Sterilization and virus inactivation by supercritical fluids (a review)

Outcomes of ACL Reconstruction Utilizing Supercritical CO2-Sterilized Allografts

Background

Allograft tendons are perceived to have a high ACL graft failure rate in primary anterior cruciate ligament (ACL) reconstruction (ACLR). Historical series may be biased by graft processing methods that degrade the biomechanical properties of donor tendons such as irradiation. Supercritical carbon dioxide (SCCO2) is a validated method of terminally sterilizing biomaterials at physiological temperatures without irradiation, but in vivo use of SCCO2-processed tendon allografts for primary ACLR has not been reported to date.

Hypothesis

ACLR with SCCO2 allografts would result in acceptable failure rates, subjective knee scores, and clinical evaluation at 2 years postoperatively.

Study Design

Case series; Level of evidence, 4.

Methods

Patients underwent primary ACLR with terminally sterilized SCCO2-processed human gracilis, peroneus longus, semitendinosus, tibialis anterior, and tibialis posterior tendon allografts. Patient demographics were collected, along with tendon donor age and sex. At 1 year postoperatively, subjective International Knee Documentation Committee (IKDC) and ACL-Return to Sport After Injury (ACL-RSI) scores were collected, as well as clinical evaluation. At 2 years postoperatively, the IKDC and ACL-RSI scores were repeated, and return to sports and further knee injuries were recorded.

Results

A total of 144 patients with a medianage of 26 (IQR 14) years formed the study group. Patients were predominately male (58%). The loss to follow-up rate was 8% (n = 12). The mean age of allograft tendon donors was 37 (range 17-58) years, and the majority were male (83%). The mean allograft diameter was 8.9 ± 1.0 mm. At 2 years, ACL graft failureoccurred in 5% (n = 7). All graft failureswere in patients aged ≤25 years (P = .007). Neither donor age (≤40 or >40 years) nor donor sex was associated with graft failure (P > .05). The median IKDC subjective score was 95 and ACL-RSI score was 75. There were no revisions for sepsis within the first 2 years postoperatively.

Conclusion

SCCO2 processing of allograft tendons demonstrated satisfactory clinical and patient-reported outcomes at 24 months postoperatively in a consecutive series of patients with primary ACLR, with similar ACL graft failure rates and subjective knee scores compared with those reported in published series of hamstring tendon autograft and fresh frozen nonirradiated allograft.

Development and optimization of a one step process for the production and sterilization of liposomes using supercritical CO2

Liposomes are very interesting drug delivery systems for pharmaceutical and therapeutic purposes. However, liposome sterilization as well as their industrial manufacturing remain challenging. Supercritical carbon dioxide is an innovative technology that can potentially overcome these limitations. The aim of this study was to optimize a one-step process for producing and sterilizing liposomes using supercritical CO2. For this purpose, a design of experiment was conducted. The analysis of the experimental design showed that the temperature is the most influential parameter to achieve the sterility assurance level (SAL) required for liposomes (≤10-6). Optimal conditions (80 °C, 240 bar, 30 min) were identified to obtain the fixed critical quality attributes of liposomes. The conditions for preparing and sterilizing empty liposomes of various compositions, as well as liposomes containing the poorly water-soluble drug budesonide, were validated. The results indicate that the liposomes have appropriate physicochemical characteristics for drug delivery, with a size of 200 nm or less and a PdI of 0.35 or less. Additionally, all liposome formulations demonstrated the required SAL and sterility at concentrations of 5 and 45 mM, with high encapsulation efficiency.

Effect of ScCO2 on the decontamination of PECs-based cryogels: A comparison with H2O steam and H2O2 nebulization methods

Biopolymers present ideal properties to be used in wound dressing solutions. By mixing two oppositely charged macromolecules it is possible to form polyelectrolyte complex (PEC) based cryogels using lyophilization. Their application in the biomedical field is limited due to their sterilization requirements, as conventional methods compromise their physicochemical properties. ScCO2 appears as an alternative method for decontamination. This work assessed several cryogel PEC formulations, chitosan-pectin, gelatine-xanthan gum and alginate-gelatine. PEC formation was confirmed by FTIR and rheological analysis. While steam sterilization compromised cryogels' chemical and morphological properties, decontamination with scCO2 proved to be a promising method for decontamination of PEC-cryogels, because, similarly to what is observed with hydrogen peroxide, it does not compromise their physicochemical properties.

Fabrication of a Zircon Microfiltration Membrane for Culture Medium Sterilization

Multilayer ceramic membranes to be used for bacteria removal by filtration were prepared from ceramic materials. They consist of a macro-porous carrier, an intermediate layer and a thin separation layer at the top. Tubular and flat disc supports were prepared from silica sand and calcite (natural raw materials), using extrusion and uniaxial pressing methods, respectively. Making use of the slip casting technique, the silica sand intermediate layer and the zircon top-layer were deposited on the supports, in this order. The particle size and the sintering temperature for each layer were optimized to achieve a suitable pore size for the deposition of the next layer. Morphology, microstructures, pore characteristics, strength and permeability were also studied. Filtration tests were conducted to optimize the permeation performance of the membrane. Experimental results show that the total porosity and average pore size of the porous ceramic supports sintered at different temperatures within the range (1150-1300 °C), and lie in the ranges of 44-52% and 5-30 μm, respectively. For the ZrSiO₄ top-layer, after firing at 1190 °C, a typical average pore size of about 0.3 μm and a thickness of about 70 μm were measured, while water permeability is estimated to a value of 440 lh^-1m^-2bar^-1. Finally, the optimized membranes were tested in the sterilization of a culture medium. Filtration results show the efficiency of the zircon-deposited membranes for bacteria removal; indeed, the growth medium was found to be free of all microorganisms.

Recent advances in sterilization and disinfection technology: A review

Sterilization and disinfection of pollutants and microorganisms have been extensively studied in order to address the problem of environmental contamination, which is a crucial issue for public health and economics. Various form of hazardous materials/pollutants including microorganisms and harmful gases are released into the environment that enter into the human body either through inhalation, adsorption or ingestion. The human death rate rises due to various respiratory ailments, strokes, lung cancer, and heart disorders related with these pollutants. Hence, it is essential to control the environmental pollution by applying economical and effective sterilization and disinfections techniques to save life. In general, numerous forms of traditional physical and chemical sterilization and disinfection treatments, such as dry and moist heat, radiation, filtration, ethylene oxide, ozone, hydrogen peroxide, etc. are known along with advanced techniques. In this review we summarized both advanced and conventional techniques of sterilization and disinfection along with their uses and mode of action. This review gives the knowledge about the advantages, disadvantages of both the methods comparatively. Despite, the effective solution given by the advanced sterilization and disinfection technology, joint technologies of sterilization and disinfection has proven to be more effective innovation to protect the indoor and outdoor environments.

Inactivation of Clostridium Spores in Honey with Supercritical CO2 and in Combination with Essential Oils

The presence of tens of Clostridium botulinum spores per gram of honey can cause infantile botulism. Thermal treatment is insufficient to inactivate these resistant forms. This study explored the effectiveness of supercritical CO2 (scCO2) on its own and combined with lemon (LEO), clove (CLEO), and cinnamon (CEO) essential oils on the inactivation of Clostridium sporogenes (CECT 553) as a surrogate of Clostridium botulinum. In water, the degree of inactivation at 10 MPa after 60 min increased with the increasing temperature, reducing the population by 90% at 40 °C and by 99.7% at 80 °C. In contrast, when applied to honey, scCO2 did not inactivate Clostridium spores satisfactorily at temperatures below 70 °C, which was related to the protective effect of honey. Meanwhile, scCO2 modified with CEO (<0.4% mass) improved the inactivation degree, with a 1.3-log reduction achieved at 60 °C. With this same mixture, a reduction of 3.7 logs was accomplished in a derivative with 70% moisture. Honey was very sensitive to the temperature of the applied CO2. The obtained product could be used as a novel food, food ingredient, cosmetic, or medicine.

Investigating the microbial inactivation effect of low temperature high pressure carbon dioxide and its application in frozen prawn (Penaeus vannamei)

During the pandemic of coronavirus disease 2019, the fact that frozen foods can carry the relevant virus raises concerns about the microbial safety of cold-chain foods. As a non-thermal processing technology, high pressure carbon dioxide (HPCD) is a potential method to reduce microbial load on cold-chain foods. In this study, we explored the microbial inactivation of low temperature (5-10 °C) HPCD (LT-HPCD) and evaluated its effect on the quality of prawn during freeze-chilled and frozen storage. LT-HPCD treatment at 6.5 MPa and 10 °C for 15 min could effectively inactivate E. coli (99.45%) and S. aureus (94.6%) suspended in 0.85% NaCl, SARS-CoV-2 Spike pseudovirus (>99%) and human coronavirus 229E (hCoV-229E) (>1-log virus tilter reduction) suspended in DMEM medium. The inactivation effect of LT-HPCD was weakened but still significant when the microorganisms were inoculated on the surface of food or package. LT-HPCD treatment at 6.5 MPa and 10 °C for 15 min achieved about 60% inactivation of total aerobic count while could maintain frozen state and quality of prawn. Moreover, LT-HPCD treated prawn exhibited significant slower microbial proliferation and no occurrence of melanosis compared with the untreated samples during chilled storage. A comprehensive quality investigation indicated that LT-HPCD treatment could maintain the color, texture and sensory of prawn during chilled or frozen storage. Consequently, LT-HPCD could improve the microbial safety of frozen prawn while maintaining its original quality, and could be a potential method for food industry to improve the microbial safety of cold-chain foods.

Supercritical CO2 sterilization: An effective treatment to reprocess FFP3 face masks and to reduce waste during COVID-19 pandemic

The outbreak of COVID-19 pandemic unveiled an unprecedented scarcity of personal protective equipment (PPE) available in sanitary premises and for the population worldwide. This situation fostered the development of new strategies to reuse PPE that would ensure sterility and, simultaneously, preserve the filtering properties of the materials. In addition, the reuse of PPEs by reprocessing could reduce the environmental impact of the massive single-use and disposal of these materials. Conventional sterilization techniques such as steam or dry heat, ethylene oxide, and gamma irradiation may alter the functional properties of the PPEs and/or leave toxic residues. Supercritical CO2 (scCO2)-based sterilization is herein proposed as a safe, sustainable, and rapid sterilization method for contaminated face masks while preserving their performance. The functional (bacterial filtration efficiency, breathability, splash resistance, straps elasticity) properties of the processed FFP3 face masks were evaluated after 1 and 10 cycles of sterilization. Log-6 sterilization reduction levels were obtained for face masks contaminated with Bacillus pumilus endospores at mild operating conditions (CO2 at 39 °C and 100 bar for 30 min) and with low contents of H2O2 (150 ppm). Physicochemical properties of the FFP3 face masks remained unchanged after reprocessing and differences in efficacy were not observed neither in the filtration tests, following UNE-EN 14683, nor in the integrity of FFP3 filtration after the sterilization process. The herein presented method based on scCO2 technology is the first reported protocol achieving the reprocessing of FFP3 masks up to 10 cycles while preserving their functional properties.

Non-conventional Stabilization for Fruit and Vegetable Juices: Overview, Technological Constraints, and Energy Cost Comparison

This study will provide an overview and a description of the most promising alternatives to conventional thermal treatments for juice stabilization, as well as a review of the literature data on fruit and vegetable juice processing in terms of three key parameters in juice production, which are microbial reduction, enzyme inactivation, and nutrient-compound retention. The alternatives taken into consideration in this work can be divided, according to the action mechanism upon which these are based, in non-conventional thermal treatments, among which microwave heating (MWH) and ohmic heating (OH), and non-thermal treatments, among which electrical treatments, i.e., pulsed electric fields (PEF), high-pressure processing (HPP), radiation treatments such as ultraviolet light (UVL) and high-intensity pulsed light (PL), and sonication (HIUS) treatment, and inert-gas treatments, i.e., the pressure change technology (PCT) and supercritical carbon dioxide (SC-CO2) treatments. For each technology, a list of the main critical process parameters (CPP), advantages (PROS), and disadvantages (CONS) will be provided. In addition, for the non-thermal technologies, a summary of the most relevant published result of their application on fruit and vegetable juices will be presented. On top of that, a comparison of typical specific working energy costs for the main effective and considered technologies will be reported in terms of KJ per kilograms of processed product.

The potential application of supercritical CO2 in microbial inactivation of food raw materials and products

The purpose of this study was to review the possibility of using supercritical CO₂ as a green and sustainable technology for microbial inactivation of raw material for further application in the food industry. The history of the development of supercritical CO₂ microbial inactivation has been widely described in this article. The fundamental scientific part of the process like mechanism of bactericidal action of CO₂ or inactivation of key enzymes were characterized in detail. In summary, this study provides an overview of the latest literature on the use of supercritical carbon dioxide in microbial inactivation of food raw materials and products.

Supercritical fluid technology for the development of innovative ophthalmic medical devices: Drug loaded intraocular lenses to mitigate posterior capsule opacification

Supercritical impregnation technology was applied to load acrylic intraocular lenses (IOLs) with methotrexate to produce a sustained drug delivery device to mitigate posterior capsule opacification. Drug release kinetics were studied in vitro and used to determine the drug loading. Loaded IOLs and control IOLs treated under the same operating conditions, but without drug, were implanted ex vivo in human donor capsular bags. The typical cell growth was observed and immunofluorescence staining of three common fibrosis markers, fibronectin, F-actin and α-smooth muscle actin was carried out. Transparent IOLs presenting a sustained release of methotrexate for more than 80 days were produced. Drug loading varying between 0.43 and 0.75 ± 0.03 µg_drug·mg^-1_IOL were obtained when varying the supercritical impregnation pressure (8 and 25 MPa) and duration (30 and 240 min) at 308 K. The use of ethanol (5 mol%) as a co-solvent did not influence the impregnation efficiency and was even unfavorable at certain conditions. Even if the implantation of methotrexate loaded IOLs did not lead to a statistically significant variation in the duration required for a full cell coverage of the posterior capsule in the human capsular bag model, it was shown to reduce fibrosis by inhibiting epithelial-mesenchymal transformation. The innovative application presented has the potential to gain clinical relevance.

Effects of SCCO2, Gamma Irradiation, and Sodium Dodecyl Sulfate Treatments on the Initial Properties of Tendon Allografts

Sterile and decellularized allograft tendons are viable biomaterials used in reconstructive surgeries for dense connective tissue injuries. Established allograft processing techniques including gamma irradiation and sodium dodecyl sulfate (SDS) can affect tissue integrity. Supercritical carbon dioxide (SCCO₂) represents a novel alternative that has the potential to decellularize and sterilize tendons with minimized exposure to denaturants, shortened treatment time, lack of toxic residues, and superior tissue penetration, and thus efficacy. This study attempted to develop a single-step hybrid decellularization and sterilization protocol for tendons that involved SCCO₂ treatment with various chemical additives. The processed tendons were evaluated with mechanical testing, histology, scanning electron microscopy (SEM), and Fourier-transform infrared (FTIR) spectroscopy. Uniaxial mechanical testing showed that tendons treated with SCCO₂ and additive NovaKill^TM Gen2 and 0.1% SDS had significantly higher (p < 0.05) ultimate tensile stress (UTS) and Young's modulus compared to gamma-irradiated and standard-SDS-treated tendons. This was corroborated by the ultrastructural intactness of SCCO₂-treated tendons as examined by SEM and FTIR spectroscopy, which was not preserved in gamma-irradiated and standard SDS-treated tendons. However, complete decellularization was not achieved by the experimented SCCO₂-SDS protocols used in this study. The present study therefore serves as a concrete starting point for development of an SCCO₂-based combined sterilization and decellularization protocol for allograft tendons, where additive choice is to be optimized.

Research Note: Microbial inactivation of raw chicken meat by supercritical carbon dioxide treatment alone and in combination with fresh culinary herbs

The objective of the present study was to assess the potential synergistic effect between supercritical carbon dioxide (SC-CO₂) and fresh culinary herbs (Coriandrum sativum and Rosmarinus officinalis) on the microbial inactivation of raw chicken meat. The microbiological inactivation was performed on Escherichia coli and natural flora (total mesophilic bacteria, yeasts, and molds). High pressure treatments were carried out at 40°C, 80 or 140 bar from 15 to 45 min. Microbial inactivation had a strong dependence on treatment time, achieving 1.4 log CFU/g reduction of E. coli after 15 min, and up to 5 log after 45 min, while a pressure increase from 80 up to 140 bar was not significant on the microbial inactivation. Mesophilic microorganisms were strongly reduced (>2.6 log CFU/g) after 45 min, and yeasts and molds were below the detection limits of the technique (<100 CFU/g) in most cases. The combination of fresh herbs together with SC-CO₂ treatment did not significantly increase the inactivation of either E. coli or natural flora, which was similar to the SC-CO₂ alone. The synergistic effect was obtained on the inactivation of E. coli using a proper concentration of coriander essential oil (EO) (0.5% v/w), while rosemary EO did not show a significant effect. Color analysis after the treatment showed an increment of lightness (L*), and a decrease of redness (a*) on the surface of the sample, making the product visually similar to cooked meat. Texture analysis demonstrated the modification of the texture parameters as a function of the process pressure making the meat more similar to the cooked one.

A new era for sterilization based on supercritical CO2 technology

The increasing complexity in morphology and composition of modern biomedical materials (e.g., soft and hard biological tissues, synthetic and natural-based scaffolds, technical textiles) and the high sensitivity to the processing environment requires the development of innovative but benign technologies for processing and treatment. This scenario is particularly applicable where current conventional techniques (steam/dry heat, ethylene oxide, and gamma irradiation) may not be able to preserve the functionality and integrity of the treated material. Sterilization using supercritical carbon dioxide emerges as a green and sustainable technology able to reach the sterility levels required by regulation without altering the original properties of even highly sensitive materials. In this review article, an updated survey of experimental protocols based on supercritical sterilization and of the efficacy results sorted by microbial strains and treated materials was carried out. The application of the supercritical sterilization process in materials used for biomedical, pharmaceutical, and food applications is assessed. The opportunity of supercritical sterilization of not only replace the above mentioned conventional techniques, but also of reach unmet needs for sterilization in highly sensitive materials (e.g., single-use medical devices, the next-generation biomaterials, and medical devices and graft tissues) is herein unveiled.

Processing of collagen based biomaterials and the resulting materials properties

Collagen, the most abundant extracellular matrix protein in animal kingdom belongs to a family of fibrous proteins, which transfer load in tissues and which provide a highly biocompatible environment for cells. This high biocompatibility makes collagen a perfect biomaterial for implantable medical products and scaffolds for in vitro testing systems. To manufacture collagen based solutions, porous sponges, membranes and threads for surgical and dental purposes or cell culture matrices, collagen rich tissues as skin and tendon of mammals are intensively processed by physical and chemical means. Other tissues such as pericardium and intestine are more gently decellularized while maintaining their complex collagenous architectures. Tissue processing technologies are organized as a series of steps, which are combined in different ways to manufacture structurally versatile materials with varying properties in strength, stability against temperature and enzymatic degradation and cellular response. Complex structures are achieved by combined technologies. Different drying techniques are performed with sterilisation steps and the preparation of porous structures simultaneously. Chemical crosslinking is combined with casting steps as spinning, moulding or additive manufacturing techniques. Important progress is expected by using collagen based bio-inks, which can be formed into 3D structures and combined with live cells. This review will give an overview of the technological principles of processing collagen rich tissues down to collagen hydrolysates and the methods to rebuild differently shaped products. The effects of the processing steps on the final materials properties are discussed especially with regard to the thermal and the physical properties and the susceptibility to enzymatic degradation. These properties are key features for biological and clinical application, handling and metabolization.

Some Advances in Supercritical Fluid Extraction for Fuels, Bio-Materials and Purification

Supercritical fluids are used for the extraction of desired ingredients from natural materials, but also for the removal of undesired and harmful ingredients. In this paper, the pertinent physical and chemical properties of supercritical water, methanol, ethanol, carbon dioxide, and their mixtures are provided. The methodologies used with supercritical fluid extraction are briefly dealt with. Advances in the application of supercritical extraction to fuels, the gaining of antioxidants and other useful items from biomass, the removal of undesired ingredients or contaminants, and the preparation of nanosized particles of drugs are described.

Supercritical CO2 technology: The next standard sterilization technique?

Sterilization of implantable medical devices is of most importance to avoid surgery related complications such as infection and rejection. Advances in biotechnology fields, such as tissue engineering, have led to the development of more sophisticated and complex biomedical devices that are often composed of natural biomaterials. This complexity poses a challenge to current sterilization techniques which frequently damage materials upon sterilization. The need for an effective alternative has driven research on supercritical carbon dioxide (scCO₂) technology. This technology is characterized by using low temperatures and for being inert and non-toxic. The herein presented paper reviews the most relevant studies over the last 15 years which cover the use of scCO₂ for sterilization and in which effective terminal sterilization is reported. The major topics discussed here are: microorganisms effectively sterilized by scCO₂, inactivation mechanisms, operating parameters, materials sterilized by scCO₂ and major requirements for validation of such technique according to medical devices' standards.

Mechanism of inactivation of Bacillus subtilis spores by high pressure CO2 at high temperature

Spores of wild-type Bacillus subtilis and some isogenic mutant strains were treated by high pressure CO₂ (HPCD) at high temperature (HT) (HPCD + HT) at 20 MPa and 84-86 °C for 0-60 min, and centrifuged on a high density solution to obtain pelleted spores that retained CaDPA and light spores that lost CaDPA. All treated spores were analyzed for viability, and tested for germination, outgrowth, core protein damage, mutagenesis and inner membrane (IM) properties. The results showed that (i) with HPCD + HT treated spores, most pelleted spores and all light spores were dead; ii) a significant amount of dead HPCD + HT-treated spores that retained CaDPA germinated, but outgrowth was blocked; (iii) minimal mutants were generated in survivors of HPCD + HT treatment; (iv) the GFP fluorescence decrease in HPCD + HT-treated spores with high GFP levels was slower than spore inactivation; (v) the IM of HPCD + HT-treated spores that retained CaDPA lost its ability to retain CaDPA at 85 °C, and almost all of these spores' outgrowth in high salt was blocked; and (vi) HPCD + HT-treated spores that retained CaDPA germinated with l-valine or AGFK were almost all stained with propidium iodide. These results indicated that HPCD + HT inactivated B. subtilis spores by damaging spores' IM, thus blocking spore outgrowth after germination.

Supercritical carbon dioxide-based technologies for the production of drug nanoparticles/nanocrystals - A comprehensive review

Low drug bioavailability, which is mostly a result of poor aqueous drug solubilities and of inadequate drug dissolution rates, is one of the most significant challenges that pharmaceutical companies are currently facing, since this may limit the therapeutic efficacy of marketed drugs, or even result in the discard of potential highly effective drug candidates during developmental stages. Two of the main approaches that have been implemented in recent years to overcome poor drug solubility/dissolution issues have frequently involved drug particle size reduction (i.e., micronization/nanonization) and/or the modification of some of the physicochemical and structural properties of poorly water soluble drugs. A large number of particle engineering methodologies have been developed, tested, and applied in the synthesis and control of particle size/particle-size distributions, crystallinities, and polymorphic purities of drug micro- and nano-particles/crystals. In recent years pharmaceutical processing using supercritical fluids (SCF), in general, and supercritical carbon dioxide (scCO₂), in particular, have attracted a great attention from the pharmaceutical industry. This is mostly due to the several well-known advantageous technical features of these processes, as well as to other increasingly important subjects for the pharmaceutical industry, namely their "green", sustainable, safe and "environmentally-friendly" intrinsic characteristics. In this work, it is presented a comprehensive state-of-the-art review on scCO₂-based processes focused on the formation and on the control of the physicochemical, structural and morphological properties of amorphous/crystalline pure drug nanoparticles. It is presented and discussed the most relevant scCO₂, scCO₂-based fluids and drug physicochemical properties that are pertinent for the development of successful pharmaceutical products, namely those that are critical in the selection of an adequate scCO₂-based method to produce pure drug nanoparticles/nanocrystals. scCO₂-based nanoparticle formation methodologies are classified in three main families, and in terms of the most important role played by scCO₂ in particle formation processes: as a solvent; as an antisolvent or a co-antisolvent; and as a "high mobility" additive (a solute, a co-solute, or a co-solvent). Specific particle formation methods belonging to each one of these families are presented, discussed and compared. Some selected amorphous/crystalline drug nanoparticles that were prepared by these methods are compiled and presented, namely those studied in the last 10-15 years. A special emphasis is given to the formation of drug cocrystals. It is also discussed the fundamental knowledge and the main mechanisms in which the scCO₂-based particle formation methods rely on, as well as the current status and urgent needs in terms of reliable experimental data and of robust modeling approaches. Other addressed and discussed topics include the currently available and the most adequate physicochemical, morphological and biological characterization methods required for pure drug nanoparticles/nanocrystals, some of the current nanometrology and regulatory issues associated to the use of these methods, as well as some scale-up, post-processing and pharmaceutical regulatory subjects related to the industrial implementation of these scCO₂-based processes. Finally, it is also discussed the current status of these techniques, as well as their future major perspectives and opportunities for industrial implementation in the upcoming years.

Decellularized heart ECM hydrogel using supercritical carbon dioxide for improved angiogenesis

Initial angiogenesis within the first 3 days is critical for healing ischemic diseases such as myocardial infarction. Recently, decellularized extracellular matrix (dECM) has been reported to provide tissue-derived ECM components and can be used as a scaffold for cell delivery for angiogenesis in tissue engineering. Decellularization by various detergents such as sodium dodecyl sulfate (SDS) and triton X-100 can remove the cell nuclei in tissue organs. However, this leads to ECM structure denaturation, decreased presence of various ECM proteins and cytokines, and loss of mechanical properties. To overcome these limitations, in this study, we developed a supercritical carbon dioxide and ethanol co-solvent (scCO₂-EtOH) decellularization method, which is a detergent-free system that prevents ECM structure disruption and retains various angiogenic proteins in the heart dECM, and tested on rat heart tissues. The heart tissue was placed into the scCO₂ reactor and decellularized at 37 °C and 350 bar. After scCO₂-EtOH treatment, the effects were evaluated by DNA, collagen, and glycosaminoglycan (GAG) quantification and hematoxylin and eosin and immunofluorescence staining to determine the absence of nucleic acids and preservation of heart ECM components. Similar to the native group, the scCO₂-EtOH group contained more ECM components such as collagen, GAGs, collagen I, laminin, and fibronectin and angiogenic factors including vascular endothelial growth factor, fibroblast growth factor, and platelet-derived growth factor and others in comparison to the detergent group. In addition, to estimate angiogenesis of the dECM hydrogels, the neutralized dECM solution was injected in a rat subcutaneous layer (n = 6 in each group: collagen, scCO₂-EOH, and detergent group), after which the solution naturally formed gelation in the subcutaneous layer. After 3 days, the gels were harvested and estimated by immunofluorescence staining and the ImageJ program for angiogenesis analysis. Consequently, blood vessel formation and density of vWF and α-SMA in the scCO₂-EtOH group were significantly greater than that in the collagen group. Here we suggest that heart-derived decellularized extracellular matrix (dECM) with scCO₂-EtOH treatment is a highly promising angiogenic material for healing in ischemic disease.

STATEMENT OF SIGNIFICANCE

Supercritical carbon dioxide (scCO₂) in a supercritical phase has low viscosity and high diffusivity between gas and liquid properties and is known to be affordable, non-toxic, and eco-friendly. Therefore, scCO₂ extraction technology has been extensively used in commercial and industrial fields. Recently, decellularized extracellular matrix (dECM) was applied to tissue engineering and regenerative medicine as a scaffold, therapeutic material, and bio-ink for 3D printing. Moreover, the general decellularization method using detergents has limitations including eliminating tissue-derived ECM components and disrupting their structures after decellularization. To overcome these limitations, heart tissues were treated with scCO₂-EtOH for decellularization, resulting in preserving of tissue due to the various ECM and angiogenic factors derived. In addition, initiation of angiogenesis was highly induced even after 3 days of injection.