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Bačáková L, Chlupáč J, Filová E, Musílková J, Tomšů J, Wu YC, Svobodová L, Pražák Š, Brož A. Vascular Damage and Repair - Are Small-Diameter Vascular Grafts Still the "Holy Grail" of Tissue Engineering? Physiol Res 2024; 73:S335-S363. [PMID: 38836460 PMCID: PMC11412351 DOI: 10.33549/physiolres.935294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Cardiovascular diseases are the most important cause of morbidity and mortality in the civilized world. Stenosis or occlusion of blood vessels leads not only to events that are directly life-threatening, such as myocardial infarction or stroke, but also to a significant reduction in quality of life, for example in lower limb ischemia as a consequence of metabolic diseases. The first synthetic polymeric vascular replacements were used clinically in the early 1950s. However, they proved to be suitable only for larger-diameter vessels, where the blood flow prevents the attachment of platelets, pro-inflammatory cells and smooth muscle cells on their inner surface, whereas in smaller-diameter grafts (6 mm or less), these phenomena lead to stenosis and failure of the graft. Moreover, these polymeric vascular replacements, like biological grafts (decellularized or devitalized), are cell-free, i.e. there are no reconstructed physiological layers of the blood vessel wall, i.e. an inner layer of endothelial cells to prevent thrombosis, a middle layer of smooth muscle cells to perform the contractile function, and an outer layer to provide innervation and vascularization of the vessel wall. Vascular substitutes with these cellular components can be constructed by tissue engineering methods. However, it has to be admitted that even about 70 years after the first polymeric vascular prostheses were implanted into human patients, there are still no functional small-diameter vascular grafts on the market. The damage to small-diameter blood vessels has to be addressed by endovascular approaches or by autologous vascular substitutes, which leads to some skepticism about the potential of tissue engineering. However, new possibilities of this approach lie in the use of modern technologies such as 3D bioprinting and/or electrospinning in combination with stem cells and pre-vascularization of tissue-engineered vascular grafts. In this endeavor, sex-related differences in the removal of degradable biomaterials by the cells and in the behavior of stem cells and pre-differentiated vascular cells need to be taken into account. Key words: Blood vessel prosthesis, Regenerative medicine, Stem cells, Footprint-free iPSCs, sr-RNA, Dynamic bioreactor, Sex-related differences.
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Affiliation(s)
- L Bačáková
- Laboratory of Biomaterials and Tissue Engineering, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic.
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Liu Y, Gao Z, Yu X, Lin W, Lian H, Meng Z. Recent Advances in the Fabrication and Performance Optimization of Polyvinyl Alcohol Based Vascular Grafts. Macromol Biosci 2024:e2400093. [PMID: 38801024 DOI: 10.1002/mabi.202400093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/11/2024] [Indexed: 05/29/2024]
Abstract
Cardiovascular disease is one of the diseases with the highest morbidity and mortality rates worldwide, and coronary artery bypass grafting (CABG) is a fast and effective treatment. More researchers are investigating in artificial blood vessels due to the limitations of autologous blood vessels. Despite the availability of large-diameter vascular grafts (Ø > 6 mm) for clinical use, small-diameter vascular grafts (Ø < 6 mm) have been a challenge for researchers to overcome in recent years. Vascular grafts made of polyvinyl alcohol (PVA) and PVA-based composites have excellent biocompatibility and mechanical characteristics. In order to gain a clearer and more specific understanding of the progress in PVA vascular graft research, particularly regarding the preparation methods, principles, and functionality of PVA vascular graft, this article discusses the mechanical properties, biocompatibility, blood compatibility, and other properties of PVA vascular graft prepared or enhanced with different blends using various techniques that mimic natural blood vessels. The findings reveal the feasibility and promising potential of PVA or PVA-based composite materials as vascular grafts.
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Affiliation(s)
- Yixuan Liu
- School of Medical Devices, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Zichun Gao
- School of Medical Devices, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Xinrong Yu
- School of Medical Devices, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Wenjiao Lin
- Qingmao Technology (Shenzhen) Co., LTD, Shenzhen, China
| | - He Lian
- School of Medical Devices, Shenyang Pharmaceutical University, Shenyang, 110016, China
| | - Zhaoxu Meng
- School of Medical Devices, Shenyang Pharmaceutical University, Shenyang, 110016, China
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Carrabba M, Fagnano M, Ghorbel MT, Rapetto F, Su B, De Maria C, Vozzi G, Biglino G, Perriman AW, Caputo M, Madeddu P. Development of a Novel Hierarchically Biofabricated Blood Vessel Mimic Decorated with Three Vascular Cell Populations for the Reconstruction of Small-Diameter Arteries. ADVANCED FUNCTIONAL MATERIALS 2024; 34:adfm.202300621. [PMID: 39257639 PMCID: PMC7616429 DOI: 10.1002/adfm.202300621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Indexed: 09/12/2024]
Abstract
The availability of grafts to replace small-diameter arteries remains an unmet clinical need. Here, the validated methodology is reported for a novel hybrid tissue-engineered vascular graft that aims to match the natural structure of small-size arteries. The blood vessel mimic (BVM) comprises an internal conduit of co-electrospun gelatin and polycaprolactone (PCL) nanofibers (corresponding to the tunica intima of an artery), reinforced by an additional layer of PCL aligned fibers (the internal elastic membrane). Endothelial cells are deposited onto the luminal surface using a rotative bioreactor. A bioprinting system extrudes two concentric cell-laden hydrogel layers containing respectively vascular smooth muscle cells and pericytes to create the tunica media and adventitia. The semi-automated cellularization process reduces the production and maturation time to 6 days. After the evaluation of mechanical properties, cellular viability, hemocompatibility, and suturability, the BVM is successfully implanted in the left pulmonary artery of swine. Here, the BVM showed good hemostatic properties, capability to withstand blood pressure, and patency at 5 weeks post-implantation. These promising data open a new avenue to developing an artery-like product for reconstructing small-diameter blood vessels.
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Affiliation(s)
- Michele Carrabba
- Bristol Heart Institute, School of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK
| | - Marco Fagnano
- Bristol Heart Institute, School of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK
| | - Mohamed T Ghorbel
- Bristol Heart Institute, School of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK
| | - Filippo Rapetto
- Bristol Heart Institute, School of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK
- Cardiac Surgery, University Hospitals Bristol, NHS Foundation Trust, Bristol BS2 8HW, UK
| | - Bo Su
- Bristol Dental School, University of Bristol, Bristol BS2 8HW, UK
| | - Carmelo De Maria
- Research Center "E. Piaggio", University of Pisa, Largo L. Lazzarino 1, 56122 Pisa, Italy
- Department of Information Engineering, University of Pisa, Via G. Caruso 16, 56122 Pisa, Italy
| | - Giovanni Vozzi
- Research Center "E. Piaggio", University of Pisa, Largo L. Lazzarino 1, 56122 Pisa, Italy
- Department of Information Engineering, University of Pisa, Via G. Caruso 16, 56122 Pisa, Italy
| | - Giovanni Biglino
- Bristol Heart Institute, School of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK
- Cardiorespiratory Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK
| | - Adam W Perriman
- School of Cellular and Molecular Medicine, University of Bristol, Bristol BS8 1TD, UK
| | - Massimo Caputo
- Bristol Heart Institute, School of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK
- Cardiac Surgery, University Hospitals Bristol, NHS Foundation Trust, Bristol BS2 8HW, UK
| | - Paolo Madeddu
- Bristol Heart Institute, School of Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK
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Sen I, Clouse WD, Lauria AL, Calderon DR, Anderson PB, DeMartino RR, Rasmussen TE. Outcomes of Arterial Bypass With the Human Acellular Vessel for Chronic Limb-Threatening Ischemia Performed Under the FDA Expanded Access Program. Mayo Clin Proc 2024; 99:57-68. [PMID: 37542500 DOI: 10.1016/j.mayocp.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/14/2023] [Accepted: 05/02/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE To report outcomes of the human acellular vessel (HAV) implanted for limb salvage through the Food and Drug Administration (FDA) Expanded Access Program for patients with chronic limb-threatening ischemia with no autologous conduit. METHODS The HAV is a bioengineered vascular conduit designed with human vascular smooth muscle cells. The product is under regulatory study. From April 2019 to November 2021, the HAV was implanted in 14 patients (12 men; mean age, 62±14 years) at 3 US centers. Each case was performed with a single-use investigational new drug Expanded Access Program issued by the FDA. Institutional review board approval was obtained; technical and clinical outcomes were analyzed. RESULTS A single 6-mm-diameter (40-cm-long) HAV was implanted in 9 patients; 5 patients required 2 HAVs sewn together as a composite. Technical success was 100%. Median follow-up was 12 (range, 1 to 41) months. Primary and secondary patency rates were 72% and 81% at 12 months; assisted primary patency was attained in 4 patients. Amputation-free survival was 93% at 6 months and 77% at 12 months. All patients with a patent HAV experienced clinical improvement with no HAV-related infections or adverse events. There were 4 deaths in the cohort, late mortality unrelated to the HAV. CONCLUSION The HAV is a safe and effective "off-the-shelf" biologic conduit. This experience from the FDA Expanded Access Program in this population with few alternative limb salvage options will help guide regulatory deliberations for patients with lower extremity ischemia and no autologous bypass conduit options.
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Affiliation(s)
- Indrani Sen
- Vascular and Endovascular Surgery, Mayo Clinic Health Systems, Eau Claire, WI
| | - W Darrin Clouse
- Division of Vascular and Endovascular Surgery, University of Virginia, Charlottesville, VA
| | - Alexis L Lauria
- Department of Surgery, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MD
| | - Daniel R Calderon
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Harrisburg, PA
| | - Peter B Anderson
- Division of Vascular and Endovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN
| | - Randall R DeMartino
- Division of Vascular and Endovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN
| | - Todd E Rasmussen
- Division of Vascular and Endovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN; Walter Reed National Military Medical Center, Bethesda, MD. https://twitter.com/@trasmussen_md
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Farazdaghi A, Sen I, Anderson PB, Shuja F, Rasmussen TE. The Human Acellular Vessel (HAV) as a vascular conduit for infrainguinal arterial bypass. J Vasc Surg Cases Innov Tech 2023; 9:101123. [PMID: 37674588 PMCID: PMC10477679 DOI: 10.1016/j.jvscit.2023.101123] [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: 01/04/2023] [Accepted: 01/24/2023] [Indexed: 09/08/2023] Open
Abstract
Autologous vein is the optimal conduit for peripheral arterial bypass surgery, a standard recently highlighted by findings from the BEST-CLI trial. The Human Acellular Vessel is a novel biologic conduit produced using regenerative medicine technologies with structural and mechanical properties like a human blood vessel. Not yet approved by the United States Food and Drug Administration, the Human Acellular Vessel is being studied as an alternative bypass conduit in patients with peripheral arterial disease, vascular injury, and those in need of arteriovenous access for hemodialysis. This report describes and illustrates the technical aspects of intraoperative handling specific to the use of this new and innovative technology.
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Affiliation(s)
- Armin Farazdaghi
- Division of Vascular and Endovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Indrani Sen
- Vascular and Endovascular Surgery, Mayo Clinic Health Systems, EauClaire, WI
| | - Peter B. Anderson
- Division of Vascular and Endovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Fahad Shuja
- Division of Vascular and Endovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Todd E. Rasmussen
- Division of Vascular and Endovascular Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
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Mir A, Lee E, Shih W, Koljaka S, Wang A, Jorgensen C, Hurr R, Dave A, Sudheendra K, Hibino N. 3D Bioprinting for Vascularization. Bioengineering (Basel) 2023; 10:bioengineering10050606. [PMID: 37237676 DOI: 10.3390/bioengineering10050606] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/27/2023] [Accepted: 05/07/2023] [Indexed: 05/28/2023] Open
Abstract
In the world of clinic treatments, 3D-printed tissue constructs have emerged as a less invasive treatment method for various ailments. Printing processes, scaffold and scaffold free materials, cells used, and imaging for analysis are all factors that must be observed in order to develop successful 3D tissue constructs for clinical applications. However, current research in 3D bioprinting model development lacks diverse methods of successful vascularization as a result of issues with scaling, size, and variations in printing method. This study analyzes the methods of printing, bioinks used, and analysis techniques in 3D bioprinting for vascularization. These methods are discussed and evaluated to determine the most optimal strategies of 3D bioprinting for successful vascularization. Integrating stem and endothelial cells in prints, selecting the type of bioink according to its physical properties, and choosing a printing method according to physical properties of the desired printed tissue are steps that will aid in the successful development of a bioprinted tissue and its vascularization.
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Affiliation(s)
- Amatullah Mir
- Section of Cardiac Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | - Eugenia Lee
- Section of Cardiac Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | - Wesley Shih
- Section of Cardiac Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | - Sarah Koljaka
- Section of Cardiac Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | - Anya Wang
- Section of Cardiac Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | - Caitlin Jorgensen
- Section of Cardiac Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | - Riley Hurr
- Section of Cardiac Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | - Amartya Dave
- Section of Cardiac Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | - Krupa Sudheendra
- Section of Cardiac Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
| | - Narutoshi Hibino
- Section of Cardiac Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA
- Pediatric Cardiac Surgery, Advocate Children's Hospital, 4440 W 95th St. Oak Lawn, IL 60453, USA
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Messner B, Grab M, Grefen L, Laufer G, Hagl C, König F. Cyclic pressure induced decellularization of porcine descending aortas. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2023; 34:19. [PMID: 37074546 PMCID: PMC10115674 DOI: 10.1007/s10856-023-06723-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 03/28/2023] [Indexed: 05/03/2023]
Abstract
The demand for decellularized xenogeneic tissues used in reconstructive heart surgery has increased over the last decades. Complete decellularization of longer and tubular aortic sections suitable for clinical application has not been achieved so far. The present study aims at analyzing the effect of pressure application on decellularization efficacy of porcine aortas using a device specifically designed for this purpose. Fresh porcine descending aortas of 8 cm length were decellularized using detergents. To increase decellularization efficacy, detergent treatment was combined with pressure application and different treatment schemes. Quantification of penetration depth as well as histological staining, scanning electron microscopy, and tensile strength tests were used to evaluate tissue structure. In general, application of pressure to aortic tissue does neither increase the decellularization success nor the penetration depth of detergents. However, it is of importance from which side of the aorta the pressure is applied. Application of intermittent pressure from the adventitial side does significantly increase the decellularization degree at the intimal side (compared to the reference group), but had no influence on the penetration depth of SDC/SDS at both sides. Although the present setup does not significantly improve the decellularization success of aortas, it is interesting that the application of pressure from the adventitial side leads to improved decellularization of the intimal side. As no adverse effects on tissue structure nor on mechanical properties were observed, optimization of the present protocol may potentially lead to complete decellularization of larger aortic segments.
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Affiliation(s)
- Barbara Messner
- Department of Cardiac Surgery, Ludwig Maximilians University, Munich, Germany.
- Cardiac Surgery Research Laboratory, Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
| | - Maximilian Grab
- Department of Cardiac Surgery, Ludwig Maximilians University, Munich, Germany
- Chair of Medical Materials and Implants, Technical University Munich, Munich, Germany
| | - Linda Grefen
- Department of Cardiac Surgery, Ludwig Maximilians University, Munich, Germany
| | - Günther Laufer
- Cardiac Surgery Research Laboratory, Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Christian Hagl
- Department of Cardiac Surgery, Ludwig Maximilians University, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner site Munich Heart Alliance, Munich, Germany
| | - Fabian König
- Department of Cardiac Surgery, Ludwig Maximilians University, Munich, Germany
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Adhami M, Martin NK, Maguire C, Courtenay AJ, Donnelly RF, Domínguez-Robles J, Larrañeta E. Drug loaded implantable devices to treat cardiovascular disease. Expert Opin Drug Deliv 2023; 20:507-522. [PMID: 36924328 DOI: 10.1080/17425247.2023.2190580] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
INTRODUCTION It is widely acknowledged that cardiovascular diseases (CVDs) continue to be the leading cause of death globally. Furthermore, CVDs are the leading cause of diminished quality of life for patients, frequently as a result of their progressive deterioration. Medical implants that release drugs into the body are active implants that do more than just provide mechanical support; they also have a therapeutic role. Primarily, this is achieved through the controlled release of active pharmaceutical ingredients (API) at the implementation site. AREAS COVERED In this review, the authors discuss drug-eluting stents, drug-eluting vascular grafts, and drug-eluting cardiac patches with the aim of providing a broad overview of the three most common types of cardiac implant. EXPERT OPINION Drug eluting implants are an ideal alternative to traditional drug delivery because they allow for accurate drug release, local drug delivery to the target tissue, and minimise the adverse side effects associated with systemic administration. Despite the fact that there are still challenges that need to be addressed, the ever-evolving new technologies are making the fabrication of drug eluting implants a rewarding therapeutic endeavour with the possibility for even greater advances.
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Affiliation(s)
| | | | | | - Aaron J Courtenay
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, UK
| | | | - Juan Domínguez-Robles
- School of Pharmacy, Queen's University Belfast, UK.,Department of Pharmacy and Pharmaceutical Technology, University of Seville, Seville, Spain
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Śmiga-Matuszowicz M, Włodarczyk J, Skorupa M, Czerwińska-Główka D, Fołta K, Pastusiak M, Adamiec-Organiściok M, Skonieczna M, Turczyn R, Sobota M, Krukiewicz K. Biodegradable Scaffolds for Vascular Regeneration Based on Electrospun Poly(L-Lactide- co-Glycolide)/Poly(Isosorbide Sebacate) Fibers. Int J Mol Sci 2023; 24:ijms24021190. [PMID: 36674709 PMCID: PMC9866311 DOI: 10.3390/ijms24021190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/01/2023] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
Vascular regeneration is a complex process, additionally limited by the low regeneration potential of blood vessels. Hence, current research is focused on the design of artificial materials that combine biocompatibility with a certain rate of biodegradability and mechanical robustness. In this paper, we have introduced a scaffold material made of poly(L-lactide-co-glycolide)/poly(isosorbide sebacate) (PLGA/PISEB) fibers fabricated in the course of an electrospinning process, and confirmed its biocompatibility towards human umbilical vein endothelial cells (HUVEC). The resulting material was characterized by a bimodal distribution of fiber diameters, with the median of 1.25 µm and 4.75 µm. Genotyping of HUVEC cells collected after 48 h of incubations on the surface of PLGA/PISEB scaffolds showed a potentially pro-angiogenic expression profile, as well as anti-inflammatory effects of this material. Over the course of a 12-week-long hydrolytic degradation process, PLGA/PISEB fibers were found to swell and disintegrate, resulting in the formation of highly developed structures resembling seaweeds. It is expected that the change in the scaffold structure should have a positive effect on blood vessel regeneration, by allowing cells to penetrate the scaffold and grow within a 3D structure of PLGA/PISEB, as well as stabilizing newly-formed endothelium during hydrolytic expansion.
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Affiliation(s)
- Monika Śmiga-Matuszowicz
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland
| | - Jakub Włodarczyk
- Centre of Polymer and Carbon Materials, Polish Academy of Science, M. Curie-Sklodowska St. 34, 41-819 Zabrze, Poland
| | - Małgorzata Skorupa
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland
- Joint Doctoral School, Silesian University of Technology, Akademicka 2A, 44-100 Gliwice, Poland
| | - Dominika Czerwińska-Główka
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland
| | - Kaja Fołta
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland
| | - Małgorzata Pastusiak
- Centre of Polymer and Carbon Materials, Polish Academy of Science, M. Curie-Sklodowska St. 34, 41-819 Zabrze, Poland
| | - Małgorzata Adamiec-Organiściok
- Biotechnology Centre, Silesian University of Technology, B. Krzywoustego 8, 44-100 Gliwice, Poland
- Department of Systems Biology and Engineering, Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland
| | - Magdalena Skonieczna
- Biotechnology Centre, Silesian University of Technology, B. Krzywoustego 8, 44-100 Gliwice, Poland
- Department of Systems Biology and Engineering, Faculty of Automatic Control, Electronics and Computer Science, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland
| | - Roman Turczyn
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland
- Centre for Organic and Nanohybrid Electronics, Silesian University of Technology, S. Konarskiego 22B, 44-100 Gliwice, Poland
| | - Michał Sobota
- Centre of Polymer and Carbon Materials, Polish Academy of Science, M. Curie-Sklodowska St. 34, 41-819 Zabrze, Poland
| | - Katarzyna Krukiewicz
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, M. Strzody 9, 44-100 Gliwice, Poland
- Centre for Organic and Nanohybrid Electronics, Silesian University of Technology, S. Konarskiego 22B, 44-100 Gliwice, Poland
- Correspondence: ; Tel.: +48-32-237-1773
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Takeuchi M, Onoda M, Iwamura M, Inokuchi T, Kawano K, Katoh T, Furutani A. A Case of Preserved Blood Flow to the Portal Vein Due to the Concurrent Reconstruction of the Superior Mesenteric Vein and the Splenic Vein Using an Artificial Blood Vessel. Cureus 2022; 14:e31457. [DOI: 10.7759/cureus.31457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2022] [Indexed: 11/15/2022] Open
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11
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Mzyk A, Imbir G, Noguchi Y, Sanak M, Major R, Wiecek J, Kurtyka P, Plutecka H, Trembecka-Wójciga K, Iwasaki Y, Ueda M, Kakinoki S. Dynamic in vitro hemocompatibility of oligoproline self-assembled monolayer surfaces. Biomater Sci 2022; 10:5498-5503. [PMID: 35904349 DOI: 10.1039/d2bm00885h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The blood compatibility of self-assembled monolayers (SAMs) of oligoproline, a nonionic antifouling peptide, was investigated using the cone-and-plate assay imitating arterial blood flow conditions. End-capped oligoprolines composed of 6 and 9 proline residues (Pro6 and Pro9) and a Cys residue were synthesized for preparing SAMs (Pro-SAMs) on Au-sputtered glass. The surface of Pro-SAMs indicated hydrophilic property with a smooth topology. The adsorption of blood components and the adhesion of blood cells, including leukocytes and platelets, were strongly suppressed on Pro-SAMs. Moreover, Pro9-SAM did not trigger the activation of platelets (i.e., the conformational change of GPIIb/IIIa and P-selectin (CD62P) expression on platelets and the formation of aggregates). Our results demonstrate that Pro9-SAM completely inhibited acute thrombogenic responses and the activation of platelets under dynamic conditions.
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Affiliation(s)
- Aldona Mzyk
- Institute of Metallurgy and Materials Science, Polish Academy of Sciences, Reymonta St. 25, 30-059 Cracow, Poland.,Department of Biomedical Engineering, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AW Groningen, Netherlands.
| | - Gabriela Imbir
- Institute of Metallurgy and Materials Science, Polish Academy of Sciences, Reymonta St. 25, 30-059 Cracow, Poland
| | - Yuri Noguchi
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai University, 3-3-35 Yamate-cho, Suita, Osaka 564-8680, Japan. .,Organization for Research and Development of Innovative Science and Technology, Kansai University, 3-3-35 Yamate-cho, Suita, Osaka, 564-8680, Japan
| | - Marek Sanak
- Department of Medicine, Jagiellonian University Medical College, Skawińska St. 8, 31-066 Cracow, Poland
| | - Roman Major
- Institute of Metallurgy and Materials Science, Polish Academy of Sciences, Reymonta St. 25, 30-059 Cracow, Poland
| | - Justyna Wiecek
- Institute of Metallurgy and Materials Science, Polish Academy of Sciences, Reymonta St. 25, 30-059 Cracow, Poland
| | - Przemyslaw Kurtyka
- Institute of Metallurgy and Materials Science, Polish Academy of Sciences, Reymonta St. 25, 30-059 Cracow, Poland
| | - Hanna Plutecka
- Department of Medicine, Jagiellonian University Medical College, Skawińska St. 8, 31-066 Cracow, Poland
| | - Klaudia Trembecka-Wójciga
- Institute of Metallurgy and Materials Science, Polish Academy of Sciences, Reymonta St. 25, 30-059 Cracow, Poland
| | - Yasuhiko Iwasaki
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai University, 3-3-35 Yamate-cho, Suita, Osaka 564-8680, Japan. .,Organization for Research and Development of Innovative Science and Technology, Kansai University, 3-3-35 Yamate-cho, Suita, Osaka, 564-8680, Japan.,Kansai University Medical Polymer Research Center (KUMP-RC), Kansai University, 3-3-35 Yamate-cho, Suita, Osaka 564-8680, Japan
| | - Masato Ueda
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai University, 3-3-35 Yamate-cho, Suita, Osaka 564-8680, Japan. .,Organization for Research and Development of Innovative Science and Technology, Kansai University, 3-3-35 Yamate-cho, Suita, Osaka, 564-8680, Japan
| | - Sachiro Kakinoki
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials and Bioengineering, Kansai University, 3-3-35 Yamate-cho, Suita, Osaka 564-8680, Japan. .,Organization for Research and Development of Innovative Science and Technology, Kansai University, 3-3-35 Yamate-cho, Suita, Osaka, 564-8680, Japan.,Kansai University Medical Polymer Research Center (KUMP-RC), Kansai University, 3-3-35 Yamate-cho, Suita, Osaka 564-8680, Japan
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12
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Vascular Remodeling of Clinically Used Patches and Decellularized Pericardial Matrices Recellularized with Autologous or Allogeneic Cells in a Porcine Carotid Artery Model. Int J Mol Sci 2022; 23:ijms23063310. [PMID: 35328732 PMCID: PMC8954945 DOI: 10.3390/ijms23063310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/04/2022] [Accepted: 03/12/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Cardiovascular surgery is confronted by a lack of suitable materials for patch repair. Acellular animal tissues serve as an abundant source of promising biomaterials. The aim of our study was to explore the bio-integration of decellularized or recellularized pericardial matrices in vivo. Methods: Porcine (allograft) and ovine (heterograft, xenograft) pericardia were decellularized using 1% sodium dodecyl sulfate ((1) Allo-decel and (2) Xeno-decel). We used two cell types for pressure-stimulated recellularization in a bioreactor: autologous adipose tissue-derived stromal cells (ASCs) isolated from subcutaneous fat of pigs ((3) Allo-ASC and (4) Xeno-ASC) and allogeneic Wharton’s jelly mesenchymal stem cells (WJCs) ((5) Allo-WJC and (6) Xeno-WJC). These six experimental patches were implanted in porcine carotid arteries for one month. For comparison, we also implanted six types of control patches, namely, arterial or venous autografts, expanded polytetrafluoroethylene (ePTFE Propaten® Gore®), polyethylene terephthalate (PET Vascutek®), chemically stabilized bovine pericardium (XenoSure®), and detoxified porcine pericardium (BioIntegral® NoReact®). The grafts were evaluated through the use of flowmetry, angiography, and histological examination. Results: All grafts were well-integrated and patent with no signs of thrombosis, stenosis, or aneurysm. A histological analysis revealed that the arterial autograft resembled a native artery. All other control and experimental patches developed neo-adventitial inflammation (NAI) and neo-intimal hyperplasia (NIH), and the endothelial lining was present. NAI and NIH were most prominent on XenoSure® and Xeno-decel and least prominent on NoReact®. In xenografts, the degree of NIH developed in the following order: Xeno-decel > Xeno-ASC > Xeno-WJC. NAI and patch resorption increased in Allo-ASC and Xeno-ASC and decreased in Allo-WJC and Xeno-WJC. Conclusions: In our setting, pre-implant seeding with ASC or WJC had a modest impact on vascular patch remodeling. However, ASC increased the neo-adventitial inflammatory reaction and patch resorption, suggesting accelerated remodeling. WJC mitigated this response, as well as neo-intimal hyperplasia on xenografts, suggesting immunomodulatory properties.
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Zhang H, Hu C, Xue J, Jin D, Tian L, Zhao D, Li X, Qi W. Ginseng in vascular dysfunction: A review of therapeutic potentials and molecular mechanisms. Phytother Res 2022; 36:857-872. [DOI: org/10.1002/ptr.7369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/16/2021] [Indexed: 07/02/2024]
Abstract
AbstractVascular dysfunction can lead to a variety of fatal diseases, including cardiovascular and cerebrovascular diseases, metabolic syndrome, and cancer. Although a large number of studies have reported the therapeutic effects of natural compounds on vascular‐related diseases, ginseng is still the focus of research. Ginseng and its active substances have bioactive effects against different diseases with vascular dysfunction. In this review, we summarized the key molecular mechanisms and signaling pathways of ginseng, its different active ingredients or formula in the prevention and treatment of vascular‐related diseases, including cardiac‐cerebral vascular diseases, hypertension, diabetes complications, and cancer. Moreover, the bidirectional roles of ginseng in promoting or inhibiting angiogenesis have been highlighted. We systematically teased out the relationship between ginseng and vascular dysfunction, which could provide a basis for the clinical application of ginseng in the future.
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Affiliation(s)
- He Zhang
- Jilin Ginseng Academy, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio‐Macromolecules of Chinese Medicine Changchun University of Chinese Medicine Changchun China
- Research Center of Traditional Chinese Medicine The Affiliated Hospital to Changchun University of Chinese Medicine Changchun China
| | - Cheng Hu
- College of Laboratory Medicine Jilin Medical University Jilin City China
| | - Jiaojiao Xue
- College of Chinese Medicine Changchun University of Chinese Medicine Changchun China
| | - Di Jin
- College of Chinese Medicine Changchun University of Chinese Medicine Changchun China
| | - Lulu Tian
- College of Chinese Medicine Changchun University of Chinese Medicine Changchun China
| | - Daqing Zhao
- Jilin Ginseng Academy, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio‐Macromolecules of Chinese Medicine Changchun University of Chinese Medicine Changchun China
| | - Xiangyan Li
- Jilin Ginseng Academy, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio‐Macromolecules of Chinese Medicine Changchun University of Chinese Medicine Changchun China
| | - Wenxiu Qi
- Jilin Ginseng Academy, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio‐Macromolecules of Chinese Medicine Changchun University of Chinese Medicine Changchun China
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15
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Zhang C, Xia D, Li J, Zheng Y, Weng B, Mao H, Mei J, Wu T, Li M, Zhao J. BMSCs and Osteoblast-Engineered ECM Synergetically Promotes Osteogenesis and Angiogenesis in an Ectopic Bone Formation Model. Front Bioeng Biotechnol 2022; 10:818191. [PMID: 35127662 PMCID: PMC8814575 DOI: 10.3389/fbioe.2022.818191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/04/2022] [Indexed: 12/16/2022] Open
Abstract
Bone mesenchymal stem cells (BMSCs) have been extensively used in bone tissue engineering because of their potential to differentiate into multiple cells, secrete paracrine factors, and attenuate immune responses. Biomaterials are essential for the residence and activities of BMSCs after implantation in vivo. Recently, extracellular matrix (ECM) modification with a favorable regenerative microenvironment has been demonstrated to be a promising approach for cellular activities and bone regeneration. The aim of the present study was to evaluate the effects of BMSCs combined with cell-engineered ECM scaffolds on osteogenesis and angiogenesis in vivo. The ECM scaffolds were generated by osteoblasts on the small intestinal submucosa (SIS) under treatment with calcium (Ca)-enriched medium and icariin (Ic) after decellularization. In a mouse ectopic bone formation model, the SIS scaffolds were demonstrated to reduce the immune response, and lower the levels of immune cells compared with those in the sham group. Ca/Ic-ECM modification inhibited the degradation of the SIS scaffolds in vivo. The generated Ca/Ic-SIS scaffolds ectopically promoted osteogenesis according to the results of micro-CT and histological staining. Moreover, BMSCs on Ca/Ic-SIS further increased the bone volume percentage (BV/TV) and bone density. Moreover, angiogenesis was also enhanced by the Ca/Ic-SIS scaffolds, resulting in the highest levels of neovascularization according to the data ofCD31 staining. In conclusion, osteoblast-engineered ECM under directional induction is a promising strategy to modify biomaterials for osteogenesis and angiogenesis. BMSCs synergetically improve the properties of ECM constructs, which may contribute to the repair of large bone defects.
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Affiliation(s)
- Chi Zhang
- Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
- Medical Research Center, Ningbo City First Hospital, Ningbo, China
| | - Dongdong Xia
- Orthopedic Department, Ningbo City First Hospital, Ningbo, China
| | - Jiajing Li
- Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
| | - Yanan Zheng
- Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
| | - Bowen Weng
- Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
| | - Haijiao Mao
- Department of Orthopaedic Surgery, the Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
| | - Jing Mei
- Medical Research Center, Ningbo City First Hospital, Ningbo, China
| | - Tao Wu
- Cardiovascular Center, the Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
| | - Mei Li
- Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
- Ningbo Institute of Medical Sciences, Ningbo, China
- *Correspondence: Mei Li, ; Jiyuan Zhao,
| | - Jiyuan Zhao
- Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
- *Correspondence: Mei Li, ; Jiyuan Zhao,
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16
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Zhang H, Hu C, Xue J, Jin D, Tian L, Zhao D, Li X, Qi W. Ginseng in vascular dysfunction: A review of therapeutic potentials and molecular mechanisms. Phytother Res 2022; 36:857-872. [PMID: 35026867 DOI: 10.1002/ptr.7369] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/24/2021] [Accepted: 12/16/2021] [Indexed: 12/23/2022]
Abstract
Vascular dysfunction can lead to a variety of fatal diseases, including cardiovascular and cerebrovascular diseases, metabolic syndrome, and cancer. Although a large number of studies have reported the therapeutic effects of natural compounds on vascular-related diseases, ginseng is still the focus of research. Ginseng and its active substances have bioactive effects against different diseases with vascular dysfunction. In this review, we summarized the key molecular mechanisms and signaling pathways of ginseng, its different active ingredients or formula in the prevention and treatment of vascular-related diseases, including cardiac-cerebral vascular diseases, hypertension, diabetes complications, and cancer. Moreover, the bidirectional roles of ginseng in promoting or inhibiting angiogenesis have been highlighted. We systematically teased out the relationship between ginseng and vascular dysfunction, which could provide a basis for the clinical application of ginseng in the future.
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Affiliation(s)
- He Zhang
- Jilin Ginseng Academy, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China.,Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Cheng Hu
- College of Laboratory Medicine, Jilin Medical University, Jilin City, China
| | - Jiaojiao Xue
- College of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Di Jin
- College of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Lulu Tian
- College of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Daqing Zhao
- Jilin Ginseng Academy, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Xiangyan Li
- Jilin Ginseng Academy, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Wenxiu Qi
- Jilin Ginseng Academy, Key Laboratory of Active Substances and Biological Mechanisms of Ginseng Efficacy, Ministry of Education, Jilin Provincial Key Laboratory of Bio-Macromolecules of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
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17
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Moore MJ, Tan RP, Yang N, Rnjak-Kovacina J, Wise SG. Bioengineering artificial blood vessels from natural materials. Trends Biotechnol 2021; 40:693-707. [PMID: 34887104 DOI: 10.1016/j.tibtech.2021.11.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 01/22/2023]
Abstract
Bioengineering an effective, small diameter (<6 mm) artificial vascular graft for use in bypass surgery when autologous grafts are unavailable remains a persistent challenge. Commercially available grafts are typically made from plastics, which have high strength but lack elasticity and present a foreign surface that triggers undesirable biological responses. Tissue engineered grafts, leveraging decellularized animal vessels or derived de novo from long-term cell culture, have dominated recent research, but failed to meet clinical expectations. More effective constructs that are readily translatable are urgently needed. Recent advances in natural materials have made the production of robust acellular conduits feasible and their use increasingly attractive. Here, we identify a subset of natural materials with potential to generate durable, small diameter vascular grafts.
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Affiliation(s)
- Matthew J Moore
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia; Charles Perkins Centre, University of Sydney, NSW 2006, Australia
| | - Richard P Tan
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia; Charles Perkins Centre, University of Sydney, NSW 2006, Australia
| | - Nianji Yang
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia; Charles Perkins Centre, University of Sydney, NSW 2006, Australia
| | - Jelena Rnjak-Kovacina
- Graduate School of Biomedical Engineering, UNSW Australia, Sydney, NSW 2052, Australia
| | - Steven G Wise
- School of Medical Sciences, Faculty of Health and Medicine, University of Sydney, NSW 2006, Australia; Charles Perkins Centre, University of Sydney, NSW 2006, Australia; The University of Sydney Nano Institute, University of Sydney, NSW 2006, Australia.
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18
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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.
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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.)
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Biomimetic tubular scaffold with heparin conjugation for rapid degradation in in situ regeneration of a small diameter neoartery. Biomaterials 2021; 274:120874. [PMID: 34051629 DOI: 10.1016/j.biomaterials.2021.120874] [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: 02/05/2020] [Revised: 04/27/2021] [Accepted: 05/02/2021] [Indexed: 01/22/2023]
Abstract
To address the clinical need for readily available small diameter vascular grafts, biomimetic tubular scaffolds were developed for rapid in situ blood vessel regeneration. The tubular scaffolds were designed to have an inner layer that is porous, interconnected, and with a nanofibrous architecture, which provided an excellent microenvironment for host cell invasion and proliferation. Through the synthesis of poly(spirolactic-co-lactic acid) (PSLA), a highly functional polymer with a norbornene substituting a methyl group in poly(l-lactic acid) (PLLA), we were able to covalently attach biomolecules onto the polymer backbone via thiol-ene click chemistry to impart desirable functionalities to the tubular scaffolds. Specifically, heparin was conjugated on the scaffolds in order to prevent thrombosis when implanted in situ. By controlling the amount of covalently attached heparin we were able to modulate the physical properties of the tubular scaffold, resulting in tunable wettability and degradation rate while retaining the porous and nanofibrous morphology. The scaffolds were successfully tested as rat abdominal aortic replacements. Patency and viability were confirmed through dynamic ultrasound and histological analysis of the regenerated tissue. The harvested tissue showed excellent vascular cellular infiltration, proliferation, and migration with laminar cellular arrangement. Furthermore, we achieved both complete reendothelialization of the vessel lumen and native-like media extracellular matrix. No signs of aneurysm or hyperplasia were observed after 3 months of vessel replacement. Taken together, we have developed an effective vascular graft able to generate small diameter blood vessels that can function in a rat model.
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Jiang T, Ran B, Guo Q, Zhang R, Duan S, Zhong K, Wen H, Shao Y, Aji T. Use of the ligamentum teres hepatis for outflow reconstruction during ex vivo liver resection and autotransplantation in patients with hepatic alveolar echinococcosis: A case series of 24 patients. Surgery 2021; 170:822-830. [PMID: 33994007 DOI: 10.1016/j.surg.2021.03.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/03/2021] [Accepted: 03/15/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with extensive hepatic alveolar echinococcosis might require ex vivo liver resection and autotransplantation to remove the lesion. Patients with extensive vascular invasion will need reconstruction, but the selection of the proper graft is complicated. This study aimed to investigate the effectiveness and adverse events of using the ligamentum teres hepatis as a vascular replacement graft in ex vivo liver resection and autotransplantation. METHODS This was a retrospective case series of patients with hepatic alveolar echinococcosis who underwent ex vivo liver resection and autotransplantation between August 2010 and October 2018 and in whom the ligamentum teres hepatis was used to repair the remnant liver. The operative outcomes, recurrence, and survival were examined. RESULTS Twenty-four patients were included (10 men, 14 women). The anhepatic period was 290 to 672 minutes (median of 450 minutes). The ratio of the remnant liver volume to the standard liver volume was 0.43 to 0.97 (median of 0.71). The blood loss was 1,000 (500-5,000) mL. The postoperative hospital stay was 23 (1-85) days. Of the 24 patients, 3 died after the operation, but those deaths were unrelated to liver vascular complications. CONCLUSION The ligamentum teres hepatis could be used as a vascular replacement graft in ex vivo liver resection and autotransplantation. It has the advantages of convenient specimen extraction, no donor site injury, and no immunological rejection, which has promising clinical application prospects.
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Affiliation(s)
- Tiemin Jiang
- State Key Laboratory of Pathogenesis, Prevention, and Management of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Xinjiang Uyghur Autonomous Region Key Laboratory of Echinococcosis, Clinical Medical Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Bo Ran
- State Key Laboratory of Pathogenesis, Prevention, and Management of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Xinjiang Uyghur Autonomous Region Key Laboratory of Echinococcosis, Clinical Medical Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Qiang Guo
- State Key Laboratory of Pathogenesis, Prevention, and Management of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Xinjiang Uyghur Autonomous Region Key Laboratory of Echinococcosis, Clinical Medical Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Ruiqing Zhang
- State Key Laboratory of Pathogenesis, Prevention, and Management of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Xinjiang Uyghur Autonomous Region Key Laboratory of Echinococcosis, Clinical Medical Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Shuai Duan
- State Key Laboratory of Pathogenesis, Prevention, and Management of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Xinjiang Uyghur Autonomous Region Key Laboratory of Echinococcosis, Clinical Medical Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Kai Zhong
- State Key Laboratory of Pathogenesis, Prevention, and Management of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Xinjiang Uyghur Autonomous Region Key Laboratory of Echinococcosis, Clinical Medical Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Hao Wen
- State Key Laboratory of Pathogenesis, Prevention, and Management of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Xinjiang Uyghur Autonomous Region Key Laboratory of Echinococcosis, Clinical Medical Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yingmei Shao
- State Key Laboratory of Pathogenesis, Prevention, and Management of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Xinjiang Uyghur Autonomous Region Key Laboratory of Echinococcosis, Clinical Medical Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Tuerganaili Aji
- State Key Laboratory of Pathogenesis, Prevention, and Management of High Incidence Diseases in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Department of Hepatobiliary and Echinococcosis Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China; Xinjiang Uyghur Autonomous Region Key Laboratory of Echinococcosis, Clinical Medical Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
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Abstract
Tissue engineering is one of the most promising scientific breakthroughs of the late 20th century. Its objective is to produce in vitro tissues or organs to repair and replace damaged ones using various techniques, biomaterials, and cells. Tissue engineering emerged to substitute the use of native autologous tissues, whose quantities are sometimes insufficient to correct the most severe pathologies. Indeed, the patient’s health status, regulations, or fibrotic scars at the site of the initial biopsy limit their availability, especially to treat recurrence. This new technology relies on the use of biomaterials to create scaffolds on which the patient’s cells can be seeded. This review focuses on the reconstruction, by tissue engineering, of two types of tissue with tubular structures: vascular and urological grafts. The emphasis is on self-assembly methods which allow the production of tissue/organ substitute without the use of exogenous material, with the patient’s cells producing their own scaffold. These continuously improved techniques, which allow rapid graft integration without immune rejection in the treatment of severely burned patients, give hope that similar results will be observed in the vascular and urological fields.
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22
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Çelebi-Saltik B, Öteyaka MÖ, Gökçinar-Yagci B. Stem cell-based small-diameter vascular grafts in dynamic culture. Connect Tissue Res 2021; 62:151-163. [PMID: 31379220 DOI: 10.1080/03008207.2019.1651848] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Purpose: Transplantation of autologous and/or allogeneic blood vessels is the most convenient treatment for vascular diseases. With regard to extensive need for blood vessels, developments in vascular tissue engineering are contributing greatly. In this study, our aim is to create intact small-diameter tubular vascular grafts cultivated in pulsatile flow bioreactor. Materials and Methods: CD146+ cell-based small-diameter vascular grafts were fabricated with ECM/glycosaminoglycans and polyurethane nanofibers. Characterization of the vascular graft was performed by SEM and WST-1. To mimic blood circulation in the bioreactor, human CD34+ cells cultured in megakaryocytes/platelets medium; then these cells were transferred inside of the vascular graft to mimic blood circulation. Cell differentiation was evaluated by flow cytometry and colony assay. Wright-Giemsa staining and polyploidy analysis were performed to show the differentiated cell population inside of the vascular graft. Anti-thrombogenic properties of the blood vessel were demonstrated by IF. Results: Polyurethane nanofibers provided a suitable environment for Human umbilical cord vein endothelial cells (HUVECs), and no significant cytotoxic effect was observed. Scanning electron microscopy (SEM) analysis of the tubular graft showed that under perfusion HUVECs, smooth muscle cells (SMCs) and fibroblasts formed layers that aligned on each other, respectively. The vascular graft was strong with a tensile strength of 0.70 MPa and elastic modulus of 0.007 GPa. When cultured in a bioreactor system, platelet adhesion to the vascular graft was remarkably low. Conclusion: In conclusion, this vascular graft may hold the potential to regenerate functional small-diameter vessels for cardiovascular tissue repair.
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Affiliation(s)
- Betül Çelebi-Saltik
- Graduate School of Health Sciences, Department of Stem Cell Sciences, Hacettepe University , Ankara, Turkey.,Center for Stem Cell Research and Development, Hacettepe University , Ankara, Turkey
| | - Mustafa Özgür Öteyaka
- Mechatronic Program, Eskişehir Vocational School, Eskişehir Osmangazi University , Eskişehir, Turkey
| | - Beyza Gökçinar-Yagci
- Graduate School of Health Sciences, Department of Stem Cell Sciences, Hacettepe University , Ankara, Turkey.,Center for Stem Cell Research and Development, Hacettepe University , Ankara, Turkey
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Rocha FA, Ribas LM, Sassaki-Neto PI, DE-Luccia N. Experimental comparative study of arterial implants made of silicone reinforced with polyester fabric and expanded polytetrafluoroethylene (PTFE) in rabbits aorta. Rev Col Bras Cir 2021; 48:e20202587. [PMID: 33533824 PMCID: PMC10683427 DOI: 10.1590/0100-6991e-20202587] [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: 04/22/2020] [Accepted: 09/18/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES the aim of this study was to compare the outcomes of a new silicone vascular prostheses with PTFE vascular prostheses, on a rabbit experimental model. METHODS forty rabbits underwent infra-renal aorta replacement with 4 mm diameter prostheses, twenty animals with PDMS and twenty animals with PTFE (control group). Retrograde aortic angiography was performed to assess patency. Histological graft samples were examined by electron microscopy to evaluate prostheses endothelialization. RESULTS patency rates were 100% for both grafts after 30 days; after 60 days, patency rate for PDMS was 92.3% (±7.4), and 73,8% (±13.1) at 90 days. PTFE grafts had patency rates of 87.5% (±11.7) at 60 and 90 days. No statistically significant difference was found in between groups for patency rates (p=0.62). Postoperative complications (death, paraplegia) rates (p=0.526) and aortic clamping times (p=0.299) were comparable in both groups. No statistically significant difference for stenosis was found on angiographical analysis between groups (p=0.650). Electron microscopy revealed limited anastomotic endothelial ingrowth in both prostheses. CONCLUSION in this experimental model, PDMS and PTFE vascular prostheses had comparable outcomes and PDMS prosthesis could be used as a vascular graft.
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Affiliation(s)
- Fernanda Appolonio Rocha
- - Faculdade de Medicina da Universidade de São Paulo - FMUSP, Universidade de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil
- - Universidade Federal de Pernambuco - UFPE, Departamento de Cirurgia - CCM - Recife - PE - Brasil
| | - Laila Massad Ribas
- - Faculdade de Medicina da Universidade de São Paulo - FMUSP, Universidade de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil
| | - Paulo Isao Sassaki-Neto
- - Faculdade de Medicina da Universidade de São Paulo - FMUSP, Universidade de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil
| | - Nelson DE-Luccia
- - Faculdade de Medicina da Universidade de São Paulo - FMUSP, Universidade de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil
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Hersh J, Broyles D, Capcha JMC, Dikici E, Shehadeh LA, Daunert S, Deo S. Peptide-Modified Biopolymers for Biomedical Applications. ACS APPLIED BIO MATERIALS 2021; 4:229-251. [PMID: 34250454 PMCID: PMC8267604 DOI: 10.1021/acsabm.0c01145] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Polymeric biomaterials have been used in a variety of applications, like cargo delivery and tissue scaffolding, because they are easily synthesized and can be adapted to many systems. However, there is still a need to further enhance and improve their functions to progress their use in the biomedical field. A promising solution is to modify the polymer surfaces with peptides that can increase biocompatibility, cellular interactions, and receptor targeting. In recent years, peptide modifications have been used to overcome many challenges to polymer biomaterial development. This review discusses recent progress in developing peptide-modified polymers for therapeutic applications including cell-specific targeting and tissue engineering. Furthermore, we will explore some of the most frequently studied base components of these biomaterials.
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Affiliation(s)
- Jessica Hersh
- Department of Biochemistry and Molecular Biology, University of Miami Leonard M. Miller School of Medicine, Miami, Florida 33136, United States
| | - David Broyles
- Department of Biochemistry and Molecular Biology, University of Miami Leonard M. Miller School of Medicine, Miami, Florida 33136, United States
| | - José Manuel Condor Capcha
- Interdisciplinary Stem Cell Institute and Division of Cardiology, Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida 33136, United States
| | - Emre Dikici
- Department of Biochemistry and Molecular Biology, University of Miami Leonard M. Miller School of Medicine, Miami, Florida 33136, United States
| | - Lina A Shehadeh
- Interdisciplinary Stem Cell Institute and Division of Cardiology, Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida 33136, United States
| | - Sylvia Daunert
- Department of Biochemistry and Molecular Biology, University of Miami Leonard M. Miller School of Medicine, Miami, Florida 33136, United States
| | - Sapna Deo
- Department of Biochemistry and Molecular Biology, University of Miami Leonard M. Miller School of Medicine, Miami, Florida 33136, United States
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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.
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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.)
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Obiweluozor FO, Emechebe GA, Kim DW, Cho HJ, Park CH, Kim CS, Jeong IS. Considerations in the Development of Small-Diameter Vascular Graft as an Alternative for Bypass and Reconstructive Surgeries: A Review. Cardiovasc Eng Technol 2020; 11:495-521. [PMID: 32812139 DOI: 10.1007/s13239-020-00482-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 08/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Current design strategies for small diameter vascular grafts (< 6 mm internal diameter; ID) are focused on mimicking native vascular tissue because the commercially available grafts still fail at small diameters, notably due to development of intimal hyperplasia and thrombosis. To overcome these challenges, various design approaches, material selection, and surface modification strategies have been employed to improve the patency of small-diameter grafts. REVIEW The purpose of this review is to outline various considerations in the development of small-diameter vascular grafts, including material choice, surface modifications to enhance biocompatibility/endothelialization, and mechanical properties of the graft, that are currently being implanted. Additionally, we have taken into account the general vascular physiology, tissue engineering approaches, and collective achievements of the authors in this area. We reviewed both commercially available synthetic grafts (e-PTFE and PET), elastic polymers such as polyurethane and biodegradable and bioresorbable materials. We included naturally occurring materials by focusing on their potential application in the development of future vascular alternatives. CONCLUSION Until now, there are few comprehensive reviews regarding considerations in the design of small-diameter vascular grafts in the literature. Here-in, we have discussed in-depth the various strategies employed to generate engineered vascular graft due to their high demand for vascular surgeries. While some TEVG design strategies have shown greater potential in contrast to autologous or synthetic ePTFE conduits, many are still hindered by high production cost which prevents their widespread adoption. Nonetheless, as tissue engineers continue to develop on their strategies and procedures for improved TEVGs, soon, a reliable engineered graft will be available in the market. Hence, we anticipate a viable TEVG with resorbable property, fabricated via electrospinning approach to hold a greater potential that can overcome the challenges observed in both autologous and allogenic grafts. This is because they can be mechanically tuned, incorporated/surface-functionalized with bioactive molecules and mass-manufactured in a reproducible manner. It is also found that most of the success in engineered vascular graft approaching commercialization is for large vessels rather than small-diameter grafts used as cardiovascular bypass grafts. Consequently, the field of vascular engineering is still available for future innovators that can take up the challenge to create a functional arterial substitute.
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Affiliation(s)
- Francis O Obiweluozor
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea.
| | - Gladys A Emechebe
- Department of Bionanosystem Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
| | - Do-Wan Kim
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea
| | - Hwa-Jin Cho
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea
| | - Chan Hee Park
- Department of Bionanosystem Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
- Department of Mechanical Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
| | - Cheol Sang Kim
- Department of Bionanosystem Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
- Department of Mechanical Engineering Graduate School, Chonbuk National University, Jeonju City, Republic of Korea
| | - In Seok Jeong
- Department of Cardiac and Thoracic Surgery, Chonnam National University Hospital and Medical School, 42 Jebong-Ro Dong-gu, Gwangju, 501-757, Republic of Korea.
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Jafarihaghighi F, Ardjmand M, Mirzadeh A, Hassani MS, Parizi SS. Current challenges and future trends in manufacturing small diameter artificial vascular grafts in bioreactors. Cell Tissue Bank 2020; 21:377-403. [PMID: 32415569 DOI: 10.1007/s10561-020-09837-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 05/09/2020] [Indexed: 01/17/2023]
Abstract
Cardiovascular diseases are a leading cause of death. Vascular surgery is mainly used to solve this problem. However, the generation of a functional and suitable substitute for small diameter (< 6 mm) displacement is challengeable. Moreover, synthetic prostheses, made of polyethylene terephthalate and extended polytetrafluoroethylene show have shown insufficient performance. Therefore, the challenges dominating the use of autografts have prevented their efficient use. Tissue engineering is highlighted in regenerative medicine perhaps in aiming to address the issue of end-stage organ failure. While organs and complex tissues require the vascular supply to support the graft survival and render the bioartificial organ role, vascular tissue engineering has shown to be a hopeful method for cell implantation by the production of tissues in vitro. Bioreactors are a salient point in vascular tissue engineering due to the capability for reproducible and controlled variations showing a new horizon in blood vessel substitution. This review strives to display the overview of current concepts in the development of small-diameter by using bioreactors. In this work, we show a critical look at different factors for developing small-diameter and give suggestions for future studies.
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Affiliation(s)
- Farid Jafarihaghighi
- Department of Chemical Engineering, South Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mehdi Ardjmand
- Department of Chemical Engineering, South Tehran Branch, Islamic Azad University, Tehran, Iran.
| | - Abolfazl Mirzadeh
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, VIC, 3052, Australia
| | - Mohammad Salar Hassani
- Department of Chemical Engineering, South Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Shahriar Salemi Parizi
- Department of Chemical Engineering, South Tehran Branch, Islamic Azad University, Tehran, Iran
- Young Researchers and Elite Club, South Tehran Branch, Islamic Azad University, Tehran, Iran
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28
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Toong DWY, Toh HW, Ng JCK, Wong PEH, Leo HL, Venkatraman S, Tan LP, Ang HY, Huang Y. Bioresorbable Polymeric Scaffold in Cardiovascular Applications. Int J Mol Sci 2020; 21:E3444. [PMID: 32414114 PMCID: PMC7279389 DOI: 10.3390/ijms21103444] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/06/2020] [Accepted: 05/08/2020] [Indexed: 12/12/2022] Open
Abstract
Advances in material science and innovative medical technologies have allowed the development of less invasive interventional procedures for deploying implant devices, including scaffolds for cardiac tissue engineering. Biodegradable materials (e.g., resorbable polymers) are employed in devices that are only needed for a transient period. In the case of coronary stents, the device is only required for 6-8 months before positive remodelling takes place. Hence, biodegradable polymeric stents have been considered to promote this positive remodelling and eliminate the issue of permanent caging of the vessel. In tissue engineering, the role of the scaffold is to support favourable cell-scaffold interaction to stimulate formation of functional tissue. The ideal outcome is for the cells to produce their own extracellular matrix over time and eventually replace the implanted scaffold or tissue engineered construct. Synthetic biodegradable polymers are the favoured candidates as scaffolds, because their degradation rates can be manipulated over a broad time scale, and they may be functionalised easily. This review presents an overview of coronary heart disease, the limitations of current interventions and how biomaterials can be used to potentially circumvent these shortcomings in bioresorbable stents, vascular grafts and cardiac patches. The material specifications, type of polymers used, current progress and future challenges for each application will be discussed in this manuscript.
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Affiliation(s)
- Daniel Wee Yee Toong
- School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, Singapore 639798, Singapore; (D.W.Y.T.); (L.P.T.)
| | - Han Wei Toh
- National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609, Singapore; (H.W.T.); (J.C.K.N.); (P.E.H.W.)
- Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, Singapore 117583, Singapore;
| | - Jaryl Chen Koon Ng
- National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609, Singapore; (H.W.T.); (J.C.K.N.); (P.E.H.W.)
- Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, Singapore 117583, Singapore;
| | - Philip En Hou Wong
- National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609, Singapore; (H.W.T.); (J.C.K.N.); (P.E.H.W.)
- Duke-NUS Medical School, National University of Singapore, 8 College Road, Singapore 169857, Singapore
| | - Hwa Liang Leo
- Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, Singapore 117583, Singapore;
| | - Subramanian Venkatraman
- Materials Science and Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore 117575, Singapore;
| | - Lay Poh Tan
- School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, Singapore 639798, Singapore; (D.W.Y.T.); (L.P.T.)
| | - Hui Ying Ang
- National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609, Singapore; (H.W.T.); (J.C.K.N.); (P.E.H.W.)
- Department of Biomedical Engineering, National University of Singapore, 4 Engineering Drive 3, Singapore 117583, Singapore;
| | - Yingying Huang
- School of Materials Science and Engineering, Nanyang Technological University, Nanyang Avenue, Singapore 639798, Singapore; (D.W.Y.T.); (L.P.T.)
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Spadaccio C, Hu H, Li C, Qiao Z, Ge Y, Tie Z, Zhu J, Moon MR, Danton M, Sun L, Gaudino MF. Thoracic aortic surgery: status and upcoming novelties. Minerva Cardioangiol 2020; 68:518-531. [PMID: 32319269 DOI: 10.23736/s0026-4725.20.05263-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Several novel technological developments and surgical approaches have characterized the field of aortic surgery in the recent decade. The progressive introduction of endovascular procedures, minimally invasive surgical techniques and hybrid approaches have changed the practice in aortic surgery and generated new trends and questions. Also, the advancements in the manufacturing of tissue engineered vascular grafts as substitutes for aortic replacements are enlightening new avenues in the treatment of aortic disease. This review will provide an overview of the current novel perspectives, debates and trends in major thoracic aortic surgery.
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Affiliation(s)
- Cristiano Spadaccio
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK - .,Department of Cardiac Surgery, Golden Jubilee National Hospital, Glasgow, UK - .,Department of Cardiovascular Surgery, Beijing Aortic Disease Centre, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Centre for Vascular Prostheses, Capital Medical University, Beijing, China -
| | - Haiou Hu
- Department of Cardiovascular Surgery, Beijing Aortic Disease Centre, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Centre for Vascular Prostheses, Capital Medical University, Beijing, China
| | - Chengnan Li
- Department of Cardiovascular Surgery, Beijing Aortic Disease Centre, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Centre for Vascular Prostheses, Capital Medical University, Beijing, China
| | - Zhiyu Qiao
- Department of Cardiovascular Surgery, Beijing Aortic Disease Centre, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Centre for Vascular Prostheses, Capital Medical University, Beijing, China
| | - Yipeng Ge
- Department of Cardiovascular Surgery, Beijing Aortic Disease Centre, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Centre for Vascular Prostheses, Capital Medical University, Beijing, China
| | - Zheng Tie
- Department of Cardiovascular Surgery, Beijing Aortic Disease Centre, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Centre for Vascular Prostheses, Capital Medical University, Beijing, China
| | - Junming Zhu
- Department of Cardiovascular Surgery, Beijing Aortic Disease Centre, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Centre for Vascular Prostheses, Capital Medical University, Beijing, China
| | - Marc R Moon
- School of Medicine, Washington University, St Louis, MI, USA
| | - Mark Danton
- Department of Cardiac Surgery, Scottish Pediatric Cardiac Services, Royal Hospital for Children, Glasgow, UK
| | - Lizhong Sun
- Department of Cardiovascular Surgery, Beijing Aortic Disease Centre, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Engineering Research Centre for Vascular Prostheses, Capital Medical University, Beijing, China
| | - Mario F Gaudino
- Department of Cardiothoracic Surgery Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA
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Kakisis JD, Geroulakos G. Off the Shelf Bioabsorbable Grafts: Meeting the Unmet Need. Eur J Vasc Endovasc Surg 2020; 59:653. [PMID: 32005634 DOI: 10.1016/j.ejvs.2020.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/16/2019] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
Affiliation(s)
- John D Kakisis
- Department of Vascular Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - George Geroulakos
- Department of Vascular Surgery, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Behr J, Irvine SA, Thwin C, Shah AH, Bae MK, Zussman E, Venkatraman S. Matching Static and Dynamic Compliance of Small‐Diameter Arteries, with Poly(lactide‐
co
‐caprolactone) Copolymers: In Vitro and In Vivo Studies. Macromol Biosci 2020; 20:e1900234. [DOI: 10.1002/mabi.201900234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 11/06/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Jean‐Marc Behr
- School of Materials Science and EngineeringNanyang Technological University 50 Nanyang Avenue Singapore 639798 Singapore
| | - Scott Alexander Irvine
- School of Materials Science and EngineeringNanyang Technological University 50 Nanyang Avenue Singapore 639798 Singapore
| | - Chaw‐Su Thwin
- School of Materials Science and EngineeringNanyang Technological University 50 Nanyang Avenue Singapore 639798 Singapore
| | - Ankur Harish Shah
- School of Materials Science and EngineeringNanyang Technological University 50 Nanyang Avenue Singapore 639798 Singapore
| | - Min‐Chul Kraun Bae
- School of Materials Science and EngineeringNanyang Technological University 50 Nanyang Avenue Singapore 639798 Singapore
| | - Eyal Zussman
- Nano Engineering groupFaculty of Mechanical EngineeringTechnion–Israel Institute of Technology Haifa 32000 Israel
| | - Subbu Venkatraman
- School of Materials Science and EngineeringNanyang Technological University 50 Nanyang Avenue Singapore 639798 Singapore
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32
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Liu Y, Fan D. Novel hyaluronic acid-tyrosine/collagen-based injectable hydrogels as soft filler for tissue engineering. Int J Biol Macromol 2019; 141:700-712. [DOI: 10.1016/j.ijbiomac.2019.08.233] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 08/06/2019] [Accepted: 08/28/2019] [Indexed: 12/20/2022]
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Iijima K, Ichikawa S, Ishikawa S, Matsukuma D, Yataka Y, Otsuka H, Hashizume M. Preparation of Cell-Paved and -Incorporated Polysaccharide Hollow Fibers Using a Microfluidic Device. ACS Biomater Sci Eng 2019; 5:5688-5697. [PMID: 33405700 DOI: 10.1021/acsbiomaterials.8b01500] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cellular constructs having hollow tubular structures are expected to be used as artificial blood vessels. We have recently demonstrated that water-insoluble polyion complexes (PICs) were formed from water-soluble polysaccharides with opposite charges at the interface of coaxial flows, which resulted in the formation of hollow fibers. In this study, both inside- and outside-cell-laden chondroitin sulfate C (CS)/chitosan (CHI) hollow fibers were prepared by utilizing a microfluidic device and modification with cell adhesive molecules. Loading of type I collagen (COL) and surface modification with fibronectin and gelatin using layer-by-layer assembly techniques improved the adhesion and spreading of fibroblast cells to/on the surface of CS/CHI hollow fibers. On the other hand, by suspending mesenchymal stem cells (MSCs) in the core flow solution, cells were successfully loaded in the walls of the hollow fibers. As the culture time extended, cells trapped in the PIC structures constituting the wall of the hollow fibers migrated to the interface between the hollow fibers and the medium: cells adhered to and stretched "on" the lumen surfaces in the COL-loaded fibers. In contrast, for the case of unmodified hollow fibers, it was difficult for cells to adhere to the lumen surfaces. Therefore, cell aggregates were formed "in" the lumen. Results of the live/dead assay and MTT assay clearly demonstrated that MSCs possessed certain levels of cell viability and proliferated for up to 10 days, especially for the cases of COL-loaded hollow fibers. On the basis of these results, the utility of the present hollow fibers in the formation of cellular constructs corresponding to blood vessels is also discussed.
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Tomášek P, Tonar Z, Grajciarová M, Kural T, Turek D, Horáková J, Pálek R, Eberlová L, Králíčková M, Liška V. Histological mapping of porcine carotid arteries - An animal model for the assessment of artificial conduits suitable for coronary bypass grafting in humans. Ann Anat 2019; 228:151434. [PMID: 31704146 DOI: 10.1016/j.aanat.2019.151434] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/12/2019] [Accepted: 10/11/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Using animal models in experimental medicine requires mapping of their anatomical variability. Porcine common carotid arteries (CCA) are often preferred for the preclinical testing of vascular grafts due to their anatomical and physiological similarity to human small-diameter arteries. Comparing the microscopic structure of animal model organs to their human counterparts reveals the benefits and limitations of translational medicine. METHODS Using quantitative histology and stereology, we performed an extensive mapping of the regional proximodistal differences in the fractions of elastin, collagen, and smooth muscle actin as well as the intima-media and wall thicknesses among 404 segments (every 1 cm) of porcine CCAs collected from male and female pigs (n = 21). We also compared the microscopic structure of porcine CCAs with segments of human coronary arteries and one of the preferred arterial conduits used for the coronary artery bypass grafting (CABG), namely, the internal thoracic artery (ITA) (n = 21 human cadavers). RESULTS The results showed that the histological structure of left and right porcine CCA can be considered equivalent, provided that gross anatomical variations of the regular branching patterns are excluded. The proximal elastic carotid (51.2% elastin, 4.2% collagen, and 37.2% actin) transitioned to more muscular middle segments (23.5% elastin, 4.9% collagen, 54.3% actin) at the range of 2-3 centimeters and then to even more muscular distal segments (17.2% elastin, 4.9% collagen, 64.0% actin). The resulting morphometric data set shows the biological variability of the artery and is made available for biomechanical modeling and for performing a power analysis and calculating the minimum number of samples per group when planning further experiments with this widely used large animal model. CONCLUSIONS Comparison of porcine carotids with human coronary arteries and ITA revealed the benefits and the limitations of using porcine CCAs as a valid model for testing bioengineered small-diameter CABG vascular conduits. Morphometry of human coronary arteries and ITA provided more realistic data for tailoring multilayered artificial vascular prostheses and the ranges of values within which the conduits should be tested in the future. Despite their limitations, porcine CCAs remain a widely used and well-characterized large animal model that is available for a variety of experiments in vascular surgery.
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Affiliation(s)
- Petr Tomášek
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, 301 66 Pilsen, Czech Republic; Department of Forensic Medicine, Second Faculty of Medicine, Charles University and Na Bulovce Hospital, Budinova 2, 180 81 Prague, Czech Republic
| | - Zbyněk Tonar
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, 301 66 Pilsen, Czech Republic.
| | - Martina Grajciarová
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, 301 66 Pilsen, Czech Republic
| | - Tomáš Kural
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, 301 66 Pilsen, Czech Republic
| | - Daniel Turek
- First Faculty of Medicine, Charles University in Prague, Katerinska 32, 121 08 Prague 2, Czech Republic; Department of Cardiac Surgery, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague, Czech Republic
| | - Jana Horáková
- Department of Nonwovens and Nanofibrous Materials, Faculty of Textile Engineering, Technical University of Liberec, Studentska 2, 461 17 Liberec, Czech Republic
| | - Richard Pálek
- Department of Surgery and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Husova 3, 306 05 Pilsen, Czech Republic
| | - Lada Eberlová
- Department of Anatomy, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, 301 66 Pilsen, Czech Republic
| | - Milena Králíčková
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Karlovarska 48, 301 66 Pilsen, Czech Republic
| | - Václav Liška
- Department of Surgery and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Husova 3, 306 05 Pilsen, Czech Republic
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A heparin-functionalized woven stent graft for endovascular exclusion. Colloids Surf B Biointerfaces 2019; 180:118-126. [DOI: 10.1016/j.colsurfb.2019.04.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/26/2019] [Accepted: 04/12/2019] [Indexed: 11/21/2022]
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Best CA, Szafron JM, Rocco KA, Zbinden J, Dean EW, Maxfield MW, Kurobe H, Tara S, Bagi PS, Udelsman BV, Khosravi R, Yi T, Shinoka T, Humphrey JD, Breuer CK. Differential outcomes of venous and arterial tissue engineered vascular grafts highlight the importance of coupling long-term implantation studies with computational modeling. Acta Biomater 2019; 94:183-194. [PMID: 31200116 PMCID: PMC6819998 DOI: 10.1016/j.actbio.2019.05.063] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/07/2019] [Accepted: 05/24/2019] [Indexed: 12/13/2022]
Abstract
Electrospinning is commonly used to generate polymeric scaffolds for tissue engineering. Using this approach, we developed a small-diameter tissue engineered vascular graft (TEVG) composed of poly-ε-caprolactone-co-l-lactic acid (PCLA) fibers and longitudinally assessed its performance within both the venous and arterial circulations of immunodeficient (SCID/bg) mice. Based on in vitro analysis demonstrating complete loss of graft strength by 12 weeks, we evaluated neovessel formation in vivo over 6-, 12- and 24-week periods. Mid-term observations indicated physiologic graft function, characterized by 100% patency and luminal matching with adjoining native vessel in both the venous and arterial circulations. An active and robust remodeling process was characterized by a confluent endothelial cell monolayer, macrophage infiltrate, and extracellular matrix deposition and remodeling. Long-term follow-up of venous TEVGs at 24 weeks revealed viable neovessel formation beyond graft degradation when implanted in this high flow, low-pressure environment. Arterial TEVGs experienced catastrophic graft failure due to aneurysmal dilatation and rupture after 14 weeks. Scaffold parameters such as porosity, fiber diameter, and degradation rate informed a previously described computational model of vascular growth and remodeling, and simulations predicted the gross differential performance of the venous and arterial TEVGs over the 24-week time course. Taken together, these results highlight the requirement for in vivo implantation studies to extend past the critical time period of polymer degradation, the importance of differential neotissue deposition relative to the mechanical (pressure) environment, and further support the utility of predictive modeling in the design, use, and evaluation of TEVGs in vivo. STATEMENT OF SIGNIFICANCE: Herein, we apply a biodegradable electrospun vascular graft to the arterial and venous circulations of the mouse and follow recipients beyond the point of polymer degradation. While venous implants formed viable neovessels, arterial grafts experienced catastrophic rupture due to aneurysmal dilation. We then inform a previously developed computational model of tissue engineered vascular graft growth and remodeling with parameters specific to the electrospun scaffolds utilized in this study. Remarkably, model simulations predict the differential performance of the venous and arterial constructs over 24 weeks. We conclude that computational simulations should inform the rational selection of scaffold parameters to fabricate tissue engineered vascular grafts that must be followed in vivo over time courses extending beyond polymer degradation.
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Affiliation(s)
- Cameron A Best
- Center for Regenerative Medicine, Tissue Engineering Program, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States; Biomedical Sciences Graduate Program, The Ohio State University College of Medicine, Columbus, OH, United States.
| | - Jason M Szafron
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States
| | | | - Jacob Zbinden
- Center for Regenerative Medicine, Tissue Engineering Program, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States; Biomedical Engineering Graduate Program, The Ohio State University College of Engineering, Columbus, OH, United States
| | - Ethan W Dean
- Department of Orthopaedic Surgery, University of Florida, Gainesville, FL, United States
| | - Mark W Maxfield
- Department of Thoracic Surgery, University of Massachusetts Memorial Medical Center, Worcester, MA, United States
| | - Hirotsugu Kurobe
- Department of Cardiovascular Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Shuhei Tara
- Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan
| | - Paul S Bagi
- Department of Orthopaedic Surgery, Yale-New Haven Hospital, New Haven, CT, United States
| | - Brooks V Udelsman
- Department of Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Ramak Khosravi
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States
| | - Tai Yi
- Center for Regenerative Medicine, Tissue Engineering Program, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
| | - Toshiharu Shinoka
- Center for Regenerative Medicine, Tissue Engineering Program, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States; Department of Cardiac Surgery, Nationwide Children's Hospital, Columbus, OH, United States
| | - Jay D Humphrey
- Department of Biomedical Engineering, Yale University, New Haven, CT, United States; Vascular Biology and Therapeutics Program, Yale University School of Medicine, New Haven, CT, United States
| | - Christopher K Breuer
- Center for Regenerative Medicine, Tissue Engineering Program, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States; Department of Surgery, Nationwide Children's Hospital, Columbus, OH, United States
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Li S, Wang K, Hu Q, Zhang C, Wang B. Direct-write and sacrifice-based techniques for vasculatures. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 104:109936. [PMID: 31500055 DOI: 10.1016/j.msec.2019.109936] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 05/22/2019] [Accepted: 07/01/2019] [Indexed: 12/27/2022]
Abstract
Fabricating biomimetic vasculatures is considered one of the greatest challenges in tissue regeneration due to their complex structures across various length scales. Many strategies have been investigated on how to fabricate tissue-engineering vasculatures (TEVs), including vascular-like and vascularized structures that can replace their native counterparts. The advancement of additive manufacturing (AM) technologies has enabled a wide range of fabrication techniques that can directly-write TEVs with complex and delicate structures. Meanwhile, sacrifice-based techniques, which rely on the removal of encapsulated sacrificial templates to form desired cavity-like structures, have also been widely studied. This review will specifically focus on the two most promising methods in these recently developed technologies, which are the direct-write method and the sacrifice-based method. The performance, advantages, and shortcomings of each technique are analyzed and compared. In the discussion, we list current challenges in this field and present our vision of next-generation TEVs technologies. Perspectives on future research in this field are given at the end.
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Affiliation(s)
- Shuai Li
- Georgia Tech Manufacturing Institute, Georgia Institute of Technology, Atlanta, GA 30332, USA; Rapid Manufacturing Engineering Center, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China
| | - Kan Wang
- Georgia Tech Manufacturing Institute, Georgia Institute of Technology, Atlanta, GA 30332, USA.
| | - Qingxi Hu
- Rapid Manufacturing Engineering Center, School of Mechatronic Engineering and Automation, Shanghai University, Shanghai 200444, China; Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai 200072, China; National Demonstration Center for Experimental Engineering Training Education, Shanghai University, Shanghai 200444, China.
| | - Chuck Zhang
- Georgia Tech Manufacturing Institute, Georgia Institute of Technology, Atlanta, GA 30332, USA; H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Ben Wang
- Georgia Tech Manufacturing Institute, Georgia Institute of Technology, Atlanta, GA 30332, USA; H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA; School of Materials Science and Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
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Watanabe A, Miki N. Connecting Mechanism for Artificial Blood Vessels with High Biocompatibility. MICROMACHINES 2019; 10:mi10070429. [PMID: 31261691 PMCID: PMC6680470 DOI: 10.3390/mi10070429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 06/23/2019] [Accepted: 06/25/2019] [Indexed: 02/04/2023]
Abstract
This paper proposes a connecting mechanism for artificial vessels, which can be attached/detached with ease and does not deteriorate the biocompatibility of the vessels at the joint. The inner surface of the artificial vessels is designed to have high biocompatibility. In order to make the best of the property, the proposed connecting mechanism contacts and fixes the two artificial vessels whose contacting edges are turned inside out. In this manner, blood flowing inside the vessels only has contact with the biocompatible surface. The biocompatibility, or biofouling at the joint was investigated after in vitro blood circulation tests for 72 h with scanning electron microscopy. Blood coagulation for a short term (120 min) was evaluated by activated partial thromboplastin time (APTT). A decrease of APTT was observed, although it was too small to conclude that the connector augmented the blood coagulation. The micro dialysis device which our group has developed as the artificial kidney was inserted into the blood circulation system with the connector. Decrease of APTT was similarly small. These experiments verified that the proposed connector can be readily applicable for implantable medical devices.
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Affiliation(s)
- Ai Watanabe
- Department of Mechanical Engineering, Keio university, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8522, Japan
| | - Norihisa Miki
- Department of Mechanical Engineering, Keio university, 3-14-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8522, Japan.
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Jalaie H, Steitz J, Afify M, Barbati ME, Hoeft K, Assar MAM, Hermanns-Sachweh B, Tolba RH, Jacobs MJ, Schleimer K. In vivo endothelialization and neointimal hyperplasia assessment after angioplasty of sheep carotid artery with a novel polycarbonate polyurethane patch. J Biomater Appl 2019; 34:208-218. [PMID: 31088184 DOI: 10.1177/0885328219849368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Houman Jalaie
- 1 European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen, Germany
| | - Julia Steitz
- 2 Institute for Laboratory Animal Science, RWTH-Aachen University, Germany
| | - Mamdouh Afify
- 2 Institute for Laboratory Animal Science, RWTH-Aachen University, Germany.,3 Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Egypt
| | - Mohammad Esmaeil Barbati
- 1 European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen, Germany
| | - Konrad Hoeft
- 4 Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Germany
| | - Mona Ali Mahmoud Assar
- 2 Institute for Laboratory Animal Science, RWTH-Aachen University, Germany.,6 Institute for Pathology, RWTH-Aachen University, Germany
| | | | - Rene H Tolba
- 2 Institute for Laboratory Animal Science, RWTH-Aachen University, Germany
| | - Michael J Jacobs
- 1 European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen, Germany
| | - Karina Schleimer
- 1 European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen, Germany
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Eghbalzadeh K, Guschlbauer M, Weber C, Wacker MT, Reinhardt S, Djordjevic I, Sabashnikov A, Maul A, Sterner-Kock A, Wahlers TCW, Scherner M, Wippermann J. Experimental Studies for Small Diameter Grafts in an In Vivo Sheep Model-Techniques and Pitfalls. Thorac Cardiovasc Surg 2019; 69:649-659. [PMID: 31030422 DOI: 10.1055/s-0039-1687887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Scientific attempts to create the "ideal" small diameter vascular graft have been compared with the "search of the holy grail." Prosthetic material as expanded polytetrafluoroethylene or Dacron shows acceptable patency rates to large caliber vessels, while small diameter (< 6 mm) prosthetic conduits present unacceptably poor patency rates. Vascular tissue engineering represents a promising option to address this problem. MATERIAL AND METHODS Thirty-two female Texel-sheep aged 6 months to 2 years underwent surgical common carotid artery (CCA) interposition using different tissue-engineered vascular substitutes. Explantation of the grafts was performed 12 (n = 12) and 36 (n = 20) weeks after surgery. Ultrasound was performed on postoperative day 1 and thereafter every 4 weeks to evaluate the graft patency. RESULTS The average length of implanted substitutes was 10.3 ± 2.2 cm. Anesthesia and surgical procedure could be performed without major surgical complications in all cases.The grafts showed a systolic blood flow velocity (BFV) of 28.24 ± 13.5 cm/s, a diastolic BFV of 9.25 ± 4.53 cm/s, and a mean BFV of 17.85 ± 9.25 cm/s. Native vessels did not differ relevantly in hemodynamic measurements (systolic: 29.77 cm/s; diastolic: 7.99 cm/s ± 5.35; mean 15.87 ± 10.75). There was no incidence of neurologic complications or subsequent postoperative occlusion. Perioperative morbidity was low and implantation of conduits was generally well tolerated. CONCLUSION This article aims to give a precise overview of in vivo experiments in sheep for the evaluation of small diameter vascular grafts performing CCA interposition, especially with regard to pitfalls and possible perioperative complications and to discuss advantages and disadvantages of this approach.
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Affiliation(s)
| | - Maria Guschlbauer
- Dezentrales Tierhaltungsnetzwerk, Universitätsklinikum Köln, Cologne, Germany
| | - Carolyn Weber
- Department of Cardiothoracic Surgery, Uniklinik Köln, Köln, Germany
| | - Max Theodor Wacker
- Department of Cardiac Surgery, Universitatsklinikum Magdeburg, Magdeburg, Germany
| | | | - Ilija Djordjevic
- Department of Cardiothoracic Surgery, Uniklinik Köln, Köln, Germany
| | | | - Alexandra Maul
- Department of Experimentelle Medizin, Universitätsklinikum Köln, Cologne, Germany
| | - Anja Sterner-Kock
- Department of Experimentelle Medizin, Universitätsklinikum Köln, Cologne, Germany
| | | | - Maximilian Scherner
- Department of Cardiac Surgery, Universitatsklinikum Magdeburg, Magdeburg, Germany
| | - Jens Wippermann
- Department of Cardiac Surgery, Universitatsklinikum Magdeburg, Magdeburg, Germany
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Katsimpoulas M, Morticelli L, Gontika I, Kouvaka A, Mallis P, Dipresa D, Böer U, Soudah B, Haverich A, Michalopoulos E, Korossis S. Biocompatibility and Immunogenicity of Decellularized Allogeneic Aorta in the Orthotopic Rat Model. Tissue Eng Part A 2019; 25:399-415. [PMID: 30582419 DOI: 10.1089/ten.tea.2018.0037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The generation of a small-caliber arterial graft, utilizing a large vessel of a small animal, such as the aorta of the rat or rabbit, for clinical use in the peripheral arterial tree, can widen the options for arterial prostheses. This in vivo study demonstrated the ability of the decellularization protocol that was used to produce a noncytotoxic acellular small-caliber arterial graft, with sufficient biomechanical and biological integrity to withstand the demanding flow and pressure environment of the rat aorta. This work also demonstrated the superiority of the decellularized homograft over its intact counterpart, in terms of lower immunogenicity.
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Affiliation(s)
- Michalis Katsimpoulas
- 1 Centre of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- 2 Attikon Animal Hospital, Paiania, Greece
| | - Lucrezia Morticelli
- 3 Lower Saxony Centre for Biomedical Engineering Implant Research and Development, Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Ioanna Gontika
- 4 Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Artemis Kouvaka
- 3 Lower Saxony Centre for Biomedical Engineering Implant Research and Development, Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Panagiotis Mallis
- 4 Hellenic Cord Blood Bank, Biomedical Research Foundation Academy of Athens, Athens, Greece
| | - Daniele Dipresa
- 3 Lower Saxony Centre for Biomedical Engineering Implant Research and Development, Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Ulrike Böer
- 3 Lower Saxony Centre for Biomedical Engineering Implant Research and Development, Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Bisharah Soudah
- 5 Institute for Pathology, Hannover Medical School, Hannover, Germany
| | - Axel Haverich
- 3 Lower Saxony Centre for Biomedical Engineering Implant Research and Development, Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
- 6 Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | | | - Sotirios Korossis
- 3 Lower Saxony Centre for Biomedical Engineering Implant Research and Development, Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
- 6 Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
- 7 Cardiopulmonary Regenerative (CARE) Group, Centre for Biological Engineering, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, United Kingdom
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Lévesque L, Loy C, Lainé A, Drouin B, Chevallier P, Mantovani D. Incrementing the Frequency of Dynamic Strain on SMC-Cellularised Collagen-Based Scaffolds Affects Extracellular Matrix Remodeling and Mechanical Properties. ACS Biomater Sci Eng 2018; 4:3759-3767. [PMID: 33429603 DOI: 10.1021/acsbiomaterials.7b00395] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Notwithstanding the efforts injected in vascular tissue engineering in the past 30 years, the clinical translation of engineered artery constructs is far from being successful. One common approach to improve artery regeneration is the use of cyclic mechanical stimuli to guide cellular remodeling. However, there is a lack of information on the effect of cyclic strain on cells within a 3D environment. To this end, this work explored the effect of gradual increase in stimulation frequency on the response of human umbilical artery smooth muscle cells (HUASMCs) embedded in a 3D collagen matrix. The results demonstrate that, with an applied strain of 5%, the gradual increase of frequency from 0.1 to 1 Hz improved collagen remodeling by HUASMCs compared to samples constantly stimulated at 1 Hz. The expression of collagen, elastin and matrix metalloproteinase-2 (MMP-2) genes was similar at 7 days for gradual and 1 Hz samples which showed lower amounts than static counterparts. Interestingly the mechanical properties of the constructs, specifically the amplitude of the time constants and the elastic equilibrium modulus, were enhanced by gradual increase of frequency. Taken together, these results show an increase in collagen remodeling by the HUASMCs overtime under incremental cyclic mechanical strain. This work suggests that only the in-depth investigation of the effects of stimulation parameters on the behavior of vSMC under cyclic strain in a 3D environment could lead to the design of optimized control strategies for enhanced vascular tissue generation and maturation in bioreactors.
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Affiliation(s)
- L Lévesque
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair I in Biomaterials and Bioengineering for the Innovation in Surgery, Department of Min-Met- Materials Engineering, Research Center of CHU de Quebec, Division of Regenerative Medicine, Université Laval, Quebec, Quebec, Canada G1V 0A6
| | - C Loy
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair I in Biomaterials and Bioengineering for the Innovation in Surgery, Department of Min-Met- Materials Engineering, Research Center of CHU de Quebec, Division of Regenerative Medicine, Université Laval, Quebec, Quebec, Canada G1V 0A6
| | - A Lainé
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair I in Biomaterials and Bioengineering for the Innovation in Surgery, Department of Min-Met- Materials Engineering, Research Center of CHU de Quebec, Division of Regenerative Medicine, Université Laval, Quebec, Quebec, Canada G1V 0A6
| | - B Drouin
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair I in Biomaterials and Bioengineering for the Innovation in Surgery, Department of Min-Met- Materials Engineering, Research Center of CHU de Quebec, Division of Regenerative Medicine, Université Laval, Quebec, Quebec, Canada G1V 0A6
| | - P Chevallier
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair I in Biomaterials and Bioengineering for the Innovation in Surgery, Department of Min-Met- Materials Engineering, Research Center of CHU de Quebec, Division of Regenerative Medicine, Université Laval, Quebec, Quebec, Canada G1V 0A6
| | - D Mantovani
- Laboratory for Biomaterials and Bioengineering, Canada Research Chair I in Biomaterials and Bioengineering for the Innovation in Surgery, Department of Min-Met- Materials Engineering, Research Center of CHU de Quebec, Division of Regenerative Medicine, Université Laval, Quebec, Quebec, Canada G1V 0A6
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Iijima K, Ohyama S, Yuyama K, Shono A, Hashizume M. Selective fabrication of hollow and solid polysaccharide composite fibers using a microfluidic device by controlling polyion complex formation. Polym J 2018. [DOI: 10.1038/s41428-018-0105-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Schleimer K, Jalaie H, Afify M, Woitok A, Barbati ME, Hoeft K, Jacobs M, Tolba RH, Steitz J. Sheep models for evaluation of novel patch and prosthesis material in vascular surgery: tips and tricks to avoid possible pitfalls. Acta Vet Scand 2018; 60:42. [PMID: 29976210 PMCID: PMC6034312 DOI: 10.1186/s13028-018-0397-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 06/27/2018] [Indexed: 11/25/2022] Open
Abstract
Background In vascular surgery, novel synthetic prosthesis materials for patch-angioplasties, interpositions, bypasses and shunts are continuously under development and optimization. The characteristics of an ideal vascular prosthesis would display long-term patency, biocompatibility, durability, low porosity, lack of stich hole bleeding, ease of handling, kink resistance, infection resistance and reasonable costs. The aim of this study was to establish and report a reliable sheep model including potential pitfalls where those parameters could be analyzed. Before surgery, sheep were acclimatized for 4–8 weeks, during which parasite infections were treated and blood and serum parameters monitored. Twenty-four sheep underwent surgery, and carotid patch-angioplasties (n = 12), graft interpositions (n = 6) or arteriovenous prosthetic shunts (n = 6) were implanted. Half of the animals in each group were sacrificed after 2 weeks and the other half after 8 weeks. The implants were analyzed for patency, endothelialization, thrombogenicity and biocompatibility by clinical observation, blood flow measurement and pathological and histopathological (H&E, EvG) as well as immunohistochemical (Ki67, CD31) evaluations. Results Health monitoring of the sheep revealed a parasitic burden with endoparasites in all animals. Some animals showed thereby infestations in the bile duct causing fibrotic cholangitis with calcifications in the liver. In addition, sarcosporidia were detected in histopathological specimen of the heart in all animals. Parasitic burden correlated with blood counts and serum bilirubin levels. Both were significantly reduced by albendazole treatment within the acclimatization time. Patches, interposition grafts, and straight shunts were successfully implanted bilaterally in all animals. The total average operation time was 136 ± 21 min. Most animals (23/24) showed good patency rates and general condition after implantation. Pathological and histopathological/immunohistochemical analyses were suitable to determine thrombogenicity, endothelialization, cellular/fibroblastic proliferation, biocompatibility, inflammatory cell infiltration, and thickness of neointima in the prosthesis material. Conclusions We have developed a suitable experimental protocol with standardized and successful anesthesia- and surgical-procedures for patch-angioplasty, graft interposition, and arteriovenous prosthetic shunts. This sheep model allows testing of new prosthetic materials for biocompatibility, thrombogenicity, and endothelialization.
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Long-term outcomes of Omniflow II biosynthetic vascular graft in lower extremity arterial revascularization. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2018; 26:407-413. [PMID: 32082771 DOI: 10.5606/tgkdc.dergisi.2018.15689] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/20/2018] [Indexed: 11/21/2022]
Abstract
Background This study aims to evaluate the patency rates and long-term outcomes of femoro-popliteal bypass procedures with Omniflow II biosynthetic vascular grafts in patients with occlusive vascular disease. Methods This retrospective, observational, clinical study included a total of 93 patients (61 males, 32 females; mean age 56.9±7.4 years; range, 43 to 83 years) who underwent femoro-popliteal bypass in which Omniflow II biosynthetic vascular grafts were used due to peripheral arterial disease. The patients were divided into two groups: 62 patients undergoing femoro-popliteal above-knee bypass and 31 patients undergoing the femoro-popliteal belowknee bypass. We evaluated preoperative clinical characteristics, postoperative graft patency rates, and other clinical results. Results The mean follow-up was 44.9±18.8 months in the femoropopliteal above-knee bypass group and 47.3±22.3 months in the femoro-popliteal below-knee bypass group (p=0.302). The cumulative primary graft patency rates of the femoro-popliteal above-knee bypass and femoro-popliteal below-knee bypass groups at three, four, and five years were 98%, 95% and 78% and 86%, 75% and 45%, respectively (log-rank; p=0.312). The cumulative assisted graft patency rates of the femoro-popliteal above-knee bypass and femoro-popliteal below-knee bypass groups at five years were 87.9% and 65.3%, respectively (log-rank; p=0.530). Conclusion The Omniflow II biosynthetic vascular graft is suitable for above- and below-knee femoro-popliteal bypass procedures. These grafts may be prefered due to high patency rates, low incidence of aneursym formations, and infections.
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Maina RM, Barahona MJ, Finotti M, Lysyy T, Geibel P, D'Amico F, Mulligan D, Geibel JP. Generating vascular conduits: from tissue engineering to three-dimensional bioprinting. Innov Surg Sci 2018; 3:203-213. [PMID: 31579784 PMCID: PMC6604577 DOI: 10.1515/iss-2018-0016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/04/2018] [Indexed: 12/25/2022] Open
Abstract
Vascular disease - including coronary artery disease, carotid artery disease, and peripheral vascular disease - is a leading cause of morbidity and mortality worldwide. The standard of care for restoring patency or bypassing occluded vessels involves using autologous grafts, typically the saphenous veins or internal mammary arteries. Yet, many patients who need life- or limb-saving procedures have poor outcomes, and a third of patients who need vascular intervention have multivessel disease and therefore lack appropriate vasculature to harvest autologous grafts from. Given the steady increase in the prevalence of vascular disease, there is great need for grafts with the biological and mechanical properties of native vessels that can be used as vascular conduits. In this review, we present an overview of methods that have been employed to generate suitable vascular conduits, focusing on the advances in tissue engineering methods and current three-dimensional (3D) bioprinting methods. Tissue-engineered vascular grafts have been fabricated using a variety of approaches such as using preexisting scaffolds and acellular organic compounds. We also give an extensive overview of the novel use of 3D bioprinting as means of generating new vascular conduits. Different strategies have been employed in bioprinting, and the use of cell-based inks to create de novo structures offers a promising solution to bridge the gap of paucity of optimal donor grafts. Lastly, we provide a glimpse of our work to create scaffold-free, bioreactor-free, 3D bioprinted vessels from a combination of rat vascular smooth muscle cells and fibroblasts that remain patent and retain the tensile and mechanical strength of native vessels.
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Affiliation(s)
- Renee M Maina
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Maria J Barahona
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Michele Finotti
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.,University of Padua, Transplantation and Hepatobiliary Surgery, Padua, Italy
| | - Taras Lysyy
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Peter Geibel
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Francesco D'Amico
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.,University of Padua, Transplantation and Hepatobiliary Surgery, Padua, Italy
| | - David Mulligan
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - John P Geibel
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
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Schneider KH, Enayati M, Grasl C, Walter I, Budinsky L, Zebic G, Kaun C, Wagner A, Kratochwill K, Redl H, Teuschl AH, Podesser BK, Bergmeister H. Acellular vascular matrix grafts from human placenta chorion: Impact of ECM preservation on graft characteristics, protein composition and in vivo performance. Biomaterials 2018; 177:14-26. [PMID: 29885585 DOI: 10.1016/j.biomaterials.2018.05.045] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/18/2018] [Accepted: 05/26/2018] [Indexed: 02/06/2023]
Abstract
Small diameter vascular grafts from human placenta, decellularized with either Triton X-100 (Triton) or SDS and crosslinked with heparin were constructed and characterized. Graft biochemical properties, residual DNA, and protein composition were evaluated to compare the effect of the two detergents on graft matrix composition and structural alterations. Biocompatibility was tested in vitro by culturing the grafts with primary human macrophages and in vivo by subcutaneous implantation of graft conduits (n = 7 per group) into the flanks of nude rats. Subsequently, graft performance was evaluated using an aortic implantation model in Sprague Dawley rats (one month, n = 14). In situ graft imaging was performed using MRI angiography. Retrieved specimens were analyzed by electromyography, scanning electron microscopy, histology and immunohistochemistry to evaluate cell migration and the degree of functional tissue remodeling. Both decellularization methods resulted in grafts of excellent biocompatibility in vitro and in vivo, with low immunogenic potential. Proteomic data revealed removal of cytoplasmic proteins with relative enrichment of ECM proteins in decelluarized specimens of both groups. Noteworthy, LC-Mass Spectrometry analysis revealed that 16 proteins were exclusively preserved in Triton decellularized specimens in comparison to SDS-treated specimens. Aortic grafts showed high patency rates, no signs of thrombus formation, aneurysms or rupture. Conduits of both groups revealed tissue-specific cell migration indicative of functional remodeling. This study strongly suggests that decellularized allogenic grafts from the human placenta have the potential to be used as vascular replacement materials. Both detergents produced grafts with low residual immunogenicity and appropriate mechanical properties. Observed differences in graft characteristics due to preservation method had no impact on successful in vivo performance in the rodent model.
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Affiliation(s)
- Karl H Schneider
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria; Center for Biomedical Research Medical University of Vienna, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Marjan Enayati
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria; Center for Biomedical Research Medical University of Vienna, Vienna, Austria
| | - Christian Grasl
- Center for Biomedical Research Medical University of Vienna, Vienna, Austria; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Ingrid Walter
- Department of Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Lubos Budinsky
- Preclinical Imaging Laboratory, Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Gabriel Zebic
- Center for Biomedical Research Medical University of Vienna, Vienna, Austria
| | - Christoph Kaun
- Division of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Anja Wagner
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Molecular Stress Research in Peritoneal Dialysis, Vienna, Austria
| | - Klaus Kratochwill
- Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria; Christian Doppler Laboratory for Molecular Stress Research in Peritoneal Dialysis, Vienna, Austria
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in AUVA Trauma Center, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Andreas H Teuschl
- Department of Biochemical Engineering, University of Applied Sciences Technikum Wien, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria; City of Vienna Competence Team Siganltransduction, Vienna, Austria
| | - Bruno K Podesser
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria; Center for Biomedical Research Medical University of Vienna, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Helga Bergmeister
- Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria; Center for Biomedical Research Medical University of Vienna, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria.
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Munisso MC, Mahara A, Yamaoka T. Design of in situ porcine closed-circuit system for assessing blood-contacting biomaterials. J Artif Organs 2018; 21:317-324. [DOI: 10.1007/s10047-018-1042-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 04/06/2018] [Indexed: 12/30/2022]
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Historical Perspective and Future Direction of Blood Vessel Developments. Cold Spring Harb Perspect Med 2018; 8:cshperspect.a025742. [PMID: 28348177 DOI: 10.1101/cshperspect.a025742] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Over the past 40 years, remarkable advances have been made in our understanding of successful blood vessel regeneration, starting with the failures of early tissue-engineered vascular grafts designed using isolated components or molecules, such as collagen gels. The vascular tissue engineers are today better educated and have steered ongoing research developments toward clinical developments of more complete vascular grafts that replicate the multitude of specialized arterial aspects required for function.
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Natural and Synthetic Biodegradable Polymers: Different Scaffolds for Cell Expansion and Tissue Formation. Int J Artif Organs 2018. [DOI: 10.5301/ijao.5000307] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The formation of tissue produced by implanted cells is influenced greatly by the scaffold onto which they are seeded. In the long term it is often preferable to use a biodegradable material scaffold so that all the implanted materials will disappear, leaving behind only the generated tissue. Research in this area has identified several natural biodegradable materials. Among them, hydrogels are receiving increasing attention due to their ability to retain a great quantity of water, their good biocompatibility, their low interfacial tension, and the minimal mechanical and frictional irritation that they cause. Biocompatibility is not an intrinsic property of materials; rather it depends on the biological environment and the tolerability that exists with respect to specific polymer-tissue interactions. The most often utilized biodegradable synthetic polymers for 3D scaffolds in tissue engineering are saturated poly-a-hydroxy esters, including poly(lactic acid) (PLA) and poly(glycolic acid) (PGA), as well as poly(lactic-co-lycolide) (PLGA) copolymers. Hard materials provide compressive and torsional strength; hydrogels and other soft composites more effectively promote cell expansion and tissue formation. This review focuses on the future potential for understanding the characteristics of the biomaterials considered evaluated for clinical use in order to repair or to replace a sizable defect by only harvesting a small tissue sample.
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