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A Critical Aspect of Bioreactor Designing and Its Application for the Generation of Tissue Engineered Construct: Emphasis on Clinical Translation of Bioreactor. BIOTECHNOL BIOPROC E 2022. [DOI: 10.1007/s12257-021-0128-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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2
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Dearman BL, Greenwood JE. Scale-up of a Composite Cultured Skin Using a Novel Bioreactor Device in a Porcine Wound Model. J Burn Care Res 2021; 42:1199-1209. [PMID: 33640976 DOI: 10.1093/jbcr/irab034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Extensive deep-burn management with a two-stage strategy can reduce reliance on skin autografts; a biodegradable polyurethane scaffold to actively temporize the wound and later an autologous composite cultured skin (CCS) for definitive closure. The materials fulfilling each stage have undergone in vitro and in vivo pretesting in "small" large animal wounds. For humans, producing multiple, large CCSs requires a specialized bioreactor. This article reports a system used to close large porcine wounds. Three Large White pigs were used, each with two wounds (24.5 cm × 12 cm) into which biodegradable dermal scaffolds were implanted. A sample from discarded tissue allowed isolation/culture of autologous fibroblasts and keratinocytes. CCS production began by presoaking a 1-mm-thick biodegradable polyurethane foam in autologous plasma. In the bioreactor cassette, fibroblasts were seeded into the matrix with thrombin until established, followed by keratinocytes. The CCSs were applied onto integrated dermal scaffolds on day 35, alongside a sheet skin graft (30% of one wound). Serial punch biopsies, trans-epidermal water loss readings (TEWL), and wound measurements indicated epithelialization. During dermal scaffold integration, negligible wound contraction was observed (average 4.5%). After CCS transplantation, the control skin grafts were "taken" by day 11 when visible islands of epithelium were clinically observed on 2/3 CCSs. Closure was confirmed histologically, with complete epithelialization by day 63 post-CCS transplantation (CCS TEWL ~ normal skin average 11.9 g/m2h). Four of six wounds demonstrated closure with robust, stratified epithelium. Generating large pieces of CCS capable of healing large wounds is thus possible using a specialized designed bioreactor.
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Affiliation(s)
- Bronwyn L Dearman
- Skin Engineering Laboratory, Adult Burn Centre, Royal Adelaide Hospital, SA, Australia.,Faculty of Health Sciences, The University of Adelaide, SA, Australia
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3
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Rios-Galacho M, Martinez-Moreno D, López-Ruiz E, Galvez-Martin P, Marchal JA. An overview on the manufacturing of functional and mature cellular skin substitutes. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:1035-1052. [PMID: 34652978 DOI: 10.1089/ten.teb.2021.0131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
There are different types of skin diseases due to chronic injuries that impede the natural healing process of the skin. Tissue engineering (TE) has focused on the development of bioengineered skin or skin substitutes that cover the wound, providing the necessary care to restore the functionality of injured skin. There are two types of substitutes: acellular skin substitutes (ASSs), which offer a low response of the body, and cellular skin substitutes (CSSs), which incorporate living cells and appear as a great alternative in the treatment of skin injuries due to them presenting a greater interaction and integration with the rest of the body. For the development of a CSS, it is necessary to select the most suitable biomaterials, cell components, and methodology of biofabrication for the wound to be treated. Moreover, these CSSs are immature substitutes that must undergo a maturing process in specific bioreactors, guaranteeing their functionality. The bioreactor simulates the natural state of maturation of the skin by controlling parameters such as temperature, pressure, or humidity, allowing a homogeneous maturation of the CSSs in an aseptic environment. The use of bioreactors not only contributes to the maturation of the CSSs, but also offers a new way of obtaining large sections of skin substitutes or natural skin from small portions acquired from the patient, donor, or substitute. Based on the innovation of this technology and the need to develop efficient CSSs, this work offers an update on bioreactor technology in the field of skin regeneration.
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Affiliation(s)
| | | | - Elena López-Ruiz
- Universidad de Jaen, 16747, Department of Health Sciences, Jaen, Andalucía, Spain;
| | | | - Juan Antonio Marchal
- University of Granada, humqn Anatomy and embriology, avd del conocimiento nº 11, Granada, Granada, Spain, 18016;
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4
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Hughes DL, Hughes A, Soonawalla Z, Mukherjee S, O’Neill E. Dynamic Physiological Culture of Ex Vivo Human Tissue: A Systematic Review. Cancers (Basel) 2021; 13:2870. [PMID: 34201273 PMCID: PMC8229413 DOI: 10.3390/cancers13122870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/26/2021] [Accepted: 06/03/2021] [Indexed: 12/20/2022] Open
Abstract
Conventional static culture fails to replicate the physiological conditions that exist in vivo. Recent advances in biomedical engineering have resulted in the creation of novel dynamic culturing systems that permit the recapitulation of normal physiological processes ex vivo. Whilst the physiological benefit for its use in the culture of two-dimensional cellular monolayer has been validated, its role in the context of primary human tissue culture has yet to be determined. This systematic review identified 22 articles that combined dynamic physiological culture techniques with primary human tissue culture. The most frequent method described (55%) utilised dynamic perfusion culture. A diverse range of primary human tissue was successfully cultured. The median duration of successful ex vivo culture of primary human tissue for all articles was eight days; however, a wide range was noted (5 h-60 days). Six articles (27%) reported successful culture of primary human tissue for greater than 20 days. This review illustrates the physiological benefit of combining dynamic culture with primary human tissue culture in both long-term culture success rates and preservation of native functionality of the tissue ex vivo. Further research efforts should focus on developing precise biochemical sensors that would allow for real-time monitoring and automated self-regulation of the culture system in order to maintain homeostasis. Combining these techniques allows the creation of an accurate system that can be used to gain a greater understanding of human physiology.
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Affiliation(s)
- Daniel Ll Hughes
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (D.L.H.); (S.M.)
| | - Aron Hughes
- Undergraduate Centre, Cardiff University Medical School, Cardiff CF14 4YS, UK;
| | - Zahir Soonawalla
- Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS, Oxford OX3 7LE, UK;
| | - Somnath Mukherjee
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (D.L.H.); (S.M.)
| | - Eric O’Neill
- Department of Oncology, University of Oxford, Oxford OX3 7DQ, UK; (D.L.H.); (S.M.)
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Castro N, Ribeiro S, Fernandes MM, Ribeiro C, Cardoso V, Correia V, Minguez R, Lanceros‐Mendez S. Physically Active Bioreactors for Tissue Engineering Applications. ACTA ACUST UNITED AC 2020; 4:e2000125. [DOI: 10.1002/adbi.202000125] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/15/2020] [Indexed: 01/09/2023]
Affiliation(s)
- N. Castro
- BCMaterials, Basque Centre for Materials, Applications and Nanostructures University of the Basque Country UPV/EHU Science Park Leioa E‐48940 Spain
| | - S. Ribeiro
- Physics Centre University of Minho Campus de Gualtar Braga 4710‐057 Portugal
- Centre of Molecular and Environmental Biology (CBMA) University of Minho Campus de Gualtar Braga 4710‐057 Portugal
| | - M. M. Fernandes
- Physics Centre University of Minho Campus de Gualtar Braga 4710‐057 Portugal
- CEB – Centre of Biological Engineering University of Minho Braga 4710‐057 Portugal
| | - C. Ribeiro
- Physics Centre University of Minho Campus de Gualtar Braga 4710‐057 Portugal
- CEB – Centre of Biological Engineering University of Minho Braga 4710‐057 Portugal
| | - V. Cardoso
- CMEMS‐UMinho Universidade do Minho Campus de Azurém Guimarães 4800‐058 Portugal
| | - V. Correia
- Algoritmi Research Centre University of Minho Campus de Azurém Guimarães 4800‐058 Portugal
| | - R. Minguez
- Department of Graphic Design and Engineering Projects University of the Basque Country UPV/EHU Bilbao E‐48013 Spain
| | - S. Lanceros‐Mendez
- BCMaterials, Basque Centre for Materials, Applications and Nanostructures University of the Basque Country UPV/EHU Science Park Leioa E‐48940 Spain
- IKERBASQUE Basque Foundation for Science Bilbao E‐48013 Spain
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6
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Abstract
Tissue engineering in orthopaedic trauma is needed. Progress has been made in all areas including regenerating bone, cartilage, soft tissue, and making up for bone defects with scaffolds. Bone regeneration and managing bone defects with scaffolds continue to be successful in the basic science realm with promising results, but currently, these successes are mostly limited to small animal models. Cartilage defects have more clinically available treatment options, but the benefits of "off-the-shelf" allograft options, and scaffolds, have little clinical evidence in the acute fracture setting. Most of the true chondrocyte replacement therapies such as matrix-induced autologous chondrocyte implantation and osteochondral allografts require delayed treatment while cell growth or graft matching occurs. Soft-tissue defects can be managed with tissue engineering for the skin with success, but muscle and nerve defects are still limited to the basic science arena. Although significant gains have been made in all areas for tissue engineering in basic science, and is very promising, this success currently comes with limited translation into clinical availability for the orthopaedic trauma patient.
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Yu JR, Navarro J, Coburn JC, Mahadik B, Molnar J, Holmes JH, Nam AJ, Fisher JP. Current and Future Perspectives on Skin Tissue Engineering: Key Features of Biomedical Research, Translational Assessment, and Clinical Application. Adv Healthc Mater 2019; 8:e1801471. [PMID: 30707508 PMCID: PMC10290827 DOI: 10.1002/adhm.201801471] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 01/04/2019] [Indexed: 12/20/2022]
Abstract
The skin is responsible for several important physiological functions and has enormous clinical significance in wound healing. Tissue engineered substitutes may be used in patients suffering from skin injuries to support regeneration of the epidermis, dermis, or both. Skin substitutes are also gaining traction in the cosmetics and pharmaceutical industries as alternatives to animal models for product testing. Recent biomedical advances, ranging from cellular-level therapies such as mesenchymal stem cell or growth factor delivery, to large-scale biofabrication techniques including 3D printing, have enabled the implementation of unique strategies and novel biomaterials to recapitulate the biological, architectural, and functional complexity of native skin. This progress report highlights some of the latest approaches to skin regeneration and biofabrication using tissue engineering techniques. Current challenges in fabricating multilayered skin are addressed, and perspectives on efforts and strategies to meet those limitations are provided. Commercially available skin substitute technologies are also examined, and strategies to recapitulate native physiology, the role of regulatory agencies in supporting translation, as well as current clinical needs, are reviewed. By considering each of these perspectives while moving from bench to bedside, tissue engineering may be leveraged to create improved skin substitutes for both in vitro testing and clinical applications.
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Affiliation(s)
- Justine R Yu
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, MD, 20742, USA
- NIH/NBIB Center for Engineering Complex Tissues, University of Maryland, College Park, College Park, MD, 20742, USA
- University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Javier Navarro
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, MD, 20742, USA
- NIH/NBIB Center for Engineering Complex Tissues, University of Maryland, College Park, College Park, MD, 20742, USA
| | - James C Coburn
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, MD, 20742, USA
- Division of Biomedical Physics, Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, MD, 20903, USA
| | - Bhushan Mahadik
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, MD, 20742, USA
- NIH/NBIB Center for Engineering Complex Tissues, University of Maryland, College Park, College Park, MD, 20742, USA
| | - Joseph Molnar
- Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - James H Holmes
- Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Arthur J Nam
- Division of Plastic, Reconstructive and Maxillofacial Surgery, R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, Baltimore, MD, 21201, USA
| | - John P Fisher
- Fischell Department of Bioengineering, University of Maryland, College Park, College Park, MD, 20742, USA
- NIH/NBIB Center for Engineering Complex Tissues, University of Maryland, College Park, College Park, MD, 20742, USA
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8
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A new dynamic culture device suitable for rat skin culture. Cell Tissue Res 2018; 375:723-731. [PMID: 30392145 DOI: 10.1007/s00441-018-2945-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 10/02/2018] [Indexed: 10/27/2022]
Abstract
Cultured skin has been used extensively for testing therapeutic drugs because it replicates the physical and biochemical properties of whole skin. However, traditional static culture cannot fully maintain cell viability and skin morphology because of the limitations involved with nutrient transmission. Here, we develop a new dynamic perfusion platform for skin culture and compare it with a static culture device. Rat skins were cultured in either static or dynamic condition for 0, 3, 6, 9 and 12 days. H&E, periodic acid-Schiff (PAS) and picrosirius red (PSR) staining were used for skin morphology detection, immunostaining against cytokeratin 10 (CK10) for differentiation detection, immunostaining against proliferating cell nuclear antigen (PCNA) for cell proliferation detection and TUNEL staining for apoptosis detection. After culturing for 12 days, the epidermis, basement membrane, hair follicles and connective tissue were disrupted in the static group, whereas these features were preserved in the dynamic group. Moreover, compared to the static group, proliferation in the epidermis and hair follicles was significantly improved and apoptosis in dermis was significantly decreased in the dynamic group. These findings suggest that our device is effective for extending the culture period of rat skin to maintain its characteristics and viability in vitro.
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Huh MI, Yi SJ, Lee KP, Kim HK, An SH, Kim DB, Ryu RH, Kim JS, Lim JO. Full Thickness Skin Expansion ex vivo in a Newly Developed Reactor and Evaluation of Auto-Grafting Efficiency of the Expanded Skin Using Yucatan Pig Model. Tissue Eng Regen Med 2018; 15:629-638. [PMID: 30603584 PMCID: PMC6171704 DOI: 10.1007/s13770-018-0154-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Skin grafts are required in numerous clinical procedures, such as reconstruction after skin removal and correction of contracture or scarring after severe skin loss caused by burns, accidents, and trauma. The current standard for skin defect replacement procedures is the use of autologous skin grafts. However, donor-site tissue availability remains a major obstacle for the successful replacement of skin defects and often limits this option. The aim of this study is to effectively expand full thickness skin to clinically useful size using an automated skin reactor and evaluate auto grafting efficiency of the expanded skin using Yucatan female pigs. METHODS We developed an automated bioreactor system with the functions of real-time monitoring and remote-control, optimization of grip, and induction of skin porosity for effective tissue expansion. We evaluated the morphological, ultra-structural, and mechanical properties of the expanded skin before and after expansion using histology, immunohistochemistry, and tensile testing. We further carried out in vivo grafting study using Yucatan pigs to investigate the feasibility of this method in clinical application. RESULTS The results showed an average expansion rate of 180%. The histological findings indicated that external expansion stimulated cellular activity in the isolated skin and resulted in successful grafting to the transplanted site. Specifically, hyperplasia did not appear at the auto-grafted site, and grafted skin appeared similar to normal skin. Furthermore, mechanical stimuli resulted in an increase in COL1A2 expression in a suitable environment. CONCLUSIONS These findings provided insight on the potential of this expansion system in promoting dermal extracellular matrix synthesis in vitro. Conclusively, this newly developed smart skin bioreactor enabled effective skin expansion ex vivo and successful grafting in vivo in a pig model.
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Affiliation(s)
- Man-Il Huh
- Biomedical Research Institute, Joint Institute for Regenerative Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944 Republic of Korea
- School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944 Republic of Korea
| | - Soo-Jin Yi
- Biomedical Research Institute, Joint Institute for Regenerative Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944 Republic of Korea
- School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944 Republic of Korea
| | - Kyung-Pil Lee
- Biomedical Research Institute, Joint Institute for Regenerative Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944 Republic of Korea
- School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944 Republic of Korea
| | - Hong Kyun Kim
- Biomedical Research Institute, Joint Institute for Regenerative Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944 Republic of Korea
- School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, 41944 Republic of Korea
| | - Sang-Hyun An
- Daegu-Gyeongbuk Medical Innovation Foundation, 88 Dongnae-ro (360-4 Dongnae-dong), Dong-gu, Daegu, 41061 Republic of Korea
| | - Dan-Bi Kim
- Daegu-Gyeongbuk Medical Innovation Foundation, 88 Dongnae-ro (360-4 Dongnae-dong), Dong-gu, Daegu, 41061 Republic of Korea
| | - Rae-Hyung Ryu
- Daegu-Gyeongbuk Medical Innovation Foundation, 88 Dongnae-ro (360-4 Dongnae-dong), Dong-gu, Daegu, 41061 Republic of Korea
| | - Jun-Sik Kim
- Daegu-Gyeongbuk Medical Innovation Foundation, 88 Dongnae-ro (360-4 Dongnae-dong), Dong-gu, Daegu, 41061 Republic of Korea
| | - Jeong Ok Lim
- Biomedical Research Institute, Joint Institute for Regenerative Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944 Republic of Korea
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10
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Prim PM, Kim HS, Shapiro LE, Lee JS, Kaan JH, Jackson JD, Yoo JJ, Atala A, Lee SJ. In vitro skin expansion: Wound healing assessment. Wound Repair Regen 2017; 25:398-407. [PMID: 28544322 DOI: 10.1111/wrr.12550] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 05/15/2017] [Indexed: 11/29/2022]
Abstract
For treatments requiring split-thickness skin grafts, it is preferable to mesh the grafts. This reduces the amount of excised skin and covers more wound area. The mesh technique, however, destroys surface continuity, which results in scarring. Strain-based bioreactors, on the other hand, have successfully expanded split-thickness skin grafts in vitro within a 7-day period, increasing graft coverage. After in vitro expansion, the expanded skin grafts were tested in a porcine full-thickness excisional wound model. Expanded graft take rate was 100%. Volumetric, histologic, and mechanical assessments indicated that expanded grafts were comparable to unexpanded grafts (positive control). While there was considerable variation in expansion (31% to -3.1%), this technique has the potential to enhance the coverage area of skin grafts while reducing or eliminating scarring.
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Affiliation(s)
- Peter M Prim
- Wake Forest School of Medicine, Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina.,Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina
| | - Han Su Kim
- Wake Forest School of Medicine, Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina.,Department of Otorhinolaryngology, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Lindsey E Shapiro
- Wake Forest School of Medicine, Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina
| | - Jae Sung Lee
- Wake Forest School of Medicine, Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina.,Department of Orthopedic, School of Medicine, Chung-Ang University, Seoul, South Korea
| | - James H Kaan
- Wake Forest School of Medicine, Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina
| | - John D Jackson
- Wake Forest School of Medicine, Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina
| | - James J Yoo
- Wake Forest School of Medicine, Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina
| | - Anthony Atala
- Wake Forest School of Medicine, Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina
| | - Sang Jin Lee
- Wake Forest School of Medicine, Wake Forest Institute for Regenerative Medicine, Winston-Salem, North Carolina
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12
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Huh MI, An SH, Kim HG, Song YJ, Choi EC, An SH, Choi WS, Huh JS, Lim JO. Rapid expansion and auto-grafting efficiency of porcine full skin expanded by a skin bioreactor ex vivo. Tissue Eng Regen Med 2016; 13:31-38. [PMID: 30603382 DOI: 10.1007/s13770-016-9096-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 10/27/2015] [Accepted: 10/29/2015] [Indexed: 11/29/2022] Open
Abstract
Full skin auto-grafts are required for reconstruction of skin burns and trauma scars. However, currently available clinical approaches such as sheet skin graft, mesh skin grafts, artificial skin graft, and in vivo skin expansion have limitations due to their potential danger for secondary damage and scar formation at the donor site, and discomfort during skin expansion. We developed an advanced bioreactor system and evaluated its function in skin expansion using porcine full skin. The reactor was designed as a pneumatic cylinder type, was programmed to adjust the pressure and the operating time. The system was composed of culture chamber unit, environmental control unit, and monitoring unit. Skins were expanded at 200 kPa pneumatic force and the expanded skins were analyzed by immunohistochemistry and histology. Furthermore we carried out auto-grafting experiment of the expanded skins in vivo using Yucatan pigs and skins were harvested and histologically analyzed after 8 weeks. The results showed that the bioreactor expanded skins to 160% in 4 hours. Histological analysis of the expanded skins revealed that epidermal cells and dermal fibroblasts were viable and remained integrity. The results of auto-grafting experiment indicated that fibrosis and scars were not detected in the grafted skins. This study demonstrates that the newly developed skin bioreactor enabled to obtain large sized full skin rapidly and successful grating.
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Affiliation(s)
- Man-Il Huh
- 1Biomedical Research Institute, Joint Institute for Regenerative Medicine, Kyungpook National University Hospital, Daegu, Korea.,2Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sun Hee An
- 1Biomedical Research Institute, Joint Institute for Regenerative Medicine, Kyungpook National University Hospital, Daegu, Korea
| | - Hwi-Gang Kim
- 3Medical IT Convergence Research Section Daegu-Gyeongbuk Research Center, Electronics and Telecommunications Research Institute, Daegu, Korea
| | - Yun-Jeong Song
- 3Medical IT Convergence Research Section Daegu-Gyeongbuk Research Center, Electronics and Telecommunications Research Institute, Daegu, Korea
| | - Eun-Chang Choi
- 3Medical IT Convergence Research Section Daegu-Gyeongbuk Research Center, Electronics and Telecommunications Research Institute, Daegu, Korea
| | - Sang-Hyun An
- Daegu-Gyeongbuk Medical Innovation Foundation, Daegu, Korea
| | - Woo-Sung Choi
- Daegu-Gyeongbuk Medical Innovation Foundation, Daegu, Korea
| | - Jeung Soo Huh
- 5Department of Materials Sciences and Metallurgy, College of Engineering, Kyungpook National University, Daegu, Korea
| | - Jeong Ok Lim
- 1Biomedical Research Institute, Joint Institute for Regenerative Medicine, Kyungpook National University Hospital, Daegu, Korea
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Applicability and safety of in vitro skin expansion using a skin bioreactor: a clinical trial. Arch Plast Surg 2014; 41:661-7. [PMID: 25396177 PMCID: PMC4228207 DOI: 10.5999/aps.2014.41.6.661] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 06/26/2014] [Accepted: 06/26/2014] [Indexed: 11/08/2022] Open
Abstract
Background Tissue expansion is an effective and valuable technique for the reconstruction of large skin lesions and scars. This study aimed to evaluate the applicability and safety of a newly designed skin expanding bioreactor system for maximizing the graft area and minimizing the donor site area. Methods A computer-controlled biaxial skin bioreactor system was used to expand skin in two directions while the culture media was changed daily. The aim was to achieve an expansion speed that enabled the skin to reach twice its original area in two weeks or less. Skin expansion and subsequent grafting were performed for 10 patients, and each patient was followed for 6 months postoperatively for clinical evaluation. Scar evaluation was performed through visual assessment and by using photos. Results The average skin expansion rate was 10.54%±6.25%; take rate, 88.89%±11.39%; and contraction rate, 4.2%±2.28% after 6 months. Evaluation of the donor and recipient sites by medical specialists resulted in an average score of 3.5 (out of a potential maximum of 5) at 3 months, and 3.9 at 6 months. The average score for patient satisfaction of the donor site was 6.2 (out of a potential maximum of 10), and an average score of 5.2 was noted for the recipient site. Histological examination performed before and after the skin expansion revealed an increase in porosity of the dermal layer. Conclusions This study confirmed the safety and applicability of the in vitro skin bioreactor, and further studies are needed to develop methods for increasing the skin expansion rate.
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HUANG HSIAOYINGSHADOW, HUANG SIYAO, FRAZIER COLINP, PRIM PETERM, HARRYSSON OLA. DIRECTIONAL BIOMECHANICAL PROPERTIES OF PORCINE SKIN TISSUE. J MECH MED BIOL 2014. [DOI: 10.1142/s0219519414500699] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Skin is a multilayered composite material and composed principally of the proteins collagen, elastic fibers and fibroblasts. The direction-dependent material properties of skin tissue is important for physiological functions like skin expansion. The current study has developed methods to characterize the directional biomechanical properties of porcine skin tissues as studies have shown that pigs represent a useful animal model due to similarities between porcine and human skin. It is observed that skin tissue has a nonlinear anisotropy biomechanical behavior, where the parameters of material modulus is 378 ± 160 kPa in the preferred-fiber direction and 65.96 ± 40.49 kPa in the cross-fiber direction when stretching above 30% strain equibiaxially. The result from the study provides methods of characterizing biaxial mechanical properties of skin tissue, as the collagen fiber direction appears to be one of the primary determinants of tissue anisotropy.
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Affiliation(s)
| | - SIYAO HUANG
- Mechanical and Aerospace Engineering Department, North Carolina State University, USA
| | - COLIN P. FRAZIER
- Mechanical and Aerospace Engineering Department, North Carolina State University, USA
| | - PETER M. PRIM
- Fitts Department of Industrial and Systems Engineering, North Carolina State University, USA
| | - OLA HARRYSSON
- Fitts Department of Industrial and Systems Engineering, North Carolina State University, USA
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15
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Wilson CJ, Pearcy MJ, Epari DR. Mechanical tension as a driver of connective tissue growth in vitro. Med Hypotheses 2014; 83:111-5. [DOI: 10.1016/j.mehy.2014.03.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 03/27/2014] [Indexed: 10/25/2022]
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dos Santos FF, Andrade PZ, da Silva CL, Cabral JMS. Bioreactor design for clinical-grade expansion of stem cells. Biotechnol J 2013; 8:644-54. [PMID: 23625834 DOI: 10.1002/biot.201200373] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 03/25/2013] [Accepted: 04/02/2013] [Indexed: 01/24/2023]
Abstract
The many clinical trials currently in progress will likely lead to the widespread use of stem cell-based therapies for an extensive variety of diseases, either in autologous or allogeneic settings. With the current pace of progress, in a few years' time, the field of stem cell-based therapy should be able to respond to the market demand for safe, robust and clinically efficient stem cell-based therapeutics. Due to the limited number of stem cells that can be obtained from a single donor, one of the major challenges on the roadmap for regulatory approval of such medicinal products is the expansion of stem cells using Good Manufacturing Practices (GMP)-compliant culture systems. In fact, manufacturing costs, which include production and quality control procedures, may be the main hurdle for developing cost-effective stem cell therapies. Bioreactors provide a viable alternative to the traditional static culture systems in that bioreactors provide the required scalability, incorporate monitoring and control tools, and possess the operational flexibility to be adapted to the differing requirements imposed by various clinical applications. Bioreactor systems face a number of issues when incorporated into stem cell expansion protocols, both during development at the research level and when bioreactors are used in on-going clinical trials. This review provides an overview of the issues that must be confronted during the development of GMP-compliant bioreactors systems used to support the various clinical applications employing stem cells.
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Affiliation(s)
- Francisco F dos Santos
- Department of Bioengineering and IBB - Institute for Biotechnology and Bioengineering - Instituto Superior Técnico IST, Technical University of Lisbon, Lisboa, Portugal
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Murphy SV, Atala A. Organ engineering--combining stem cells, biomaterials, and bioreactors to produce bioengineered organs for transplantation. Bioessays 2012; 35:163-72. [PMID: 22996568 DOI: 10.1002/bies.201200062] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Often the only treatment available for patients suffering from diseased and injured organs is whole organ transplant. However, there is a severe shortage of donor organs for transplantation. The goal of organ engineering is to construct biological substitutes that will restore and maintain normal function in diseased and injured tissues. Recent progress in stem cell biology, biomaterials, and processes such as organ decellularization and electrospinning has resulted in the generation of bioengineered blood vessels, heart valves, livers, kidneys, bladders, and airways. Future advances that may have a significant impact for the field include safe methods to reprogram a patient's own cells to directly differentiate into functional replacement cell types. The subsequent combination of these cells with natural, synthetic and/or decellularized organ materials to generate functional tissue substitutes is a real possibility. This essay reviews the current progress, developments, and challenges facing researchers in their goal to create replacement tissues and organs for patients.
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Affiliation(s)
- Sean Vincent Murphy
- Wake Forest Institute for Regenerative Medicine, Wake Forest University Health Sciences, Winston-Salem, NC, USA
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Yang TL. Chitin-based materials in tissue engineering: applications in soft tissue and epithelial organ. Int J Mol Sci 2011; 12:1936-63. [PMID: 21673932 PMCID: PMC3111643 DOI: 10.3390/ijms12031936] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 03/07/2011] [Accepted: 03/08/2011] [Indexed: 01/15/2023] Open
Abstract
Chitin-based materials and their derivatives are receiving increased attention in tissue engineering because of their unique and appealing biological properties. In this review, we summarize the biomedical potential of chitin-based materials, specifically focusing on chitosan, in tissue engineering approaches for epithelial and soft tissues. Both types of tissues play an important role in supporting anatomical structures and physiological functions. Because of the attractive features of chitin-based materials, many characteristics beneficial to tissue regeneration including the preservation of cellular phenotype, binding and enhancement of bioactive factors, control of gene expression, and synthesis and deposition of tissue-specific extracellular matrix are well-regulated by chitin-based scaffolds. These scaffolds can be used in repairing body surface linings, reconstructing tissue structures, regenerating connective tissue, and supporting nerve and vascular growth and connection. The novel use of these scaffolds in promoting the regeneration of various tissues originating from the epithelium and soft tissue demonstrates that these chitin-based materials have versatile properties and functionality and serve as promising substrates for a great number of future applications.
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Affiliation(s)
- Tsung-Lin Yang
- Department of Otolaryngology, National Taiwan University Hospital and College of Medicine, Taipei, 100, Taiwan; E-Mail: ; Tel.: +886-2-23123456 ext. 63526
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