombosis and restenosis through re-endothelialization due to highly efficient specific cell capture. STATEMENT OF SIGNIFICANCE: Stents have been developed from simple metal stents to functionalized stents for past decades. However, they have still risks to relapse the occlusion in stented arteries. In this paper, we describe the fabrication and optimization of cell capturing stents to maximize the effective re-endothelialization through the serial coating of silicone nanofilaments and anti-CD146 antibody. The nanofilaments increase the amount of coated antibodies and provide the anchoring points of circulating angiogenic cells for strong focal adhesion. We demonstrate high immobilizing ability of circulating angiogenic cells (endotheliali progenitor cells and mesenchymal stem cells) in vitro under similar shear stress to coronary arteries (15 dyne/cm2). Also, we show accelerating re-endothelialization and the efficient prevention of restenosis in porcine coronary arteries in vivo.
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Affiliation(s)
- Kwang-Sook Park
- Center for Biomaterials, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea
| | - Sung Nam Kang
- Center for Biomaterials, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea; Department of Biomedical Engineering, Korea University of Science and Technology, Daejeon 34113, Republic of Korea
| | - Dae Hwan Kim
- Center for Biomaterials, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea
| | - Han-Byual Kim
- The Heart Center of Chonnam National University Hospital, Gwangju 61469, Republic of Korea
| | - Kyung Seob Im
- Futuristic Animal Resource & Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
| | - Wooram Park
- Department of Biomedical Science, College of Life Sciences, CHA University, Gyeonggi 13488, Republic of Korea
| | - Young Joon Hong
- The Heart Center of Chonnam National University Hospital, Gwangju 61469, Republic of Korea
| | - Dong Keun Han
- Department of Biomedical Science, College of Life Sciences, CHA University, Gyeonggi 13488, Republic of Korea.
| | - Yoon Ki Joung
- Center for Biomaterials, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea; Department of Biomedical Engineering, Korea University of Science and Technology, Daejeon 34113, Republic of Korea.
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Effect of linking arm hydrophilic/hydrophobic nature, length and end-group on the conformation and the RGD accessibility of surface-immobilized fibronectin. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 107:110335. [DOI: 10.1016/j.msec.2019.110335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 06/03/2019] [Accepted: 10/16/2019] [Indexed: 12/30/2022]
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Covalent immobilization of fibroblast-derived matrix on metallic stent for expeditious re-endothelialization. J IND ENG CHEM 2019. [DOI: 10.1016/j.jiec.2018.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Bekmurzayeva A, Duncanson WJ, Azevedo HS, Kanayeva D. Surface modification of stainless steel for biomedical applications: Revisiting a century-old material. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 93:1073-1089. [PMID: 30274039 DOI: 10.1016/j.msec.2018.08.049] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 07/06/2018] [Accepted: 08/22/2018] [Indexed: 12/12/2022]
Abstract
Stainless steel (SS) has been widely used as a material for fabricating cardiovascular stents/valves, orthopedic prosthesis, and other devices and implants used in biomedicine due to its malleability and resistance to corrosion and fatigue. Despite its good mechanical properties, SS (as other metals) lacks biofunctionality. To be successfully used as a biomaterial, SS must be made resistant to the biological environment by increasing its anti-fouling properties, preventing biofilm formation (passive surface modification), and imparting functionality for eluting a specific drug or capturing selected cells (active surface modification); these features depend on the final application. Various physico-chemical techniques, including plasma vapor deposition, electrochemical treatment, and attachment of different linkers that add functional groups, are used to obtain SS with increased corrosion resistance, improved osseointegration capabilities, added hemocompatibility, and enhanced antibacterial properties. Existing literature on this topic is extensive and has not been covered in an integrated way in previous reviews. This review aims to fill this gap, by surveying the literature on SS surface modification methods, as well as modification routes tailored for specific biomedical applications. STATEMENT OF SIGNIFICANCE Stainless steel (SS) is widely used in many biomedical applications including bone implants and cardiovascular stents due to its good mechanical properties, biocompatibility and low price. Surface modification allows improving its characteristics without compromising its important bulk properties. SS with improved blood compatibility (blood contacting implants), enhanced ability to resist bacterial infection (long-term devices), better integration with a tissue (bone implants) are examples of successful SS surface modifications. Existing literature on this topic is extensive and has not been covered in an integrated way in previous reviews. This review paper aims to fill this gap, by surveying the literature on SS surface modification methods, as well as to provide guidance for selecting appropriate modification routes tailored for specific biomedical applications.
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Affiliation(s)
- Aliya Bekmurzayeva
- Engineering and Technology Program, Nazarbayev University, Astana 010000, Kazakhstan; National Laboratory Astana, Nazarbayev University, Astana 010000, Kazakhstan; School of Engineering and Materials Science, Queen Mary University of London, London E1 4NS, UK
| | - Wynter J Duncanson
- School of Engineering, Nazarbayev University, Astana 010000, Kazakhstan; College of Engineering, Boston University, Boston, MA 02215, USA
| | - Helena S Azevedo
- School of Engineering and Materials Science, Queen Mary University of London, London E1 4NS, UK
| | - Damira Kanayeva
- School of Science and Technology, Nazarbayev University, Astana 010000, Kazakhstan.
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Metal release from stainless steel in biological environments: A review. Biointerphases 2016; 11:018901. [DOI: 10.1116/1.4934628] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Zhang H, Han J, Sun Y, Huang Y, Zhou M. MC3T3-E1 cell response to stainless steel 316L with different surface treatments. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 56:22-9. [DOI: 10.1016/j.msec.2015.06.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 04/29/2015] [Accepted: 06/09/2015] [Indexed: 01/20/2023]
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Heller M, Kämmerer PW, Al‐Nawas B, Luszpinski M, Förch R, Brieger J. The effect of extracellular matrix proteins on the cellular response of
HUVECS
and
HOBS
after covalent immobilization onto titanium. J Biomed Mater Res A 2014; 103:2035-44. [DOI: 10.1002/jbm.a.35340] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/17/2014] [Accepted: 09/19/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Martin Heller
- Department of Otorhinolaryngolgy of the Johannes Gutenberg University Mainz55131Mainz Germany
- Department of Oral and Maxillofacial Surgery of the Johannes Gutenberg University Mainz55131Mainz Germany
- Max Planck Institute for Polymer Research55128Mainz Germany
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial SurgeryUniversity Medical Center Rostock18057Rostock Germany
| | - Bilal Al‐Nawas
- Department of Oral and Maxillofacial Surgery of the Johannes Gutenberg University Mainz55131Mainz Germany
| | - Marie‐Anne Luszpinski
- Department of Otorhinolaryngolgy of the Johannes Gutenberg University Mainz55131Mainz Germany
| | - Renate Förch
- Max Planck Institute for Polymer Research55128Mainz Germany
- Fraunhofer ICT‐IMM55129Mainz Germany
| | - Jürgen Brieger
- Department of Otorhinolaryngolgy of the Johannes Gutenberg University Mainz55131Mainz Germany
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