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Zhang X, Xu B, Puperi DS, Wu Y, West JL, Grande-Allen KJ. Application of hydrogels in heart valve tissue engineering. J Long Term Eff Med Implants 2016; 25:105-34. [PMID: 25955010 DOI: 10.1615/jlongtermeffmedimplants.2015011817] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
With an increasing number of patients requiring valve replacements, there is heightened interest in advancing heart valve tissue engineering (HVTE) to provide solutions to the many limitations of current surgical treatments. A variety of materials have been developed as scaffolds for HVTE including natural polymers, synthetic polymers, and decellularized valvular matrices. Among them, biocompatible hydrogels are generating growing interest. Natural hydrogels, such as collagen and fibrin, generally show good bioactivity but poor mechanical durability. Synthetic hydrogels, on the other hand, have tunable mechanical properties; however, appropriate cell-matrix interactions are difficult to obtain. Moreover, hydrogels can be used as cell carriers when the cellular component is seeded into the polymer meshes or decellularized valve scaffolds. In this review, we discuss current research strategies for HVTE with an emphasis on hydrogel applications. The physicochemical properties and fabrication methods of these hydrogels, as well as their mechanical properties and bioactivities are described. Performance of some hydrogels including in vitro evaluation using bioreactors and in vivo tests in different animal models are also discussed. For future HVTE, it will be compelling to examine how hydrogels can be constructed from composite materials to replicate mechanical properties and mimic biological functions of the native heart valve.
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Affiliation(s)
- Xing Zhang
- Department of Bioengineering, Rice University, Houston, TX 77030, USA; Institute of Metal Research, Chinese Academy of Sciences, Shenyang, Liaoning 110016, China
| | - Bin Xu
- Department of Bioengineering, Rice University, Houston, TX 77030, USA
| | - Daniel S Puperi
- Department of Bioengineering, Rice University, Houston, TX 77030, USA
| | - Yan Wu
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
| | - Jennifer L West
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, USA
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Di Liddo R, Aguiari P, Barbon S, Bertalot T, Mandoli A, Tasso A, Schrenk S, Iop L, Gandaglia A, Parnigotto PP, Conconi MT, Gerosa G. Nanopatterned acellular valve conduits drive the commitment of blood-derived multipotent cells. Int J Nanomedicine 2016; 11:5041-5055. [PMID: 27789941 PMCID: PMC5068475 DOI: 10.2147/ijn.s115999] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Considerable progress has been made in recent years toward elucidating the correlation among nanoscale topography, mechanical properties, and biological behavior of cardiac valve substitutes. Porcine TriCol scaffolds are promising valve tissue engineering matrices with demonstrated self-repopulation potentiality. In order to define an in vitro model for investigating the influence of extracellular matrix signaling on the growth pattern of colonizing blood-derived cells, we cultured circulating multipotent cells (CMC) on acellular aortic (AVL) and pulmonary (PVL) valve conduits prepared with TriCol method and under no-flow condition. Isolated by our group from Vietnamese pigs before heart valve prosthetic implantation, porcine CMC revealed high proliferative abilities, three-lineage differentiative potential, and distinct hematopoietic/endothelial and mesenchymal properties. Their interaction with valve extracellular matrix nanostructures boosted differential messenger RNA expression pattern and morphologic features on AVL compared to PVL, while promoting on both matrices the commitment to valvular and endothelial cell-like phenotypes. Based on their origin from peripheral blood, porcine CMC are hypothesized in vivo to exert a pivotal role to homeostatically replenish valve cells and contribute to hetero- or allograft colonization. Furthermore, due to their high responsivity to extracellular matrix nanostructure signaling, porcine CMC could be useful for a preliminary evaluation of heart valve prosthetic functionality.
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Affiliation(s)
- Rosa Di Liddo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova; Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling ONLUS
| | - Paola Aguiari
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Silvia Barbon
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova; Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling ONLUS
| | - Thomas Bertalot
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova
| | - Amit Mandoli
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova
| | - Alessia Tasso
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova
| | - Sandra Schrenk
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova
| | - Laura Iop
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Alessandro Gandaglia
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Pier Paolo Parnigotto
- Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling ONLUS
| | - Maria Teresa Conconi
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova; Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling ONLUS
| | - Gino Gerosa
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
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Gallo M, Bonetti A, Poser H, Naso F, Bottio T, Bianco R, Paolin A, Franci P, Busetto R, Frigo AC, Buratto E, Spina M, Marchini M, Ortolani F, Iop L, Gerosa G. Decellularized aortic conduits: could their cryopreservation affect post-implantation outcomes? A morpho-functional study on porcine homografts. Heart Vessels 2016; 31:1862-1873. [PMID: 27115146 DOI: 10.1007/s00380-016-0839-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/15/2016] [Indexed: 12/30/2022]
Abstract
Decellularized porcine aortic valve conduits (AVCs) implanted in a Vietnamese Pig (VP) experimental animal model were matched against decellularized and then cryopreserved AVCs to assess the effect of cryopreservation on graft hemodynamic performance and propensity to in vivo repopulation by host's cells. VPs (n = 12) underwent right ventricular outflow tract substitution using AVC allografts and were studied for 15-month follow-up. VPs were randomized into two groups, receiving AVCs treated with decellularization alone (D; n = 6) or decellularization/cryopreservation (DC; n = 6), respectively. Serial echocardiography was carried out to follow up hemodynamic function. All explanted AVCs were processed for light and electron microscopy. No signs of dilatation, progressive stenosis, regurgitation, and macroscopic calcification were echocardiographically observed in both D and DC groups. Explanted D grafts exhibited near-normal features, whereas the presence of calcification, inflammatory infiltrates, and disarray of elastic lamellae occurred in some DC grafts. In the unaltered regions of AVCs from both groups, almost complete re-endothelialization was observed for both valve cusps and aorta walls. In addition, side-by-side repopulation by recipient's fibroblasts, myofibroblasts, and smooth muscle cells was paralleled by ongoing tissue remodeling, as revealed by the ultrastructural identification of typical canals of collagen fibrillogenesis and elastogenesis-related features. Incipient neo-vascularization and re-innervation of medial and adventitial tunicae of grafted aortic walls were also detected for both D and DC groups. Cryopreservation did not affect post-implantation AVC hemodynamic behavior and was topically propensive to cell repopulation and tissue renewal, although graft deterioration including calcification was present in several areas. Thus, these preliminary data provide essential information on feasibility of decellularization and cryopreservation coupling in the perspective of treatment optimization and subsequent clinical trials using similarly treated human allografts as innovative heart valve substitutes.
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Affiliation(s)
- Michele Gallo
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35128, Padua, Italy.
| | - Antonella Bonetti
- Department of Experimental and Clinical Medicine, University of Udine, Udine, Italy
| | - Helen Poser
- Department of Animal Medicine, Productions and Health, University of Padua, Legnaro, Italy
| | - Filippo Naso
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Tomaso Bottio
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Roberto Bianco
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35128, Padua, Italy
| | - Adolfo Paolin
- Tissue Bank of Veneto Region, Treviso Regional Hospital, Treviso, Italy
| | - Paolo Franci
- Department of Animal Medicine, Productions and Health, University of Padua, Legnaro, Italy
| | - Roberto Busetto
- Department of Animal Medicine, Productions and Health, University of Padua, Legnaro, Italy
| | - Anna Chiara Frigo
- Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology and Public Health Unit, University of Padua, Padua, Italy
| | - Edward Buratto
- Department of Cardiothoracic Surgery, Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Australia
| | - Michele Spina
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Maurizio Marchini
- Department of Experimental and Clinical Medicine, University of Udine, Udine, Italy
| | - Fulvia Ortolani
- Department of Experimental and Clinical Medicine, University of Udine, Udine, Italy
| | - Laura Iop
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35128, Padua, Italy.,Cardiovascular Regenerative Medicine, Venetian Institute of Molecular Medicine (VIMM), Biomedical Campus Pietro d'Abano, Padua, Italy
| | - Gino Gerosa
- Division of Cardiac Surgery, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35128, Padua, Italy.,Cardiovascular Regenerative Medicine, Venetian Institute of Molecular Medicine (VIMM), Biomedical Campus Pietro d'Abano, Padua, Italy
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Patanè S. Is there a need for bacterial endocarditis prophylaxis in patients undergoing urological procedures? J Cardiovasc Transl Res 2014; 7:369-71. [PMID: 24566724 DOI: 10.1007/s12265-014-9550-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 02/12/2014] [Indexed: 02/03/2023]
Abstract
Heart valve repair or replacement is a serious problem.The focused update on infective endocarditis of American College of Cardiology/American Heart Association 2008 (ACC/AHA guidelines) and Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009) of the European Society of Cardiology (ESC guidelines) describe prophylaxis against infective endocarditis as not recommended for urinary tract procedures in the absence of active infection. A statistical association has been recently shown between urological procedures and the development of infective endocarditis. New evidences concerning infective endocarditis due to Actinobaculum schaalii, Neisseria gonorrhoeae, Streptococcus agalactiae, Enterococcus faecalis, Pseudomonas aeruginosa, Aerococci and Staphylococcus aureus, and new findings indicate there is a need for bacterial endocarditis prophylaxis in patients undergoing urological procedures especially in elderly patients and in cancer and immunocompromised patients, to avoid serious consequences.
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Affiliation(s)
- Salvatore Patanè
- Cardiologia Ospedale San Vincenzo, Taormina (Me) Azienda Sanitaria Provinciale di Messina, Contrada Sirina, 98039, Taormina, Messina, Italy, patane-@libero.it
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Is there a need for bacterial endocarditis prophylaxis in patients undergoing gastrointestinal endoscopy? J Cardiovasc Transl Res 2014; 7:372-4. [PMID: 24566725 DOI: 10.1007/s12265-014-9553-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 02/14/2014] [Indexed: 12/13/2022]
Abstract
Heart valve repair or replacement is a serious problem. Patients can benefit from an open dialogue between both cardiologists and gastroenterologists for the optimal effective patients care. The focused update on infective endocarditis of the American College of Cardiology/American Heart Association 2008 (ACC/AHA guidelines) and guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009) of the European Society of Cardiology (ESC guidelines) describe prophylaxis against infective endocarditis (IE) as not recommended for gastroscopy and colonoscopy in the absence of active infection but increasing evidence suggests that the role of IE antibiotic prophylaxis remains a dark side of the cardio-oncology prevention. New evidences concerning infective endocarditis due to Streptococcus bovis, Streptococcus agalactiae, Enterococcus faecalis, Enterococcus faecium, Enterococcus durans, and new findings indicate that there is a need for bacterial endocarditis prophylaxis in patients undergoing gastrointestinal endoscopy especially in elderly patients and in cancer and immunocompromised patients, to avoid serious consequences.
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