Composite vascular grafts with high cell infiltration by co-electrospinning

Advancements in textile techniques for cardiovascular tissue replacement and repair

In cardiovascular therapeutics, procedures such as heart transplants and coronary artery bypass graft are pivotal. However, an acute shortage of organ donors increases waiting times of patients, which is reflected in negative effects on the outcome for the patient. Post-procedural complications such as thrombotic events and atherosclerotic developments may also have grave clinical implications. To address these challenges, tissue engineering is emerging as a solution, using textile technologies to synthesize biomimetic scaffolds resembling natural tissues. This comprehensive analysis explains methodologies including electrospinning, electrostatic flocking, and advanced textile techniques developed from weaving, knitting, and braiding. These techniques are evaluated in the context of fabricating cardiac patches, vascular graft constructs, stent designs, and state-of-the-art wearable sensors. We also closely examine the interaction of distinct process parameters with the biomechanical and morphological attributes of the resultant scaffolds. The research concludes by combining current findings and recommendations for subsequent investigation.

Improving hemocompatibility in tissue-engineered products employing heparin-loaded nanoplatforms

The enhancement of hemocompatibility through the use of nanoplatforms loaded with heparin represents a highly desirable characteristic in the context of emerging tissue engineering applications. The significance of employing heparin in biological processes is unquestionable, owing to its ability to interact with a diverse range of proteins. It plays a crucial role in numerous biological processes by engaging in interactions with diverse proteins and hydrogels. This review provides a summary of recent endeavors focused on augmenting the hemocompatibility of tissue engineering methods through the utilization of nanoplatforms loaded with heparin. This study also provides a comprehensive review of the various applications of heparin-loaded nanofibers and nanoparticles, as well as the techniques employed for encapsulating heparin within these nanoplatforms. The biological and physical effects resulting from the encapsulation of heparin in nanoplatforms are examined. The potential applications of heparin-based materials in tissue engineering are also discussed, along with future perspectives in this field.

Coaxial electrospun Ag-NPs-loaded endograft membrane with long-term antibacterial function treating mycotic aortic aneurysm

The use of endovascular stent-graft has become an important option in the treatment of aortic pathologies. However, the currently used endograft membranes have limited ability to prevent bacterial colonization. This makes them unsuitable for the treatment of mycotic aneurysms, as the infection is prone to progress after endograft implantation. Moreover, even in non-mycotic aortic pathologies, endograft infections can occur in the short or long term, especially for patients with diabetes mellitus or in immune insufficiency conditions. So, this study aimed to develop a kind of Ag-NPs-loaded endograft membrane by coaxial electrospinning technique, and a series of physical and chemical properties and biological properties of the Ag-NPs-loaded membrane were characterized. Animal experiments conducted in pigs confirmed that the Ag-NPs-loaded membrane was basically non-toxic, exhibited good biocompatibility, and effectively prevented bacterial growth in a mycotic aortic aneurysm model. In conclusion, the Ag-NPs-loaded membrane exhibited good biocompatibility, good anti-infection function and slow-release of Ag-NPs for long-term bacteriostasis. Thus, the Ag-NPs-loaded membrane might hold potential for preventing infection progression and treating mycotic aortic aneurysms in an endovascular way.

Correlation between porosity and physicochemical and biological properties of electrospinning PLA/PVA membranes for skin regeneration

Electrospinning is an increasingly popular technique for obtaining scaffolds for skin regeneration. However, electrospun scaffolds may also have some disadvantages, as the densely packed fibers in the scaffold structure can limit the penetration of skin cells into the inner part of the material. Such a dense arrangement of fibers can cause the cells to treat the 3D material as 2D one, and thus cause them to accumulate only on the upper surface. In this study, bi-polymer scaffolds made of polylactide (PLA) and polyvinyl alcohol (PVA) electrospun in a sequential or a concurrent system were investigated in a different PLA:PVA ratio (2:1 and 1:1). The properties of six types of model materials were investigated and compared i.e.; the initial materials electrospun by the sequential (PLA/PVA, 2PLA/PVA) and the concurrent system (PLA||PVA) and the same materials with removed PVA fibers (PLA/rPVA, 2PLA/rPVA, PLA||rPVA). The fiber models were intended to increase the porosity and coherent structure parameters of the scaffolds. The applied treatment involving the removal of PVA nanofibers increased the size of interfibrous pores formed between the PLA fibers. Ultimately, the porosity of the PLA/PVA scaffolds increased from 78 % to 99 %, and the time of water absorption decreased from 516 to 2 s. The change in wettability was induced by a synergistic effect of decrease in roughness after washing out and the presence of residual PVA fibers. The chemical analysis carried out confirmed the presence of PVA residues on the PLA fibers (FTIR-ATR study). In vitro studies were performed on human keratinocytes (HaKaT) and macrophages (RAW264.7), for which penetration into the inner part of the PLAIIPVA scaffold was observed. The new proposed approach, which allows the removal of PVA fibers from the bicomponent material, allows to obtain a scaffold with increased porosity, and thus better permeability for cells and nutrients.

Electrospun hybrid nanofibers: Fabrication, characterization, and biomedical applications

Nanotechnology is one of the most promising technologies available today, holding tremendous potential for biomedical and healthcare applications. In this field, there is an increasing interest in the use of polymeric micro/nanofibers for the construction of biomedical structures. Due to its potential applications in various fields like pharmaceutics and biomedicine, the electrospinning process has gained considerable attention for producing nano-sized fibers. Electrospun nanofiber membranes have been used in drug delivery, controlled drug release, regenerative medicine, tissue engineering, biosensing, stent coating, implants, cosmetics, facial masks, and theranostics. Various natural and synthetic polymers have been successfully electrospun into ultrafine fibers. Although biopolymers demonstrate exciting properties such as good biocompatibility, non-toxicity, and biodegradability, they possess poor mechanical properties. Hybrid nanofibers from bio and synthetic nanofibers combine the characteristics of biopolymers with those of synthetic polymers, such as high mechanical strength and stability. In addition, a variety of functional agents, such as nanoparticles and biomolecules, can be incorporated into nanofibers to create multifunctional hybrid nanofibers. Due to the remarkable properties of hybrid nanofibers, the latest research on the unique properties of hybrid nanofibers is highlighted in this study. Moreover, various established hybrid nanofiber fabrication techniques, especially the electrospinning-based methods, as well as emerging strategies for the characterization of hybrid nanofibers, are summarized. Finally, the development and application of electrospun hybrid nanofibers in biomedical applications are discussed.

Acellular Tissue-Engineered Vascular Grafts from Polymers: Methods, Achievements, Characterization, and Challenges

Extensive and permanent damage to the vasculature leading to different pathogenesis calls for developing innovative therapeutics, including drugs, medical devices, and cell therapies. Innovative strategies to engineer bioartificial/biomimetic vessels have been extensively exploited as an effective replacement for vessels that have seriously malfunctioned. However, further studies in polymer chemistry, additive manufacturing, and rapid prototyping are required to generate highly engineered vascular segments that can be effectively integrated into the existing vasculature of patients. One recently developed approach involves designing and fabricating acellular vessel equivalents from novel polymeric materials. This review aims to assess the design criteria, engineering factors, and innovative approaches for the fabrication and characterization of biomimetic macro- and micro-scale vessels. At the same time, the engineering correlation between the physical properties of the polymer and biological functionalities of multiscale acellular vascular segments are thoroughly elucidated. Moreover, several emerging characterization techniques for probing the mechanical properties of tissue-engineered vascular grafts are revealed. Finally, significant challenges to the clinical transformation of the highly promising engineered vessels derived from polymers are identified, and unique perspectives on future research directions are presented.

Negative In Vivo Results Despite Promising In Vitro Data With a Coated Compliant Electrospun Polyurethane Vascular Graft

INTRODUCTION

There is a growing need for small-diameter (<6 mm) off-the-shelf synthetic vascular conduits for different surgical bypass procedures, with actual synthetic conduits showing unacceptable thrombosis rates. The goal of this study was to build vascular grafts with better compliance than standard synthetic conduits and with an inner layer stimulating endothelialization while remaining antithrombogenic.

METHODS

Tubular vascular conduits made of a scaffold of polyurethane/polycaprolactone combined with a bioactive coating based on chondroitin sulfate (CS) were created using electrospinning and plasma polymerization. In vitro testing followed by a comparative in vivo trial in a sheep model as bilateral carotid bypasses was performed to assess the conduits' performance compared to the actual standard.

RESULTS

In vitro, the novel small-diameter (5 mm) electrospun vascular grafts coated with chondroitin sulfate (CS) showed 10 times more compliance compared to commercial expanded polytetrafluoroethylene (ePTFE) conduits while maintaining adequate suturability, burst pressure profiles, and structural stability over time. The subsequent in vivo trial was terminated after electrospun vascular grafts coated with CS showed to be inferior compared to their expanded polytetrafluoroethylene counterparts.

CONCLUSIONS

The inability of the experimental conduits to perform well in vivo despite promising in vitro results may be related to the low porosity of the grafts and the lack of rapid endothelialization despite the presence of the CS coating. Further research is warranted to explore ways to improve electrospun polyurethane/polycaprolactone scaffold in order to make it prone to transmural endothelialization while being resistant to strenuous conditions.

Effect of sequential electrospinning and co-electrospinning on morphological and fluid mechanical wall properties of polycaprolactone and bovine gelatin scaffolds, for potential use in small diameter vascular grafts

BACKGROUND

Nowadays, the engineering vascular grafts with a diameter less than 6 mm by means of electrospinning, is an attracted alternative technique to create different three-dimensional microenvironments with appropriate physicochemical properties to promote the nutrient transport and to enable the bioactivity, dynamic growth and differentiation of cells. Although the performance of a well-designed porous wall is key for these functional requirements maintaining the mechanical function, yet predicting the flow rate and cellular transport are still not widely understood and many questions remain open about new configurations of wall can be used for modifying the conventional electrospun samples. The aim of the present study was to evaluate the effect of fabrication techniques on scaffolds composed of bovine gelatin and polycaprolactone (PCL) developed by sequential electrospinning and co-electrospinning, on the morphology and fluid-mechanical properties of the porous wall.

METHODOLOGY

For this purpose, small diameter tubular structures were manufactured and experimental tests were performed to characterize the crystallinity, morphology, wettability, permeability, degradability, and mechanical properties. Some samples were cross-linked with Glutaraldehyde (GA) to improve the stability of the gelatin fiber. In addition, it was analyzed how the characteristics of the scaffold favored the levels of cell adhesion and proliferation in an in vitro model of 3T3 fibroblasts in incubation periods of 24, 48 and 72 h.

RESULTS

It was found that in terms of the morphology of tubular scaffolds, the co-electrospun samples had a better alignment with higher values of fiber diameters and apparent pore area than the sequential samples. The static permeability was more significant in the sequential scaffolds and the hydrophilic was higher in the co-electrospun samples. Therefore, the gelatin mass losses were less in the co-electrospun samples, which promote cellular functions. In terms of mechanical properties, no significant differences were observed for different types of samples.

CONCLUSION

This research concluded that the tubular scaffolds generated by sequential and co-electrospinning with modification in the microarchitecture could be used as a vascular graft, as they have better permeability and wettability, interconnected pores, and a circumferential tensile strength similar to native vessel compared to the commercial graft analyzed.

Electrospun nanofiber scaffold for vascular tissue engineering

Due to the prevalence of cardiovascular diseases, there is a large need for small diameter vascular grafts that cannot be fulfilled using autologous vessels. Although medium to large diameter synthetic vessels are in use, no suitable small diameter vascular graft has been developed due to the unique dynamic environment that exists in small vessels. To achieve long term patency, a successful tissue engineered vascular graft would need to closely match the mechanical properties of native tissue, be non-thrombotic and non-immunogenic, and elicit the proper healing response and undergo remodeling to incorporate into the native vasculature. Electrospinning presents a promising approach to the development of a suitable tissue engineered vascular graft. This review provides a comprehensive overview of the different polymers, techniques, and functionalization approaches that have been used to develop an electrospun tissue engineered vascular graft.

Glycosaminoglycans: From Vascular Physiology to Tissue Engineering Applications

Cardiovascular diseases represent the number one cause of death globally, with atherosclerosis a major contributor. Despite the clinical need for functional arterial substitutes, success has been limited to arterial replacements of large-caliber vessels (diameter > 6 mm), leaving the bulk of demand unmet. In this respect, one of the most challenging goals in tissue engineering is to design a "bioactive" resorbable scaffold, analogous to the natural extracellular matrix (ECM), able to guide the process of vascular tissue regeneration. Besides adequate mechanical properties to sustain the hemodynamic flow forces, scaffold's properties should include biocompatibility, controlled biodegradability with non-toxic products, low inflammatory/thrombotic potential, porosity, and a specific combination of molecular signals allowing vascular cells to attach, proliferate and synthesize their own ECM. Different fabrication methods, such as phase separation, self-assembly and electrospinning are currently used to obtain nanofibrous scaffolds with a well-organized architecture and mechanical properties suitable for vascular tissue regeneration. However, several studies have shown that naked scaffolds, although fabricated with biocompatible polymers, represent a poor substrate to be populated by vascular cells. In this respect, surface functionalization with bioactive natural molecules, such as collagen, elastin, fibrinogen, silk fibroin, alginate, chitosan, dextran, glycosaminoglycans (GAGs), and growth factors has proven to be effective. GAGs are complex anionic unbranched heteropolysaccharides that represent major structural and functional ECM components of connective tissues. GAGs are very heterogeneous in terms of type of repeating disaccharide unit, relative molecular mass, charge density, degree and pattern of sulfation, degree of epimerization and physicochemical properties. These molecules participate in a number of vascular events such as the regulation of vascular permeability, lipid metabolism, hemostasis, and thrombosis, but also interact with vascular cells, growth factors, and cytokines to modulate cell adhesion, migration, and proliferation. The primary goal of this review is to perform a critical analysis of the last twenty-years of literature in which GAGs have been used as molecular cues, able to guide the processes leading to correct endothelialization and neo-artery formation, as well as to provide readers with an overall picture of their potential as functional molecules for small-diameter vascular regeneration.

Hyaluronic acid electrospinning: Challenges, applications in wound dressings and new perspectives

Hyaluronic acid (HA) has already been consolidated in the literature as an extremely efficient biopolymer for biomedical applications. In addition to its biodegradability, HA also has excellent biological properties. In the nanofiber form, this polymer can mimic biological tissues, mainly the layers of the skin, and therefore has great potential as structures for the construction of wound dressings. Despite the numerous efforts from the scientific community proposing new dressings, this is an area in constant evolution. A dressing that brings together all the properties of an ideal dressing has not been developed yet. Electrospinning is a simple and versatile technique that correctly aligned with the functional properties of HA can produce multifunctional nanofiber structures capable of promoting skin recover quickly. This review discusses (i) key strategies for successful electrospinning of HA, (ii) main challenges and advances found in the electrospinning process, (iii) the bioactive properties of this polymer in the treatment of wounds, as well as (iv) the results obtained in the last decade by the in vitro and in vivo evaluation of the healing properties of these nanosystems.

Development of an electrospun polycaprolactone/silk scaffold for potential vascular tissue engineering applications

Long-distance (⩾10 mm) arterial vascular defect injury was a massive challenge affecting human health. Compared with autologous transplantation, tissue-engineered scaffolds such as biocompatible silk fibroin (SF) scaffolds have been developed because they exhibit equivalent functional repair effects without adverse reactions. However, its mechanical strength and structural stability needed to be further improved to match the longer repair cycle of blood vessels while maintaining the original biological safety. Hence, we designed and prepared SF and hydrophobic polycaprolactone (PCL) composite microfibers by an improving electrospinning method. It was found that when the weight ratio of PCL to SF was 1: 1, a microfiber scaffold with high strength (6.16 N) and minimum degradability can be obtained. More importantly, compared with natural silk fibroin, the novel composite microfiber scaffolds can slightly inhibit cell infiltration and inflammation through co-culture with HUVECs in vitro and rabbit back transplantation in vivo. Furthermore, the fabricated scaffolds also demonstrated excellent structural stability in vivo because of the well-organized PCL doping in the structure. All these results indicated that the novel PCL/SF composite microfiber scaffolds were promising candidates for vascular tissue engineering applications.

Long-term results of triple-layered small diameter vascular grafts in sheep carotid arteries

There is an urgent clinical for small diameter vascular grafts (SDVGs) for use in the treatment of coronary artery disease. Moreover, biodegradable SDVGs are drawing increasing attention because they have the potential to restore vascular function with the degradation of vascular graft and tissue regeneration. In this study, we designed triple-layered SDVGs to mimic the native arterial structure, with each layer contributing its unique porosity to the porous structure. We evaluated triple-layered SDVGs in a sheep carotid arterial replacement model. After implantation for 12 months, two grafts were patent and indicated the feasibility of using grafts in large animals. Nevertheless, it was determined that both grafts formed aneurysms at the proximal end. The prevention of such aneurysms remains a challenge for future investigation.

Electrospun nanofibers: A nanotechnological approach for drug delivery and dissolution optimization in poorly water-soluble drugs

Electrospinning is a novel and sophisticated technique for the production of nanofibers with high surface area, extreme porous structure, small pore size, and surface morphologies that make them suitable for biomedical and bioengineering applications, which can provide solutions to current drug delivery issues of poorly water-soluble drugs. Electrospun nanofibers can be obtained through different methods asides from the conventional one, such as coaxial, multi-jet, side by side, emulsion, and melt electrospinning. In general, the application of an electric potential to a polymer solution causes a charged liquid jet that moves downfield to an oppositely charged collector, where the nanofibers are deposited. Plenty of polymers that differ in their origin, degradation character and water affinity are used during the process. Physicochemical properties of the drug, polymer(s), and solvent systems need to be addressed to guarantee successful manufacturing. Therefore, this review summarizes the recent progress in electrospun nanofibers for their use as a nanotechnological tool for dissolution optimization and drug delivery systems for poorly water-soluble drugs.

One-Pot Covalent Grafting of Gelatin on Poly(Vinyl Alcohol) Hydrogel to Enhance Endothelialization and Hemocompatibility for Synthetic Vascular Graft Applications

Cardiovascular diseases remain the leading cause of death worldwide. Patency rates of clinically-utilized small diameter synthetic vascular grafts such as Dacron® and expanded polytetrafluoroethylene (ePTFE) to treat cardiovascular disease are inadequate due to lack of endothelialization. Sodium trimetaphosphate (STMP) crosslinked PVA could be potentially employed as blood-compatible small diameter vascular graft for the treatment of cardiovascular disease. However, PVA severely lacks cell adhesion properties, and the efforts to endothelialize STMP-PVA have been insufficient to produce a functioning endothelium. To this end, we developed a one-pot method to conjugate cell-adhesive protein via hydroxyl-to-amine coupling using carbonyldiimidazole by targeting residual hydroxyl groups on crosslinked STMP-PVA hydrogel. Primary human umbilical vascular endothelial cells (HUVECs) demonstrated significantly improved cells adhesion, viability and spreading on modified PVA. Cells formed a confluent endothelial monolayer, and expressed vinculin focal adhesions, cell-cell junction protein zonula occludens 1 (ZO1), and vascular endothelial cadherin (VE-Cadherin). Extensive characterization of the blood-compatibility was performed on modified PVA hydrogel by examining platelet activation, platelet microparticle formation, platelet CD61 and CD62P expression, and thrombin generation, which showed that the modified PVA was blood-compatible. Additionally, grafts were tested under whole, flowing blood without any anticoagulants in a non-human primate, arteriovenous shunt model. No differences were seen in platelet or fibrin accumulation between the modified-PVA, unmodified PVA or clinical, ePTFE controls. This study presents a significant step in the modification of PVA for the development of next generation in situ endothelialized synthetic vascular grafts.

A chitosan modified asymmetric small-diameter vascular graft with anti-thrombotic and anti-bacterial functions for vascular tissue engineering

Rapid endothelialization and prevention of restenosis are two vital challenges for the preparation of a small-diameter vascular graft (SDVG), while postoperative infection after implantation is often neglected.

Poly(Vinyl Alcohol)-Based Nanofibrous Electrospun Scaffolds for Tissue Engineering Applications

Tissue engineering (TE) holds an enormous potential to develop functional scaffolds resembling the structural organization of native tissues, to improve or replace biological functions and prevent organ transplantation. Amongst the many scaffolding techniques, electrospinning has gained widespread interest because of its outstanding features that enable the production of non-woven fibrous structures with a dimensional organization similar to the extracellular matrix. Various polymers can be electrospun in the form of three-dimensional scaffolds. However, very few are successfully processed using environmentally friendly solvents; poly(vinyl alcohol) (PVA) is one of those. PVA has been investigated for TE scaffolding production due to its excellent biocompatibility, biodegradability, chemo-thermal stability, mechanical performance and, most importantly, because of its ability to be dissolved in aqueous solutions. Here, a complete overview of the applications and recent advances in PVA-based electrospun nanofibrous scaffolds fabrication is provided. The most important achievements in bone, cartilage, skin, vascular, neural and corneal biomedicine, using PVA as a base substrate, are highlighted. Additionally, general concepts concerning the electrospinning technique, the stability of PVA when processed, and crosslinking alternatives to glutaraldehyde are as well reviewed.

E-jet 3D printed drug delivery implants to inhibit growth and metastasis of orthotopic breast cancer

Drug-loaded implants have attracted considerable attention in cancer treatment due to their precise delivery of drugs into cancer tissues. Contrary to injected drug delivery, the application of drug-loaded implants remains underutilized given the requirement for a surgical operation. Nevertheless, drug-loaded implants have several advantages, including a reduction in frequency of drug administration, minimal systemic toxicity, and increased delivery efficacy. Herein, we developed a new, precise, drug delivery device for orthotopic breast cancer therapy able to suppress breast tumor growth and reduce pulmonary metastasis using combination chemotherapy. Poly-lactic-co-glycolic acid scaffolds were fabricated by 3D printing to immobilize 5-fluorouracil and NVP-BEZ235. The implantable scaffolds significantly reduced the required drug dosages and ensured curative drug levels near tumor sites for prolonged period, while drug exposure to normal tissues was minimized. Moreover, long-term drug release was achieved, potentially allowing one-off implantation and, thus, a major reduction in the frequency of drug administration. This drug-loaded scaffold has great potential in anti-tumor treatment, possibly paving the way for precise, effective, and harmless cancer therapy.

Fabrication Techniques for Vascular and Vascularized Tissue Engineering

Impaired or damaged blood vessels can occur at all levels in the hierarchy of vascular systems from large vasculatures such as arteries and veins to meso- and microvasculatures such as arterioles, venules, and capillary networks. Vascular tissue engineering has become a promising approach for fabricating small-diameter vascular grafts for occlusive arteries. Vascularized tissue engineering aims to fabricate meso- and microvasculatures for the prevascularization of engineered tissues and organs. The ideal small-diameter vascular graft is biocompatible, bridgeable, and mechanically robust to maintain patency while promoting tissue remodeling. The desirable fabricated meso- and microvasculatures should rapidly integrate with the host blood vessels and allow nutrient and waste exchange throughout the construct after implantation. A number of techniques used, including engineering-based and cell-based approaches, to fabricate these synthetic vasculatures are herein explored, as well as the techniques developed to fabricate hierarchical structures that comprise multiple levels of vasculature.

Cellular Response to Cyclic Compression of Tissue Engineered Intervertebral Disk Constructs Composed of Electrospun Polycaprolactone

There is lack of investigation capturing the complex mechanical interaction of tissue-engineered intervertebral disk (IVD) constructs in physiologically relevant environmental conditions. In this study, mechanical characterization of anisotropic electrospinning (ES) substrates made of polycaprolactone (PCL) was carried out in wet and dry conditions and viability of human bone marrow derived mesenchymal stem cells (hMSCs) seeded within double layers of ES PCL were also studied. Cyclic compression of IVD-like constructs composed of an agarose core confined by ES PCL double layers was implemented using a bioreactor and the cellular response to the mechanical stimulation was evaluated. Tensile tests showed decrease of elastic modulus of ES PCL as the angle of stretching increased, and at 60 deg stretching angle in wet, the maximum ultimate tensile strength (UTS) was observed. Based on the configuration of IVD-like constructs, the calculated circumferential stress experienced by the ES PCL double layers was 40 times of the vertical compressive stress. Confined compression of IVD-like constructs at 5% and 10% displacement dramatically reduced cell viability, particularly at 10%, although cell presence in small and isolated area can still be observed after mechanical conditioning. Hence, material mechanical properties of tissue-engineered scaffolds, composed of fibril structure of polymer with low melting point, are affected by the testing condition. Circumferential stress induced by axial compressive stimulation, conveyed to the ES PCL double layer wrapped around an agarose core, can affect the viability of cells seeded at the interface, depending on the mechanical configuration and magnitude of the load.

Towards compliant small-diameter vascular grafts: Predictive analytical model and experiments

The search for novel, more compliant vascular grafts for the replacement of blood vessels is ongoing, and predictive tools are needed to identify the most promising biomaterials. A simple analytical model was designed that enables the calculation of the ratio between the ultimate stress (σ_ult) and the elastic modulus (E). To reach both the compliance of small-diameter coronary arteries (0.0725%/mmHg) and a burst pressure of 2031 mmHg, a material with a minimum σ_ult/E ratio of 1.78 is required. Based on this result and on data from the literature, random electrospun Polyurethane/Polycaprolactone (PU/PCL) tubular scaffolds were fabricated and compared to commercial ePTFE prostheses. PU/PCL grafts showed mechanical properties close to those of native arteries, with a circumferential elastic modulus of 4.8 MPa and a compliance of 0.036%/mmHg at physiological pressure range (80-120 mmHg) for a 145 μm-thick prosthesis. In contrast, commercial expanded polytetrafluoroethylene (ePTFE) grafts presented a high Young's modulus (17.4 MPa) and poor compliance of 0.0034%/mmHg. The electrospun PU/PCL did not however reach the target values as its σ_ult/E ratio was lower than expected, at 1.54, well below the calculated threshold (1.78). The model tended to overestimate both the compliance and burst pressure, with the differences between the analytical and experimental results ranging between 13 and 34%, depending on the pressure range tested. This can be explained by the anisotropy of random electrospun PU/PCL and its slightly non-linear elastic behavior, in contrast to the hypotheses of our model. Impermeability tests showed that the electrospun scaffolds were impermeable to blood for all thicknesses above 50 μm. In conclusion, this analytical model allows to select materials with suitable mechanical properties for the design of small-diameter vascular grafts. The novel electrospun PU/PCL tubular scaffolds showed strongly improved compliance as compared to commercial ePTFE prostheses.

Computationally optimizing the compliance of multilayered biomimetic tissue engineered vascular grafts

Coronary artery bypass grafts used to treat coronary artery disease often fail due to compliance mismatch. In this study, we have developed an experimental/computational approach to fabricate an acellular biomimetic hybrid tissue engineered vascular graft composed of alternating layers of electrospun porcine gelatin/polycaprolactone (PCL) and human tropoelastin/PCL blends with the goal of compliance-matching to rat abdominal aorta, while maintaining specific geometrical constraints. Polymeric blends at three different gelatin:PCL (G:PCL) and tropoelastin:PCL (T:PCL) ratios (80:20, 50:50 and 20:80) were mechanically characterized. The stress-strain data was used to develop predictive models, which were used as part of an optimization scheme that was implemented to determine the ratios of G:PCL and T:PCL and the thickness of the individual layers within a tissue engineered vascular graft that would compliance match a target compliance value. The hypocompliant, isocompliant, and hypercompliant grafts had target compliance values of 0.000256, 0.000568 and 0.000880 mmHg-1, respectively. Experimental validation of the optimization demonstrated that the hypercompliant and isocompliant grafts were not statistically significant from their respective target compliance values (p-value=0.37 and 0.89, respectively). The experimental compliance value of the hypocompliant graft was statistically significant than their target compliance value (p-value=0.047). We have successfully demonstrated a design optimization scheme that can be used to fabricate multilayered and biomimetic vascular grafts with targeted geometry and compliance.

Enhanced growth and differentiation of myoblast cells grown on E-jet 3D printed platforms

BACKGROUND

Skeletal muscle tissue engineering often involves the prefabrication of muscle tissues in vitro by differentiation and maturation of muscle precursor cells on a platform which provides an environment that facilitates the myogenic differentiation of the seeded cells.

METHODS

Poly lactic-co-glycolic acid (PLGA) 3D printed scaffolds, which simulate the highly complex structure of extracellular matrix (ECM), were fabricated by E-jet 3D printing in this study. The scaffolds were used as platforms, providing environment that aids in growth, differentiation and other properties of C2C12 myoblast cells.

RESULTS

The C2C12 myoblast cells grown on the PLGA 3D printed platforms had enhanced cell adhesion and proliferation. Moreover, the platforms were able to induce myogenic differentiation of the myoblast cells by promoting the formation of myotubes and up-regulating the expressions of myogenic genes (MyHC and MyOG).

CONCLUSION

The fabricated 3D printed platforms have excellent biocompatibility, thereby can potentially be used as functional cell culture platforms in skeletal tissue engineering and regeneration.

Triple-Layer Vascular Grafts Fabricated by Combined E-Jet 3D Printing and Electrospinning

Small-diameter tissue-engineered vascular grafts are urgently needed for clinic arterial substitute. To simulate the structures and functions of natural blood vessels, we designed a novel triple-layer poly(ε-caprolactone) (PCL) fibrous vascular graft by combining E-jet 3D printing and electrospinning techniques. The resultant vascular graft consisted of an interior layer comprising 3D-printed highly aligned strong fibers, a middle layer made by electrospun densely fibers, and an exterior structure composed of mixed fibers fabricated by co-electrospraying. The biocompatible triple-layer graft was used for in vivo implantation, and results demonstrated that the longitudinally-aligned fibers within the lumen of the graft could enhance the proliferation and migration of endothelial cells, while maintained good mechanical properties. The exterior layer provided a pathway that encouraged cells to migrate into the scaffold after implantation. This experimental graft overcame the limitations of conventionally electrospun vascular grafts of inadequate porosity and lowly cell penetration. The unique structure of the triple-layer vascular graft promoted cell growth and infiltration in vivo, thus provided an encouraging substitute for in situ tissue engineering.

Pre-clinical evaluation of advanced nerve guide conduits using a novel 3D in vitro testing model

Autografts are the current gold standard for large peripheral nerve defects in clinics despite the frequently occurring side effects like donor site morbidity. Hollow nerve guidance conduits (NGC) are proposed alternatives to autografts, but failed to bridge gaps exceeding 3 cm in humans. Internal NGC guidance cues like microfibres are believed to enhance hollow NGCs by giving additional physical support for directed regeneration of Schwann cells and axons. In this study, we report a new 3D in vitro model that allows the evaluation of different intraluminal fibre scaffolds inside a complete NGC. The performance of electrospun polycaprolactone (PCL) microfibres inside 5 mm long polyethylene glycol (PEG) conduits were investigated in neuronal cell and dorsal root ganglion (DRG) cultures in vitro. Z-stack confocal microscopy revealed the aligned orientation of neuronal cells along the fibres throughout the whole NGC length and depth. The number of living cells in the centre of the scaffold was not significantly different to the tissue culture plastic (TCP) control. For ex vivo analysis, DRGs were placed on top of fibre-filled NGCs to simulate the proximal nerve stump. In 21 days of culture, Schwann cells and axons infiltrated the conduits along the microfibres with 2.2 ± 0.37 mm and 2.1 ± 0.33 mm, respectively. We conclude that this in vitro model can help define internal NGC scaffolds in the future by comparing different fibre materials, composites and dimensions in one setup prior to animal testing.

The post-morphological analysis of electrospun vascular grafts following mechanical testing

Vascular grafts provide promising scaffolds for patients recuperating from cardiovascular diseases. Since it is necessary to mimic the native vessel in order to overcome the limitations of currently employed synthetic prostheses, researchers are tending to focus on the design of electrospun biodegradable multi-layer scaffolds which involves varying either the polymer type or constructional properties in each layer which, in turn, reveals the importance of layer interactions and their composite effect on the final multi-layer graft. This study describes the fabrication of biodegradable single-layer tubular scaffolds from polycaprolactone and poly(L-lactide)caprolactone polymers composed of either randomly distributed or, preferably, radially oriented fibers. Subsequently, bi-layer scaffolds were fabricated with a randomly distributed inner layer and a radially oriented outer layer from various polymer couple variations. The study focuses on vascular graft production technology including its morphology and mechanical properties. The post-morphologies of single-layer and bi-layer tubular scaffolds designed for vascular grafts were investigated as a continuation of a previously performed analysis of their mechanical properties. The results indicate that the mechanical properties of the final bi-layer grafts were principally influenced by the radially oriented outer layers acting as the tunica media of the native vessels when the appropriate polymer couples were chosen for the sub-layers.

Control of cell growth on 3D-printed cell culture platforms for tissue engineering

Biocompatible tissue growth has excellent prospects for tissue engineering. These tissues are built over scaffolds, which can influence aspects such as cell adhesion, proliferation rate, morphology, and differentiation. However, the ideal 3D biological structure has not been developed yet. Here, we applied the electro-hydrodynamic jet (E-jet) 3D printing technology using poly-(lactic-co-glycolic acid, PLGA) solution to print varied culture platforms for engineered tissue structures. The effects of different parameters (electrical voltage, plotting speed, and needle sizes) on the outcome were investigated. We compared the biological compatibility of the 3D printed culture platforms with that of random fibers. Finally, we used the 3D-printed PLGA platforms to culture fibroblasts, the main cellular components of loose connective tissue. The results show that the E-jet printed platforms could guide and improve cell growth. These highly aligned fibers were able to support cellular alignment and proliferation. Cell angle was consistent with the direction of the fibers, and cells cultured on these fibers showed a much faster migration, potentially enhancing wound healing performance. Thus, the potential of this technology for 3D biological printing is large. This process can be used to grow biological scaffolds for the engineering of tissues. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 3281-3292, 2017.

Electrospun vein grafts with high cell infiltration for vascular tissue engineering

Demand is increasing for functional small-diameter vascular grafts (diameter<6mm) for clinical arterial replacement. In the present study, we develop a bilayer poly(ε-caprolactone, PCL) fibrous vascular graft consisting of a thin internal layer made of longitudinally aligned fibers and a relatively thick highly porous external layer. The internal layer provides a scaffold with the necessary mechanical strength and enhances the growth of endothelial cells, whereas the external layer enhances cell motility through the scaffold bulk. The biocompatibility and biological performance of bilayer fibrous scaffolds are evaluated by in vivo experiments, molecular biology, and histology studies. Our bilayer scaffolds demonstrate much better fiber alignment and higher porosity than do normal electrospun vascular grafts with randomly distributed fibers. The results suggest that the proposed grafts can overcome limitations owing to the inadequate porosity, small pores, and poor cell infiltration of scaffolds fabricated by conventional electrospinning. The unique structure of bilayer scaffolds is satisfactory and promotes cell proliferation, collagen-fiber deposition, and ingrowth of smooth muscle cells and endothelial cells in vivo. The results of this study illustrate the strong potential of such bilayer fibrous scaffolds for vascular tissue engineering and regeneration.

Small-diameter hybrid vascular grafts composed of polycaprolactone and polydioxanone fibers

Electrospun polycaprolactone (PCL) vascular grafts showed good mechanical properties and patency. However, the slow degradation of PCL limited vascular regeneration in the graft. Polydioxanone (PDS) is a biodegradable polymer with high mechanical strength and moderate degradation rate in vivo. In this study, a small-diameter hybrid vascular graft was prepared by co-electrospinning PCL and PDS fibers. The incorporation of PDS improves mechanical properties, hydrophilicity of the hybrid grafts compared to PCL grafts. The in vitro/vivo degradation assay showed that PDS fibers completely degraded within 12 weeks, which resulted in the increased pore size of PCL/PDS grafts. The healing characteristics of the hybrid grafts were evaluated by implantation in rat abdominal aorta replacement model for 1 and 3 months. Color Doppler ultrasound demonstrated PCL/PDS grafts had good patency, and did not show aneurysmal dilatation. Immunofluorescence staining showed the coverage of endothelial cells (ECs) was significantly enhanced in PCL/PDS grafts due to the improved surface hydrophilicity. The degradation of PDS fibers provided extra space, which facilitated vascular smooth muscle regeneration within PCL/PDS grafts. These results suggest that the hybrid PCL/PDS graft may be a promising candidate for the small-diameter vascular grafts.

Increased Energy Loss Due to Twist and Offset Buckling of the Total Cavopulmonary Connection

The hemodynamic energy loss through the surgically implanted conduits determines the postoperative cardiac output and exercise capacity following the palliative repair of single-ventricle congenital heart defects. In this study, the hemodynamics of severely deformed surgical pathways due to torsional deformation and anastomosis offset are investigated. We designed a mock-up total cavopulmonary connection (TCPC) circuit to replicate the mechanically failed inferior vena cava (IVC) anastomosis morphologies under physiological venous pressure (9, 12, 15 mmHg), in vitro, employing the commonly used conduit materials: Polytetrafluoroethylene (PTFE), Dacron, and porcine pericardium. The sensitivity of hemodynamic performance to torsional deformation for three different twist angles (0 deg, 30 deg, and 60 deg) and three different caval offsets (0 diameter (D), 0.5D, and 1D) are digitized in three dimensions and employed in computational fluid dynamic (CFD) simulations to determine the corresponding hydrodynamic efficiency levels. A total of 81 deformed conduit configurations are analyzed; the pressure drop values increased from 80 to 1070% with respect to the ideal uniform diameter IVC conduit flow. The investigated surgical materials resulted in significant variations in terms of flow separation and energy loss. For example, the porcine pericardium resulted in a pressure drop that was eight times greater than the Dacron conduit. Likewise, PTFE conduit resulted in a pressure drop that was three times greater than the Dacron conduit under the same venous pressure loading. If anastomosis twist and/or caval offset cannot be avoided intraoperatively due to the anatomy of the patient, alternative conduit materials with high structural stiffness and less influence on hemodynamics can be considered.

Manufacture and property research of heparin grafted electrospinning PCU artificial vascular scaffolds

PCU (polycarbonate polyurethane) is supposed to be an ideal elastomer for manufacturing artificial vessel scaffold with perfect mechanical strength and biocompatibility. Surface grafting by heparin sodium can increase its anticoagulant hemorrhagic, achieving a better application in artificial vessels. Artificial vessels were preliminarily prepared by electrostatic spinning, treated by NH₃ plasma and cross-linked with the anticoagulant heparin sodium chemically. Performances of the PCU-Hep (heparin sodium grafted purethane artificial vessels) artificial vessel were calculated through the physical and chemical property tests, evaluation of blood and biocompatibility. Results manifested that heparin sodium was successfully grafted to the vascular surface, porosity, pore diameter and water permeability of the vascular prosthesis fitted the requirements of artificial vessels, the blood test results demonstrated that the vascular material had a low hemolysis, in vitro cytotoxicity experiment and animal experiments proved an excellent biocompatibility. Thus the heparin sodium grafted electrospinning vessels could reduce intravascular thrombus and had potential clinical application.

Cell-free vascular grafts: Recent developments and clinical potential

Recent advances in vascular tissue engineering have led to the development of cell-free grafts that are available off-the-shelf for on demand surgery. Challenges associated with cell-based technologies including cell sourcing, cell expansion and long-term bioreactor culture motivated the development of completely cell-free vascular grafts. These are based on decellularized arteries, decellularized cultured cell-based tissue engineered grafts or biomaterials functionalized with biological signals that promote in situ tissue regeneration. Clinical trials undertaken to demonstrate the applicability of these grafts are also discussed. This comprehensive review summarizes recent developments in vascular graft technologies, with potential applications in coronary artery bypass procedures, lower extremity bypass, vascular injury and trauma, congenital heart diseases and dialysis access shunts, to name a few.

Control of cell proliferation in E-jet 3D-printed scaffolds for tissue engineering applications: the influence of the cell alignment angle

This study used E-jet 3D printing to fabricate various scaffolds for tissue engineering which could guide and improve cell growth.

Fabrication and effect on regulating vSMC phenotype of a biomimetic tunica media scaffold

We constructed a bFGF@TGF-β1 loaded porous film-like PLGA scaffold with dual surface topography of nanofiber and micro-orientation structures for regulating the phenotype of vascular smooth muscle cell (vSMC).