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Shai SE, Lai YL, Hung YW, Hsieh CW, Su KC, Wang CH, Chao TH, Chiu YT, Wu CC, Hung SC. Long-Term Survival and Regeneration Following Transplantation of 3D-Printed Biodegradable PCL Tracheal Grafts in Large-Scale Porcine Models. Bioengineering (Basel) 2024; 11:832. [PMID: 39199790 PMCID: PMC11351403 DOI: 10.3390/bioengineering11080832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 08/09/2024] [Accepted: 08/13/2024] [Indexed: 09/01/2024] Open
Abstract
Polycaprolactone (PCL) implants in large animals show great promise for tracheal transplantation. However, the longest survival time achieved to date is only about three weeks. To meet clinical application standards, it is essential to extend the survival time and ensure the complete integration and functionality of the implant. Our study investigates the use of three-dimensional (3D)-printed, biodegradable, PCL-based tracheal grafts for large-scale porcine tracheal transplantation, assessing the feasibility and early structural integrity crucial for long-term survival experiments. A biodegradable PCL tracheal graft was fabricated using a BIOX bioprinter and transplanted into large-scale porcine models. The grafts, measuring 20 × 20 × 1.5 mm, were implanted following a 2 cm circumferential resection of the porcine trachea. The experiment design was traditionally implanted in eight porcines to replace four-ring tracheal segments, only two of which survived more than three months. Data were collected on the graft construction and clinical outcomes. The 3D-printed biosynthetic grafts replicated the native organ with high fidelity. The implantations were successful, without immediate complications. At two weeks, bronchoscopy revealed significant granulation tissue around the anastomosis, which was managed with laser ablation. The presence of neocartilage, neoglands, and partial epithelialization near the anastomosis was verified in the final pathology findings. Our study demonstrates in situ regenerative tissue growth with intact cartilage following transplantation, marked by neotissue formation on the graft's exterior. The 90-day survival milestone was achieved due to innovative surgical strategies, reinforced with strap muscle attached to the distal trachea. Further improvements in graft design and granulation tissue management are essential to optimize outcomes.
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Affiliation(s)
- Sen-Ei Shai
- Department of Thoracic Surgery, Taichung Veterans General Hospital, Taichung 407219, Taiwan;
- Department of Applied Chemistry, National Chi Nan University, Nantou 545301, Taiwan
- Institute of Clinical Medicine, National Yang-Ming Chiao-Tung University, Taipei 112304, Taiwan
| | - Yi-Ling Lai
- Department of Thoracic Surgery, Taichung Veterans General Hospital, Taichung 407219, Taiwan;
| | - Yi-Wen Hung
- Animal Radiation Therapy Research Center, Central Taiwan University of Science and Technology, Taichung 406053, Taiwan;
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung 404327, Taiwan
| | - Chi-Wei Hsieh
- School of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; (C.-W.H.); (C.-C.W.)
| | - Kuo-Chih Su
- Department of Medical Research, Three Dimensional Printing Research and Development Group, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (K.-C.S.); (C.-H.W.)
| | - Chun-Hsiang Wang
- Department of Medical Research, Three Dimensional Printing Research and Development Group, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (K.-C.S.); (C.-H.W.)
| | - Te-Hsin Chao
- Division of Colon and Rectal Surgery, Department of Surgery, Chiayi and Wangiao Branch, Taichung Veterans General Hospital, Chiayi 600573, Taiwan;
| | - Yung-Tsung Chiu
- Department of Medical Research and Education, Taichung Veterans General Hospital, Taichung 407219, Taiwan;
| | - Chia-Ching Wu
- School of Medicine, National Cheng Kung University, Tainan 701401, Taiwan; (C.-W.H.); (C.-C.W.)
- Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
| | - Shih-Chieh Hung
- Integrative Stem Cell Center, China Medical University Hospital, Taichung 404327, Taiwan;
- Institute of New Drug Development, China Medical University, Taichung 404328, Taiwan
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Feng M, Ahmed KH, Punjabi N, Inman JC. A Contemporary Review of Trachea, Nose, and Ear Cartilage Bioengineering and Additive Manufacturing. Biomimetics (Basel) 2024; 9:327. [PMID: 38921207 PMCID: PMC11202182 DOI: 10.3390/biomimetics9060327] [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: 04/17/2024] [Revised: 05/18/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
The complex structure, chemical composition, and biomechanical properties of craniofacial cartilaginous structures make them challenging to reconstruct. Autologous grafts have limited tissue availability and can cause significant donor-site morbidity, homologous grafts often require immunosuppression, and alloplastic grafts may have high rates of infection or displacement. Furthermore, all these grafting techniques require a high level of surgical skill to ensure that the reconstruction matches the original structure. Current research indicates that additive manufacturing shows promise in overcoming these limitations. Autologous stem cells have been developed into cartilage when exposed to the appropriate growth factors and culture conditions, such as mechanical stress and oxygen deprivation. Additive manufacturing allows for increased precision when engineering scaffolds for stem cell cultures. Fine control over the porosity and structure of a material ensures adequate cell adhesion and fit between the graft and the defect. Several recent tissue engineering studies have focused on the trachea, nose, and ear, as these structures are often damaged by congenital conditions, trauma, and malignancy. This article reviews the limitations of current reconstructive techniques and the new developments in additive manufacturing for tracheal, nasal, and auricular cartilages.
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Affiliation(s)
- Max Feng
- Department of Otolaryngology–Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
| | - Khwaja Hamzah Ahmed
- Department of Otolaryngology–Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
| | - Nihal Punjabi
- Department of Otolaryngology–Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
- School of Medicine, Case Western Reserve University, Cleveland, OH 44116, USA
| | - Jared C. Inman
- Department of Otolaryngology–Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA
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Mammana M, Bonis A, Verzeletti V, Dell'Amore A, Rea F. Tracheal Tissue Engineering: Principles and State of the Art. Bioengineering (Basel) 2024; 11:198. [PMID: 38391684 PMCID: PMC10886658 DOI: 10.3390/bioengineering11020198] [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: 10/26/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 02/24/2024] Open
Abstract
Patients affected by long-segment tracheal defects or stenoses represent an unsolved surgical issue, since they cannot be treated with the conventional surgery of tracheal resection and consequent anastomosis. Hence, different strategies for tracheal replacement have been proposed (synthetic materials, aortic allografts, transplantation, autologous tissue composites, and tissue engineering), each with advantages and drawbacks. Tracheal tissue engineering, on the other hand, aims at recreating a fully functional tracheal substitute, without the need for the patient to receive lifelong immunosuppression or endotracheal stents. Tissue engineering approaches involve the use of a scaffold, stem cells, and humoral signals. This paper reviews the main aspects of tracheal TE, starting from the choice of the scaffold to the type of stem cells that can be used to seed the scaffold, the methods for their culture and expansion, the issue of graft revascularization at the moment of in vivo implantation, and experimental models of tracheal research. Moreover, a critical insight on the state of the art of tracheal tissue engineering is also presented.
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Affiliation(s)
- Marco Mammana
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
| | - Alessandro Bonis
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
| | - Vincenzo Verzeletti
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
| | - Andrea Dell'Amore
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
| | - Federico Rea
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, 35128 Padua, Italy
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Melgarejo-Ramírez Y, Ceballos-Cantú JC, Montes-Olave EDJ, Hernández-Tapia B, Rojas-Figueroa V, Ramírez-Arroyo G, Cortés-Acosta F, Dorantes-Pavón M, Lecona-Butrón H, Beltrán-Rodríguez-Cabo OE. Novel Therapy for Acquired Tracheomalacia with a Tissue-Engineered Extraluminal Tracheal Splint and Autologous Mesenchymal-Derived Chondrocytes. Int Arch Otorhinolaryngol 2022; 27:e342-e350. [PMID: 37125371 PMCID: PMC10147475 DOI: 10.1055/s-0042-1746194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/01/2022] [Indexed: 10/14/2022] Open
Abstract
Abstract
Introduction Acquired tracheomalacia (ATM) is characterized by a loss of structural strength of the tracheal framework, resulting in airway collapse during breathing. Near half of the patients undergoing prolonged invasive mechanical ventilation will suffer tracheal lesions. Treatment for ATM includes external splinting with rib grafts, prosthetic materials, and tracheal resection. Failure in the use of prosthetic materials has made reconsidering natural origin scaffolds and tissue engineering as a suitable alternative.
Objective To restore adequate airway patency in an ovine model with surgically-induced ATM employing a tissue-engineered extraluminal tracheal splint (TE-ETS).
Methods In the present prospective pilot study, tracheal rings were partially resected to induce airway collapse in 16 Suffolk sheep (Ovis aries). The TE-ETS was developed with autologous mesenchymal-derived chondrocytes and allogenic decellularized tracheal segments and was implanted above debilitated tracheal rings. The animals were followed-up at 8, 12, and 16 weeks and at 1-year postinsertion. Flexible tracheoscopies were performed at each stage. After sacrifice, a histopathological study of the trachea and the splint were performed.
Results The TE-ETS prevented airway collapse for 16 weeks and up to 1-year postinsertion. Tracheoscopies revealed a noncollapsing airway during inspiration. Histopathological analyses showed the organization of mesenchymal-derived chondrocytes in lacunae, the proliferation of blood vessels, and recovery of epithelial tissue subjacent to the splint. Splints without autologous cells did not prevent airway collapse.
Conclusion It is possible to treat acquired tracheomalacia with TE-ETS without further surgical removal since it undergoes physiological degradation. The present study supports the development of tissue-engineered tracheal substitutes for airway disease.
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Affiliation(s)
- Yaaziel Melgarejo-Ramírez
- Laboratorio de Biotecnología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
| | - Juan C. Ceballos-Cantú
- Subdirección de Otorrinolaringología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
| | - Eric de J. Montes-Olave
- Subdirección de Otorrinolaringología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
| | - Bruno Hernández-Tapia
- Laboratorio de Biotecnología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
| | - Víctor Rojas-Figueroa
- Subdirección de Otorrinolaringología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
| | - Gabriela Ramírez-Arroyo
- Subdirección de Otorrinolaringología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
| | - Fabiana Cortés-Acosta
- Subdirección de Otorrinolaringología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
| | - Mario Dorantes-Pavón
- Subdirección de Otorrinolaringología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
| | - Hugo Lecona-Butrón
- Bioterio y Cirugía Experimental, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
| | - Olga E. Beltrán-Rodríguez-Cabo
- Subdirección de Otorrinolaringología, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, México
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Zhang B, Sun F, Lu Y, Wang Z, Shen Z, Yuan L, Wu Q, Wu C, Shi H. A Novel Decellularized Trachea Preparation Method for Rapid Construction of a Functional Tissue Engineered Trachea to Repair Tracheal Defects. J Mater Chem B 2022; 10:4810-4822. [PMID: 35237780 DOI: 10.1039/d1tb02100a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Long segment trachea defects are repaired by tracheal substitution, while the decellularized technology has been effectively employed to prepare tissue engineering trachea (TET). However, its clinical application is restrictied by...
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Affiliation(s)
- Boyou Zhang
- The Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
- Clinical Medical College, Yangzhou University, No. 98 Nantong West Road, Yangzhou, Jiangsu 225009, P. R. China.
- Northern Jiangsu People's Hospital Affiliated Hospital to Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Fei Sun
- Clinical Medical College, Yangzhou University, No. 98 Nantong West Road, Yangzhou, Jiangsu 225009, P. R. China.
- Northern Jiangsu People's Hospital Affiliated Hospital to Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Yi Lu
- Clinical Medical College, Yangzhou University, No. 98 Nantong West Road, Yangzhou, Jiangsu 225009, P. R. China.
- Northern Jiangsu People's Hospital Affiliated Hospital to Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Zhihao Wang
- Clinical Medical College, Yangzhou University, No. 98 Nantong West Road, Yangzhou, Jiangsu 225009, P. R. China.
- Northern Jiangsu People's Hospital Affiliated Hospital to Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Zhiming Shen
- Clinical Medical College, Yangzhou University, No. 98 Nantong West Road, Yangzhou, Jiangsu 225009, P. R. China.
- Northern Jiangsu People's Hospital Affiliated Hospital to Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Lei Yuan
- Clinical Medical College, Yangzhou University, No. 98 Nantong West Road, Yangzhou, Jiangsu 225009, P. R. China.
- Northern Jiangsu People's Hospital Affiliated Hospital to Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Qiang Wu
- The Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
- Clinical Medical College, Yangzhou University, No. 98 Nantong West Road, Yangzhou, Jiangsu 225009, P. R. China.
- Northern Jiangsu People's Hospital Affiliated Hospital to Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Cong Wu
- Clinical Medical College, Yangzhou University, No. 98 Nantong West Road, Yangzhou, Jiangsu 225009, P. R. China.
- Northern Jiangsu People's Hospital Affiliated Hospital to Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
| | - Hongcan Shi
- Clinical Medical College, Yangzhou University, No. 98 Nantong West Road, Yangzhou, Jiangsu 225009, P. R. China.
- Northern Jiangsu People's Hospital Affiliated Hospital to Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou, China
- The Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
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6
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Lei C, Mei S, Zhou C, Xia C. Decellularized tracheal scaffolds in tracheal reconstruction: An evaluation of different techniques. J Appl Biomater Funct Mater 2021; 19:22808000211064948. [PMID: 34903089 DOI: 10.1177/22808000211064948] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In humans, the trachea is a conduit for ventilation connecting the throat and lungs. However, certain congenital or acquired diseases may cause long-term tracheal defects that require replacement. Tissue engineering is considered a promising method to reconstruct long-segment tracheal lesions and restore the structure and function of the trachea. Decellularization technology retains the natural structure of the trachea, has good biocompatibility and mechanical properties, and is currently a hotspot in tissue engineering studies. This article lists various recent representative protocols for the generation of decellularized tracheal scaffolds (DTSs), as well as their validity and limitations. Based on the advancements in decellularization methods, we discussed the impact and importance of mechanical properties, revascularization, recellularization, and biocompatibility in the production and implantation of DTS. This review provides a basis for future research on DTS and its application in clinical therapy.
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Affiliation(s)
- Chenyang Lei
- Department of Otorhinolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Sheng Mei
- Department of Otorhinolaryngology, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Chun Zhou
- Department of Geriatrics, The 903 Hospital of the Chinese People's Liberation Army Joint Logistics Support Force, Hangzhou, China
| | - Chen Xia
- Department of Orthopedic Surgery, Zhejiang Provincial People's Hospital, Hangzhou, China
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Varma R, Marin‐Araujo AE, Rostami S, Waddell TK, Karoubi G, Haykal S. Short-Term Preclinical Application of Functional Human Induced Pluripotent Stem Cell-Derived Airway Epithelial Patches. Adv Healthc Mater 2021; 10:e2100957. [PMID: 34569180 DOI: 10.1002/adhm.202100957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/15/2021] [Indexed: 12/17/2022]
Abstract
Airway pathologies including cancer, trauma, and stenosis lack effective treatments, meanwhile airway transplantation and available tissue engineering approaches fail due to epithelial dysfunction. Autologous progenitors do not meet the clinical need for regeneration due to their insufficient expansion and differentiation, for which human induced pluripotent stem cells (hiPSCs) are promising alternatives. Airway epithelial patches are engineered by differentiating hiPSC-derived airway progenitors into physiological proportions of ciliated (73.9 ± 5.5%) and goblet (2.1 ± 1.4%) cells on a silk fibroin-collagen vitrigel membrane (SF-CVM) composite biomaterial for transplantation in porcine tracheal defects ex vivo and in vivo. Evaluation of ex vivo tracheal repair using hiPSC-derived SF-CVM patches demonstrate native-like tracheal epithelial metabolism and maintenance of mucociliary epithelium to day 3. In vivo studies demonstrate SF-CVM integration and maintenance of airway patency, showing 80.8 ± 3.6% graft coverage with an hiPSC-derived pseudostratified epithelium and 70.7 ± 2.3% coverage with viable cells, 3 days postoperatively. The utility of bioengineered, hiPSC-derived epithelial patches for airway repair is demonstrated in a short-term preclinical survival model, providing a significant leap for airway reconstruction approaches.
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Affiliation(s)
- Ratna Varma
- Latner Thoracic Surgery Laboratories Toronto General Hospital Research Institute University Health Network Toronto General Hospital University of Toronto 101 College St Toronto ON M5G 0A3 Canada
- Institute of Biomedical Engineering (BME) University of Toronto 164 College St Toronto ON M5S 3G9 Canada
| | - Alba E. Marin‐Araujo
- Latner Thoracic Surgery Laboratories Toronto General Hospital Research Institute University Health Network Toronto General Hospital University of Toronto 101 College St Toronto ON M5G 0A3 Canada
| | - Sara Rostami
- Latner Thoracic Surgery Laboratories Toronto General Hospital Research Institute University Health Network Toronto General Hospital University of Toronto 101 College St Toronto ON M5G 0A3 Canada
| | - Thomas K. Waddell
- Latner Thoracic Surgery Laboratories Toronto General Hospital Research Institute University Health Network Toronto General Hospital University of Toronto 101 College St Toronto ON M5G 0A3 Canada
- Institute of Biomedical Engineering (BME) University of Toronto 164 College St Toronto ON M5S 3G9 Canada
- Institute of Medical Sciences University of Toronto 27 King's College Cir Toronto ON M5S 1A8 Canada
| | - Golnaz Karoubi
- Latner Thoracic Surgery Laboratories Toronto General Hospital Research Institute University Health Network Toronto General Hospital University of Toronto 101 College St Toronto ON M5G 0A3 Canada
- Department of Mechanical and Industrial Engineering University of Toronto 5 King's College Circle Toronto ON M5S 3G8 Canada
- Department of Laboratory Medicine and Pathobiology University of Toronto 1 King's College Circle Toronto ON M5S 1A8 Canada
| | - Siba Haykal
- Latner Thoracic Surgery Laboratories Toronto General Hospital Research Institute University Health Network Toronto General Hospital University of Toronto 101 College St Toronto ON M5G 0A3 Canada
- Institute of Medical Sciences University of Toronto 27 King's College Cir Toronto ON M5S 1A8 Canada
- Division of Plastic and Reconstructive Surgery Department of Surgery University of Toronto 200 Elizabeth Street 8N‐869 Toronto ON M5G2P7 Canada
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8
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Sun F, Lu Y, Wang Z, Zhang B, Shen Z, Yuan L, Wu C, Wu Q, Yang W, Zhang G, Pan Z, Shi H. Directly construct microvascularization of tissue engineering trachea in orthotopic transplantation. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 128:112201. [PMID: 34474813 DOI: 10.1016/j.msec.2021.112201] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 05/10/2021] [Accepted: 05/17/2021] [Indexed: 12/17/2022]
Abstract
Tissue engineering technology provides effective alternative treatments for tracheal reconstruction. The formation of a functional microvascular network is essential to support cell metabolism and ensure the long-term survival of grafts. However, given the lack of an identifiable vascular pedicle of the trachea that could be anastomosed to the blood vessels directly in the recipient's neck, successful tracheal transplantation faces significant challenges in rebuilding the adequate blood supply of the graft. Herein, we describe a one-step method to construct microvascularization of tissue-engineered trachea in orthotopic transplantation. Forty rabbit tracheae were decellularized using a vacuum-assisted decellularization (VAD) method. Histological appearance and immunohistochemical (IHC) analysis demonstrated efficient removal of cellular components and nuclear material from natural tissue, which was also confirmed by 4'-6-diamidino-2-phenylindole(DAPI) staining and DNA quantitative analysis, thus significantly reducing the antigenicity. Scanning electron microscopy (SEM), immunofluorescence (IF) analysis, GAG and collagen quantitative analysis showed that the hierarchical structures, composition and integrity of the extracellular matrix (ECM) were protected. IF analysis also demonstrated that basic fibroblast growth factor (b-FGF) was preserved during the decellularization process, and also exerted biocompatibility and proangiogenic properties by the chick chorioallantoic membrane(CAM) assay. Xenotransplantation assays indicated that the VAD tracheal matrix would no longer induced inflammatory reactions implanted in the body for 4 weeks after treated by VAD more than 16 h. Furthermore, we seeded the matrix with bone marrow-derived endothelial cells (BMECs) in vitro and performed in vivo tracheal patch repair assays to prove the biocompatibility and neovascularization of VAD-treated tracheal matrix, and the formation of a vascular network around the patch promoted the crawling of surrounding ciliated epithelial cells to the surface of the graft. We conclude that this natural VAD tracheal matrix is non-immunogenic and no inflammatory reactions in vivo transplantation. Seeding with BMECs on the grafts and then performing orthotopic transplantation can effectively promote the microvascularization and accelerate the native epithelium cells crawling to the lumen of the tracheal graft.
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Affiliation(s)
- Fei Sun
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225001, China; Clinical Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China
| | - Yi Lu
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225001, China; Clinical Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China
| | - Zhihao Wang
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225001, China; Clinical Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China
| | - Boyou Zhang
- Clinical Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China; The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Zhiming Shen
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225001, China; Clinical Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China
| | - Lei Yuan
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225001, China; Clinical Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China
| | - Cong Wu
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225001, China; Clinical Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China
| | - Qiang Wu
- Clinical Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China; The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Wenlong Yang
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225001, China; Clinical Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China
| | - Guozhong Zhang
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225001, China; Clinical Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China
| | - Ziyin Pan
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China
| | - Hongcan Shi
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou 225001, China; Clinical Medical College, Yangzhou University, Yangzhou 225001, China; Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou University, Yangzhou 225001, China.
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Parihar A, Pandita V, Kumar A, Parihar DS, Puranik N, Bajpai T, Khan R. 3D Printing: Advancement in Biogenerative Engineering to Combat Shortage of Organs and Bioapplicable Materials. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2021; 8:173-199. [PMID: 34230892 PMCID: PMC8252697 DOI: 10.1007/s40883-021-00219-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/26/2021] [Accepted: 06/08/2021] [Indexed: 02/06/2023]
Abstract
Abstract Organ or cell transplantation is medically evaluated for end-stage failure saving or extending the lives of thousands of patients who are suffering from organ failure disorders. The unavailability of adequate organs for transplantation to meet the existing demand is a major challenge in the medical field. This led to day-day-increase in the number of patients on transplant waiting lists as well as in the number of patients dying while on the queue. Recently, technological advancements in the field of biogenerative engineering have the potential to regenerate tissues and, in some cases, create new tissues and organs. In this context, major advances and innovations are being made in the fields of tissue engineering and regenerative medicine which have a huge impact on the scientific community is three-dimensional bioprinting (3D bioprinting) of tissues and organs. Besides this, the decellularization of organs and using this as a scaffold for generating new organs through the recellularization process shows promising results. This review discussed about current approaches for tissue and organ engineering including methods of scaffold designing, recent advances in 3D bioprinting, organs regenerated successfully using 3D printing, and extended application of 3D bioprinting technique in the field of medicine. Besides this, information about commercially available 3D printers has also been included in this article. Lay Summary Today's need for organs for the transplantation process in order to save a patient's life or to enhance the survival rate of diseased one is the prime concern among the scientific community. Recent, advances in the field of biogenerative engineering have the potential to regenerate tissues and create organs compatible with the patient's body. In this context, major advances and innovations are being made in the fields of tissue engineering and regenerative medicine which have a huge impact on the scientific community is three-dimensional bioprinting (3D bioprinting) of tissues and organs. Besides this, the decellularization of organs and using this as a scaffold for generating new organs through the recellularization process shows promising results. This review dealt with the current approaches for tissue and organ engineering including methods of scaffold designing, recent advances in 3D bioprinting, organs regenerated successfully using 3D printing, and extended application of 3D bioprinting technique in the field of medicine. Furthermore, information about commercially available 3D printers has also been included in this article.
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Affiliation(s)
- Arpana Parihar
- Department of Biochemistry and Genetics, Barkatullah University, Bhopal, Madhya Pradesh 462026 India
- Microfluidics & MEMS Centre, CSIR-Advanced Materials and Processes Research Institute (AMPRI), Hoshangabad Road Bhopal, 462026 India
| | - Vasundhara Pandita
- Department of Biochemistry and Genetics, Barkatullah University, Bhopal, Madhya Pradesh 462026 India
| | - Avinash Kumar
- Department of Mechanical Engineering, Indian Institute of Information Technology, Design & Manufacturing (IIITD&M), Kancheepuram, 600127 India
| | - Dipesh Singh Parihar
- Engineering College Tuwa , At. & Post. Tuwa, Taluka Godhra, Dist. Panchmahal, Godhra, Gujarat 388713 India
| | - Nidhi Puranik
- Department of Biochemistry and Genetics, Barkatullah University, Bhopal, Madhya Pradesh 462026 India
| | - Tapas Bajpai
- Department of Mechanical Engineering, Malaviya National Institute of Technology, Jaipur, 302017 India
| | - Raju Khan
- Microfluidics & MEMS Centre, CSIR-Advanced Materials and Processes Research Institute (AMPRI), Hoshangabad Road Bhopal, 462026 India
- Academy of Scientific and Innovative Research (AcSIR), CSIR-AMPRI, Bhopal, 462026 India
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10
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Current Strategies for Tracheal Replacement: A Review. Life (Basel) 2021; 11:life11070618. [PMID: 34202398 PMCID: PMC8306535 DOI: 10.3390/life11070618] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/18/2021] [Accepted: 06/19/2021] [Indexed: 01/30/2023] Open
Abstract
Airway cancers have been increasing in recent years. Tracheal resection is commonly performed during surgery and is burdened from post-operative complications severely affecting quality of life. Tracheal resection is usually carried out in primary tracheal tumors or other neoplasms of the neck region. Regenerative medicine for tracheal replacement using bio-prosthesis is under current research. In recent years, attempts were made to replace and transplant human cadaver trachea. An effective vascular supply is fundamental for a successful tracheal transplantation. The use of biological scaffolds derived from decellularized tissues has the advantage of a three-dimensional structure based on the native extracellular matrix promoting the perfusion, vascularization, and differentiation of the seeded cell typologies. By appropriately modulating some experimental parameters, it is possible to change the characteristics of the surface. The obtained membranes could theoretically be affixed to a decellularized tissue, but, in practice, it needs to ensure adhesion to the biological substrate and/or glue adhesion with biocompatible glues. It is also known that many of the biocompatible glues can be toxic or poorly tolerated and induce inflammatory phenomena or rejection. In tissue and organ transplants, decellularized tissues must not produce adverse immunological reactions and lead to rejection phenomena; at the same time, the transplant tissue must retain the mechanical properties of the original tissue. This review describes the attempts so far developed and the current lines of research in the field of tracheal replacement.
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11
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Sun F, Lu Y, Wang Z, Shi H. Vascularization strategies for tissue engineering for tracheal reconstruction. Regen Med 2021; 16:549-566. [PMID: 34114475 DOI: 10.2217/rme-2020-0091] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Tissue engineering technology provides effective alternative treatments for tracheal reconstruction. The formation of a functional microvascular network is essential to support cell metabolism and ensure the long-term survival of grafts. Although several tracheal replacement therapy strategies have been developed in the past, the critical significance of the formation of microvascular networks in 3D scaffolds has not attracted sufficient attention. Here, we review key technologies and related factors of microvascular network construction in tissue-engineered trachea and explore optimized preparation processes of vascularized functional tissues for clinical applications.
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Affiliation(s)
- Fei Sun
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, PR China.,Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, PR China.,Jiangsu Key Laboratory of Integrated Traditional Chinese & Western Medicine for Prevention & Treatment of Senile Diseases, Yangzhou University, Yangzhou, 225001, PR China
| | - Yi Lu
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, PR China.,Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, PR China.,Jiangsu Key Laboratory of Integrated Traditional Chinese & Western Medicine for Prevention & Treatment of Senile Diseases, Yangzhou University, Yangzhou, 225001, PR China
| | - Zhihao Wang
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, PR China.,Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, PR China.,Jiangsu Key Laboratory of Integrated Traditional Chinese & Western Medicine for Prevention & Treatment of Senile Diseases, Yangzhou University, Yangzhou, 225001, PR China
| | - Hongcan Shi
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, PR China.,Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, 225001, PR China.,Jiangsu Key Laboratory of Integrated Traditional Chinese & Western Medicine for Prevention & Treatment of Senile Diseases, Yangzhou University, Yangzhou, 225001, PR China
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12
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Serrano Martinez P, Giuranno L, Vooijs M, Coppes RP. The Radiation-Induced Regenerative Response of Adult Tissue-Specific Stem Cells: Models and Signaling Pathways. Cancers (Basel) 2021; 13:cancers13040855. [PMID: 33670536 PMCID: PMC7921940 DOI: 10.3390/cancers13040855] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/10/2021] [Accepted: 02/14/2021] [Indexed: 02/07/2023] Open
Abstract
Radiotherapy is involved in the treatment of many cancers, but damage induced to the surrounding normal tissue is often inevitable. Evidence suggests that the maintenance of homeostasis and regeneration of the normal tissue is driven by specific adult tissue stem/progenitor cells. These tasks involve the input from several signaling pathways. Irradiation also targets these stem/progenitor cells, triggering a cellular response aimed at achieving tissue regeneration. Here we discuss the currently used in vitro and in vivo models and the involved specific tissue stem/progenitor cell signaling pathways to study the response to irradiation. The combination of the use of complex in vitro models that offer high in vivo resemblance and lineage tracing models, which address organ complexity constitute potential tools for the study of the stem/progenitor cellular response post-irradiation. The Notch, Wnt, Hippo, Hedgehog, and autophagy signaling pathways have been found as crucial for driving stem/progenitor radiation-induced tissue regeneration. We review how these signaling pathways drive the response of solid tissue-specific stem/progenitor cells to radiotherapy and the used models to address this.
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Affiliation(s)
- Paola Serrano Martinez
- Department of Biomedical Sciences of Cells and Systems-Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, 9713 AV Groningen, The Netherlands;
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
| | - Lorena Giuranno
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Marc Vooijs
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
- Correspondence: (M.V.); (R.P.C.)
| | - Robert P. Coppes
- Department of Biomedical Sciences of Cells and Systems-Section Molecular Cell Biology, University of Groningen, University Medical Center Groningen, 9713 AV Groningen, The Netherlands;
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands
- Correspondence: (M.V.); (R.P.C.)
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Hu Q, Wu C, Zhang H. Preparation and Optimization of a Biomimetic Triple-Layered Vascular Scaffold Based on Coaxial Electrospinning. Appl Biochem Biotechnol 2019; 190:1106-1123. [PMID: 31705366 DOI: 10.1007/s12010-019-03147-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 09/12/2019] [Indexed: 12/28/2022]
Abstract
Electrospinning is a promising method for preparing bionic vascular scaffolds. In particular, coaxial electrospinning can encapsulate polymer materials in biological materials and provide vascular scaffolds with good biomechanical properties. However, it is difficult to produce a stable Taylor cone during the coaxial electrospinning process. Moreover, glutaraldehyde cross-linked natural biomaterials are cytotoxic. To address these issues, a novel electrospinning process is proposed in this report. A non-ionic surfactant (Tween 80) was added to poly(lactic-co-glycolic acid) electrospinning solution and gelatin-collagen electrospinning solution, which prevented the interfacial effect of coaxial electrospinning due to different core/shell solutions. The as-prepared materials were then cross-linked with the non-toxic coupling agents N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide/N-hydroxysuccinimide (EDC/NHS). By comparing the biomechanical properties of EDC/NHS cross-linked vascular scaffold with glutaraldehyde vapor-cross-linked vascular scaffold, it was found that the fracture strain and biological performance of EDC/NHS cross-linked vascular scaffold were better than those of the glutaraldehyde cross-linked scaffold. Finally, a three-layer bionic vascular scaffold was prepared by the proposed electrospinning process. Biomechanical performance tests were carried out and the prepared scaffold was found to meet the requirements of tissue-engineered blood vessels. The research in this paper provides a useful reference for the preparation and optimization of vascular scaffolds.
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Affiliation(s)
- Qingxi Hu
- Rapid Manufacturing Engineering Center, School of Mechatronical Engineering and Automation, Shanghai University, Shanghai, 200444, China.,Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, 200444, China.,National Demonstration Center for Experimental Engineering Training Education, Shanghai University, Shanghai, 200444, China
| | - Chuang Wu
- Rapid Manufacturing Engineering Center, School of Mechatronical Engineering and Automation, Shanghai University, Shanghai, 200444, China.,National Demonstration Center for Experimental Engineering Training Education, Shanghai University, Shanghai, 200444, China
| | - Haiguang Zhang
- Rapid Manufacturing Engineering Center, School of Mechatronical Engineering and Automation, Shanghai University, Shanghai, 200444, China. .,Shanghai Key Laboratory of Intelligent Manufacturing and Robotics, Shanghai University, Shanghai, 200444, China. .,National Demonstration Center for Experimental Engineering Training Education, Shanghai University, Shanghai, 200444, China.
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Abstract
The larynx sometimes requires repair and reconstruction due to cancer resection, trauma, stenosis, or developmental disruptions. Bioengineering has provided some scaffolding materials and initial attempts at tissue engineering, especially of the trachea, have been made. The critical issues of providing protection, maintaining a patent airway, and controlling swallowing and phonation, require that the regenerated laryngotracheal cartilages must have mechanical and material properties that closely mimic native tissue. These properties are determined by the cellular and proteomic characteristics of these tissues. However, little is known of these properties for these specific cartilages. This review considers what is known and what issues need to be addressed.
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Affiliation(s)
- Christine M. Pauken
- Head and Neck Regeneration Program, Mayo Clinic Center for Regenerative Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Richard Heyes
- Head and Neck Regeneration Program, Mayo Clinic Center for Regenerative Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - David G. Lott
- Head and Neck Regeneration Program, Mayo Clinic Center for Regenerative Medicine, Mayo Clinic, Phoenix, AZ, USA,David G. Lott, Head and Neck Regeneration Program, Mayo Clinic Center for Regenerative Medicine, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.
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15
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Tint D, Stabler CT, Hanifi A, Yousefi F, Linkov G, Hy K, Soliman AMS, Pleshko N. Spectroscopic Analysis of Human Tracheal Tissue during Decellularization. Otolaryngol Head Neck Surg 2019; 160:302-309. [PMID: 30325714 DOI: 10.1177/0194599818806271] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/20/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To use mid-infrared (IR) spectroscopy to assess changes in the cartilaginous framework of human trachea during decellularization. STUDY DESIGN Laboratory-based study. SETTING Research laboratory. METHODS Six cadaveric human tracheas were decellularized using a detergent enzymatic method (DEM). Tissue samples were obtained from each specimen after 0, 1, 10, and 25 DEM cycles for histologic and spectroscopic analysis. Decellularization was confirmed using hematoxylin and eosin (H&E) and 2-(4-amidinophenyl)-1H-indole-6-carboxamidine (DAPI) staining. Changes in cartilaginous framework were examined using Fourier transform infrared imaging spectroscopy (FT-IRIS) and an attenuated total reflectance (ATR) probe in the mid-IR frequencies. Results were statistically analyzed using 1-way analysis of variance (ANOVA) and principal component analysis (PCA). RESULTS Six decellularized tracheal scaffolds were successfully created using a DEM protocol. Histologic examination showed near-complete nuclear loss following 25 DEM cycles. As observed with FT-IRIS analysis, the collagen absorbance signal (1336 cm-1) was predominantly in the perichondria and remained stable after 25 DEM cycles ( P = .132), while the absorbance from sugar rings in proteoglycans and nucleic acids in hyaline cartilage (1080 cm-1) showed a significant decrease after 1 DEM cycle ( P = .0007). Examination of the luminal surface of the trachea with an ATR probe showed raw mid-IR spectra consistent with cartilage. PCA showed significant separation of spectra corresponding to treatment cycle along the principal components 1 and 2. CONCLUSION Mid-IR spectroscopy is a viable method of monitoring changes in extracellular matrix components during the decellularization of human trachea.
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Affiliation(s)
- Derrick Tint
- 1 Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Collin T Stabler
- 2 Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- 3 Penn Center for Pulmonary Biology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- 4 Penn Cardiovascular Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- 5 Penn Institute for Regenerative Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Arash Hanifi
- 6 Department of Bioengineering, Temple University, Philadelphia, Pennsylvania, USA
| | - Farzad Yousefi
- 6 Department of Bioengineering, Temple University, Philadelphia, Pennsylvania, USA
| | - Gary Linkov
- 1 Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Kenneth Hy
- 6 Department of Bioengineering, Temple University, Philadelphia, Pennsylvania, USA
| | - Ahmed M S Soliman
- 1 Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Nancy Pleshko
- 6 Department of Bioengineering, Temple University, Philadelphia, Pennsylvania, USA
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16
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Varma R, Aoki FG, Soon K, Karoubi G, Waddell TK. Optimal biomaterials for tracheal epithelial grafts: An in vitro systematic comparative analysis. Acta Biomater 2018; 81:146-157. [PMID: 30268918 DOI: 10.1016/j.actbio.2018.09.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/19/2018] [Accepted: 09/26/2018] [Indexed: 12/17/2022]
Abstract
Tracheal injury, stenosis, and malignancy demand tracheal reconstruction, which often fails due to the lack of a functioning epithelium. We performed an extensive comparative analysis to determine optimal biomaterials for developing tracheal epithelial grafts with mucociliary function. We screened Hyaluronan-Poly(Ethylene Glycol), Chitosan-Collagen, Collagen Vitrigel Membrane, Fibrin Glue, Silk Fibroin, and Gelatin based on various parameters including mechanical strength, bulk degradation, cell attachment, spreading, metabolic activity, focal adhesion formation, and differentiation into ciliated and goblet cells. Silk Fibroin had significantly higher tensile strength (21.23 ± 4.42 MPa), retained 50% of its mass across 5 weeks, allowed 80-100% cell spreading and increasing metabolic activity across 10 days, focal adhesion formation within 2 h, and differentiation into 5.9 ± 2.6% goblet cells. Silk Fibroin, however, led to poor ciliation, producing 5.5 ± 3.9% ciliated cells, whereas Collagen Vitrigel Membrane promoted excellent ciliation. To capitalize on the mechanical and differentiation benefits of its respective components, we developed a composite biomaterial of Silk Fibroin and Collagen Vitrigel Membrane (SF-CVM), which demonstrated enhanced maturation into 20.6 ± 1.7% ciliated and 5.6 ± 1.0% goblet cells. Development of biomaterials-based airway epithelial grafts that provide desirable mechanics and differentiation is a major step towards treatment of airway disease. STATEMENT OF SIGNIFICANCE: Tracheal blockage, injury, and malignancy greater than 50% of the adult tracheal length cannot be safely resected. Tracheal replacement is one approach, but a major cause of transplant failure is the lack of a functioning epithelium. While tissue engineering for tracheal regeneration using biomaterials is promising, there is currently no gold standard. Therefore, we performed a systematic comparative study to characterize relevant materials for generating a biomaterials-based airway epithelial graft. We developed a composite biomaterial intended for surgical implantation providing tensile strength, slow biodegradation, and optimal support for differentiation of mature epithelia. This is a significant step augmenting current state-of-the-art methods for airway surgeries, laryngeal reconstruction, and tracheal tissue engineering.
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Affiliation(s)
- Ratna Varma
- Institute for Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario M5S 3G9, Canada; Latner Thoracic Surgery Research Laboratories and the McEwen Centre for Regenerative Medicine, Toronto General Hospital, 101 College St, Toronto, ON M5G 1L7, Canada.
| | - Fabio G Aoki
- Latner Thoracic Surgery Research Laboratories and the McEwen Centre for Regenerative Medicine, Toronto General Hospital, 101 College St, Toronto, ON M5G 1L7, Canada
| | - Kayla Soon
- Latner Thoracic Surgery Research Laboratories and the McEwen Centre for Regenerative Medicine, Toronto General Hospital, 101 College St, Toronto, ON M5G 1L7, Canada
| | - Golnaz Karoubi
- Institute for Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario M5S 3G9, Canada; Latner Thoracic Surgery Research Laboratories and the McEwen Centre for Regenerative Medicine, Toronto General Hospital, 101 College St, Toronto, ON M5G 1L7, Canada.
| | - Thomas K Waddell
- Institute for Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario M5S 3G9, Canada; Latner Thoracic Surgery Research Laboratories and the McEwen Centre for Regenerative Medicine, Toronto General Hospital, 101 College St, Toronto, ON M5G 1L7, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada.
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17
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3D Bioprinted Artificial Trachea with Epithelial Cells and Chondrogenic-Differentiated Bone Marrow-Derived Mesenchymal Stem Cells. Int J Mol Sci 2018; 19:ijms19061624. [PMID: 29857483 PMCID: PMC6032277 DOI: 10.3390/ijms19061624] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 05/27/2018] [Accepted: 05/29/2018] [Indexed: 12/13/2022] Open
Abstract
Tracheal resection has limited applicability. Although various tracheal replacement strategies were performed using artificial prosthesis, synthetic stents and tissue transplantation, the best method in tracheal reconstruction remains to be identified. Recent advances in tissue engineering enabled 3D bioprinting using various biocompatible materials including living cells, thereby making the product clinically applicable. Moreover, clinical interest in mesenchymal stem cell has dramatically increased. Here, rabbit bone marrow-derived mesenchymal stem cells (bMSC) and rabbit respiratory epithelial cells were cultured. The chondrogenic differentiation level of bMSC cultured in regular media (MSC) and that in chondrogenic media (d-MSC) were compared. Dual cell-containing artificial trachea were manufactured using a 3D bioprinting method with epithelial cells and undifferentiated bMSC (MSC group, n = 6) or with epithelial cells and chondrogenic-differentiated bMSC (d-MSC group, n = 6). d-MSC showed a relatively higher level of glycosaminoglycan (GAG) accumulation and chondrogenic marker gene expression than MSC in vitro. Neo-epithelialization and neo-vascularization were observed in all groups in vivo but neo-cartilage formation was only noted in d-MSC. The epithelial cells in the 3D bioprinted artificial trachea were effective in respiratory epithelium regeneration. Chondrogenic-differentiated bMSC had more neo-cartilage formation potential in a short period. Nevertheless, the cartilage formation was observed only in a localized area.
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Bhora FY, Lewis EE, Rehmani SS, Ayub A, Raad W, Al-Ayoubi AM, Lebovics RS. Circumferential Three-Dimensional-Printed Tracheal Grafts: Research Model Feasibility and Early Results. Ann Thorac Surg 2017; 104:958-963. [PMID: 28619543 DOI: 10.1016/j.athoracsur.2017.03.064] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/14/2017] [Accepted: 03/27/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Methods for tracheal graft research have presented persistent challenges to investigators, and three-dimensional (3D)-printed biosynthetic grafts offer one potential development platform. We aimed to develop an efficient research platform for customizable circumferential 3D-printed tracheal grafts and evaluate feasibility and early structural integrity with a large-animal model. METHODS Virtual 3D models of porcine subject tracheas were generated using preoperative computed tomography scans. Two designs were used to test graft customizability and the limits of the construction process. Designs I and II used 270-degree and 360-degree external polycaprolactone scaffolds, respectively, both encompassing a circumferential extracellular matrix collagen layer. The polycaprolactone scaffolds were made in a fused-deposition modeling 3D printer and customized to the recipient's anatomy. Design I was implanted in 3 pigs and design II in 2 pigs, replacing 4-ring tracheal segments. Data collected included details of graft construction, clinical outcomes, bronchoscopy, and gross and histologic examination. RESULTS The 3D-printed biosynthetic grafts were produced with high fidelity to the native organ. The fabrication process took 36 hours. Grafts were implanted without immediate complication. Bronchoscopy immediately postoperatively and at 1 week demonstrated patent grafts and appropriate healing. All animals lived beyond a predetermined 1-week survival period. Bronchoscopy at 2 weeks showed significant paraanastomotic granulation tissue, which, along with partial paraanastomotic epithelialization, was confirmed on pathology. Overall survival was 17 to 34 days. CONCLUSIONS We propose a rapid, reproducible, resource efficient method to develop various anatomically precise grafts. Further graft refinement and strategies for granulation tissue management are needed to improve outcomes.
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Affiliation(s)
- Faiz Y Bhora
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Erik E Lewis
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sadiq S Rehmani
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Adil Ayub
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Wissam Raad
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Adnan M Al-Ayoubi
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert S Lebovics
- Department of Otolaryngology, Mount Sinai West, Mount Sinai Health System, New York, New York
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Krishnan G, Du C, Fishman JM, Foreman A, Lott DG, Farwell G, Belafsky P, Krishnan S, Birchall MA. The current status of human laryngeal transplantation in 2017: A state of the field review. Laryngoscope 2017; 127:1861-1868. [PMID: 28224630 DOI: 10.1002/lary.26503] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Human laryngeal allotransplantation has long been contemplated as a surgical option following laryngectomy, but there is a paucity of information regarding the indications, surgical procedure, and patient outcomes. Our objectives were to identify all human laryngeal allotransplants that have been undertaken and reported in the English literature and to evaluate the success of the procedure. DATA SOURCES MEDLINE, Embase, Current Index to Nursing and Allied Health Literature, Web of Science and Scopus, and the Gray literature. REVIEW METHODS A comprehensive search strategy was undertaken across multiple databases. Inclusion criteria were case reports of patients who had undergone human laryngeal allotransplantation. Information regarding indications, operative techniques, complications, graft viability, and functional outcomes were extracted. RESULTS A total of 5,961 articles, following removal of duplicates, matched the search criteria and were screened, with five case reports relating to two patients, ultimately fulfilling the entry criteria. CONCLUSIONS Two laryngeal transplants have been reported in the medical literature. Although both patients report improved quality of life relating to their ability to communicate with voice, further research is necessary to shape our understanding of this complicated operation, its indications, and its functional outcomes. Laryngoscope, 127:1861-1868, 2017.
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Affiliation(s)
- Giri Krishnan
- Department of Otolaryngology-Head and Neck Surgery, The Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Charles Du
- Department of Otolaryngology-Head and Neck Surgery, The Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Jonathan M Fishman
- Department of Otolaryngology-Head and Neck Surgery, UCL Ear Institute, University College London, London, United Kingdom
| | - Andrew Foreman
- Department of Otolaryngology-Head and Neck Surgery, The Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - David G Lott
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A
| | - Gregory Farwell
- Department of Otolaryngology, Division of Head and Neck Surgery, University of California Davis, Sacramento, California, U.S.A
| | - Peter Belafsky
- Department of Otolaryngology, Division of Head and Neck Surgery, University of California Davis, Sacramento, California, U.S.A
| | - Suren Krishnan
- Department of Otolaryngology-Head and Neck Surgery, The Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Martin A Birchall
- Department of Otolaryngology-Head and Neck Surgery, UCL Ear Institute, University College London, London, United Kingdom
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Iyer R, Hsia CCW, Nguyen KT. Nano-Therapeutics for the Lung: State-of-the-Art and Future Perspectives. Curr Pharm Des 2016; 21:5233-44. [PMID: 26412358 DOI: 10.2174/1381612821666150923095742] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 09/22/2015] [Indexed: 11/22/2022]
Abstract
Inhalation of aerosolized compounds is a popular, non-invasive route for the targeted delivery of therapeutic molecules to the lung. Various types of nanoparticles have been used as carriers to facilitate drug uptake and intracellular action in order to treat lung diseases and/or to facilitate lung repair and growth. These include polymeric nanoparticles, liposomes, and dendrimers, among many others. In addition, nanoparticles are sometimes used in combination with small molecules, cytokines, growth factors, and/or pluripotent stem cells. Here we review the rationale and state-of-the-art nanotechnology for pulmonary drug delivery, with particular attention to new technological developments and approaches as well as the challenges associated with them, the emerging advances, and opportunities for future development in this field.
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Affiliation(s)
| | | | - Kytai T Nguyen
- Department of Bioengineering, University of Texas at Arlington, 500 UTA Blvd, ERB 241, Arlington, TX 76019.
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21
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Chiang T, Pepper V, Best C, Onwuka E, Breuer CK. Clinical Translation of Tissue Engineered Trachea Grafts. Ann Otol Rhinol Laryngol 2016; 125:873-885. [PMID: 27411362 DOI: 10.1177/0003489416656646] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To provide a state-of-the-art review discussing recent achievements in tissue engineered tracheal reconstruction. DATA SOURCES AND REVIEW METHODS A structured PubMed search of the current literature up to and including October 2015. Representative articles that discuss the translation of tissue engineered tracheal grafts (TETG) were reviewed. CONCLUSIONS The integration of a biologically compatible support with autologous cells has resulted in successful regeneration of respiratory epithelium, cartilage, and vascularization with graft patency, although the optimal construct composition has yet to be defined. Segmental TETG constructs are more commonly complicated by stenosis and delayed epithelialization when compared to patch tracheoplasty. IMPLICATIONS FOR PRACTICE The recent history of human TETG recipients represents revolutionary proof of principle studies in regenerative medicine. Application of TETG remains limited to a compassionate use basis; however, defining the mechanisms of cartilage formation, epithelialization, and refinement of in vivo regeneration will advance the translation of TETG from the bench to the bedside.
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Affiliation(s)
- Tendy Chiang
- Tissue Engineering and Surgical Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, USA Department of Otolaryngology-Head & Neck Surgery, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Victoria Pepper
- Tissue Engineering and Surgical Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Cameron Best
- Tissue Engineering and Surgical Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Ekene Onwuka
- Tissue Engineering and Surgical Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA Department of Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio, USA
| | - Christopher K Breuer
- Tissue Engineering and Surgical Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
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22
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Maughan E, Lesage F, Butler CR, Hynds RE, Hewitt R, Janes SM, Deprest JA, Coppi PD. Airway tissue engineering for congenital laryngotracheal disease. Semin Pediatr Surg 2016; 25:186-90. [PMID: 27301606 DOI: 10.1053/j.sempedsurg.2016.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Regenerative medicine offers hope of a sustainable solution for severe airway disease by the creation of functional, immunocompatible organ replacements. When considering fetuses and newborns, there is a specific spectrum of airway pathologies that could benefit from cell therapy and tissue engineering applications. While hypoplastic lungs associated with congenital diaphragmatic hernia (CDH) could benefit from cellular based treatments aimed at ameliorating lung function, patients with upper airway obstruction could take advantage from a de novo tissue engineering approach. Moreover, the international acceptance of the EXIT procedure as a means of securing the precarious neonatal airway, together with the advent of fetal surgery as a method of heading off postnatal co-morbidities, offers the revolutionary possibility of extending the clinical indication for tissue-engineered airway transplantation to infants affected by diverse severe congenital laryngotracheal malformations. This article outlines the necessary basic components for regenerative medicine solutions in this potential clinical niche.
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Affiliation(s)
- Elizabeth Maughan
- Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Flore Lesage
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK; Department of Development and Regeneration, Biomedical Sciences Group, University of Leuven, Leuven, Belgium
| | - Colin R Butler
- Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Robert E Hynds
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Richard Hewitt
- Ear, Nose and Throat Department, Great Ormond Street Hospital, London, UK
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Jan A Deprest
- Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Department of Development and Regeneration, Biomedical Sciences Group, University of Leuven, Leuven, Belgium; Department of Paediatric Surgery, Great Ormond Street Hospital, London, UK; Department of Obstetrics and Gynaecology, Fetal Medicine Unit, University Hospitals Leuven, Leuven, Belgium
| | - Paolo De Coppi
- Stem Cells and Regenerative Medicine Section, DBC, UCL Institute of Child Health, 30 Guilford St, London, UK; Department of Paediatric Surgery, Great Ormond Street Hospital, London, UK.
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23
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Bogan SL, Teoh GZ, Birchall MA. Tissue Engineered Airways: A Prospects Article. J Cell Biochem 2016; 117:1497-505. [PMID: 26853803 DOI: 10.1002/jcb.25512] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 11/11/2022]
Abstract
An ideal tracheal scaffold must withstand luminal collapse yet be flexible, have a sufficient degree of porosity to permit vascular and cellular ingrowth, but also be airtight and must facilitate growth of functional airway epithelium to avoid infection and aid in mucocilliary clearance. Finally, the scaffold must also be biocompatible to avoid implant rejection. Over the last 40 years, efforts to design and manufacture the airway have been undertaken worldwide but success has been limited and far apart. As a result, tracheal resection with primary repair remains the Gold Standard of care for patients presenting with airway disorders and malignancies. However, the maximum resectable length of the trachea is restricted to 30% of the total length in children or 50% in adults. Attempts to provide autologous grafts for human application have also been disappointing for a host of different reasons, including lack of implant integration, insufficient donor organs, and poor mechanical strength resulting in an unmet clinical need. The two main approaches researchers have taken to address this issue have been the development of synthetic scaffolds and the use of decellularized organs. To date, a number of different decellularization techniques and a variety of materials, including polyglycolic acid (PGA) and nanocomposite polymers have been explored. The findings thus far have shown great promise, however, there remain a significant number of caveats accompanying each approach. That being said, the possibilities presented by these two approaches could be combined to produce a highly successful, clinically viable hybrid scaffold. This article aims to highlight advances in airway tissue engineering and provide an overview of areas to explore and utilize in accomplishing the aim of developing an ideal tracheal prosthesis. J. Cell. Biochem. 117: 1497-1505, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Stephanie L Bogan
- University College London, Gower Street London WC1E 6BT, United Kingdom of Great Britain and Northern Ireland
| | - Gui Zhen Teoh
- University College London, Gower Street London WC1E 6BT, United Kingdom of Great Britain and Northern Ireland
| | - Martin A Birchall
- University College London, Gower Street London WC1E 6BT, United Kingdom of Great Britain and Northern Ireland.,Royal National Throat Nose and Ear Hospital, London WC1X 8DA, United Kingdom of Great Britain and Northern Ireland
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Kirkpatrick CJ. Modelling the regenerative niche: a major challenge in biomaterials research. Regen Biomater 2015; 2:267-72. [PMID: 26816650 PMCID: PMC4676329 DOI: 10.1093/rb/rbv018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 08/25/2015] [Accepted: 08/30/2015] [Indexed: 01/01/2023] Open
Abstract
By definition, biomaterials are developed for clinical application. In the field of regenerative medicine their principal function is to play a significant, and, if possible, an instructive role in tissue healing. In the last analysis the latter involves targeting the ‘regenerative niche’. The present paper will address the problem of simulating this niche in the laboratory and adopts a life science approach involving the harnessing of heterotypic cellular communication to achieve this, that is, the ability of cells of different types to mutually influence cellular functions. Thus, co-culture systems using human cells are the methodological focus and will concern four exemplary fields of regeneration, namely, bone, soft tissue, lower respiratory tract and airway regeneration. The working hypothesis underlying this approach is that in vitro models of higher complexity will be more clinically relevant than simple monolayer cultures of transformed cell lines in testing innovative strategies with biomaterials for regeneration.
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Affiliation(s)
- C James Kirkpatrick
- REPAIR-Lab, Institute of Pathology, University Medical Center, Johannes Gutenberg University Mainz, D-55101 Mainz, Germany;; Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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25
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Prakash YS, Tschumperlin DJ, Stenmark KR. Coming to terms with tissue engineering and regenerative medicine in the lung. Am J Physiol Lung Cell Mol Physiol 2015; 309:L625-38. [PMID: 26254424 DOI: 10.1152/ajplung.00204.2015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 08/04/2015] [Indexed: 01/10/2023] Open
Abstract
Lung diseases such as emphysema, interstitial fibrosis, and pulmonary vascular diseases cause significant morbidity and mortality, but despite substantial mechanistic understanding, clinical management options for them are limited, with lung transplantation being implemented at end stages. However, limited donor lung availability, graft rejection, and long-term problems after transplantation are major hurdles to lung transplantation being a panacea. Bioengineering the lung is an exciting and emerging solution that has the ultimate aim of generating lung tissues and organs for transplantation. In this article we capture and review the current state of the art in lung bioengineering, from the multimodal approaches, to creating anatomically appropriate lung scaffolds that can be recellularized to eventually yield functioning, transplant-ready lungs. Strategies for decellularizing mammalian lungs to create scaffolds with native extracellular matrix components vs. de novo generation of scaffolds using biocompatible materials are discussed. Strengths vs. limitations of recellularization using different cell types of various pluripotency such as embryonic, mesenchymal, and induced pluripotent stem cells are highlighted. Current hurdles to guide future research toward achieving the clinical goal of transplantation of a bioengineered lung are discussed.
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Affiliation(s)
- Y S Prakash
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota;
| | - Daniel J Tschumperlin
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota; Division of Pulmonary Medicine, Mayo Clinic, Rochester, Minnesota; and
| | - Kurt R Stenmark
- Department of Pediatrics, University of Colorado, Aurora, Colorado
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Salehi M, Naseri Nosar M, Amani A, Azami M, Tavakol S, Ghanbari H. Preparation of Pure PLLA, Pure Chitosan, and PLLA/Chitosan Blend Porous Tissue Engineering Scaffolds by Thermally Induced Phase Separation Method and Evaluation of the Corresponding Mechanical and Biological Properties. INT J POLYM MATER PO 2015. [DOI: 10.1080/00914037.2014.1002093] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Colvin KL, Yeager ME. Applying Biotechnology and Bioengineering to Pediatric Lung Disease: Emerging Paradigms and Platforms. Front Pediatr 2015; 3:45. [PMID: 26106589 PMCID: PMC4460801 DOI: 10.3389/fped.2015.00045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 05/08/2015] [Indexed: 11/15/2022] Open
Abstract
Pediatric lung diseases remain a costly worldwide health burden. For many children with end-stage lung disease, lung transplantation remains the only therapeutic option. Due to the limited number of lungs available for transplantation, alternatives to lung transplant are desperately needed. Recently, major improvements in tissue engineering have resulted in newer technology and methodology to develop viable bioengineered lungs. These include critical advances in lung cell biology, stem cell biology, lung extracellular matrix, microfabrication techniques, and orthotopic transplantation of bioartificial lungs. The goal of this short review is to engage the reader's interest with regard to these emerging concepts and to stimulate their interest to learn more. We review the existing state of the art of lung tissue engineering, and point to emerging paradigms and platforms in the field. Finally, we summarize the challenges and unmet needs that remain to be overcome.
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Affiliation(s)
- Kelley L Colvin
- Department of Pediatrics-Critical Care, University of Colorado Denver , Denver, CO , USA ; Cardiovascular Pulmonary Research, University of Colorado Denver , Denver, CO , USA ; Department of Bioengineering, University of Colorado Denver , Denver, CO , USA ; Linda Crnic Institute for Down Syndrome, University of Colorado Denver , Denver, CO , USA
| | - Michael E Yeager
- Department of Pediatrics-Critical Care, University of Colorado Denver , Denver, CO , USA ; Cardiovascular Pulmonary Research, University of Colorado Denver , Denver, CO , USA ; Department of Bioengineering, University of Colorado Denver , Denver, CO , USA ; Linda Crnic Institute for Down Syndrome, University of Colorado Denver , Denver, CO , USA
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