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Kandi R, Sachdeva K, Choudhury SD, Pandey PM, Mohanty S. A facile 3D bio-fabrication of customized tubular scaffolds using solvent-based extrusion printing for tissue-engineered tracheal grafts. J Biomed Mater Res A 2023; 111:278-293. [PMID: 36210769 DOI: 10.1002/jbm.a.37458] [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: 01/29/2022] [Revised: 09/17/2022] [Accepted: 09/28/2022] [Indexed: 12/13/2022]
Abstract
Tracheal implantation remains a major therapeutic challenge due to the unavailability of donors and the lack of biomimetic tubular grafts. Fabrication of biomimetic tracheal scaffolds of suitable materials with matched rigidity, enhanced flexibility and biocompatibility has been a major challenge in the field of tracheal reconstruction. In this study, customized tubular grafts made up of FDA-approved polycaprolactone ( PCL ) and polyurethane ( PU ) were fabricated using a novel solvent-based extrusion 3D printing. The printed scaffolds were investigated by various physical, thermal, and mechanical characterizations such as contact angle measurement, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), radial compression, longitudinal compression, and cyclic radial compression. In this study, the native goat trachea was used as a reference for the fabrication of different types of scaffolds (cylindrical, bellow-shaped, and spiral-shaped). The mechanical properties of the goat trachea were also compared to find suitable formulations of PCL / PU . Spiral-shaped scaffolds were found to be an ideal shape based on longitudinal compression and torsion load maintaining clear patency. To check the long-term implantation, in vitro degradation test was performed for all the 3D printed scaffolds and it was found that blending of PU with PCL reduced the degradation behavior. The printed scaffolds were further evaluated for biocompatibility assay, live/dead assay, and cell adhesion assay using bone marrow-derived human mesenchymal stem cells (hMSCs). From biomechanical and biological assessments, PCL 70 / PU 30 of spiral-shaped scaffolds could be a suitable candidate for the development of tracheal regenerative applications.
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Affiliation(s)
- Rudranarayan Kandi
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | - Kunj Sachdeva
- Stem Cell Facility, DBT-Centre of Excellence for Stem cell Research, All India Institute of Medical Sciences, New Delhi, India
| | - Saumitra Dey Choudhury
- Confocal Facility, Centralized Core Research Facility, All India Institute of Medical Sciences, New Delhi, India
| | - Pulak Mohan Pandey
- Department of Mechanical Engineering, Indian Institute of Technology Delhi, New Delhi, India.,Bundelkhand Institute of Engineering & Technology, Jhansi, Uttar Pradesh, India
| | - Sujata Mohanty
- Stem Cell Facility, DBT-Centre of Excellence for Stem cell Research, All India Institute of Medical Sciences, New Delhi, India
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Khalid T, O'Leary C. Engineering Large Airways. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1413:121-135. [PMID: 37195529 DOI: 10.1007/978-3-031-26625-6_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
A key issue facing trachea replacement attempts has been the discrepancy of the mechanical properties between the native tracheal tissue and that of the replacement construct; this difference is often one of the major causes for implant failure in vivo and within clinical efforts. The trachea is composed of distinct structural regions, with each component fulfilling a different role in maintaining overall tracheal stability. The trachea's horseshoe-shaped hyaline cartilage rings, smooth muscle and annular ligament collectively produce an anisotropic tissue that allows for longitudinal extensibility and lateral rigidity. Therefore, any tracheal substitute must be mechanically robust in order to withstand intra-thoracic pressure changes that occur during respiration. Conversely, they must also be able to deform radially to allow for changes in the cross-sectional area during coughing and swallowing. These complicated native tissue characteristics, coupled with a lack of standardised protocols to accurately quantify tracheal biomechanics as guidance for implant design, constitute a significant hurdle for tracheal biomaterial scaffold fabrication. This chapter aims to highlight the pressure forces exerted on the trachea and how they can influence tracheal construct design and also the biomechanical properties of the three main components of the trachea and how to mechanically assess them.
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Affiliation(s)
- Tehreem Khalid
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Tissue Engineering Research Group, RCSI, Dublin, Ireland
- Advanced Materials & Bioengineering Research (AMBER) Centre, RCSI & Trinity College, Dublin, Ireland
| | - Cian O'Leary
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
- Tissue Engineering Research Group, RCSI, Dublin, Ireland.
- Advanced Materials & Bioengineering Research (AMBER) Centre, RCSI & Trinity College, Dublin, Ireland.
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3
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Abstract
Trachea replacement for nonoperable defects remains an unsolved problem due to complications with stenosis and mechanical insufficiency. While native trachea has anisotropic mechanical properties, the vast majority of engineered constructs focus on uniform cartilaginous-like conduits. These conduits often lack quantitative mechanical analysis at the construct level, which limits analysis of functional outcomes in vivo, as well as comparisons across studies. This review aims to present a clear picture of native tracheal mechanics at the tissue and organ level, as well as loading conditions to establish design criteria for trachea replacements. We further explore the implications of failing to match native properties with regards to implant collapse, stenosis, and infection.
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Affiliation(s)
- Elizabeth M Boazak
- Department of Biomedical Engineering, The City College of New York, Steinman Hall, 160 Convent Avenue, New York, New York 10031, United States
| | - Debra T Auguste
- Department of Biomedical Engineering, The City College of New York, Steinman Hall, 160 Convent Avenue, New York, New York 10031, United States.,Department of Chemical Engineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 02115, United States
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4
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Boazak EM, Benson JM, Auguste DT. R- and Z-Axis Patterned Scaffolds Mimic Tracheal Circumferential Compliance and Longitudinal Extensibility. ACS Biomater Sci Eng 2017; 3:3222-3229. [DOI: 10.1021/acsbiomaterials.7b00641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Elizabeth M. Boazak
- Department of Biomedical
Engineering, The City College of New York, Steinman Hall, 160 Convent Avenue, New York, New York 10031, United States
| | - Jamie M. Benson
- Department of Biomedical
Engineering, The City College of New York, Steinman Hall, 160 Convent Avenue, New York, New York 10031, United States
| | - Debra T. Auguste
- Department of Biomedical
Engineering, The City College of New York, Steinman Hall, 160 Convent Avenue, New York, New York 10031, United States
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5
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Liu Y, Lu T, Zhang Y, Qiao Y, Xi J, Wang Q. Collagen-conjugated tracheal prosthesis tested in dogs without omental wrapping and silicone stenting. Interact Cardiovasc Thorac Surg 2016; 23:710-715. [DOI: 10.1093/icvts/ivw240] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 06/03/2016] [Accepted: 06/22/2016] [Indexed: 11/12/2022] Open
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6
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Mansfield EG, Greene VK, Auguste DT. Patterned, tubular scaffolds mimic longitudinal and radial mechanics of the neonatal trachea. Acta Biomater 2016; 33:176-82. [PMID: 26821338 DOI: 10.1016/j.actbio.2016.01.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 01/08/2016] [Accepted: 01/23/2016] [Indexed: 11/30/2022]
Abstract
Tracheal damage, abnormality or absence can result from the growth of tumors or from Congenital High Airway Obstruction Syndrome. No optimal or routine treatment has been established for tracheal repair, despite numerous attempts with natural and artificial prostheses. The fetal trachea is comprised of cartilaginous rings connected by an elastomeric tissue. In an effort to design an engineered trachea replacement, we have synthesized 2-hydroxyethyl methacrylate hydrogels with moduli of 67 ± 3.1 kPa (soft) and 13.0 ± 1.8 MPa (hard). Given the criteria for longitudinal extensibility and lateral rigidity applied during respiration, we evaluated a series of patterned hydrogels with different sizes of hard and soft segments to mimic fetal tracheas. A 1:2 ratio of soft:hard segments resulted in a construct capable of 11.0 ± 1% extension within the elastic range. Tubular constructs with this ratio required similar load/length for cyclic compression as ovine trachea samples. Achieving biomimetic mechanical properties in a trachea replacement may be essential for achieving normal respiration in recipient patients. STATEMENT OF SIGNIFICANCE Fetal abnormalities or tumors can result in tracheal absence or damage. Despite numerous attempts with natural and artificial replacements, there is still no routine treatment for tracheal repair. The literature recognizes the importance of tracheal lateral rigidity and longitudinal extensibility for normal respiration. Achieving closely matched mechanical properties may provide proper function and help decrease implant fibrosis and subsequent occlusion. In this study, we evaluated the mechanics of a series of patterned, tubular hydrogels with different ratios of hard and soft segments to mimic alternating cartilage and ligament sections in fetal tracheas. We compared our results to that of sheep trachea. This is the first report to assess both radial rigidity and longitudinal extensibility in an engineered trachea construct.
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Affiliation(s)
- Elizabeth G Mansfield
- The City College of New York, Department of Biomedical Engineering, Steinman Hall Room 508, 160 Convent Avenue, New York, NY 10031, USA.
| | - Vaughn K Greene
- The City College of New York, Department of Biomedical Engineering, Steinman Hall Room 508, 160 Convent Avenue, New York, NY 10031, USA.
| | - Debra T Auguste
- The City College of New York, Department of Biomedical Engineering, Steinman Hall Room 508, 160 Convent Avenue, New York, NY 10031, USA.
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7
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Mechanical properties of a bioabsorbable nerve guide tube for long nerve defects. ACTA ACUST UNITED AC 2015; 34:186-92. [DOI: 10.1016/j.main.2015.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 05/24/2015] [Accepted: 05/27/2015] [Indexed: 11/21/2022]
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8
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Li G, Li Y, Chen G, He J, Han Y, Wang X, Kaplan DL. Silk-based biomaterials in biomedical textiles and fiber-based implants. Adv Healthc Mater 2015; 4:1134-51. [PMID: 25772248 PMCID: PMC4456268 DOI: 10.1002/adhm.201500002] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 02/04/2015] [Indexed: 01/25/2023]
Abstract
Biomedical textiles and fiber-based implants (BTFIs) have been in routine clinical use to facilitate healing for nearly five decades. Amongst the variety of biomaterials used, silk-based biomaterials (SBBs) have been widely used clinically viz. sutures for centuries and are being increasingly recognized as a prospective material for biomedical textiles. The ease of processing, controllable degradability, remarkable mechanical properties and biocompatibility have prompted the use of SBBs for various BTFIs for extracorporeal implants, soft tissue repair, healthcare/hygiene products and related needs. The present Review focuses on BTFIs from the perspective of types and physical and biological properties, and this discussion is followed with an examination of the advantages and limitations of BTFIs from SBBs. The Review covers progress in surface coatings, physical and chemical modifications of SBBs for BTFIs and identifies future needs and opportunities for the further development for BTFIs using SBBs.
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Affiliation(s)
- Gang Li
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, P.R. China
| | - Yi Li
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Guoqiang Chen
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, P.R. China
| | - Jihuan He
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, P.R. China
| | - Yifan Han
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China
| | - Xiaoqin Wang
- National Engineering Laboratory for Modern Silk, College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, P.R. China
| | - David L. Kaplan
- Department of Biomedical Engineering, Tufts University, 4 Colby St, Room 153, Medford, MA 02155, USA
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Park JH, Hong JM, Ju YM, Jung JW, Kang HW, Lee SJ, Yoo JJ, Kim SW, Kim SH, Cho DW. A novel tissue-engineered trachea with a mechanical behavior similar to native trachea. Biomaterials 2015; 62:106-15. [PMID: 26041482 DOI: 10.1016/j.biomaterials.2015.05.008] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/30/2015] [Accepted: 05/14/2015] [Indexed: 12/12/2022]
Abstract
A novel tissue-engineered trachea was developed with appropriate mechanical behavior and substantial regeneration of tracheal cartilage. We designed hollow bellows scaffold as a framework of a tissue-engineered trachea and demonstrated a reliable method for three-dimensional (3D) printing of monolithic bellows scaffold. We also functionalized gelatin sponge to allow sustained release of TGF-β1 for stimulating tracheal cartilage regeneration and confirmed that functionalized gelatin sponge induces cartilaginous tissue formation in vitro. A tissue-engineered trachea was then created by assembling chondrocytes-seeded functionalized gelatin sponges into the grooves of bellows scaffold and it showed very similar mechanical behavior to that of native trachea along with substantial regeneration of tracheal cartilage in vivo. The tissue-engineered trachea developed here represents a novel concept of tracheal substitute with appropriate mechanical behavior similar to native trachea for use in reconstruction of tracheal stenosis.
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Affiliation(s)
- Jeong Hun Park
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 790-784, South Korea
| | - Jung Min Hong
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 790-784, South Korea
| | - Young Min Ju
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Jin Woo Jung
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 790-784, South Korea
| | - Hyun-Wook Kang
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Sang Jin Lee
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - James J Yoo
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Sung Won Kim
- Division of Otolaryngology and HNS, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
| | - Soo Hyun Kim
- Biomaterials Research Center, Korea Institute of Science and Technology, 5 Hwarang-ro 14-gil, Seongbuk-gu, Seoul, 136-791, South Korea
| | - Dong-Woo Cho
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Gyeongbuk, 790-784, South Korea.
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10
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Patient-specific carbon nanocomposite tracheal prosthesis. Int J Artif Organs 2015; 38:31-8. [PMID: 25633892 DOI: 10.5301/ijao.5000374] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE Surgical removal of the trachea is the current gold standard for treating severe airway carcinoma and stenosis. Resection of 6 cm or more of the trachea requires a replacement graft due to anastomotic tension. The high failure rates of current grafts are attributed to a mismatching of mechanical properties and slow epithelium formation on the inner lumen surface. There is also a current lack of tracheal prostheses that are closely tailored to the patient's anatomy. METHODS We propose the development of a patient-specific, artificial trachea made of carbon nanotubes and poly-di-methyl-siloxane (CNT-PDMS) composite material. Computational simulations and finite element analysis were used to study the stress behavior of the designed implant in a patient-specific, tracheal model. RESULTS Finite element studies indicated that the patient-specific carbon nanocomposite prosthesis produced stress distributions that are closer to that of the natural trachea. In vitro studies conducted on the proposed material have demonstrated its biocompatibility and suitability for sustaining tracheal epithelial cell proliferation and differentiation. In vivo studies done in porcine models showed no adverse side effects or breathing difficulties, with complete regeneration of the epithelium in the prosthesis lumen within 2 weeks. CONCLUSIONS This paper highlights the potential of a patient-specific CNT-PDMS graft as a viable airway replacement in severe tracheal carcinoma.
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11
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Chua M, Chui CK, Chng CB, Lau D. Carbon Nanotube-Based Artificial Tracheal Prosthesis: Carbon nanocomposite implants for patient-specific ENT care. IEEE NANOTECHNOLOGY MAGAZINE 2013. [DOI: 10.1109/mnano.2013.2289691] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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12
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Park JH, Jung JW, Kang HW, Joo YH, Lee JS, Cho DW. Development of a 3D bellows tracheal graft: mechanical behavior analysis, fabrication and an in vivo feasibility study. Biofabrication 2012; 4:035004. [PMID: 22914577 DOI: 10.1088/1758-5082/4/3/035004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Artificial tracheal grafts should have not only enough compressive strength to maintain an open tracheal lumen, but also sufficient flexibility for stable mechanical behavior, similar to the native trachea at the implant site. In this study, we developed a new 3D artificial tracheal graft using a bellows design for considering its mechanical behavior. To investigate the mechanical behavior of the bellows structure, finite element method (FEM) analysis in terms of longitudinal tension/compression, bending and radial compression was conducted. The bellows structure was then compared with the cylinder structure generally used for artificial tracheal grafts. The FEM analysis showed that the bellows had outstanding flexibility in longitudinal tension/compression and bending. Moreover, the bellows kept the lumen open without severe luminal deformation in comparison with the cylinder structure. A three-dimensional artificial tracheal graft with a bellows design was fabricated using indirect solid freeform fabrication technology, and the actual mechanical test was conducted to investigate the actual mechanical behavior of the bellows graft. The fabricated bellows graft was then applied to segmental tracheal reconstruction in a rabbit model to assess its applicability. The bellows graft was completely incorporated into newly regenerated connective tissue and no obstruction at the implanted site was observed for up to 8 weeks after implantation. The data suggested that the developed bellows tracheal graft could be a promising alternative for tracheal reconstruction.
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Affiliation(s)
- Jeong Hun Park
- Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang, Korea
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13
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Imaizumi M, Nomoto Y, Sato Y, Sugino T, Miyake M, Wada I, Nakamura T, Omori K. Evaluation of the use of induced pluripotent stem cells (iPSCs) for the regeneration of tracheal cartilage. Cell Transplant 2012; 22:341-53. [PMID: 22863018 DOI: 10.3727/096368912x653147] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The treatment of laryngotracheal stenosis remains a challenge as treatment often requires multistaged procedures, and successful decannulation sometimes fails after a series of operations. Induced pluripotent stem cells (iPSCs) were generated in 2006. These cells are capable of unlimited symmetrical self-renewal, thus providing an unlimited cell source for tissue-engineering applications. We have previously reported tracheal wall regeneration using a three-dimensional (3D) scaffold containing iPSCs. However, the efficiency of differentiation into cartilage was low. In addition, it could not be proven that the cartilage tissues were in fact derived from the implanted iPSCs. The purpose of this study was to evaluate and improve the use of iPSCs for the regeneration of tracheal cartilage. iPSCs were cultured in vitro in a 3D scaffold in chondrocyte differentiation medium. After cultivation, differentiation into chondrocytes was examined. The ratio of undifferentiated cells was analyzed by flow cytometry. The 3D scaffolds were implanted into tracheal defects, as an injury site, in 24 nude rats. Differentiation into chondrocytes in vitro was confirmed histologically, phenotypically, and genetically. Flow cytometric analysis demonstrated that the population of undifferentiated cells was decreased. Cartilage tissue was observed in the regenerated tracheal wall in 6 of 11 rats implanted with induced iPSCs, but in none of 13 rats implanted with the control and noninduced iPSCs. The expression of cartilage-specific protein was also demonstrated in vivo in 3D scaffolds containing iPSCs. The presence of the GFP gene derived from iPSCs was confirmed in samples of cartilage tissue by the combination of laser microdissection (LMD) and polymerase chain reaction (PCR) techniques. Our study demonstrated that iPSCs have the potential to differentiate into chondrogenic cells in vitro. Cartilage tissue was regenerated in vivo. Our results suggest that iPSCs could be a new cell source for the regeneration of tracheal cartilage.
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Affiliation(s)
- Mitsuyoshi Imaizumi
- Department of Otolaryngology, School of Medicine, Fukushima Medical University, Fukushima City, Japan
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14
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Lin CH, Hsu SH, Su JM, Chen CW. Surface modification of poly(ε-caprolactone) porous scaffolds using gelatin hydrogel as the tracheal replacement. J Tissue Eng Regen Med 2011; 5:156-62. [PMID: 20662011 DOI: 10.1002/term.301] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study evaluates the feasibility of poly(ε-caprolactone) as a tracheal replacement. To improve biocompatibility, the lumen was modified by gelatin hydrogel crosslinked with two different reagents, EDC and genipin. It was found that the choice of crosslinking agents could significantly affect human lung carcinoma cell proliferation. Genipin-crosslinked gelatin hydrogel had significantly better cell proliferation than EDC-crosslinked hydrogel. The study further investigated the performance of the PCL tube modified by genipin-crosslinked gelatin, using a rabbit tracheal implantation model with implants harvested and histologically examined. In vivo results showed that the PCL tube possessed suitable mechanical properties for resisting collapse during implantation. Additionally, PCL modified by genipin-crosslinked gelatin was found to suppress granulation tissue growth and prolong animal survival time in comparison with the original PCL tube. Genipin could be an effective treatment to reduce granulation tissue formation at the tracheal anastomoses.
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Affiliation(s)
- Chen-Huan Lin
- Department of Chemical Engineering, National Chung Hsing University, Taichung, Taiwan, Republic of China
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15
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Nakamura T, Ohmori K, Kanemaru SI. Tissue-engineered airway and "in situ tissue engineering". Gen Thorac Cardiovasc Surg 2011; 59:91-7. [PMID: 21308434 DOI: 10.1007/s11748-010-0677-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Indexed: 01/22/2023]
Abstract
Since the 1980s, tissue engineering has become one of the major areas of endeavor in medical research, applying the principles of biology and engineering to the development of functional substitutes for damaged tissue. Using this technology, various attempts have been made to create and apply a tissue-engineered prosthetic trachea, or airway. In addition to the conventional tissue engineering approach, a new substantially different concept has been advocated in Japan since 2000. This is "in situ tissue engineering," where a tissue is created not in vitro but in vivo, exploiting the potential of the living body for wound healing. An artificial trachea created by in situ tissue engineering has already been applied in human patients for reconstruction of airway defects, and promising results have been obtained. This article reviews recent progress in the relatively new field of airway reconstruction employing tissue engineering.
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Affiliation(s)
- Tatsuo Nakamura
- Institute for Frontier Medical Sciences, Kyoto University, Shogoin, Kyoto 606-8507, Japan.
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16
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Imaizumi M, Nomoto Y, Sugino T, Miyake M, Wada I, Nakamura T, Omori K. Potential of induced pluripotent stem cells for the regeneration of the tracheal wall. Ann Otol Rhinol Laryngol 2010; 119:697-703. [PMID: 21049856 DOI: 10.1177/000348941011901009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Our previous studies focused on basic research and the clinical applications of an artificial trachea. However, the prefabricated artificial trachea cannot be utilized for pediatric airways, because the tracheal frame needs to expand as the child develops. The purpose of this study was to evaluate the potential of induced pluripotent stem (iPS) cells for the regeneration of the tracheal wall. METHODS We cultured iPS cells in a 3-dimensional (3-D) scaffold in chondrocyte differentiation medium (bioengineered scaffold model), and the results were compared with those in a 3-D scaffold without iPS cells (control scaffold model). The 3-D scaffolds were implanted into tracheal defects in 8 nude rats. After 4 weeks, the regenerated tissue was histologically examined. RESULTS Implanted iPS cells were confirmed to exist in all 5 rats implanted with bioengineered scaffolds. Cartilage-like tissue was observed in the regenerated tracheal wall in 2 of the 5 rats in the bioengineered scaffold model, but in none of the 3 rats in the control scaffold model. CONCLUSIONS Implanted iPS cells were confirmed to exist in the bioengineered scaffold. Cartilage-like tissue was regenerated in the tracheal defect. This study demonstrated the potential of iPS cells in the regeneration of the tracheal wall.
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Affiliation(s)
- Mitsuyoshi Imaizumi
- Dept of Otolaryngology, Fukushima Medical University, School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan
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Matsuno T, Omata K, Hashimoto Y, Tabata Y, Satoh T. Alveolar bone tissue engineering using composite scaffolds for drug delivery. JAPANESE DENTAL SCIENCE REVIEW 2010. [DOI: 10.1016/j.jdsr.2009.12.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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A tissue-engineered trachea derived from a framed collagen scaffold, gingival fibroblasts and adipose-derived stem cells. Biomaterials 2010; 31:4855-63. [DOI: 10.1016/j.biomaterials.2010.02.027] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 02/10/2010] [Indexed: 01/15/2023]
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19
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Shi HC, Deng WJ, Pei C, Lu D, Zhang XJ, Wang XH, Zeng YJ. Biomechanical properties of adult-excised porcine trachea for tracheal xenotransplantation. Xenotransplantation 2009; 16:181-6. [PMID: 19566657 DOI: 10.1111/j.1399-3089.2009.00532.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND To investigate and evaluate the biomechanical properties of adult-excised porcine trachea, thereby providing experimental methods and evidence for biomedical engineering of artificial trachea. METHODS The TY8000 servo-handle tension test machine was used to measure biomechanical indices, such as bending stiffness, radial pedestal, and stress-straining. The residual stress and bursting strength of adult-excised porcine trachea was evaluated. RESULTS Residual stress was retained in the adult-excised porcine trachea. The force of radial pedestal was detected as 10 N, when the diameter of a 50-mm trachea was compressed to 50%. The bursting strength decreased from 180 mmHg of pharyngeal portion to 110 mmHg in tracheal carina. When the trachea flexed forward or either right or left by 50 degrees , tension reached 0.296 to 0.131 N and 0.254 to 0.150 N, respectively. The curve of stress-straining measured, according to computer data and results, suggested that tension was maintained at a low level at 50% strain. CONCLUSIONS Residual stress was retained in the excised porcine trachea, and the porcine trachea membrane disrupted when pressure in the inner wall increased. The porcine trachea exhibits good radial pedestal force, bending, and elongation properties.
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Affiliation(s)
- Hong-Can Shi
- Department of Thoracic and Cardiovascular Surgery, College of Clinical Medicine, Yangzhou University, Yangzhou, Jiangsu Province, China.
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Biodegradable polymer coating promotes the epithelization of tissue-engineered airway prostheses. J Thorac Cardiovasc Surg 2009; 139:26-31. [PMID: 19660391 DOI: 10.1016/j.jtcvs.2009.04.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Revised: 01/14/2009] [Accepted: 04/01/2009] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We have developed a prosthesis that includes a collagen layer for tracheobronchial reconstruction and applied it in a canine model. In previous studies luminal epithelization remained partial or rather slow because of the early disintegration of the collagen layer. We have improved this type of prosthesis by coating the luminal surface with a biodegradable polymer, which serves to protect the collagen layer. The effect of the polymer coating on the epithelization of the luminal surface of the prosthesis was examined. METHODS The main frame consisted of a polypropylene mesh tube, measuring 15 mm in inner diameter and 30 mm in length, with reinforcing rings. Collagen extracted from porcine skin was conjugated to this frame. The luminal surface was coated with a polymer, poly (L-lactic-acid-co-epsilon-caprolactone). In 5 beagle dogs the left main bronchus was replaced with this prosthesis, periodic bronchoscopic observations were conducted, and microscopic evaluations were performed. RESULTS All dogs survived until they were killed, except for 1 animal in which pneumonia developed, and this animal died at 13 months after replacement. None of the dogs showed adverse complications caused by the prosthesis. Bronchoscopic observations revealed that the polymer remained on the luminal surface for 2 weeks. The luminal surface in 4 dogs was completely covered with ciliated columnar epithelium or nonciliated squamous epithelium, and 90% epithelization was achieved in 1 dog. CONCLUSIONS The biodegradable polymer coating protected the collagen layer and promoted better epithelization. This improved epithelization on the luminal surface could therefore potentially increase the success rates in airway replacement with artificial prostheses.
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Nakamura T, Sato T, Araki M, Ichihara S, Nakada A, Yoshitani M, Itoi SI, Yamashita M, Kanemaru SI, Omori K, Hori Y, Endo K, Inada Y, Hayakawa K. In situ tissue engineering for tracheal reconstruction using a luminar remodeling type of artificial trachea. J Thorac Cardiovasc Surg 2009; 138:811-9. [PMID: 19660365 DOI: 10.1016/j.jtcvs.2008.07.072] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2008] [Revised: 05/12/2008] [Accepted: 07/03/2008] [Indexed: 12/15/2022]
Abstract
BACKGROUND After successful trials of tracheal reconstruction using mesh-type prostheses in canine models, the technique has been applied clinically to human patients since 2002. To enhance tissue regeneration, we have applied a new tissue engineering approach to this mesh-type prosthesis. METHODS The prosthesis consists of a polypropylene mesh tube reinforced with a polypropylene spiral and atelocollagen layer. The cervical tracheas of 18 beagle dogs were replaced with the prosthesis. The collagen layer was soaked with peripheral blood in 6 of the dogs, with bone marrow aspirate in another 6, and with autologous multipotential bone marrow-derived cells (mesenchymal stem cells) in another 6. The dogs were humanely killed at 1 to 12 months after the operation. RESULTS All 18 dogs survived the postoperative period. Bronchoscopically, 3 of 4 dogs in the peripheral blood group showed stenosis, whereas no stenosis was evident in all 8 of the dogs in the bone marrow and mesenchymal stem cell groups 6 months after the operation. Faster epithelialization and fewer complications, such as mesh exposure and luminal stenosis, were observed in these two groups than in the peripheral blood group. Histologically, the cells from autologous bone marrow were found to proliferate into the tracheal tissue during the first month. Cilial movement in these two groups was faster than that in the peripheral blood group and recovered to 80% to 90% of the normal level. CONCLUSIONS Bone marrow aspirate and mesenchymal stem cells enhance the regeneration of the tracheal mucosa on this prosthesis. This in situ tissue engineering approach may facilitate tracheal reconstruction in the clinical setting.
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Affiliation(s)
- Tatsuo Nakamura
- Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
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Sato T, Tao H, Araki M, Ueda H, Omori K, Nakamura T. Replacement of the left main bronchus with a tissue-engineered prosthesis in a canine model. Ann Thorac Surg 2008; 86:422-8. [PMID: 18640308 DOI: 10.1016/j.athoracsur.2008.04.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 04/03/2008] [Accepted: 04/03/2008] [Indexed: 12/15/2022]
Abstract
BACKGROUND Stenosis of the left main bronchus caused by inflammatory diseases and neoplasms is a serious clinical problem because it can cause obstructive pneumonia and may require pneumonectomy. As an alternative to various treatments currently available, including balloon dilatation, stenting, and bronchoplasty, we propose the use of a prosthesis developed based on the concept of in situ tissue engineering for replacement of the left main bronchus. METHODS The main frame of the tissue-engineered prosthesis is a polypropylene mesh tube, 12 to 15 mm in inner diameter and 30 mm in length, with reinforcing rings. Collagen extracted from porcine skin is conjugated to this frame. A consecutive series of 8 beagle dogs underwent replacement of the left main bronchus with this tissue-engineered prosthesis. RESULTS All dogs survived the postoperative period with no morbidity except 1, which required intravenous administration of antibiotic for a week for pneumonia and recovered. Three dogs were euthanized for examination at 3 and 4 months after bronchus replacement, and the other five were monitored for more than 1 year. In two dogs, histologic examination revealed that the luminal surface was completely covered with ciliated columnar epithelium or nonciliated squamous epithelium. Exposure of the polypropylene mesh to various degrees was observed in 6 dogs, but the prosthesis remained stable and no adverse effects such as infection, sputum retention, or dehiscence were observed. CONCLUSIONS These long-term results suggest that our tissue-engineered prosthesis is applicable for replacement of the left main bronchus.
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Affiliation(s)
- Toshihiko Sato
- Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
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Suzuki T, Kobayashi K, Tada Y, Suzuki Y, Wada I, Nakamura T, Omori K. Regeneration of the Trachea Using a Bioengineered Scaffold with Adipose-Derived Stem Cells. Ann Otol Rhinol Laryngol 2008; 117:453-63. [DOI: 10.1177/000348940811700609] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: Our group has developed and clinically applied an artificial graft made from a collagen sponge scaffold for the regeneration of tracheal tissue. However, the artificial graft requires about 2 months for epithelial regeneration. The purpose of the present study was to accelerate the regeneration process of the trachea through the effective use of a bioengineered scaffold. Adipose-derived stem cells (ASCs) with multilineage differentiation capability were used. In our study, we implanted a bioengineered scaffold that included autologous ASCs into tracheal defects in rats. Methods: Collagen gel, including ASCs labeled with monomeric yellow fluorescent protein, was layered onto the surface of the collagen sponge to form a bioengineered scaffold. This scaffold was implanted into the tracheal defects in rats. A control scaffold without ASCs was also implanted. Results: On day 14 after implantation, a pseudostratified columnar epithelium with well-differentiated ciliated and goblet cells and neovascularization was observed in rats that received the implant with the bioengineered scaffold that included ASCs. Conclusions: These results suggested that implanted ASCs accelerated neovascularization and epithelialization on the regenerated trachea. Thus, our newly developed bioengineered scaffold contributes to tracheal regeneration.
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Kobayashi K, Suzuki T, Nomoto Y, Tada Y, Miyake M, Hazama A, Nakamura T, Omori K. Potential of Heterotopic Fibroblasts as Autologous Transplanted Cells for Tracheal Epithelial Regeneration. ACTA ACUST UNITED AC 2007; 13:2175-84. [PMID: 17539734 DOI: 10.1089/ten.2007.0008] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The tracheal epithelium maintains the health of the respiratory tract through mucociliary clearance and regulation of ion and water balance. When the trachea is surgically removed, artificial grafts have been clinically used by our group to regenerate the trachea. In such cases, the tracheal epithelium needs 2 months for functional regeneration. Previous study has shown that fibroblasts facilitate tracheal epithelial regeneration. In this study, heterotopic fibroblasts originating from the dermis, nasal, and gingival mucosa were cocultured with tracheal epithelial cells to evaluate their potential as autologous transplanted cells for tracheal epithelial regeneration. The epithelia induced by the heterotopic fibroblasts showed differences in structure, cilia development, mucin secretion, and expression of ion and water channels. These results indicated that nasal fibroblasts could not induce mature tracheal epithelium and that dermal fibroblasts induced epidermis-like epithelium. Only the gingival fibroblasts (GFBs) could induce morphologically and functionally normalized tracheal epithelium comparable to the epithelium induced by tracheal fibroblasts. Epithelial cell proliferation and migration were also upregulated by GFBs. These results indicate that GFBs are useful as autologous transplant cells for tracheal epithelial regeneration.
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Affiliation(s)
- Ken Kobayashi
- Department of Otolaryngology, School of Medicine, Fukushima Medical University, Fukushima, Japan
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Kobayashi K, Nomoto Y, Suzuki T, Tada Y, Miyake M, Hazama A, Kanemaru S, Nakamura T, Omori K. Effect of Fibroblasts on Tracheal Epithelial Regenerationin vitro. ACTA ACUST UNITED AC 2006; 12:2619-28. [PMID: 16995795 DOI: 10.1089/ten.2006.12.2619] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Several artificial grafts for covering deficient trachea have been produced through tissue engineering. Recently, our group clinically used an artificial trachea made from collagen sponge for patients with noncircumferential tracheal resection. However, the slowness of epithelial regeneration on the surface of the artificial trachea was confirmed as one particular problem. In this study, we co-cultured tracheal epithelial cells with fibroblasts and examined effects of fibroblasts on epithelial regeneration in vitro. Fibroblasts activated epithelial cell proliferation and migration. In co-culture with fibroblasts, epithelial cells reconstructed pseudostratified epithelium, which was composed of ciliated, goblet, and basal cells. Furthermore, a basement membrane was reconstructed between epithelial cells and fibroblasts, and integrin beta4 was also observed there. Fibroblasts rapidly increased mucin secretion by epithelial cells. These results indicate that stimulatory effects of fibroblasts on epithelial cell migration, proliferation, and differentiation would reduce the time required for covering of epithelial cells on the defect of luminal surface and hasten regeneration of morphologically and functionally normalized epithelium involving the reconstruction of basement membrane.
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Affiliation(s)
- Ken Kobayashi
- Department of Otolaryngology, School of Medicine, Fukushima Medical University, Fukushima, Japan.
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Tanaka S, Takigawa T, Ichihara S, Nakamura T. Mechanical properties of the bioabsorbable polyglycolic acid-collagen nerve guide tube. POLYM ENG SCI 2006. [DOI: 10.1002/pen.20600] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Matsuno T, Nakamura T, Kuremoto KI, Notazawa S, Nakahara T, Hashimoto Y, Satoh T, Shimizu Y. Development of .BETA.-tricalcium Phosphate/Collagen Sponge Composite for Bone Regeneration. Dent Mater J 2006; 25:138-44. [PMID: 16706309 DOI: 10.4012/dmj.25.138] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Synthetic biomaterials have been developed and used for bone grafting. Here, we developed a biodegradable sponge composite for bone tissue engineering by combining beta-tricalcium phosphate (beta-TCP) and collagen. In addition, we sought to determine the optimal beta-TCP granules/collagen ratio by evaluating and bone formation in vivo. Porous beta-TCP granules were mixed with atelocollagen hydrochloride solution at various ratios--0.02, 0.05, 0.1, and 0.2 g/mL. The resultant mixtures were freeze-dried and subjected to dehydrothermal treatment in vacuo. The final composites obtained were designated beta-TCP/collagen sponge composites (beta-TCP/CS). Through compression testing, it was found that the stress values for beta-TCP/CS (0.2 g/mL) were higher than those of the other three composites over the whole strain range. Histological evaluation at four weeks after implantation revealed that the collagen sponge had degraded and newly formed bone was present on the surface of the beta-TCP granules. At 12 weeks, the beta-TCP granules were completely degraded and remodeling of the lamellar bone was observed.
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Affiliation(s)
- Tomonori Matsuno
- Department of Oral & Maxillofacial Surgery, The Nippon Dental University School of Dentistry at Tokyo, Japan.
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