Quantification of cell-bubble interactions in a 3D engineered tissue phantom

Iatrogenic air embolism: pathoanatomy, thromboinflammation, endotheliopathy, and therapies

Iatrogenic vascular air embolism is a relatively infrequent event but is associated with significant morbidity and mortality. These emboli can arise in many clinical settings such as neurosurgery, cardiac surgery, and liver transplantation, but more recently, endoscopy, hemodialysis, thoracentesis, tissue biopsy, angiography, and central and peripheral venous access and removal have overtaken surgery and trauma as significant causes of vascular air embolism. The true incidence may be greater since many of these air emboli are asymptomatic and frequently go undiagnosed or unreported. Due to the rarity of vascular air embolism and because of the many manifestations, diagnoses can be difficult and require immediate therapeutic intervention. An iatrogenic air embolism can result in both venous and arterial emboli whose anatomic locations dictate the clinical course. Most clinically significant iatrogenic air emboli are caused by arterial obstruction of small vessels because the pulmonary gas exchange filters the more frequent, smaller volume bubbles that gain access to the venous circulation. However, there is a subset of patients with venous air emboli caused by larger volumes of air who present with more protean manifestations. There have been significant gains in the understanding of the interactions of fluid dynamics, hemostasis, and inflammation caused by air emboli due to in vitro and in vivo studies on flow dynamics of bubbles in small vessels. Intensive research regarding the thromboinflammatory changes at the level of the endothelium has been described recently. The obstruction of vessels by air emboli causes immediate pathoanatomic and immunologic and thromboinflammatory responses at the level of the endothelium. In this review, we describe those immunologic and thromboinflammatory responses at the level of the endothelium as well as evaluate traditional and novel forms of therapy for this rare and often unrecognized clinical condition.

Cell viability assessment associated with a contact of gas bubbles produced by femtosecond laser breakdown in cell culture media

High intensity near infrared femtosecond laser is a promising tool for three-dimensional processing of biological materials. During the processing of cells and tissues, long lasting gas bubbles randomly appeared around the laser focal point, however physicochemical and mechanical effects of the gas bubbles has not been emphasized. This paper presents characteristic behaviors of the gas bubbles and their contact effects on cell viability. High-speed imaging of the gas bubble formation with various additives in physiological medium confirms that the gas bubble consists of dissolved air, and amphipathic proteins stabilize the bubble surface. This surface protective layer inhibits interactions of gas bubbles and cell membranes. Consequently, the gas bubble contact does not cause critical effects on cell viability. On the other hands, burst of gas bubbles stimulated by an impact of femtosecond laser induced cavitation can lead to liquid jet flow that might cause serious mechanical damages on cells. These results provide insights for the parameter of biological tissue processing with intense fs laser pulses.

Expansion and differentiation of ex vivo cultured erythroblasts in scalable stirred bioreactors

Transfusion of donor-derived red blood cells (RBCs) is the most common form of cell therapy. Production of transfusion-ready cultured RBCs (cRBCs) is a promising replacement for the current, fully donor-dependent therapy. A single transfusion unit, however, contains 2 × 10¹² RBC, which requires large scale production. Here, we report on the scale-up of cRBC production from static cultures of erythroblasts to 3 L stirred tank bioreactors, and identify the effect of operating conditions on the efficiency of the process. Oxygen requirement of proliferating erythroblasts (0.55-2.01 pg/cell/h) required sparging of air to maintain the dissolved oxygen concentration at the tested setpoint (2.88 mg O₂ /L). Erythroblasts could be cultured at dissolved oxygen concentrations as low as 0.7 O₂ mg/ml without negative impact on proliferation, viability or differentiation dynamics. Stirring speeds of up to 600 rpm supported erythroblast proliferation, while 1800 rpm led to a transient halt in growth and accelerated differentiation followed by a recovery after 5 days of culture. Erythroblasts differentiated in bioreactors, with final enucleation levels and hemoglobin content similar to parallel cultures under static conditions.

Optimization and Validation of a Custom-Designed Perfusion Bioreactor for Bone Tissue Engineering: Flow Assessment and Optimal Culture Environmental Conditions

Various perfusion bioreactor systems have been designed to improve cell culture with three-dimensional porous scaffolds, and there is some evidence that fluid force improves the osteogenic commitment of the progenitors. However, because of the unique design concept and operational configuration of each study, the experimental setups of perfusion bioreactor systems are not always compatible with other systems. To reconcile results from different systems, the thorough optimization and validation of experimental configuration are required in each system. In this study, optimal experimental conditions for a perfusion bioreactor were explored in three steps. First, an in silico modeling was performed using a scaffold geometry obtained by microCT and an expedient geometry parameterized with porosity and permeability to assess the accuracy of calculated fluid shear stress and computational time. Then, environmental factors for cell culture were optimized, including the volume of the medium, bubble suppression, and medium evaporation. Further, by combining the findings, it was possible to determine the optimal flow rate at which cell growth was supported while osteogenic differentiation was triggered. Here, we demonstrated that fluid shear stress up to 15 mPa was sufficient to induce osteogenesis, but cell growth was severely impacted by the volume of perfused medium, the presence of air bubbles, and medium evaporation, all of which are common concerns in perfusion bioreactor systems. This study emphasizes the necessity of optimization of experimental variables, which may often be underreported or overlooked, and indicates steps which can be taken to address issues common to perfusion bioreactors for bone tissue engineering.

An integrated microfluidic device for studying controllable gas embolism induced cellular responses

Gas embolism is the abnormal emergence of bubble in the vascular system, which can induce local ischemic symptoms. For studying the mechanism underlying gas embolism and revealing local ischemic diseases information, novel technique for analyzing cells response to bubble contact with high controllability is highly desired. In this paper, we present an integrated microfluidic device for the precise generation and control of microbubble based on the gas permeability of polydimethysiloxane (PDMS) to study the effect of bubble's mechanical contact on cells. Cell viability analysis demonstrated that short-term (<15 min) bubble contact was generally non-lethal to cultured endothelial cells. The significant increase in intracellular calcium of the microbubble-contacted cells and cell-to-cell propagation of calcium signal in the adjacent cells were observed during the process of bubble expansion. In addition, the analysis of intercellular calcium signal in the cells treated with suramin and octanol revealed that cell-released small nucleotides and gap junction played an important role in regulating the propagation of calcium wave triggered by bubble contact. Thus, our microfluidic method provides an effective platform for studying the effect of gas embolism on cultured adherent cells and can be further needed for anti-embolism drugs test.

Static Metabolic Bubbles as Precursors of Vascular Gas Emboli During Divers' Decompression: A Hypothesis Explaining Bubbling Variability

Introduction

The risk for decompression sickness (DCS) after hyperbaric exposures (such as SCUBA diving) has been linked to the presence and quantity of vascular gas emboli (VGE) after surfacing from the dive. These VGE can be semi-quantified by ultrasound Doppler and quantified via precordial echocardiography. However, for an identical dive, VGE monitoring of divers shows variations related to individual susceptibility, and, for a same diver, dive-to-dive variations which may be influenced by pre-dive pre-conditioning. These variations are not explained by currently used algorithms. In this paper, we present a new hypothesis: individual metabolic processes, through the oxygen window (OW) or Inherent Unsaturation of tissues, modulate the presence and volume of static metabolic bubbles (SMB) that in turn act as precursors of circulating VGE after a dive.

Methods

We derive a coherent system of assumptions to describe static gas bubbles, located on the vessel endothelium at hydrophobic sites, that would be activated during decompression and become the source of VGE. We first refer to the OW and show that it creates a local tissue unsaturation that can generate and stabilize static gas phases in the diver at the surface. We then use Non-extensive thermodynamics to derive an equilibrium equation that avoids any geometrical description. The final equation links the SMB volume directly to the metabolism.

Results and Discussion

Our model introduces a stable population of small gas pockets of an intermediate size between the nanobubbles nucleating on the active sites and the VGE detected in the venous blood. The resulting equation, when checked against our own previously published data and the relevant scientific literature, supports both individual variation and the induced differences observed in pre-conditioning experiments. It also explains the variability in VGE counts based on age, fitness, type and frequency of physical activities. Finally, it fits into the general scheme of the arterial bubble assumption for the description of the DCS risk.

Conclusion

Metabolism characterization of the pre-dive SMB population opens new possibilities for decompression algorithms by considering the diver's individual susceptibility and recent history (life style, exercise) to predict the level of VGE during and after decompression.

Tunable microfluidic standing air bubbles and its application in acoustic microstreaming

Microbubbles are often used in chemistry, biophysics, and medicine. Properly controlled microbubbles have been proved beneficial for various applications by previous scientific endeavors. However, there is still a plenty of room for further development of efficient microbubble handling methods. Here, this paper introduces a tunable, stable, and robust microbubble interface handling mechanism, named as microfluidic standing air bubbles (μSABs), by studying the multiphysical phenomena behind the gas-liquid interface formation and variation. A basic μSAB system consists specially structured fluidic channels, pneumatic channels, and selectively permeable porous barriers between them. The μSABs originate inside the crevice structures on the fluidic channel walls in a repeatable and robust manner. The volumetric variation of the μSAB is a multiphysical phenomenon that dominated by the air diffusion between the pneumatic channel and the bubble. Theoretical analysis and experimental data illustrate the coupling processes of the repeatable and linear μSAB volumetric variation when operated under common handling conditions (control pneumatic pressure: -90 kPa to 200 kPa). Furthermore, an adjustable acoustic microstreaming is demonstrated as an application using the alterable μSAB gas-liquid interface. Derived equations and microscopic observations elucidate the mechanism of the continuous and linear regulation of the acoustic microstreaming using varying μSAB gas-liquid interfaces. The μSAB system provides a new tool to handle the flexible and controllable gas-liquid interfaces in a repeatable and robust manner, which makes it a promising candidate for innovative biochemical, biophysical, and medical applications.

A combined three-dimensional in vitro-in silico approach to modelling bubble dynamics in decompression sickness

The growth of bubbles within the body is widely believed to be the cause of decompression sickness (DCS). Dive computer algorithms that aim to prevent DCS by mathematically modelling bubble dynamics and tissue gas kinetics are challenging to validate. This is due to lack of understanding regarding the mechanism(s) leading from bubble formation to DCS. In this work, a biomimetic in vitro tissue phantom and a three-dimensional computational model, comprising a hyperelastic strain-energy density function to model tissue elasticity, were combined to investigate key areas of bubble dynamics. A sensitivity analysis indicated that the diffusion coefficient was the most influential material parameter. Comparison of computational and experimental data revealed the bubble surface's diffusion coefficient to be 30 times smaller than that in the bulk tissue and dependent on the bubble's surface area. The initial size, size distribution and proximity of bubbles within the tissue phantom were also shown to influence their subsequent dynamics highlighting the importance of modelling bubble nucleation and bubble-bubble interactions in order to develop more accurate dive algorithms.