Complete in vitro prosthesis endothelialization induced by artificial extracellular matrix

Tissue engineering vascular grafts a fortiori: looking back and going forward

INTRODUCTION

Cardiovascular diseases such as coronary heart disease often necessitate the surgical repair using conduits. Although autografts still remain the gold standard, the inconvenience of harvesting and/or insufficient availability in patients with atherosclerotic disease has given impetus to look into alternative sources for vascular grafts.

AREAS COVERED

There are four main techniques to produce tissue-engineered vascular grafts (TEVGs): i) biodegradable synthetic scaffolds; ii) gel-based scaffolds; iii) decellularised scaffolds and iv) self-assembled cell-sheet-based techniques. The first three techniques can be grouped together as scaffold-guided approach as it involves the use of a construct to function as a supportive framework for the vascular graft. The most significant advantages of TEVGs are that it possesses the ability to grow, remodel and respond to environmental factors. Cell sources for TEVGs include mature somatic cells, stem cells, adult progenitor cells and pluripotent stem cells.

EXPERT OPINION

TEVG holds great promise with advances in nanotechnology, coupled with important refinements in tissue engineering and decellularisation techniques. This will undoubtedly be an important milestone for cardiovascular medicine when it is eventually translated to clinical use.

ECM-based materials in cardiovascular applications: Inherent healing potential and augmentation of native regenerative processes

The in vivo healing process of vascular grafts involves the interaction of many contributing factors. The ability of vascular grafts to provide an environment which allows successful accomplishment of this process is extremely difficult. Poor endothelisation, inflammation, infection, occlusion, thrombosis, hyperplasia and pseudoaneurysms are common issues with synthetic grafts in vivo. Advanced materials composed of decellularised extracellular matrices (ECM) have been shown to promote the healing process via modulation of the host immune response, resistance to bacterial infections, allowing re-innervation and reestablishing homeostasis in the healing region. The physiological balance within the newly developed vascular tissue is maintained via the recreation of correct biorheology and mechanotransduction factors including host immune response, infection control, homing and the attraction of progenitor cells and infiltration by host tissue. Here, we review the progress in this tissue engineering approach, the enhancement potential of ECM materials and future prospects to reach the clinical environment.

VEGF-E enhances endothelialization and inhibits thrombus formation on polymeric surfaces

Thrombotic complications of long-term blood-contacting devices can be avoided by formation of an endothelial cell layer on the blood-contacting surface. The endothelial cells form a bioactive boundary between the synthetic surface and blood, regulating haemostasis and inflammation. Biofunctionalization of synthetic blood-contacting surfaces is necessary to accommodate growth of endothelial cells. Vascular endothelial growth factor E (VEGF-E) or collagen I may stimulate endothelialization of a polymeric surface coating of a prototype small diameter vascular prosthesis. VEGF-E was produced in Escherichia coli and could be easily purified in large quantities. Recombinant VEGF-E or purified collagen I was allowed to adsorb onto the polymeric surfaces and enhanced formation of an endothelial cell layer. Adsorption of VEGF-E was increased by the inclusion of the anti-coagulant drug heparin in the polymeric coating. Collagen I adsorption induced rapid thrombin generation and increased platelet adhesion on surfaces with or without heparin. VEGF-E inhibited thrombus formation, and did not interfere with the anti-thrombogenic effect of heparin. Additionally, VEGF-E did not affect platelet adhesion. Adsorption of VEGF-E, especially on heparin containing surfaces, provides an economical strategy to improve endothelialization of cardiovascular implants without disturbing blood-compatibility.

Addressing thrombogenicity in vascular graft construction

Thrombosis is a major cause of poor patency in synthetic vascular grafts for small diameter vessel (< 6 mm) bypass. Arteries have a host of structural mechanisms by which they prevent triggering of platelet activation and the clotting cascade. Many of these are present in vascular endothelial cells. These mechanisms act together with perpetual feedback at different levels, providing a constantly fine-tuned non-thrombogenic environment. The arterial wall anatomy also serves to promote thrombosis as a healing mechanism when it has been severely injured. Surface modification of synthetic graft surfaces to attenuate the coagulation cascade has reduced thrombosis levels and improved patency in vitro and in animal models. Success in this endeavor is critically dependent on the methods used to modify the surface. Platelets adhere to positively charged surfaces due to their own negative charge. They also preferentially attach to hydrophobic surfaces. Therefore synthetic graft development is concerned with hydrophilic materials with negative surface charge. However, fibrinogen has both hydrophilic and hydrophobic binding sites-amphiphilic materials reduce its adhesion and subsequent platelet activation. The self-endothelializing synthetic graft is an attractive proposition as a confluent endothelial layer incorporates many of the anti-thrombogenic properties of arteries. Surface modification to promote this has shown good results in animal models. The difficulties experienced in achieving spontaneous endothelialisation in humans have lead to the investigation of pre-implantation in vitro endothelial cell seeding. These approaches ultimately aim to result in novel synthetic grafts which are anti-thrombogenic and hence suitable for coronary and distal infrainguinal bypass.

Fibronectin and culture temperature modulate the efficacy of an avidin–biotin binding system for chondrocyte adhesion and growth on biodegradable polymers

Cell adhesion to a scaffold is a prerequisite for tissue engineering. Many studies have been focused on enhancing cell adhesion to synthetic materials that are used for scaffold fabrication. Previously, we showed that immobilization of biotin molecules to chondrocyte surfaces enhanced cell adhesion to avidin-coated biodegradable polymers such as poly-L-lactic acid, poly-D,L-lactic acid and polycaprolactone. However, the endocytosis of cell membrane biotin molecules decreases binding strength between biotinylated-chondrocytes (B-chondrocytes) and avidin-coated substrata, and therefore decreases cell spreading and discourages long-term chondrocytes culture. In this study, we proposed two strategies to solve the shortcoming of the avidin-biotin binding system. First, the avidin-biotin binding system is combined with the intrinsic integrin-dependent adhesion systems in order to enhance long-term cell culture. Second, the incubation temperature is lowered in order to slow down the endocytosis process. We found that the avidin-biotin binding system in combination with FN-integrin binding system enhanced cell adhesion, cell spreading and cell growth. Decrease of cell culture temperature to 4 degrees C enhanced the adhesion of B-chondrocytes to the avidin-coated surfaces, but decreased cell viability and proliferation, compared to culture temperature of 37 degrees C. Whether there is an optimal seeding temperature between 4 and 37 degrees C for both adhesion and proliferation of B-chondrocytes needs further investigation. Our results indicated that modulation of the adhesion conditions could further enhance the efficacy of the avidin-biotin binding system in mediating cell adhesion, and subsequent tissue culture.

Effect of an avidin-biotin binding system on chondrocyte adhesion, growth and gene expression

Cell adhesion to synthetic biomaterials is a prerequisite for anchorage cell culture and tissue engineering. The current study investigated utilization of an avidin-biotin binding system in enhancing chondrocyte adhesion to tissue culture polystyrene (TCPS). Biotinylated chondrocytes adhered to avidin-coated TCPS more quickly than untreated chondrocytes to bare TCPS. Also the avidin-biotin binding system enhanced cell initial spreading. However, the effects were only transient. The growth of biotinylated chondrocytes was first decreased during the first 3 days but increased afterwards. The progeny of biotinylated chondrocytes still maintained the ability in expressing cartilage extracellular matrix proteins such as type II collagen, type IX collagen and aggrecan. These results show potential for the application of the avidin-biotin binding system to cell culture and tissue engineering.

Effects of an Avidin-Biotin Binding System on Chondrocyte Adhesion and Growth on Biodegradable Polymers

Cell adhesion to a scaffold is a prerequisite for tissue engineering. Many studies have been focused on enhancing cell adhesion to synthetic materials that are used for scaffold fabrication. In this study, we applied an avidin-biotin binding system to enhance chondrocyte adhesion to biodegradable polymers. Biotin molecules were conjugated to the cell membrane of chondrocytes, and mediated cell adhesion to avidin-coated surfaces. We demonstrated that immobilization of biotin molecules to chondrocyte surfaces enhanced cell adhesion to avidin-coated biodegradable polymers such as poly(L-lactic acid), poly(D,L-lactic acid), and polycaprolactone, compared to the adhesion of normal chondrocytes to the same type of biodegradable polymer. The biotinylated chondrocytes still maintained their proliferation ability. This study showed the promise of applying the avidin-biotin system in cartilage tissue engineering. [diagram in text].

High-affinity augmentation of endothelial cell attachment: long-term effects on focal contact and actin filament formation

Coadsorption of high-affinity avidin with lower affinity cell adhesion protein fibronectin has been shown to significantly augment short-term (1 h) adhesion and spreading of endothelial cells; however, the longer term persistence of avidin binding and its effect on endothelial cell adhesion have not been addressed. In this study, the presence of avidin-biotin bonds 24 h after cell adhesion to the dual ligand surfaces was verified by laser confocal microscopy of a fluorescent avidin analog, streptavidin. Total internal reflection microscopy showed that the focal contact area, focal contact density, and cell spreading all increased significantly at 24 h compared to fibronectin-treated control surfaces. Focal contact area was identical when measured with cells that were labeled with either the fluorescent streptavidin or a carbocyanine dye incorporated in the cell membrane. Confocal images of stress fibers formed in cells adherent to dual ligand surfaces after 24 h were thicker and more numerous compared to cells adherent to fibronectin controls. The results indicate that 24 h after initial attachment avidin-biotin is localized to focal contacts on the basal surface and affects cell spreading, actin filament organization, and focal contact density.

Enhanced retroviral transduction of 293 cells cultured on liquid-liquid interfaces

In clinical research, retrovirus-mediated gene therapy is one of the most commonly used methods to deliver and express the gene of interest due its ability to allow for stable gene integration into the chromosomes of target cells. To elevate the efficiency of viral transduction, several restrictions, such as low virus-cell encounters and the necessity for cell division, must be improved. In this study, we focused on the possibility of accelerating cell division and the ensuing increment of viral transduction on flexible substrata. Perfluorocarbon FC-40 was harnessed to form a liquid-liquid interface with culture medium. Enhanced green fluorescence protein (EGFP) was employed as the marker gene to quickly illustrate the percentage of viral infection. The results indicate that the gene transfer efficiency to 293 cells cultured on protein-precoated liquid-liquid interfaces was higher than in cells cultured on rigid polystyrene surfaces. This increased transduction rate on the liquid-liquid interface is consistent with the acceleration of division of 293 cells on a flexible interface, which exhibited less adhesiveness. The effect of cell-cell contact inhibition on the rate of gene transduction is also addressed in this study.