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Saeid Nia M, Floder LM, Seiler JA, Puehler T, Pommert NS, Berndt R, Meier D, Sellers SL, Sathananthan J, Zhang X, Hasler M, Gorb SN, Warnecke G, Lutter G. Optimization of Enzymatic and Chemical Decellularization of Native Porcine Heart Valves for the Generation of Decellularized Xenografts. Int J Mol Sci 2024; 25:4026. [PMID: 38612836 PMCID: PMC11012489 DOI: 10.3390/ijms25074026] [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: 02/29/2024] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
One of the most important medical interventions for individuals with heart valvular disease is heart valve replacement, which is not without substantial challenges, particularly for pediatric patients. Due to their biological properties and biocompatibility, natural tissue-originated scaffolds derived from human or animal sources are one type of scaffold that is widely used in tissue engineering. However, they are known for their high potential for immunogenicity. Being free of cells and genetic material, decellularized xenografts, consequently, have low immunogenicity and, thus, are expected to be tolerated by the recipient's immune system. The scaffold ultrastructure and ECM composition can be affected by cell removal agents. Therefore, applying an appropriate method that preserves intact the structure of the ECM plays a critical role in the final result. So far, there has not been an effective decellularization technique that preserves the integrity of the heart valve's ultrastructure while securing the least amount of genetic material left. This study demonstrates a new protocol with untraceable cells and residual DNA, thereby maximally reducing any chance of immunogenicity. The mechanical and biochemical properties of the ECM resemble those of native heart valves. Results from this study strongly indicate that different critical factors, such as ionic detergent omission, the substitution of Triton X-100 with Tergitol, and using a lower concentration of trypsin and a higher concentration of DNase and RNase, play a significant role in maintaining intact the ultrastructure and function of the ECM.
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Affiliation(s)
- Monireh Saeid Nia
- Department of Cardiac Surgery, University Hospital Schleswig-Holstein (UKSH), 24105 Kiel, Germany; (M.S.N.); (L.M.F.); (J.A.S.); (N.S.P.); (X.Z.); (G.W.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 69120 Hamburg, Germany;
| | - Lena Maria Floder
- Department of Cardiac Surgery, University Hospital Schleswig-Holstein (UKSH), 24105 Kiel, Germany; (M.S.N.); (L.M.F.); (J.A.S.); (N.S.P.); (X.Z.); (G.W.)
| | - Jette Anika Seiler
- Department of Cardiac Surgery, University Hospital Schleswig-Holstein (UKSH), 24105 Kiel, Germany; (M.S.N.); (L.M.F.); (J.A.S.); (N.S.P.); (X.Z.); (G.W.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 69120 Hamburg, Germany;
| | - Thomas Puehler
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 69120 Hamburg, Germany;
- Department of Cardiac Surgery, University Hospital Schleswig-Holstein (UKSH), 23562 Lübeck, Germany
| | - Nina Sophie Pommert
- Department of Cardiac Surgery, University Hospital Schleswig-Holstein (UKSH), 24105 Kiel, Germany; (M.S.N.); (L.M.F.); (J.A.S.); (N.S.P.); (X.Z.); (G.W.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 69120 Hamburg, Germany;
| | - Rouven Berndt
- Clinic of Vascular and Endovascular Surgery, University Hospital Schleswig-Holstein (UKSH), 24105 Kiel, Germany;
| | - David Meier
- Department of Cardiology, Lausanne University Hospital and University of Lausanne, 1015 Lausanne, Switzerland;
| | - Stephanie L. Sellers
- Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, BC V5Z 1M9, Canada; (S.L.S.); (J.S.)
- Cardiovascular Translational Laboratory, Providence Research & Centre for Heart Lung Innovation, Vancouver, BC V6Z 1Y6, Canada
- Centre for Heart Valve Innovation, St. Paul’s Hospital, Vancouver, BC V6Z 1Y6, Canada
| | - Janarthanan Sathananthan
- Centre for Cardiovascular Innovation, University of British Columbia, Vancouver, BC V5Z 1M9, Canada; (S.L.S.); (J.S.)
- Cardiovascular Translational Laboratory, Providence Research & Centre for Heart Lung Innovation, Vancouver, BC V6Z 1Y6, Canada
- Centre for Heart Valve Innovation, St. Paul’s Hospital, Vancouver, BC V6Z 1Y6, Canada
| | - Xiling Zhang
- Department of Cardiac Surgery, University Hospital Schleswig-Holstein (UKSH), 24105 Kiel, Germany; (M.S.N.); (L.M.F.); (J.A.S.); (N.S.P.); (X.Z.); (G.W.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 69120 Hamburg, Germany;
| | - Mario Hasler
- Lehrfach Variationsstatistik, Christian-Albrechts-University of Kiel, 24118 Kiel, Germany;
| | - Stanislav N. Gorb
- Department of Functional Morphology and Biomechanics, Zoological Institute, Christian-Albrechts-University of Kiel, 24118 Kiel, Germany;
| | - Gregor Warnecke
- Department of Cardiac Surgery, University Hospital Schleswig-Holstein (UKSH), 24105 Kiel, Germany; (M.S.N.); (L.M.F.); (J.A.S.); (N.S.P.); (X.Z.); (G.W.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 69120 Hamburg, Germany;
| | - Georg Lutter
- Department of Cardiac Surgery, University Hospital Schleswig-Holstein (UKSH), 24105 Kiel, Germany; (M.S.N.); (L.M.F.); (J.A.S.); (N.S.P.); (X.Z.); (G.W.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 69120 Hamburg, Germany;
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Khaboushan AS, Ebadpour N, Moghadam MMJ, Rezaee Z, Kajbafzadeh AM, Zolbin MM. Cell therapy for retinal degenerative disorders: a systematic review and three-level meta-analysis. J Transl Med 2024; 22:227. [PMID: 38431596 PMCID: PMC10908175 DOI: 10.1186/s12967-024-05016-x] [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: 12/22/2023] [Accepted: 02/22/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Retinal degenerative disorders (RDDs) cause vision loss by damaging retinal neurons and photoreceptors, affecting individuals of all ages. Cell-based therapy has emerged as an effective approach for the treatment of RDDs with promising results. This meta-analysis aims to comprehensively evaluate the efficacy of cell therapy in treating age-related macular degeneration (AMD), retinitis pigmentosa (RP), and Stargardt macular degeneration (SMD) as the most prevalent RDDs. METHODS PubMed, Scopus, Web of Science, and Embase were searched using keywords related to various retinal diseases and cell therapy treatments until November 25th, 2023. The studies' quality was evaluated using the Joanna Briggs Institute's (JBI) checklist for quasi-experimental studies. Visual acuity measured as LogMAR score was used as our main outcome. A three-level random-effect meta-analysis was used to explore the visual acuity in patients who received cell-based therapy. Heterogeneity among the included studies was evaluated using subgroup and sensitivity analyses. Moreover, meta-regression for the type of cells, year of publication, and mean age of participants were performed. RESULTS Overall, 8345 studies were retrieved by the search, and 39 met the eligibility criteria, out of which 18 studies with a total of 224 eyes were included in the meta-analysis. There were 12 studies conducted on AMD, 7 on SMD, and 2 on RP. Cell therapy for AMD showed significant improvement in LogMAR (p < 0.05). Also, cell therapy decreased the LogMAR score in SMD and RP (p < 0.01 and p < 0.0001, respectively). Across all conditions, no substantial publication bias was detected (p < 0.05). CONCLUSION The findings of the study highlight that the application of cell therapy can enhance the visual acuity in AMD, SMD, and RP.
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Affiliation(s)
- Alireza Soltani Khaboushan
- Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Gene, Cell and Tissue Research Institute, Tehran University of Medical Science, Tehran, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Ebadpour
- Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Gene, Cell and Tissue Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - Mohammad Mehdi Johari Moghadam
- Department of Ophthalmology & Vision Science, Tschannen Eye Institute, University of California, Davis, Sacramento, CA, USA
| | - Zahra Rezaee
- Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Gene, Cell and Tissue Research Institute, Tehran University of Medical Science, Tehran, Iran
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Abdol-Mohammad Kajbafzadeh
- Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Gene, Cell and Tissue Research Institute, Tehran University of Medical Science, Tehran, Iran
| | - Masoumeh Majidi Zolbin
- Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Gene, Cell and Tissue Research Institute, Tehran University of Medical Science, Tehran, Iran.
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Neishabouri A, Soltani Khaboushan A, Daghigh F, Kajbafzadeh AM, Majidi Zolbin M. Decellularization in Tissue Engineering and Regenerative Medicine: Evaluation, Modification, and Application Methods. Front Bioeng Biotechnol 2022; 10:805299. [PMID: 35547166 PMCID: PMC9081537 DOI: 10.3389/fbioe.2022.805299] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 04/04/2022] [Indexed: 12/14/2022] Open
Abstract
Reproduction of different tissues using scaffolds and materials is a major element in regenerative medicine. The regeneration of whole organs with decellularized extracellular matrix (dECM) has remained a goal despite the use of these materials for different purposes. Recently, decellularization techniques have been widely used in producing scaffolds that are appropriate for regenerating damaged organs and may be able to overcome the shortage of donor organs. Decellularized ECM offers several advantages over synthetic compounds, including the preserved natural microenvironment features. Different decellularization methods have been developed, each of which is appropriate for removing cells from specific tissues under certain conditions. A variety of methods have been advanced for evaluating the decellularization process in terms of cell removal efficiency, tissue ultrastructure preservation, toxicity, biocompatibility, biodegradability, and mechanical resistance in order to enhance the efficacy of decellularization methods. Modification techniques improve the characteristics of decellularized scaffolds, making them available for the regeneration of damaged tissues. Moreover, modification of scaffolds makes them appropriate options for drug delivery, disease modeling, and improving stem cells growth and proliferation. However, considering different challenges in the way of decellularization methods and application of decellularized scaffolds, this field is constantly developing and progressively moving forward. This review has outlined recent decellularization and sterilization strategies, evaluation tests for efficient decellularization, materials processing, application, and challenges and future outlooks of decellularization in regenerative medicine and tissue engineering.
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Affiliation(s)
- Afarin Neishabouri
- Pediatric Urology and Regenerative Medicine Research Center, Children’s Medical Center, Pediatric Center of Excellence, Tehran University of Medical Science, Tehran, Iran
| | - Alireza Soltani Khaboushan
- Pediatric Urology and Regenerative Medicine Research Center, Children’s Medical Center, Pediatric Center of Excellence, Tehran University of Medical Science, Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Daghigh
- Department of Physiology, Faculty of Medicine, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran
| | - Abdol-Mohammad Kajbafzadeh
- Pediatric Urology and Regenerative Medicine Research Center, Children’s Medical Center, Pediatric Center of Excellence, Tehran University of Medical Science, Tehran, Iran
- *Correspondence: Masoumeh Majidi Zolbin, ; Abdol-Mohammad Kajbafzadeh,
| | - Masoumeh Majidi Zolbin
- Pediatric Urology and Regenerative Medicine Research Center, Children’s Medical Center, Pediatric Center of Excellence, Tehran University of Medical Science, Tehran, Iran
- *Correspondence: Masoumeh Majidi Zolbin, ; Abdol-Mohammad Kajbafzadeh,
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