1
|
Jin Q, Yu C, Xu L, Zhang G, Ju J, Hou R. Combined light-cured and sacrificial hydrogels for fabrication of small-diameter bionic vessels by 3D bioprinting. Technol Health Care 2023:THC220393. [PMID: 36872804 DOI: 10.3233/thc-220393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
BACKGROUND Bionic grafts can replace autologous tissue through tissue engineering in cases of cardiovascular disease. However, small-diameter vessel grafts remain challenging to precellularize. OBJECTIVE Bionic small-diameter vessels with endothelial and smooth muscle cells (SMCs) manufactured with a novel approach. METHODS A 1-mm-diameter bionic blood vessel was constructed by combining light-cured hydrogel gelatin-methacryloyl (GelMA) with sacrificial hydrogel Pluronic F127. Mechanical properties of GelMA (Young's modulus and tensile stress) were tested. Cell viability and proliferation were detected using Live/dead staining and CCK-8 assays, respectively. The histology and function of the vessels were observed using hematoxylin and eosin and immunofluorescence staining. RESULTS GelMA and Pluronic were printed together using extrusion. The temporary Pluronic support was removed by cooling during GelMA crosslinking, yielding a hollow tubular construct. A bionic bilayer vascular structure was fabricated by loading SMCs into the GelMA bioink, followed by perfusion with endothelial cells. In the structure, both cell types maintained good cell viability. The vessel showed good histological morphology and function. CONCLUSION Using light-cured and sacrificial hydrogels, we formed a small ca bionic vessel with a small caliber containing SMCs and endothelial cells, demonstrating an innovative approach for construction of bionic vascular tissues.
Collapse
Affiliation(s)
- Qianheng Jin
- Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China.,Suzhou Ruihua Orthopedic Hospital, Suzhou, Jiangsu, China.,Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Chenghao Yu
- Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China.,Suzhou Ruihua Orthopedic Hospital, Suzhou, Jiangsu, China.,Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Lei Xu
- Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China.,Suzhou Ruihua Orthopedic Hospital, Suzhou, Jiangsu, China
| | - Guangliang Zhang
- Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China.,Suzhou Ruihua Orthopedic Hospital, Suzhou, Jiangsu, China
| | - Jihui Ju
- Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China.,Suzhou Ruihua Orthopedic Hospital, Suzhou, Jiangsu, China
| | - Ruixing Hou
- Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China.,Suzhou Ruihua Orthopedic Hospital, Suzhou, Jiangsu, China
| |
Collapse
|
2
|
Jin Q, Guangzhe J, Ju J, Xu L, Tang L, Fu Y, Hou R, Atala A, Zhao W. Bioprinting small-diameter vascular vessel with endothelium and smooth muscle by the approach of two-step crosslinking process. Biotechnol Bioeng 2022; 119:1673-1684. [PMID: 35244205 PMCID: PMC9314886 DOI: 10.1002/bit.28075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/20/2022] [Accepted: 02/26/2022] [Indexed: 11/30/2022]
Abstract
Three‐dimensional bioprinting shows great potential for autologous vascular grafts due to its simplicity, accuracy, and flexibility. The 6‐mm‐diameter vascular grafts are used in clinic. However, producing small‐diameter vascular grafts are still an enormous challenge. Normally, sacrificial hydrogels are used as temporary lumen support to mold tubular structure which will affect the stability of the fabricated structure. In this study, we have developed a new bioprinting approach to fabricating small‐diameter vessel using two‐step crosslinking process. The ¼ lumen wall of bioprinted gelatin mechacrylate (GelMA) flat structure was exposed to ultraviolet (UV) light briefly for gaining certain strength, while ¾ lumen wall showed as concave structure which remained uncrosslinked. Precrosslinked flat structure was merged towards the uncrosslinked concave structure. Two individual structures were combined tightly into an intact tubular structure after receiving more UV exposure time. Complicated tubular structures were constructed by these method. Notably, the GelMA‐based bioink loaded with smooth muscle cells are bioprinted to form the outer layer of the tubular structure and human umbilical vein endothelial cells were seeded onto the inner surface of the tubular structure. A bionic vascular vessel with dual layers was fabricated successfully, and kept good viability and functionality. This study may provide a novel idea for fabricating biomimetic vascular network or other more complicated organs.
Collapse
Affiliation(s)
- Qianheng Jin
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.,Department of Hand surgery, Ruihua affiliated hospital of Soochow University, Suzhou, China
| | - Jin Guangzhe
- Department of Hand surgery, Ruihua affiliated hospital of Soochow University, Suzhou, China
| | - Jihui Ju
- Department of Hand surgery, Ruihua affiliated hospital of Soochow University, Suzhou, China
| | - Lei Xu
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.,Department of Hand surgery, Ruihua affiliated hospital of Soochow University, Suzhou, China
| | - Linfeng Tang
- Department of Hand surgery, Ruihua affiliated hospital of Soochow University, Suzhou, China
| | - Yi Fu
- Department of Human Anatomy, Histology and Embryology, School of Biology and Basic Medical Sciences, Soochow University, Suzhou, China
| | - Ruixing Hou
- Department of Hand surgery, Ruihua affiliated hospital of Soochow University, Suzhou, China
| | - Anthony Atala
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Weixin Zhao
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| |
Collapse
|
3
|
Mallis P, Michalopoulos E, Stavropoulos-Giokas C. Modern Approaches in Cardiovascular Disease Therapeutics: From Molecular Genetics to Tissue Engineering. Bioengineering (Basel) 2021; 8:bioengineering8110174. [PMID: 34821740 PMCID: PMC8614975 DOI: 10.3390/bioengineering8110174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/03/2021] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular disease (CVD) currently represents one of the leading causes of death worldwide. It is estimated that more than 17.9 million people die each year due to CVD manifestations. Often, occlusion or stenosis of the vascular network occurs, either in large- or small-diameter blood vessels. Moreover, the obstruction of small vessels such as the coronary arteries may be related to more pronounced events, which can be life-threatening. The gold standard procedure utilizes the transplantation of secondary vessels or the use of synthetic vascular grafts. However, significant adverse reactions have accompanied the use of the above grafts. Therefore, modern therapeutic strategies must be evaluated for better disease administration. In the context of alternative therapies, advanced tissue-engineering approaches including the decellularization procedure and the 3D additive bioprinting methods, have been proposed. In this way the availability of bioengineered vascular grafts will be increased, covering the great demand that exists globally. In this Special Issue of Bioengineering, we tried to highlight the modern approaches which are focused on CVD therapeutics. This issue includes articles related to the efficient development of vascular grafts, 3D printing approaches and suitable atherosclerosis models.
Collapse
Affiliation(s)
- Panagiotis Mallis
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece
| | - Efstathios Michalopoulos
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece
| | - Catherine Stavropoulos-Giokas
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece
| |
Collapse
|
4
|
Mallis P, Sokolis DP, Katsimpoulas M, Kostakis A, Stavropoulos-Giokas C, Michalopoulos E. Improved Repopulation Efficacy of Decellularized Small Diameter Vascular Grafts Utilizing the Cord Blood Platelet Lysate. Bioengineering (Basel) 2021; 8:bioengineering8090118. [PMID: 34562940 PMCID: PMC8467559 DOI: 10.3390/bioengineering8090118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The development of functional bioengineered small-diameter vascular grafts (SDVGs), represents a major challenge of tissue engineering. This study aimed to evaluate the repopulation efficacy of biological vessels, utilizing the cord blood platelet lysate (CBPL). METHODS Human umbilical arteries (hUAs, n = 10) were submitted to decellularization. Then, an evaluation of decellularized hUAs, involving histological, biochemical and biomechanical analysis, was performed. Wharton's Jelly (WJ) Mesenchymal Stromal Cells (MSCs) were isolated and characterized for their properties. Then, WJ-MSCs (1.5 × 106 cells) were seeded on decellularized hUAs (n = 5) and cultivated with (Group A) or without the presence of the CBPL, (Group B) for 30 days. Histological analysis involving immunohistochemistry (against Ki67, for determination of cell proliferation) and indirect immunofluorescence (against activated MAP kinase, additional marker for cell growth and proliferation) was performed. RESULTS The decellularized hUAs retained their initial vessel's properties, in terms of key-specific proteins, the biochemical and biomechanical characteristics were preserved. The evaluation of the repopulation process indicated a more uniform distribution of WJ-MSCs in group A compared to group B. The repopulated vascular grafts of group B were characterized by greater Ki67 and MAP kinase expression compared to group A. CONCLUSION The results of this study indicated that the CBPL may improve the repopulation efficacy, thus bringing the biological SDVGs one step closer to clinical application.
Collapse
Affiliation(s)
- Panagiotis Mallis
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece; (C.S.-G.); (E.M.)
- Correspondence: ; Tel.: +30-2106597331 or +30-6971616467; Fax: +30-210-6597345
| | - Dimitrios P. Sokolis
- Laboratory of Biomechanics, Center for Experimental Surgery, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece;
| | - Michalis Katsimpoulas
- Center of Experimental Surgery and Translational Research, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece; (M.K.); (A.K.)
| | - Alkiviadis Kostakis
- Center of Experimental Surgery and Translational Research, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece; (M.K.); (A.K.)
| | - Catherine Stavropoulos-Giokas
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece; (C.S.-G.); (E.M.)
| | - Efstathios Michalopoulos
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece; (C.S.-G.); (E.M.)
| |
Collapse
|
5
|
Shen N, Zhang Y, Raza A, Chang L, Wang JY. Effects of the micro/nanostructure of electrospun zein fibres on cells in simulated blood flow environment. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 122:111900. [PMID: 33641903 DOI: 10.1016/j.msec.2021.111900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 11/21/2020] [Accepted: 01/17/2021] [Indexed: 12/14/2022]
Abstract
In order to prevent thrombosis, reduce intima hyperplasia, and to maintain long-term patency after implantation of an artificial blood vessel, the formation of intact endothelial cells layer on an inner surface of graft is desirable. The present study aimed to improve endothelial cell adhesion by regulating the morphology of the inner surface of artificial blood vessels. Zein fibre membranes with three fibre diameters (small, ~100 nm; medium, ~500 nm; and large, ~1000 nm) were constructed by electrospinning. A flow chamber device was designed to simulate the blood flow environment. The morphology and adhesion of human umbilical vein fusion cells (EA.hy926) on the surface of the fibre membranes were studied under a shear stress of approximately 15 dynes/cm2. The results showed that oriented electrospun zein fibre surfaces with both medium- and large-diameter fibres can regulate the morphology of endothelial cells (EA.hy926), which are aligned by the fibre direction. The three fibre membranes improved the adhesion of endothelial cells significantly compared to that on the flat membrane. When the fibre direction was fixed parallel to the fluid direction, the medium-diameter oriented-fibre membrane could significantly improve the ability endothelial cells to resist shear stress, and there was a significant difference at 1, 2 and 4 h time points compared with the shear stress resistance on the small-diameter and large-diameter oriented-fibre membranes. When the fibre direction was perpendicular to the fluid direction, again the medium-diameter oriented-fibre membrane improved the ability of endothelial cells to resist shear stress significantly at 1 and 2 h time points. It was concluded that by changing the diameter and arrangement of electrospun fibres, cell morphology control and shear stress resistance can be achieved.
Collapse
Affiliation(s)
- Naian Shen
- School of Biomedical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Yue Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Ali Raza
- School of Biomedical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Liu Chang
- School of Biomedical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Jin-Ye Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China.
| |
Collapse
|
6
|
Mallis P, Kostakis A, Stavropoulos-Giokas C, Michalopoulos E. Future Perspectives in Small-Diameter Vascular Graft Engineering. Bioengineering (Basel) 2020; 7:E160. [PMID: 33321830 PMCID: PMC7763104 DOI: 10.3390/bioengineering7040160] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/04/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023] Open
Abstract
The increased demands of small-diameter vascular grafts (SDVGs) globally has forced the scientific society to explore alternative strategies utilizing the tissue engineering approaches. Cardiovascular disease (CVD) comprises one of the most lethal groups of non-communicable disorders worldwide. It has been estimated that in Europe, the healthcare cost for the administration of CVD is more than 169 billion €. Common manifestations involve the narrowing or occlusion of blood vessels. The replacement of damaged vessels with autologous grafts represents one of the applied therapeutic approaches in CVD. However, significant drawbacks are accompanying the above procedure; therefore, the exploration of alternative vessel sources must be performed. Engineered SDVGs can be produced through the utilization of non-degradable/degradable and naturally derived materials. Decellularized vessels represent also an alternative valuable source for the development of SDVGs. In this review, a great number of SDVG engineering approaches will be highlighted. Importantly, the state-of-the-art methodologies, which are currently employed, will be comprehensively presented. A discussion summarizing the key marks and the future perspectives of SDVG engineering will be included in this review. Taking into consideration the increased number of patients with CVD, SDVG engineering may assist significantly in cardiovascular reconstructive surgery and, therefore, the overall improvement of patients' life.
Collapse
Affiliation(s)
- Panagiotis Mallis
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece; (C.S.-G.); (E.M.)
| | - Alkiviadis Kostakis
- Center of Experimental Surgery and Translational Research, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece;
| | - Catherine Stavropoulos-Giokas
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece; (C.S.-G.); (E.M.)
| | - Efstathios Michalopoulos
- Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, 4 Soranou Ephessiou Street, 115 27 Athens, Greece; (C.S.-G.); (E.M.)
| |
Collapse
|
7
|
Xu L, Varkey M, Jorgensen A, Ju J, Jin Q, Park JH, Fu Y, Zhang G, Ke D, Zhao W, Hou R, Atala A. Bioprinting small diameter blood vessel constructs with an endothelial and smooth muscle cell bilayer in a single step. Biofabrication 2020; 12:045012. [DOI: 10.1088/1758-5090/aba2b6] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
8
|
Regan R, Sampath KK, Devan H, Arumugam A. Effectiveness of physiotherapy interventions on disease-specific and generic outcomes for individuals with cardiovascular diseases in India – a systematic review and Meta-analysis. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1792204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Raja Regan
- PSG College of Physiotherapy, Coimbatore, Tamil Nadu, India
| | - Kesava Kovanur Sampath
- Department of Allied Health and Social Practice, Ara Institute of Canterbury, Christchurch, New Zealand
| | - Hemakumar Devan
- Centre for Health, Activity and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Wellington, New Zealand
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Adjunct Faculty, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Adjunct Faculty, Department of Physiotherapy, Binawan University, Jakarta, Indonesia
| |
Collapse
|
9
|
Fusaro L, Calvo Catoira M, Ramella M, Sacco Botto F, Talmon M, Fresu LG, Hidalgo-Bastida A, Boccafoschi F. Polylysine Enriched Matrices: A Promising Approach for Vascular Grafts. Front Bioeng Biotechnol 2020; 8:281. [PMID: 32318560 PMCID: PMC7147808 DOI: 10.3389/fbioe.2020.00281] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 03/17/2020] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular diseases represent the leading cause of death in developed countries. Modern surgical methods show poor efficiency in the substitution of small-diameter arteries (<6 mm). Due to the difference in mechanical properties between the native artery and the substitute, the behavior of the vessel wall is a major cause of inefficient substitutions. The use of decellularized scaffolds has shown optimal prospects in different applications for regenerative medicine. The purpose of this work was to obtain polylysine-enriched vascular substitutes, derived from decellularized porcine femoral and carotid arteries. Polylysine acts as a matrix cross-linker, increasing the mechanical resistance of the scaffold with respect to decellularized vessels, without altering the native biocompatibility and hemocompatibility properties. The biological characterization showed an excellent biocompatibility, while mechanical tests displayed that the Young's modulus of the polylysine-enriched matrix was comparable to native vessel. Burst pressure test demonstrated strengthening of the polylysine-enriched matrix, which can resist to higher pressures with respect to native vessel. Mechanical analyses also show that polylysine-enriched vessels presented minimal degradation compared to native. Concerning hemocompatibility, the performed analyses show that polylysine-enriched matrices increase coagulation time, with respect to commercial Dacron vascular substitutes. Based on these findings, polylysine-enriched decellularized vessels resulted in a promising approach for vascular substitution.
Collapse
Affiliation(s)
- Luca Fusaro
- Department of Health Sciences, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy.,Tissuegraft srl, Novara, Italy
| | - Marta Calvo Catoira
- Tissuegraft srl, Novara, Italy.,Center for Translational Research on Autoimmune and Allergic Diseases - CAAD, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Martina Ramella
- Department of Health Sciences, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy.,Tissuegraft srl, Novara, Italy
| | - Federico Sacco Botto
- Physiology and Experimental Surgery, Department of Translational Medicine, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Maria Talmon
- Department of Health Sciences, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Luigia Grazia Fresu
- Department of Health Sciences, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy
| | - Araida Hidalgo-Bastida
- Centre for Bioscience, Manchester Metropolitan University, Manchester, United Kingdom.,Centre for Advanced Materials and Surface Engineering, Manchester Metropolitan University, Manchester, United Kingdom.,Centre for Musculoskeletal Science and Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| | - Francesca Boccafoschi
- Department of Health Sciences, University of Eastern Piedmont Amedeo Avogadro, Novara, Italy.,Tissuegraft srl, Novara, Italy
| |
Collapse
|
10
|
Jin D, Hu J, Xia D, Liu A, Kuang H, Du J, Mo X, Yin M. Evaluation of a simple off-the-shelf bi-layered vascular scaffold based on poly(L-lactide-co-ε-caprolactone)/silk fibroin in vitro and in vivo. Int J Nanomedicine 2019; 14:4261-4276. [PMID: 31289441 PMCID: PMC6565934 DOI: 10.2147/ijn.s205569] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/01/2019] [Indexed: 12/20/2022] Open
Abstract
Purpose: In the field of small-caliber vascular scaffold research, excellent vascular remodeling is the key to ensuring anticoagulant function. We prepared an off-the-shelf bi-layered vascular scaffold with a dense inner layer and a loose outer layer and evaluated its remodeling capabilities by in vivo transplantation. Materials and Methods: Based on poly(L-lactide-co-ε-caprolactone) (PLCL), silk fibroin(SF), and heparin (Hep), PLCL/SF/Hep bi-layered scaffolds and PLCL/Hep bi-layered scaffolds were prepared by electrospinning. The inner layer was a PLCL/SF/Hep or PLCL/Hep nanofiber membrane, and the outer layer was PLCL/SF nano yarn. The in vitro tests included a hydrophilicity test, mechanical properties test, and blood and cell compatibility evaluation. The in vivo evaluation was conducted via single rabbit carotid artery replacement and subsequent examinations, including ultrasound imaging, immunoglobulin assays, and tissue section staining. Results: Compared to the PLCL/Hep nanofiber membrane, the hydrophilicity of the PLCL/SF/Hep nanofiber membrane was significantly improved. The mechanical strength met application requirements. Both the blood and cell compatibility were optimal. Most importantly, the PLCL/SF/Hep scaffolds maintained lumen patency for 3 months after carotid artery transplantation in live rabbits. At the same time, CD31 and α-SMA immunofluorescence staining confirmed bionic endothelial and smooth muscle layers remodeling. Conclusion: Using this hybrid strategy, PLCL and SF were combined to manufacture bi-layered small-caliber vascular scaffolds; these PLCL/SF/Hep scaffolds showed satisfactory vascular remodeling.
Collapse
Affiliation(s)
- Dawei Jin
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
| | - Junfeng Hu
- State Key Lab for Modification of Chemical Fibers and Polymer Materials, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, People's Republic of China
| | - Dekai Xia
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
| | - A'li Liu
- Imaging Diagnosis Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
| | - Haizhu Kuang
- State Key Lab for Modification of Chemical Fibers and Polymer Materials, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, People's Republic of China
| | - Jun Du
- Imaging Diagnosis Center, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
| | - Xiumei Mo
- State Key Lab for Modification of Chemical Fibers and Polymer Materials, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai 201620, People's Republic of China
| | - Meng Yin
- Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, People's Republic of China
| |
Collapse
|
11
|
Yang J, Wei K, Wang Y, Li Y, Ding N, Huo D, Wang T, Yang G, Yang M, Ju T, Zeng W, Zhu C. Construction of a small-caliber tissue-engineered blood vessel using icariin-loaded β-cyclodextrin sulfate for in situ anticoagulation and endothelialization. SCIENCE CHINA-LIFE SCIENCES 2018; 61:1178-1188. [PMID: 30159681 DOI: 10.1007/s11427-018-9348-9] [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: 04/21/2018] [Accepted: 06/07/2018] [Indexed: 02/06/2023]
Abstract
The rapid endothelialization of tissue-engineered blood vessels (TEBVs) can effectively prevent thrombosis and inhibit intimal hyperplasia. The traditional Chinese medicine ingredient icariin is highly promising for the treatment of cardiovascular diseases. β-cyclodextrin sulfate is a type of hollow molecule that has good biocompatibility and anticoagulation properties and exhibits a sustained release of icariin. We studied whether icariin-loaded β-cyclodextrin sulfate can promote the endothelialization of TEBVs. The experimental results showed that icariin could significantly promote the proliferation and migration of endothelial progenitor cells; at the same time, icariin could promote the migration of rat vascular endothelial cells (RAVECs). Subsequently, we used an electrostatic force to modify the surface of the TEBVs with icariin-loaded β-cyclodextrin sulfate, and these vessels were implanted into the rat common carotid artery. After 3 months, micro-CT results showed that the TEBVs modified using icariin-loaded β-cyclodextrin sulfate had a greater patency rate. Scanning electron microscopy (SEM) and CD31 immunofluorescence results showed a better degree of endothelialization. Taken together, icariin-loaded β-cyclodextrin sulfate can achieve anticoagulation and rapid endothelialization of TEBVs to ensure their long-term patency.
Collapse
Affiliation(s)
- Jingyuan Yang
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China
| | - Keyu Wei
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China
| | - Yeqin Wang
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China
| | - Yanzhao Li
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China
| | - Ning Ding
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China
| | - Da Huo
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China
| | - Tianran Wang
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China
| | - Guanyuan Yang
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China
| | - Mingcan Yang
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China
| | - Tan Ju
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China
| | - Weng Zeng
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China.
| | - Chuhong Zhu
- Department of Anatomy, State Key Laboratory of Trauma, Burn and Combined Injury, National & Regional Engineering Laboratory of Tissue Engineering, State and Local Joint Engineering Laboratory for Vascular Implants, Key Lab for Biomechanics and Tissue Engineering of Chongqing, Third Military Medical University, Chongqing, 400038, China.
| |
Collapse
|
12
|
Feinstein MJ, Kim JH, Bibangambah P, Sentongo R, Martin JN, Tsai AC, Bangsberg DR, Hemphill L, Triant VA, Boum Y, Hunt PW, Okello S, Siedner MJ. Ideal Cardiovascular Health and Carotid Atherosclerosis in a Mixed Cohort of HIV-Infected and Uninfected Ugandans. AIDS Res Hum Retroviruses 2017; 33:49-56. [PMID: 27476547 DOI: 10.1089/aid.2016.0104] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Preventable cardiovascular disease (CVD) risk factors are responsible for the majority of CVD-related deaths, and are increasingly recognized as a cause of morbidity and mortality for HIV-infected persons taking antiretroviral therapy (ART). Simplified tools such as the American Heart Association's ideal cardiovascular health (iCVH) construct may identify and prognosticate CVD risk in resource-limited settings. No studies have evaluated iCVH metrics in sub-Saharan Africa or among HIV-infected adults. Thus, the central aim of this study was to compare levels of iCVH metrics and their correlations with carotid atherosclerosis for HIV-infected adults versus uninfected controls in a well-phenotyped Ugandan cohort. We analyzed the prevalence of iCVH metrics in a mixed cohort of HIV-infected persons on stable ART and uninfected, population-based comparators in Mbarara, Uganda. We also assessed the validity of iCVH by correlating iCVH values with common carotid intima media thickness (CCIMT). HIV-infected persons had a mean of 4.9 (SD 1.1) iCVH metrics at ideal levels versus 4.3 (SD 1.2) for uninfected controls (p = .002). This difference was largely driven by differences in blood pressure, blood glucose, and diet. In multivariable-adjusted linear regression models, each additional iCVH metric at an ideal level was associated with a significant 0.024 mm decrease in CCIMT (p < .001).HIV-infected persons on ART in rural Uganda had more iCVH metrics at ideal levels than uninfected persons. The difference appeared driven by factors that are putatively influenced by access to routine medical care. Composite scores of iCVH metrics were associated with subclinical atherosclerosis and more predictive of atherosclerosis for uninfected persons.
Collapse
Affiliation(s)
- Matthew J. Feinstein
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - June-Ho Kim
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Prossy Bibangambah
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Ruth Sentongo
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Jeffrey N. Martin
- Division of Infectious Diseases, Department of Medicine, University of California-San Francisco, San Francisco, California
| | - Alexander C. Tsai
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts
| | - David R. Bangsberg
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Linda Hemphill
- Harvard Medical School, Boston, Massachusetts
- Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Virginia A. Triant
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Yap Boum
- Epicentre Research Base, Mbarara, Uganda
| | - Peter W. Hunt
- Division of Infectious Diseases, Department of Medicine, University of California-San Francisco, San Francisco, California
| | - Samson Okello
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mark J. Siedner
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
13
|
Babu AS, Lopez-Jimenez F, Thomas RJ, Isaranuwatchai W, Herdy AH, Hoch JS, Grace SL. Advocacy for outpatient cardiac rehabilitation globally. BMC Health Serv Res 2016; 16:471. [PMID: 27600379 PMCID: PMC5013580 DOI: 10.1186/s12913-016-1658-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 08/11/2016] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) are the leading cause of death globally. Cardiac rehabilitation (CR) is an evidence-based intervention recommended for patients with CVD, to prevent recurrent events and to improve quality of life. However, despite the proven benefits, only a small percentage of those would benefit from CR actually receive it worldwide. This paper by the International Council of Cardiovascular Prevention and Rehabilitation forwards the groundwork for successful CR advocacy to achieve broader reimbursement, and hence implementation. METHODS First, the results of the International Council's survey on national CR reimbursement policies by government and insurance companies are summarized. Second, a multi-faceted approach to CR advocacy is forwarded. Finally, as per the advocacy recommendations, the economic impact of CVD and the corresponding benefits of CR and its cost-effectiveness are summarized. This provides the case for CR reimbursement advocacy. RESULTS Thirty-one responses were received, from 25 different countries: 18 (58.1 %) were from high-income countries, 10 (32.4 %) from upper middle-income, and 3 (9.9 %) from lower middle-income countries. When asked who reimburses at least some portion of CR services in their country, 19 (61.3 %) reported the government, 17 (54.8 %) reported patients pay out-of-pocket, 16 (51.6 %) reported insurance companies, 12 (38.7 %) reported that it is shared between the patient and another source, and 7 (22.6 %) reported another source. CONCLUSIONS Many patients pay out-of-pocket for CR. CR reimbursement around the world is inconsistent and insufficient. Advocacy campaigns forwarding the CR cause, supported by the relevant literature, enlisting sources of support in a unified manner with an organized plan, are needed, and must be pursued persistently.
Collapse
Affiliation(s)
- Abraham Samuel Babu
- Department of Physiotherapy, School of Allied Health Sciences, Manipal University, Manipal, 576104 Karnataka India
| | - Francisco Lopez-Jimenez
- Preventive Cardiology Program, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN USA
| | - Randal J. Thomas
- Preventive Cardiology Program, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN USA
| | - Wanrudee Isaranuwatchai
- Centre for Excellence in Economic Analysis Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto, M5B 1 W8 ON Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, M5T 3 M7 ON Canada
| | - Artur Haddad Herdy
- Institute of Cardiology of Santa Catarina, Universidade e do Sul de Santa Catarina, Palhoça, Brazil
| | - Jeffrey S. Hoch
- Centre for Excellence in Economic Analysis Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto, M5B 1 W8 ON Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, M5T 3 M7 ON Canada
| | - Sherry L. Grace
- School of Kinesiology and Health Science, York University, Bethune 368, York University, 4700 Keele Street, Toronto, M3J 1P3 ON Canada
- Toronto Western Hospital, GoodLife Fitness Cardiovascular Rehabilitation Unit, University Health Network, Toronto, ON Canada
| | - in conjunction with the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR)
- Department of Physiotherapy, School of Allied Health Sciences, Manipal University, Manipal, 576104 Karnataka India
- Preventive Cardiology Program, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN USA
- Centre for Excellence in Economic Analysis Research, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond Street, Toronto, M5B 1 W8 ON Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, M5T 3 M7 ON Canada
- Institute of Cardiology of Santa Catarina, Universidade e do Sul de Santa Catarina, Palhoça, Brazil
- School of Kinesiology and Health Science, York University, Bethune 368, York University, 4700 Keele Street, Toronto, M3J 1P3 ON Canada
- Toronto Western Hospital, GoodLife Fitness Cardiovascular Rehabilitation Unit, University Health Network, Toronto, ON Canada
| |
Collapse
|