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Iwasaki S, Deguchi K, Iwai R, Nakayama Y, Okuyama H. Regeneration Process of an Autologous Tissue-Engineered Trachea (aTET) in a Rat Patch Tracheoplasty Model. Bioengineering (Basel) 2024; 11:243. [PMID: 38534518 DOI: 10.3390/bioengineering11030243] [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: 01/11/2024] [Revised: 02/18/2024] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
The treatment of long-tracheal lesion is difficult because there are currently no viable grafts for tracheal replacement. To solve this problem, we have developed an autologous Tissue-Engineered Trachea (aTET), which is made up of collagenous tissues and cartilage-like structures derived from rat chondrocytes. This graft induced successful long-term survival in a small-animal experiment in our previous study. In this study, we investigated the regeneration process of an aTET to attain reproducible success. We prepared an aTET by using a specially designed mold and performed patch tracheoplasty with an aTET. We assigned twenty-seven rats to three groups according to the three types of patch grafts used: aTET patches (the aTET group), fresh tracheal autograft patches (the Ag group), or polylactic acid and polycaprolactone copolymer sheets (the PPc group). In each group, gross and histological evaluations were performed at 1 month (n = 3), 3 months (n = 3), and 6 months (n = 3) after implantation. We obtained high survival rates in all groups, but only the PPc group attained thick tracheal walls with granular tissues and no tracheal regeneration. On the other hand, the aTET and Ag groups reproducibly achieved complete tracheal regeneration in 6 months. So, an aTET could be a promising candidate for tracheal regeneration grafts.
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Affiliation(s)
- Shun Iwasaki
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Koichi Deguchi
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
| | - Ryosuke Iwai
- Research Institute of Technology, Okayama University of Science, 1-1, Ridaicho, Kita-Ku, Okayama 700-0005, Japan
| | - Yasuhide Nakayama
- Osaka Laboratory, Biotube Co., Ltd., 3-10-1 Senriyama-Higashi, Suita 565-0842, Japan
| | - Hiroomi Okuyama
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan
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Feng J, Qi J, Fu S, Luan J. Effect of radiation sterilization on the ability to induce adipose regeneration in vivo in decellularized adipose-derived matrix. Biotechnol J 2023; 18:e2300098. [PMID: 37449520 DOI: 10.1002/biot.202300098] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/24/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Decellularized adipose-derived matrix (DAM), a biological scaffold that can induce adipose regeneration. The balance between its sterilization efficiency and its ability to maintain in situ adipose regeneration should be considered in terminal sterilization. The purpose of this study was to investigate the effects of radiation sterilization of cobalt-60 (60 Co)with different doses on adipogenesis induced by different forms of DAM, so as to reduce radiation dose under the premise of safe and effective sterilization and ensure adipogenesis induced by DAM in vivo. METHODS High dose (25 kGy) and low dose (5 kGy) radiation were used to sterilize freeze-dried and wet DAM, respectively. The sterilization efficiency, macro and micro characteristics, mechanical and mechanical properties of DAM were compared, and then implanted into the immunocompromised mice to evaluate the adipose regeneration. RESULTS Under the two radiation doses, no microbial growth was found in the freeze-dried and wet DAM sterility tests, and no significant changes were observed in the macro and micro structures. In terms of mechanical properties, the elastic modulus of high dose freeze-dried DAM decreased significantly (p < 0.001). In vivo animal experiments, the freeze-dried DAM irradiated with high dose almost completely lost its function of adipogenesis in vivo. Although the wet DAM irradiated with high dose could induce fat regeneration in the early stage, the adipocyte deformation and atrophy appeared in the later stage. The freeze-dried and wet DAM after low dose irradiation was similar to the wet DAM without irradiation in the blank control, which could maintain excellent adipogenic and angiogenic functions in vivo. CONCLUSION High dose 60 Co irradiation can completely destroy the ability of freeze-dried DAM to induce adipose regeneration in situ, while low dose irradiation (5 kGy) can effectively sterilize the DAM without damaging in vivo induced adipose regeneration. Radiation has more damage to freeze-dried DAM than wet DAM in adipogenesis properties.
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Affiliation(s)
- Jiayi Feng
- Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Qi
- Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Su Fu
- Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Luan
- Department of Aesthetic and Reconstructive Breast Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Tan ZH, Liu L, Dharmadhikari S, Shontz KM, Kreber L, Sperber S, Yu J, Byun WY, Nyirjesy SC, Manning A, Reynolds SD, Chiang T. Partial decellularization eliminates immunogenicity in tracheal allografts. Bioeng Transl Med 2023; 8:e10525. [PMID: 37693070 PMCID: PMC10487308 DOI: 10.1002/btm2.10525] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 09/12/2023] Open
Abstract
There is currently no suitable autologous tissue to bridge large tracheal defects. As a result, no standard of care exists for long-segment tracheal reconstruction. Tissue engineering has the potential to create a scaffold from allografts or xenografts that can support neotissue regeneration identical to the native trachea. Recent advances in tissue engineering have led to the idea of partial decellularization that allows for the creation of tracheal scaffolds that supports tracheal epithelial formation while preserving mechanical properties. However, the ability of partial decellularization to eliminate graft immunogenicity remains unknown, and understanding the immunogenic properties of partially decellularized tracheal grafts (PDTG) is a critical step toward clinical translation. Here, we determined that tracheal allograft immunogenicity results in epithelial cell sloughing and replacement with dysplastic columnar epithelium and that partial decellularization creates grafts that are able to support an epithelium without histologic signs of rejection. Moreover, allograft implantation elicits CD8+ T-cell infiltration, a mediator of rejection, while PDTG did not. Hence, we establish that partial decellularization eliminates allograft immunogenicity while creating a scaffold for implantation that can support spatially appropriate airway regeneration.
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Affiliation(s)
- Zheng Hong Tan
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
- College of Medicine, The Ohio State UniversityColumbusOhioUSA
| | - Lumei Liu
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
| | - Sayali Dharmadhikari
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
- College of Medicine, The Ohio State UniversityColumbusOhioUSA
| | - Kimberly M. Shontz
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
| | - Lily Kreber
- College of Medicine, The Ohio State UniversityColumbusOhioUSA
| | - Sarah Sperber
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
| | - Jane Yu
- College of Medicine, The Ohio State UniversityColumbusOhioUSA
| | - Woo Yul Byun
- College of Medicine, The Ohio State UniversityColumbusOhioUSA
| | - Sarah C. Nyirjesy
- Department of Pediatric OtolaryngologyNationwide Children's HospitalColumbusOhioUSA
| | - Amy Manning
- Department of Pediatric OtolaryngologyNationwide Children's HospitalColumbusOhioUSA
| | - Susan D. Reynolds
- Center for Perinatal Research, Nationwide Children's HospitalColumbusOhioUSA
| | - Tendy Chiang
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's HospitalColumbusOhioUSA
- Department of Pediatric OtolaryngologyNationwide Children's HospitalColumbusOhioUSA
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4
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Kato A, Go T, Otsuki Y, Yokota N, Soo CS, Misaki N, Yajima T, Yokomise H. Perpendicular implantation of porcine trachea extracellular matrix for enhanced xenogeneic scaffold surface epithelialization in a canine model. Front Surg 2023; 9:1089403. [PMID: 36713663 PMCID: PMC9877415 DOI: 10.3389/fsurg.2022.1089403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/26/2022] [Indexed: 01/13/2023] Open
Abstract
Objective The availability of clinically applied medical materials in thoracic surgery remains insufficient, especially materials for treating tracheal defects. Herein, the potential of porcine extracellular matrix (P-ECM) as a new airway reconstruction material was explored by xenotransplanting it into a canine trachea. Methods P-ECM was first transplanted into the buttocks of Narc Beagle dogs (n = 3) and its overall immuno-induced effects were evaluated. Subsequently, nine dogs underwent surgery to create a tracheal defect that was 1 × 2 cm. In group A, the P-ECM was implanted parallel to the tracheal axis (n = 3), whereas in group B the P-ECM was implanted perpendicular to the tracheal axis (n = 6). The grafts were periodically observed by bronchoscopy and evaluated postoperatively at 1 and 3 months through macroscopic and microscopic examinations. Immunosuppressants were not administered. Statistical evaluation was performed for Bronchoscopic stenosis rate, graft epithelialization rate, shrinkage rate and ECM live-implantation rate. Results No sign of P-ECM rejection was observed after its implantation in the buttocks. Bronchoscopic findings showed no improvement concerning stenosis in group A until 3 months after surgery; epithelialization of the graft site was not evident, and the ECM site appeared scarred and faded. In contrast, stenosis gradually improved in group B, with continuous epithelium within the host tissues and P-ECM. Histologically, the graft site contracted longitudinally and no epithelialization was observed in group A, whereas full epithelialization was observed on the P-ECM in group B. No sign of cartilage regeneration was confirmed in both groups. No statistically significant differences were found in bronchoscopic stenosis rate, shrinkage rate and ECM live-implantation rate, but graft epithelialization rate showed a statistically significant difference (G-A; sporadic (25%) 3, vs. G-B; full covered (100%) 3; p = 0.047). Conclusions P-ECM can support full re-epithelialization without chondrocyte regeneration, with perpendicular implantation facilitating epithelialization of the ECM. Our results showed that our decellularized tracheal matrix holds clinical potential as a biological xenogeneic material for airway defect repair.
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Stocco E, Barbon S, Mammana M, Zambello G, Contran M, Parnigotto PP, Macchi V, Conconi MT, Rea F, De Caro R, Porzionato A. Preclinical and clinical orthotopic transplantation of decellularized/engineered tracheal scaffolds: A systematic literature review. J Tissue Eng 2023; 14:20417314231151826. [PMID: 36874984 PMCID: PMC9974632 DOI: 10.1177/20417314231151826] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/04/2023] [Indexed: 03/07/2023] Open
Abstract
Severe tracheal injuries that cannot be managed by mobilization and end-to-end anastomosis represent an unmet clinical need and an urgent challenge to face in surgical practice; within this scenario, decellularized scaffolds (eventually bioengineered) are currently a tempting option among tissue engineered substitutes. The success of a decellularized trachea is expression of a balanced approach in cells removal while preserving the extracellular matrix (ECM) architecture/mechanical properties. Revising the literature, many Authors report about different methods for acellular tracheal ECMs development; however, only few of them verified the devices effectiveness by an orthotopic implant in animal models of disease. To support translational medicine in this field, here we provide a systematic review on studies recurring to decellularized/bioengineered tracheas implantation. After describing the specific methodological aspects, orthotopic implant results are verified. Furtherly, the only three clinical cases of compassionate use of tissue engineered tracheas are reported with a focus on outcomes.
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Affiliation(s)
- Elena Stocco
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Padova, Italy.,L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Padova, Italy.,Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling-TES, Onlus, Padova, Italy
| | - Silvia Barbon
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Padova, Italy.,L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Padova, Italy.,Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling-TES, Onlus, Padova, Italy
| | - Marco Mammana
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Padova, Italy.,Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University Hospital of Padova, Padova, Italy
| | - Giovanni Zambello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University Hospital of Padova, Padova, Italy
| | - Martina Contran
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Padova, Italy
| | - Pier Paolo Parnigotto
- Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling-TES, Onlus, Padova, Italy
| | - Veronica Macchi
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Padova, Italy.,L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Padova, Italy.,Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling-TES, Onlus, Padova, Italy
| | - Maria Teresa Conconi
- Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling-TES, Onlus, Padova, Italy.,Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padova, Italy
| | - Federico Rea
- L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Padova, Italy.,Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University Hospital of Padova, Padova, Italy
| | - Raffaele De Caro
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Padova, Italy.,L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Padova, Italy.,Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling-TES, Onlus, Padova, Italy
| | - Andrea Porzionato
- Department of Neurosciences, Section of Human Anatomy, University of Padova, Padova, Italy.,L.i.f.e.L.a.b. Program, Consorzio per la Ricerca Sanitaria (CORIS), Veneto Region, Padova, Italy.,Foundation for Biology and Regenerative Medicine, Tissue Engineering and Signaling-TES, Onlus, Padova, Italy
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6
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Liu L, Dharmadhikari S, Spector BM, Tan ZH, Van Curen CE, Agarwal R, Nyirjesy S, Shontz K, Sperber SA, Breuer CK, Zhao K, Reynolds SD, Manning A, VanKoevering KK, Chiang T. Tissue-engineered composite tracheal grafts create mechanically stable and biocompatible airway replacements. J Tissue Eng 2022; 13:20417314221108791. [PMID: 35782992 PMCID: PMC9243572 DOI: 10.1177/20417314221108791] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/07/2022] [Indexed: 12/02/2022] Open
Abstract
We tested composite tracheal grafts (CTG) composed of a partially decellularized
tracheal graft (PDTG) combined with a 3-dimensional (3D)-printed airway splint
for use in long-segment airway reconstruction. CTG is designed to recapitulate
the 3D extracellular matrix of the trachea with stable mechanical properties
imparted from the extraluminal airway splint. We performed segmental orthotopic
tracheal replacement in a mouse microsurgical model. MicroCT was used to measure
graft patency. Tracheal neotissue formation was quantified histologically.
Airflow dynamic properties were analyzed using computational fluid dynamics. We
found that CTG are easily implanted and did not result in vascular erosion,
tracheal injury, or inflammation. Graft epithelialization and endothelialization
were comparable with CTG to control. Tracheal collapse was absent with CTG.
Composite tracheal scaffolds combine biocompatible synthetic support with PDTG,
supporting the regeneration of host epithelium while maintaining graft
structure.
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Affiliation(s)
- Lumei Liu
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Sayali Dharmadhikari
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatric Otolaryngology, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Barak M Spector
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA
| | - Zheng Hong Tan
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Catherine E Van Curen
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA
| | - Riddhima Agarwal
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Sarah Nyirjesy
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Kimberly Shontz
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Sarah A Sperber
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Christopher K Breuer
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatric Surgery, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Kai Zhao
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA
| | - Susan D Reynolds
- Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Amy Manning
- Department of Pediatric Otolaryngology, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Kyle K VanKoevering
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA
- College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Tendy Chiang
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatric Otolaryngology, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Otolaryngology-Head & Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA
- College of Medicine, The Ohio State University, Columbus, OH, USA
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7
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Tan ZH, Dharmadhikari S, Liu L, Wolter G, Shontz KM, Reynolds SD, Johnson J, Breuer CK, Chiang T. Tracheal Macrophages During Regeneration and Repair of Long-Segment Airway Defects. Laryngoscope 2022; 132:737-746. [PMID: 34153127 PMCID: PMC8688581 DOI: 10.1002/lary.29698] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES/HYPOTHESIS Tissue-engineered tracheal grafts (TETGs) offer a potential solution for repair of long-segment airway defects. However, preclinical and clinical TETGs have been associated with chronic inflammation and macrophage infiltration. Macrophages express great phenotypic heterogeneity (generally characterized as classically activated [M1] vs. alternatively activated [M2]) and can influence tracheal repair and regeneration. We quantified and characterized infiltrating host macrophages using mouse microsurgical tracheal replacement models. STUDY DESIGN Translational research, animal model. METHODS We assessed macrophage infiltration and phenotype in animals implanted with syngeneic tracheal grafts, synthetic TETGs, or partially decellularized tracheal scaffolds (DTSs). RESULTS Macrophage infiltration was observed following tracheal replacement with syngeneic trachea. Both M1 and M2 macrophages were present in native trachea and increased during early tracheal repair (P = .014), with an M1/M2 ratio of 0.48 ± 0.15. In contrast, orthotopic implantation of synthetic TETGs resulted in a shift to M1 predominant macrophage phenotype with an increased M1/M2 ratio of 1.35 ± 0.41 by 6 weeks following implant (P = .035). Modulation of the synthetic scaffold with the addition of polyglycolic acid (PGA) resulted in a reduction of M1/M2 ratio due to an increase in M2 macrophages (P = .006). Using systemic macrophage depletion, the M1/M2 ratio reverted to native values in synthetic TETG recipients and was associated with an increase in graft epithelialization. Macrophage ratios seen in DTSs were similar to native values. CONCLUSIONS M1 and M2 macrophages are present during tracheal repair. Poor epithelialization with synthetic TETG is associated with an elevation of the M1/M2 ratio. Macrophage phenotype can be altered with scaffold composition and host-directed systemic therapies. DTSs exhibit M1/M2 ratios similar to those seen in native trachea and syngeneic tracheal replacement. LEVEL OF EVIDENCE NA Laryngoscope, 132:737-746, 2022.
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Affiliation(s)
- Zheng Hong Tan
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Sayali Dharmadhikari
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Lumei Liu
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Gabrielle Wolter
- College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Kimberly M Shontz
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Susan D Reynolds
- Center for Perinatal Research, Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Christopher K Breuer
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Tendy Chiang
- Center of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, USA
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8
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Pai AC, Lynch TJ, Ahlers BA, Ievlev V, Engelhardt JF, Parekh KR. A Novel Bioreactor for Reconstitution of the Epithelium and Submucosal Glands in Decellularized Ferret Tracheas. Cells 2022; 11:1027. [PMID: 35326478 PMCID: PMC8947657 DOI: 10.3390/cells11061027] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/03/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022] Open
Abstract
Tracheal grafts introduce the possibility to treat airway pathologies that require resection. While there has been success with engraftment of the surface airway epithelium (SAE) onto decellularized tracheas, there has been minimal advancement in regenerating the submucosal glands (SMGs). We designed a cost-effective open-system perfusion bioreactor to investigate the engraftment potential of ferret SAEs and murine myoepithelial cells (MECs) on a partly decellularized ferret trachea with the goal of creating a fully functional tracheal replacement. An air-liquid interface was also arranged by perfusing humidified air through the lumen of a recellularized conduit to induce differentiation. Our versatile bioreactor design was shown to support the successful partial decellularization and recellularization of ferret tracheas. The decellularized grafts maintained biomechanical integrity and chondrocyte viability, consistent with other publications. The scaffolds supported SAE basal cell engraftment, and early differentiation was observed once an air-liquid interface had been established. Lastly, MEC engraftment was sustained, with evidence of diffuse SMG reconstitution. This model will help shed light on SMG regeneration and basal cell differentiation in vitro for the development of fully functional tracheal grafts before transplantation.
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Affiliation(s)
- Albert C. Pai
- Department of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA;
| | - Thomas J. Lynch
- Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA 52242, USA; (T.J.L.); (B.A.A.); (V.I.); (J.F.E.)
| | - Bethany A. Ahlers
- Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA 52242, USA; (T.J.L.); (B.A.A.); (V.I.); (J.F.E.)
| | - Vitaly Ievlev
- Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA 52242, USA; (T.J.L.); (B.A.A.); (V.I.); (J.F.E.)
| | - John F. Engelhardt
- Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA 52242, USA; (T.J.L.); (B.A.A.); (V.I.); (J.F.E.)
| | - Kalpaj R. Parekh
- Department of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA;
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9
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Chen J, Mir SM, Pinezich MR, O'Neill JD, Guenthart BA, Bacchetta M, Vunjak-Novakovic G, Huang SXL, Kim J. Homogeneous Distribution of Exogenous Cells onto De-epithelialized Rat Trachea via Instillation of Cell-Loaded Hydrogel. ACS Biomater Sci Eng 2022; 8:82-88. [PMID: 34874712 PMCID: PMC9195637 DOI: 10.1021/acsbiomaterials.1c01031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Injured or diseased airway epithelium due to repeated environmental insults or genetic mutations can lead to a functional decline of the lung and incurable lung diseases. Bioengineered airway tissue constructs can facilitate in vitro investigation of human lung diseases and accelerate the development of effective therapeutics. Here, we report robust tissue manipulation modalities that allow: (i) selective removal of the endogenous epithelium of in vitro cultured airway tissues and (ii) spatially uniform distribution and prolonged cultivation of exogenous cells that are implanted topically onto the denuded airway lumen. Results obtained highlight that our approach to airway tissue manipulation can facilitate controlled removal of the airway epithelium and subsequent homogeneous distribution of newly implanted cells. This study can contribute to the creation of innovative tissue engineering methodologies that can facilitate the treatment of lung diseases, such as cystic fibrosis, primary ciliary dyskinesia, and chronic obstructive pulmonary disease.
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Affiliation(s)
- Jiawen Chen
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey 07302, United States
| | - Seyed Mohammad Mir
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey 07302, United States
| | - Meghan R Pinezich
- Department of Biomedical Engineering, Columbia University, New York, New York 10032, United States
| | - John D O'Neill
- Department of Cell Biology, State University of New York Downstate Medical Center, Brooklyn, New York 11203, United States
| | - Brandon A Guenthart
- Department of Cardiothoracic Surgery, Stanford University, Stanford, California 94305, United States
| | - Matthew Bacchetta
- Department of Thoracic Surgery, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Gordana Vunjak-Novakovic
- Department of Biomedical Engineering, Columbia University, New York, New York 10032, United States
| | - Sarah X L Huang
- Center for Stem Cell and Regenerative Medicine, University of Texas Health Science Center, Houston, Texas 77030, United States
| | - Jinho Kim
- Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, New Jersey 07302, United States
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10
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Villalba-Caloca J, Sotres-Vega A, Giraldo-Gómez DM, Gaxiola-Gaxiola MO, Piña-Barba MC, García-Montes JA, Martínez-Fonseca S, Alonso-Gómez M, Santibáñez-Salgado JA. In vivo performance of decellularized tracheal grafts in the reconstruction of long length tracheal defects: Experimental study. Int J Artif Organs 2021; 44:718-726. [PMID: 34365843 DOI: 10.1177/03913988211025991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The repair of long-segment tracheal lesions remains an important challenge. Nowdays no predictable and dependable substitute has been found. Decellularized tracheal scaffolds have shown to be a promising graft for tracheal transplantation, since it is non-immunogenic. OBJECTIVE Evaluate in vivo decellularized tracheal allografts performance to replace long tracheal segment. METHODS Forty-five swines underwent surgery as follows: Fifteen trachea donors and 30 receptors of decellularized trachea allografts. The receptors were randomly divided in five groups (n = 6). In groups I and II, donor trachea segment was decellularized by 15 cycles with sodium deoxycholate and deoxyribonuclease, in group II, the allograft was reinforced with external surgical steel wire. Groups, III, IV, and V decellularization was reduced to seven cycles, supplemented with cryopreservation in group IV and with glutaraldehyde in group V. A 10 rings segment was excised from the receptor swine and the decellularized trachea graft was implanted to re-establish trachea continuity. RESULTS Both decellularization cycles caused decreased stiffness. All trachea receptors underwent euthanasia before the third post-implant week due to severe dyspnea and trachea graft stenosis, necrosis, edema, inflammation, hemorrhage, and granulation tissue formation in anastomotic sites. Histologically all showed total loss of epithelium, separation of collagen fibers, and alterations in staining. CONCLUSIONS Both decellularization techniques severely damaged the structure of the trachea and the extracellular matrix of the cartilage, resulting in a no functional graft, in spite of the use of surgical wire, cryopreservation or glutaraldehyde treatment. An important drawback was the formation of fibrotic stenosis in both anastomosis.
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Affiliation(s)
- Jaime Villalba-Caloca
- Unidad de Trasplante Pulmonar Experimental, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Ciudad de México, México
| | - Avelina Sotres-Vega
- Unidad de Trasplante Pulmonar Experimental, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Ciudad de México, México
| | - David M Giraldo-Gómez
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Miguel O Gaxiola-Gaxiola
- Unidad de Trasplante Pulmonar Experimental, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Ciudad de México, México
| | - Maria C Piña-Barba
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - Jazmín A García-Montes
- Unidad de Trasplante Pulmonar Experimental, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Ciudad de México, México
| | - Sergio Martínez-Fonseca
- Unidad de Trasplante Pulmonar Experimental, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Ciudad de México, México
| | - Marcelino Alonso-Gómez
- Unidad de Trasplante Pulmonar Experimental, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Ciudad de México, México
| | - J Alfredo Santibáñez-Salgado
- Unidad de Trasplante Pulmonar Experimental, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Ciudad de México, México.,Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ciudad de México, México
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11
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Capella-Monsonís H, Zeugolis DI. Decellularized xenografts in regenerative medicine: From processing to clinical application. Xenotransplantation 2021; 28:e12683. [PMID: 33709410 DOI: 10.1111/xen.12683] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/28/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022]
Abstract
Decellularized xenografts are an inherent component of regenerative medicine. Their preserved structure, mechanical integrity and biofunctional composition have well established them in reparative medicine for a diverse range of clinical indications. Nonetheless, their performance is highly influenced by their source (ie species, age, tissue) and processing (ie decellularization, crosslinking, sterilization and preservation), which govern their final characteristics and determine their success or failure for a specific clinical target. In this review, we provide an overview of the different sources and processing methods used in decellularized xenografts fabrication and discuss their effect on the clinical performance of commercially available decellularized xenografts.
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Affiliation(s)
- Héctor Capella-Monsonís
- 1Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland.,Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
| | - Dimitrios I Zeugolis
- 1Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland.,Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland.,Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
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12
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Human Bronchial Epithelial Cell Growth on Homologous Versus Heterologous Tissue Extracellular Matrix. J Surg Res 2021; 263:215-223. [PMID: 33691244 DOI: 10.1016/j.jss.2021.01.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 01/19/2021] [Accepted: 01/26/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Extracellular matrix (ECM) bioscaffolds produced by decellularization of source tissue have been effectively used for numerous clinical applications. However, decellularized tracheal constructs have been unsuccessful due to the immediate requirement of a functional airway epithelium on surgical implantation. ECM can be solubilized to form hydrogels that have been shown to support growth of many different cell types. The purpose of the present study is to compare the ability of airway epithelial cells to attach, form a confluent monolayer, and differentiate on homologous (trachea) and heterologous (urinary bladder) ECM substrates for potential application in full tracheal replacement. MATERIALS AND METHODS Porcine tracheas and urinary bladders were decellularized. Human bronchial epithelial cells (HBECs) were cultured under differentiation conditions on acellular tracheal ECM and urinary bladder matrix (UBM) bioscaffolds and hydrogels and were assessed by histology and immunolabeling for markers of ciliation, goblet cell formation, and basement membrane deposition. RESULTS Both trachea and urinary bladder tissues were successfully decellularized. HBEC formed a confluent layer on both trachea and UBM scaffolds and on hydrogels created from these bioscaffolds. Cells grown on tracheal and UBM hydrogels, but not on bioscaffolds, showed positive-acetylated tubulin staining and the presence of mucus-producing goblet cells. Collagen IV immunolabeling showed basement membrane deposition by these cells on the surface of the hydrogels. CONCLUSIONS ECM hydrogels supported growth and differentiation of HBEC better than decellularized ECM bioscaffolds and show potential utility as substrates for promotion of a mature respiratory epithelium for regenerative medicine applications in the trachea.
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13
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Tao M, Ao T, Mao X, Yan X, Javed R, Hou W, Wang Y, Sun C, Lin S, Yu T, Ao Q. Sterilization and disinfection methods for decellularized matrix materials: Review, consideration and proposal. Bioact Mater 2021; 6:2927-2945. [PMID: 33732964 PMCID: PMC7930362 DOI: 10.1016/j.bioactmat.2021.02.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 02/08/2023] Open
Abstract
Sterilization is the process of killing all microorganisms, while disinfection is the process of killing or removing all kinds of pathogenic microorganisms except bacterial spores. Biomaterials involved in cell experiments, animal experiments, and clinical applications need to be in the aseptic state, but their physical and chemical properties as well as biological activities can be affected by sterilization or disinfection. Decellularized matrix (dECM) is the low immunogenicity material obtained by removing cells from tissues, which retains many inherent components in tissues such as proteins and proteoglycans. But there are few studies concerning the effects of sterilization or disinfection on dECM, and the systematic introduction of sterilization or disinfection for dECM is even less. Therefore, this review systematically introduces and analyzes the mechanism, advantages, disadvantages, and applications of various sterilization and disinfection methods, discusses the factors influencing the selection of sterilization and disinfection methods, summarizes the sterilization and disinfection methods for various common dECM, and finally proposes a graphical route for selecting an appropriate sterilization or disinfection method for dECM and a technical route for validating the selected method, so as to provide the reference and basis for choosing more appropriate sterilization or disinfection methods of various dECM. Asepsis is the prerequisite for the experiment and application of biomaterials. Sterilization or disinfection affects physic-chemical properties of biomaterials. Mechanism, advantages and disadvantages of sterilization or disinfection methods. Factors influencing the selection of sterilization or disinfection methods. Selection of sterilization or disinfection methods for decellularized matrix.
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Affiliation(s)
- Meihan Tao
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Tianrang Ao
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoyan Mao
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Xinzhu Yan
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Rabia Javed
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Weijian Hou
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Yang Wang
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Cong Sun
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Shuang Lin
- Department of Tissue Engineering, China Medical University, Shenyang, China
| | - Tianhao Yu
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Qiang Ao
- Department of Tissue Engineering, China Medical University, Shenyang, China.,Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China.,Institute of Regulatory Science for Medical Device, National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
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14
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Cercone M, Brown BN, Stahl EC, Mitchell LM, Fortier LA, Mohammed HO, Ducharme NG. An Exploratory Study into the Implantation of Arytenoid Cartilage Scaffold in the Horse. Tissue Eng Part A 2021; 27:165-176. [PMID: 32539568 DOI: 10.1089/ten.tea.2019.0295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Respiratory function in the horse can be severely compromised by arytenoid chondritis, or arytenoid chondropathy, a pathologic condition leading to deformity and dysfunction of the affected cartilage. Current treatment in cases unresponsive to medical management is removal of the cartilage, which can improve the airway obstruction, but predisposes the patient to other complications like tracheal penetration of oropharyngeal content and dynamic collapse of the now unsupported soft tissue lateral to the cartilage. A tissue engineering approach to reconstructing the arytenoid cartilage would represent a significant advantage in the management of arytenoid chondritis. In this study, we explored if decellularized matrix could potentially be incorporated into the high motion environment of the arytenoid cartilages of horses. Equine arytenoid cartilages were decellularized and a portion of the resultant acellular scaffolds was implanted in a full-thickness defect created in the arytenoids of eight horses. The implantation was performed bilaterally in each horse, with one side randomly selected to receive an implant seeded with autologous bone marrow-derived nucleated cells (BMNCs). Arytenoids structure and function were monitored up to 4 months. In vivo assessments included laryngeal ultrasound, and laryngeal endoscopy at rest and during exercise on a high-speed treadmill. Histologic evaluation of the arytenoids was performed postmortem. Implantation of the cartilaginous graft had no adverse effect on laryngeal respiratory function or swallowing, despite induction of a transient granuloma on the medial aspect of the arytenoids. Ultrasonographic monitoring detected a postoperative increase in the thickness and cross-sectional area of the arytenoid body that receded faster in the arytenoids not seeded with BMNCs. The explanted tissue showed epithelialization of the mucosal surface, integration of the implant into the native arytenoid, with minimal adverse cellular reaction. Remodeling of the scaffold material was evident by 2 months after implantation. Preseeding the scaffold with BMNCs increased the rate of scaffold degradation and incorporation. Replacement of arytenoid portion with a tissue-engineered cartilaginous graft preseeded with BMNCs is surgically feasible in the horse, is well tolerated, and results in appropriate integration within the native tissue, also preventing laryngeal tissue collapse during exercise.
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Affiliation(s)
- Marta Cercone
- Department of Clinical Sciences, College of Veterinary medicine, Cornell University, Ithaca, New York, USA
| | - Bryan N Brown
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth C Stahl
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lisa M Mitchell
- Department of Clinical Sciences, College of Veterinary medicine, Cornell University, Ithaca, New York, USA
| | - Lisa A Fortier
- Department of Clinical Sciences, College of Veterinary medicine, Cornell University, Ithaca, New York, USA
| | - Hussni O Mohammed
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary medicine, Cornell University, Ithaca, New York, USA
| | - Norm G Ducharme
- Department of Clinical Sciences, College of Veterinary medicine, Cornell University, Ithaca, New York, USA
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15
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Liu L, Dharmadhikari S, Shontz KM, Tan ZH, Spector BM, Stephens B, Bergman M, Manning A, Zhao K, Reynolds SD, Breuer CK, Chiang T. Regeneration of partially decellularized tracheal scaffolds in a mouse model of orthotopic tracheal replacement. J Tissue Eng 2021; 12:20417314211017417. [PMID: 34164107 PMCID: PMC8188978 DOI: 10.1177/20417314211017417] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/26/2021] [Indexed: 12/26/2022] Open
Abstract
Decellularized tracheal scaffolds offer a potential solution for the repair of long-segment tracheal defects. However, complete decellularization of trachea is complicated by tracheal collapse. We created a partially decellularized tracheal scaffold (DTS) and characterized regeneration in a mouse model of tracheal transplantation. All cell populations except chondrocytes were eliminated from DTS. DTS maintained graft integrity as well as its predominant extracellular matrix (ECM) proteins. We then assessed the performance of DTS in vivo. Grafts formed a functional epithelium by study endpoint (28 days). While initial chondrocyte viability was low, this was found to improve in vivo. We then used atomic force microscopy to quantify micromechanical properties of DTS, demonstrating that orthotopic implantation and graft regeneration lead to the restoration of native tracheal rigidity. We conclude that DTS preserves the cartilage ECM, supports neo-epithelialization, endothelialization and chondrocyte viability, and can serve as a potential solution for long-segment tracheal defects.
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Affiliation(s)
- Lumei Liu
- Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Sayali Dharmadhikari
- Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatric Surgery, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Kimberly M Shontz
- Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Zheng Hong Tan
- Collage of Medicine, The Ohio State University, Columbus, OH, USA
| | - Barak M Spector
- Department of Otolaryngology–Head & Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA
| | - Brooke Stephens
- Collage of Medicine, The Ohio State University, Columbus, OH, USA
| | - Maxwell Bergman
- Department of Otolaryngology–Head & Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA
| | - Amy Manning
- Department of Pediatric Otolaryngology, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Kai Zhao
- Department of Otolaryngology–Head & Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA
| | - Susan D Reynolds
- Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Christopher K Breuer
- Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Pediatric Surgery, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Tendy Chiang
- Center for Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
- Department of Otolaryngology–Head & Neck Surgery, The Ohio State University Medical Center, Columbus, OH, USA
- Department of Pediatric Otolaryngology, Nationwide Children’s Hospital, Columbus, OH, USA
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16
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Nokhbatolfoghahaei H, Paknejad Z, Bohlouli M, Rezai Rad M, Aminishakib P, Derakhshan S, Mohammadi Amirabad L, Nadjmi N, Khojasteh A. Fabrication of Decellularized Engineered Extracellular Matrix through Bioreactor-Based Environment for Bone Tissue Engineering. ACS OMEGA 2020; 5:31943-31956. [PMID: 33344849 PMCID: PMC7745398 DOI: 10.1021/acsomega.0c04861] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/17/2020] [Indexed: 05/31/2023]
Abstract
Extracellular matrix (ECM)-contained grafts can be achieved by decellularization of native bones or synthetic scaffolds. Limitations associated with harvesting the native bone has raised interest in preparing in vitro ECM bioscaffold for bone tissue engineering. Here, we intend to develop an ECM-contained construct via decellularizing an engineered gelatin-coated β-tricalcium phosphate (gTCP) scaffold. In order to find an optimal protocol for decellularization of cell-loaded gTCP scaffolds, they were seeded with buccal fat pad-derived stem cells. Then, four decellularization protocols including sodium dodecyl sulfate, trypsin, Triton X-100, and combined solution methods were compared for the amounts of residual cells and remnant collagen and alteration of scaffold structure. Then, the efficacy of the selected protocol in removing cells from gTCP scaffolds incubated in a rotating and perfusion bioreactor for 24 days was evaluated and compared with static condition using histological analysis. Finally, decellularized scaffolds, reloaded with cells, and their cytotoxicity and osteoinductive capability were evaluated. Complete removal of cells from gTCP scaffolds was achieved from all protocols. However, treatment with Triton X-100 showed significantly higher amount of remnant ECM. Bioreactor-incubated scaffolds possessed greater magnitude of ECM proteins including collagen and glycosaminoglycans. Reseeding the decellularized scaffolds also represented higher osteoinductivity of bioreactor-based scaffolds. Application of Triton X-100 as decellularization protocol and usage of bioreactors are suggested as a suitable technique for designing ECM-contained grafts for bone tissue engineering.
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Affiliation(s)
- Hanieh Nokhbatolfoghahaei
- Dental
Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1983969413, Iran
- Student
Research Committee, Department of Tissue Engineering and Applied Cell
Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran
| | - Zahrasadat Paknejad
- Department
of Tissue Engineering and Applied Cell Sciences, School of Advanced
Technologies in Medicine, Shahid Beheshti
University of Medical Sciences, Tehran 1985717443, Iran
- Medical
Nanotechnology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran
| | - Mahboubeh Bohlouli
- Student
Research Committee, Department of Tissue Engineering and Applied Cell
Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran
| | - Maryam Rezai Rad
- Dental
Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1983969413, Iran
| | - Pouyan Aminishakib
- Department
of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran
| | - Samira Derakhshan
- Department
of Oral and Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Tehran 1439955991, Iran
| | | | - Nasser Nadjmi
- Department
of Cranio-Maxillofacial Surgery/University Hospital, Faculty of Medicine
& Health Sciences, University of Antwerp, Antwerp 2100, Belgium
- All
for Research vzw, Harmoniestraat
68, Antwerp 2018, Belgium
| | - Arash Khojasteh
- Dental
Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran 1983969413, Iran
- Department
of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983969411, Iran
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17
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Nayakawde NB, Methe K, Premaratne GU, Banerjee D, Olausson M. Combined Use of Detergents and Ultrasonication for Generation of an Acellular Pig Larynx. Tissue Eng Part A 2020; 27:362-371. [PMID: 32723005 DOI: 10.1089/ten.tea.2020.0054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The larynx is a fairly complex organ comprised of different muscles, cartilages, mucosal membrane, and nerves. Larynx cancer is generally the most common type of head and neck cancer. Treatment options are limited in patients with total or partial laryngectomy. Tissue-engineered organs have shown to be a promising alternative treatment for patients with laryngectomy. In this report we present an alternative and simple procedure to construct a whole pig larynx scaffold consisting of complete acellular structures of integrated muscle and cartilage. Larynges were decellularized (DC) using perfusion-agitation with detergents coupled with ultrasonication. DC larynges were then characterized to investigate the extracellular matrix (ECM) proteins, residual DNA, angiogenic growth factors, and morphological and ultrastructural changes to ECM fibers. After 17 decellularization cycles, no cells were observed in all areas of the larynx as confirmed by hematoxylin and eosin and DAPI (4',6-diamidino-2-phenylindole) staining. However, DC structures of dense thyroid and cricoid cartilage showed remnants of cells. All structures of DC larynges (epiglottis [p < 0.0001], muscle [p < 0.0001], trachea [p = 0.0045], and esophagus [p = 0.0008]) showed DNA <50 ng/mg compared with native larynx. Immunohistochemistry, Masson's trichrome staining, and Luminex analyses showed preservation of important ECM proteins and angiogenic growth factors in DC larynges. Compared with other growth factors, mostly retained growth factors in DC epiglottis, thyroid muscle, and trachea include granulocyte colony-stimulating factor, Leptin, fibroblast growth factor-1, Follistatin, hepatocyte growth factor, and vascular endothelial growth factor-A. Scanning electron microscopy and transmission electron microscopy analysis confirmed the structural arrangements of ECM fibers in larynges to be well preserved after DC. Our findings suggest that larynges can be effectively DC using detergent ultrasonication. ECM proteins and angiogenic growth factors appear to be better preserved using this method when compared with the native structures of larynges. This alternative DC method could be helpful in building scaffolds from dense tissue structures such as cartilage, tendon, larynx, or trachea for future in vitro recellularization studies or in vivo implantation studies in the clinic.
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Affiliation(s)
- Nikhil B Nayakawde
- Laboratory for Transplantation and Regenerative Medicine, Sahlgrenska Academy at Gothenburg University and the Sahlgrenska Transplant Institute at Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ketaki Methe
- Laboratory for Transplantation and Regenerative Medicine, Sahlgrenska Academy at Gothenburg University and the Sahlgrenska Transplant Institute at Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Goditha U Premaratne
- Laboratory for Transplantation and Regenerative Medicine, Sahlgrenska Academy at Gothenburg University and the Sahlgrenska Transplant Institute at Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Debashish Banerjee
- Laboratory for Transplantation and Regenerative Medicine, Sahlgrenska Academy at Gothenburg University and the Sahlgrenska Transplant Institute at Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Michael Olausson
- Laboratory for Transplantation and Regenerative Medicine, Sahlgrenska Academy at Gothenburg University and the Sahlgrenska Transplant Institute at Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Transplantation Surgery, Sahlgrenska Academy at Gothenburg University and the Sahlgrenska Transplant Institute at Sahlgrenska University Hospital, Gothenburg, Sweden
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18
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Niermeyer WL, Rodman C, Li MM, Chiang T. Tissue engineering applications in otolaryngology-The state of translation. Laryngoscope Investig Otolaryngol 2020; 5:630-648. [PMID: 32864434 PMCID: PMC7444782 DOI: 10.1002/lio2.416] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/06/2020] [Accepted: 05/11/2020] [Indexed: 12/14/2022] Open
Abstract
While tissue engineering holds significant potential to address current limitations in reconstructive surgery of the head and neck, few constructs have made their way into routine clinical use. In this review, we aim to appraise the state of head and neck tissue engineering over the past five years, with a specific focus on otologic, nasal, craniofacial bone, and laryngotracheal applications. A comprehensive scoping search of the PubMed database was performed and over 2000 article hits were returned with 290 articles included in the final review. These publications have addressed the hallmark characteristics of tissue engineering (cellular source, scaffold, and growth signaling) for head and neck anatomical sites. While there have been promising reports of effective tissue engineered interventions in small groups of human patients, the majority of research remains constrained to in vitro and in vivo studies aimed at furthering the understanding of the biological processes involved in tissue engineering. Further, differences in functional and cosmetic properties of the ear, nose, airway, and craniofacial bone affect the emphasis of investigation at each site. While otolaryngologists currently play a role in tissue engineering translational research, continued multidisciplinary efforts will likely be required to push the state of translation towards tissue-engineered constructs available for routine clinical use. LEVEL OF EVIDENCE NA.
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Affiliation(s)
| | - Cole Rodman
- The Ohio State University College of MedicineColumbusOhioUSA
| | - Michael M. Li
- Department of Otolaryngology—Head and Neck SurgeryThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| | - Tendy Chiang
- Department of OtolaryngologyNationwide Children's HospitalColumbusOhioUSA
- Department of Otolaryngology—Head and Neck SurgeryThe Ohio State University Wexner Medical CenterColumbusOhioUSA
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19
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Ohno M, Fuchimoto Y, Higuchi M, Yamaoka T, Komura M, Umezawa A, Hsu HC, Enosawa S, Kuroda T. Long-term observation of airway reconstruction using decellularized tracheal allografts in micro-miniature pigs at growing stage. Regen Ther 2020; 15:64-69. [PMID: 33426203 PMCID: PMC7770338 DOI: 10.1016/j.reth.2020.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/15/2020] [Accepted: 04/25/2020] [Indexed: 12/30/2022] Open
Abstract
Introduction Decellularized tissue exhibits cell matrix-like properties, along with reduced antigenicity. We explored the potential of decellularized allogeneic trachea to restore the upper respiratory tract, focusing on pediatric application. This study specifically aimed at long-term observation of tissue regeneration using a micro-miniature pig model. Methods Artificial defects (15 × 15 mm) in the subglottis and trachea of micro-miniature pigs were repaired by transplantation of either allogeneic decellularized or fresh (control) tracheal patches. Pigs were evaluated in situ, by bronchoscopy, every three months, and sacrificed for histological examination at six and twelve months after transplantation. Results No airway symptom was observed in any pig during the observation period. Bronchoscopy revealed the tracheal lumen to be restored by fresh grafts, showing an irregular surface with remarkable longitudinal compression; these changes were mild after restoration with decellularized grafts. Histologically, while fresh graft patches were denatured and replaced by calcified tissue, decellularized patches remained unchanged throughout the observation period. There were regeneration foci of cartilage adjacent to the grafts, and some foci joined the decellularized graft uniformly, suggesting the induction of tracheal reconstitution. Conclusion Allogeneic decellularized tracheal tissue could serve as a promising biomaterial for tracheal restoration, especially for pediatric patients at the growing stage.
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Affiliation(s)
- Michinobu Ohno
- Department of Pediatric Surgery, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama-shi, Saitama 336-8522, Japan.,Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Yasushi Fuchimoto
- Department of Pediatric Surgery, International University of Health and Welfare School of Medicine, 2600-1 Kitakanemaru, Ohtawara-shi, Tochigi 324-8501, Japan.,Department of Pediatric Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo 160-8582, Japan
| | - Masataka Higuchi
- Division of Pulmonology, Department of Medical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Tetsuji Yamaoka
- Department of Biomedical Engineering, National Cerebral and Cardiovascular Center Research Institute, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
| | - Makoto Komura
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Akihiro Umezawa
- Department of Reproductive Biology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Huai-Che Hsu
- Division for Advanced Medical Sciences, National Center for Child Health and Development, 2-10-1 Okura,Setagaya-ku, Tokyo 157-8535, Japan
| | - Shin Enosawa
- Division for Advanced Medical Sciences, National Center for Child Health and Development, 2-10-1 Okura,Setagaya-ku, Tokyo 157-8535, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjyuku-ku, Tokyo 160-8582, Japan
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20
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Hamilton NJI, Lee DDH, Gowers KHC, Butler CR, Maughan EF, Jevans B, Orr JC, McCann CJ, Burns AJ, MacNeil S, Birchall MA, O'Callaghan C, Hynds RE, Janes SM. Bioengineered airway epithelial grafts with mucociliary function based on collagen IV- and laminin-containing extracellular matrix scaffolds. Eur Respir J 2020; 55:1901200. [PMID: 32444408 PMCID: PMC7301290 DOI: 10.1183/13993003.01200-2019] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 02/26/2020] [Indexed: 12/15/2022]
Abstract
Current methods to replace damaged upper airway epithelium with exogenous cells are limited. Existing strategies use grafts that lack mucociliary function, leading to infection and the retention of secretions and keratin debris. Strategies that regenerate airway epithelium with mucociliary function are clearly desirable and would enable new treatments for complex airway disease.Here, we investigated the influence of the extracellular matrix (ECM) on airway epithelial cell adherence, proliferation and mucociliary function in the context of bioengineered mucosal grafts. In vitro, primary human bronchial epithelial cells (HBECs) adhered most readily to collagen IV. Biological, biomimetic and synthetic scaffolds were compared in terms of their ECM protein content and airway epithelial cell adherence.Collagen IV and laminin were preserved on the surface of decellularised dermis and epithelial cell attachment to decellularised dermis was greater than to the biomimetic or synthetic alternatives tested. Blocking epithelial integrin α2 led to decreased adherence to collagen IV and to decellularised dermis scaffolds. At air-liquid interface (ALI), bronchial epithelial cells cultured on decellularised dermis scaffolds formed a differentiated respiratory epithelium with mucociliary function. Using in vivo chick chorioallantoic membrane (CAM), rabbit airway and immunocompromised mouse models, we showed short-term preservation of the cell layer following transplantation.Our results demonstrate the feasibility of generating HBEC grafts on clinically applicable decellularised dermis scaffolds and identify matrix proteins and integrins important for this process. The long-term survivability of pre-differentiated epithelia and the relative merits of this approach against transplanting basal cells should be assessed further in pre-clinical airway transplantation models.
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Affiliation(s)
- Nick J I Hamilton
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- UCL Ear Institute, The Royal National Throat Nose and Ear Hospital, London, UK
- Nick J.I. Hamilton and Sam M. Janes are joint-senior authors
| | - Dani Do Hyang Lee
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Kate H C Gowers
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Colin R Butler
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Elizabeth F Maughan
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Benjamin Jevans
- Stem Cell and Regenerative Medicine, Birth Defects Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jessica C Orr
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Conor J McCann
- Stem Cell and Regenerative Medicine, Birth Defects Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Alan J Burns
- Stem Cell and Regenerative Medicine, Birth Defects Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sheila MacNeil
- Dept of Materials and Science Engineering, The Kroto Research Institute, North Campus, University of Sheffield, Sheffield, UK
| | - Martin A Birchall
- UCL Ear Institute, The Royal National Throat Nose and Ear Hospital, London, UK
| | - Christopher O'Callaghan
- Respiratory, Critical Care and Anaesthesia, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Robert E Hynds
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Nick J.I. Hamilton and Sam M. Janes are joint-senior authors
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21
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Deconstructing tissue engineered trachea: Assessing the role of synthetic scaffolds, segmental replacement and cell seeding on graft performance. Acta Biomater 2020; 102:181-191. [PMID: 31707085 DOI: 10.1016/j.actbio.2019.11.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/04/2019] [Accepted: 11/05/2019] [Indexed: 01/05/2023]
Abstract
The ideal construct for tracheal replacement remains elusive in the management of long segment airway defects. Tissue engineered tracheal grafts (TETG) have been limited by the development of graft stenosis or collapse, infection, or lack of an epithelial lining. We applied a mouse model of orthotopic airway surgery to assess the impact of three critical barriers encountered in clinical applications: the scaffold, the extent of intervention, and the impact of cell seeding and characterized their impact on graft performance. First, synthetic tracheal scaffolds electrospun from polyethylene terephthalate / polyurethane (PET/PU) were orthotopically implanted in anterior tracheal defects of C57BL/6 mice. Scaffolds demonstrated complete coverage with ciliated respiratory epithelium by 2 weeks. Epithelial migration was accompanied by macrophage infiltration which persisted at long term (>6 weeks) time points. We then assessed the impact of segmental tracheal implantation using syngeneic trachea as a surrogate for the ideal tracheal replacement. Graft recovery involved local upregulation of epithelial progenitor populations and there was no evidence of graft stenosis or necrosis. Implantation of electrospun synthetic tracheal scaffold for segmental replacement resulted in respiratory distress and required euthanasia at an early time point. There was limited epithelial coverage of the scaffold with and without seeded bone marrow-derived mononuclear cells (BM-MNCs). We conclude that synthetic scaffolds support re-epithelialization in orthotopic patch implantation, syngeneic graft integration occurs with focal repair mechanisms, however epithelialization in segmental synthetic scaffolds is limited and is not influenced by cell seeding. STATEMENT OF SIGNIFICANCE: The life-threatening nature of long-segment tracheal defects has led to clinical use of tissue engineered tracheal grafts in the last decade for cases of compassionate use. However, the ideal tracheal reconstruction using tissue-engineered tracheal grafts (TETG) has not been clarified. We addressed the core challenges in tissue engineered tracheal replacement (re-epithelialization and graft patency) by defining the role of cell seeding with autologous bone marrow-derived mononuclear cells, the mechanism of respiratory epithelialization and proliferation, and the role of the inflammatory immune response in regeneration. This research will facilitate comprehensive understanding of cellular regeneration and neotissue formation on TETG, which will permit targeted therapies for accelerating re-epithelialization and attenuating stenosis in tissue engineered airway replacement.
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22
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Selvarajah J, Saim AB, Bt Hj Idrus R, Lokanathan Y. Current and Alternative Therapies for Nasal Mucosa Injury: A Review. Int J Mol Sci 2020; 21:E480. [PMID: 31940884 PMCID: PMC7014293 DOI: 10.3390/ijms21020480] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/15/2022] Open
Abstract
Nasal mucosa injury can be caused by trauma, radiotherapy, chronic infection such as sinusitis, and post sinus surgery. The rate of healing and its treatment are important in the recovery of patients especially in post sinus surgery, which introduces new injuries. In this review, the current knowledge in terms of the mechanism underlying nasal wound healing was initially discussed. The currently available treatment options for enhancement of wound healing following sinus surgery were discussed and these had included intravenous antibiotics or steroids, various nasal sprays, and nasal packing. In addition, emerging alternative therapies in nasal mucosa wound healing such as herbal medicine and the advancement of regenerative medicine therapies such as stem cells and their byproducts were also discussed. Despite the various available treatment options for wound healing in nasal mucosa, rigorous strong evidence of their efficacy is gravely warranted in order to recommend them as part of the treatment modality.
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Affiliation(s)
- Jegadevswari Selvarajah
- Tissue Engineering Centre, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia;
| | - Aminuddin Bin Saim
- Ear, Nose & Throat Consultant Clinic, Ampang Puteri Specialist Hospital, Ampang, Selangor 68000, Malaysia
| | - Ruszymah Bt Hj Idrus
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia;
| | - Yogeswaran Lokanathan
- Tissue Engineering Centre, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur 56000, Malaysia;
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23
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Boyd R, Parisi F, Kalfa D. State of the Art: Tissue Engineering in Congenital Heart Surgery. Semin Thorac Cardiovasc Surg 2019; 31:807-817. [PMID: 31176798 DOI: 10.1053/j.semtcvs.2019.05.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 05/28/2019] [Indexed: 12/17/2022]
Abstract
Congenital heart disease is the leading cause of death secondary to congenital abnormalities in the United States and the incidence has increased significantly over the last 50 years. For those defects requiring surgical repair, bioprosthetic xenografts, allografts, and synthetic materials have traditionally been used. However, none of these modalities offer the potential for growth and accommodation within the pediatric population. Tissue engineering has been an area of great interest in a variety of cardiac applications as an innovative solution to create a product that can grow and regenerate within the body over time. Over the last 30 years, the original tissue engineering paradigm of a scaffold seeded with cells and cultured in a bioreactor has been expanded upon to include innovative methods of decellularization and production of "off-the-shelf" tissue-engineered products capable of in situ host cell repopulation. Despite progress in conceptual design and promising clinical results, widespread use of tissue-engineered products remains limited due to both regulatory and ongoing scientific challenges. Here, we describe the current state of the art with regards to in vitro, in vivo, and in situ tissue engineering as applicable within the field of congenital heart surgery and provide a brief overview of challenges and future directions.
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Affiliation(s)
- Rebekah Boyd
- Division of Cardiac, Thoracic and Vascular Surgery, Section of Pediatric and Congenital Cardiac Surgery, New-York Presbyterian Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, New York
| | - Frank Parisi
- Division of Cardiac, Thoracic and Vascular Surgery, Section of Pediatric and Congenital Cardiac Surgery, New-York Presbyterian Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, New York
| | - David Kalfa
- Division of Cardiac, Thoracic and Vascular Surgery, Section of Pediatric and Congenital Cardiac Surgery, New-York Presbyterian Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, New York.
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24
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Pepper V, Best CA, Buckley K, Schwartz C, Onwuka E, King N, White A, Dharmadhikari S, Reynolds SD, Johnson J, Grischkan J, Breuer CK, Chiang T. Factors Influencing Poor Outcomes in Synthetic Tissue-Engineered Tracheal Replacement. Otolaryngol Head Neck Surg 2019; 161:458-467. [PMID: 31035858 DOI: 10.1177/0194599819844754] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Humans receiving tissue-engineered tracheal grafts have experienced poor outcomes ultimately resulting in death or the need for graft explantation. We assessed the performance of the synthetic scaffolds used in humans with an ovine model of orthotopic tracheal replacement, applying standard postsurgical surveillance and interventions to define the factors that contributed to the complications seen at the bedside. STUDY DESIGN Large animal model. SETTING Pediatric academic research institute. SUBJECTS AND METHODS Human scaffolds were manufactured with an electrospun blend of polyethylene terephthalate and polyurethane reinforced with polycarbonate rings. They were seeded with autologous bone marrow-derived mononuclear cells and implanted in sheep. Animals were evaluated with routine bronchoscopy and fluoroscopy. Endoscopic dilation and stenting were performed to manage graft stenosis for up to a 4-month time point. Grafts and adjacent native airway were sectioned and evaluated with histology and immunohistochemistry. RESULTS All animals had signs of graft stenosis. Three of 5 animals (60%) designated for long-term surveillance survived until the 4-month time point. Graft dilation and stent placement resolved respiratory symptoms and prolonged survival. Necropsy demonstrated evidence of infection and graft encapsulation. Granulation tissue with signs of neovascularization was seen at the anastomoses, but epithelialization was never observed. Acute and chronic inflammation of the native airway epithelium was observed at all time points. Architectural changes of the scaffold included posterior wall infolding and scaffold delamination. CONCLUSIONS In our ovine model, clinically applied synthetic tissue-engineered tracheas demonstrated infectious, inflammatory, and mechanical failures with a lack of epithelialization and neovascularization.
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Affiliation(s)
- Victoria Pepper
- 1 Division of Pediatric Surgery, Loma Linda Children's Hospital, Loma Linda, California, USA
| | - Cameron A Best
- 2 Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,3 Biomedical Sciences Graduate Program, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Kaila Buckley
- 4 Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Cynthia Schwartz
- 5 Department of Otolaryngology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Ekene Onwuka
- 6 Department of General Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Nakesha King
- 6 Department of General Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Audrey White
- 7 College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Sayali Dharmadhikari
- 2 Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,8 Department of Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Susan D Reynolds
- 9 Center for Perinatal Research, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Jed Johnson
- 10 Nanofiber Solutions Inc, Hilliard, Ohio, USA
| | - Jonathan Grischkan
- 8 Department of Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Christopher K Breuer
- 2 Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,11 Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Tendy Chiang
- 2 Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,8 Department of Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
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25
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Dharmadhikari S, Best CA, King N, Henderson M, Johnson J, Breuer CK, Chiang T. Mouse Model of Tracheal Replacement With Electrospun Nanofiber Scaffolds. Ann Otol Rhinol Laryngol 2019; 128:391-400. [PMID: 30700095 DOI: 10.1177/0003489419826134] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The clinical experience with tissue-engineered tracheal grafts (TETGs) has been fraught with graft stenosis and delayed epithelialization. A mouse model of orthotopic replacement that recapitulates the clinical findings would facilitate the study of the cellular and molecular mechanisms underlying graft stenosis. METHODS Electrospun nanofiber tracheal scaffolds were created using nonresorbable (polyethylene terephthalate + polyurethane) and co-electrospun resorbable (polylactide-co-caprolactone/polyglycolic acid) polymers (n = 10/group). Biomechanical testing was performed to compare load displacement of nanofiber scaffolds to native mouse tracheas. Mice underwent orthotopic tracheal replacement with syngeneic grafts (n = 5) and nonresorbable (n = 10) and resorbable (n = 10) scaffolds. Tissue at the anastomosis was evaluated using hematoxylin and eosin (H&E), K5+ basal cells were evaluated with the help of immunofluorescence testing, and cellular infiltration of the scaffold was quantified. Micro computed tomography was performed to assess graft patency and correlate radiographic and histologic findings with respiratory symptoms. RESULTS Synthetic scaffolds were supraphysiologic in compression tests compared to native mouse trachea ( P < .0001). Nonresorbable scaffolds were stiffer than resorbable scaffolds ( P = .0004). Eighty percent of syngeneic recipients survived to the study endpoint of 60 days postoperatively. Mean survival with nonresorbable scaffolds was 11.40 ± 7.31 days and 6.70 ± 3.95 days with resorbable scaffolds ( P = .095). Stenosis manifested with tissue overgrowth in nonresorbable scaffolds and malacia in resorbable scaffolds. Quantification of scaffold cellular infiltration correlated with length of survival in resorbable scaffolds (R2 = 0.95, P = .0051). Micro computed tomography demonstrated the development of graft stenosis at the distal anastomosis on day 5 and progressed until euthanasia was performed on day 11. CONCLUSION Graft stenosis seen in orthotopic tracheal replacement with synthetic tracheal scaffolds can be modeled in mice. The wide array of lineage tracing and transgenic mouse models available will permit future investigation of the cellular and molecular mechanisms underlying TETG stenosis.
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Affiliation(s)
- Sayali Dharmadhikari
- 1 Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,2 Department of Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Cameron A Best
- 1 Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,3 Biomedical Sciences Graduate Program, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Nakesha King
- 4 Department of General Surgery, The Ohio State University, Columbus, Ohio, USA
| | | | - Jed Johnson
- 5 Nanofiber Solutions, Inc, Hilliard, Ohio, USA
| | - Christopher K Breuer
- 1 Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,6 Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Tendy Chiang
- 1 Center for Regenerative Medicine, Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,2 Department of Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, USA
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26
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A Comparative Study of the Effects of Different Decellularization Methods and Genipin-Cross-Linking on the Properties of Tracheal Matrices. Tissue Eng Regen Med 2018; 16:39-50. [PMID: 30815349 DOI: 10.1007/s13770-018-0170-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/02/2018] [Accepted: 11/09/2018] [Indexed: 12/22/2022] Open
Abstract
Background Different decellularization methods can affect the integrity and the biomechanical and biocompatible properties of the tracheal matrix. Natural cross-linking with genipin can be applied to improve those properties. The goals of this study were to evaluate the effects of different decellularization methods on the properties of genipin-cross-linked decellularized tracheal matrices in rabbits. Methods The tracheas of New Zealand rabbits were decellularized by the Triton-X 100-processed method (TPM) and the detergent-enzymatic method (DEM) and were then cross-linked with genipin. Mechanical tests, haematoxylin-eosin staining, Masson trichrome staining, Safranin O staining, DAPI staining, scanning electronic microscopy (SEM), and biocompatibility tests were used to evaluate the treatment. The bioengineered trachea and control trachea were then implanted into allogeneic rabbits for 30 days. The structural and functional analyses were performed after transplantation. Results The biomechanical tests demonstrated that the biomechanical properties of the decellularized tracheas decreased and that genipin improved them (p < 0.05). The histological staining results revealed that most of the mucosal epithelial cells were removed and that the decellularized trachea had lower immunogenicity than the control group. The analysis of SEM revealed that the decellularized trachea retained the micro- and ultra-structural architectures of the trachea and that the matrices cross-linked with genipin were denser. The biocompatibility evaluation and in vivo implantation experiments showed that the decellularized trachea treated with the DEM had better biocompatibility than that treated with the TPM and that immunogenicity in the cross-linked tissues was lower than that in the uncross-linked tissues (p < 0.05). Conclusions Compared with the trachea treated with the TPM, the rabbit trachea processed by the DEM had better biocompatibility and lower immunogenicity, and its structural and mechanical characteristics were effectively improved after the genipin treatment, which is suitable for engineering replacement tracheal tissue.
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27
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Park JH, Park JY, Nam IC, Ahn M, Lee JY, Choi SH, Kim SW, Cho DW. A rational tissue engineering strategy based on three-dimensional (3D) printing for extensive circumferential tracheal reconstruction. Biomaterials 2018; 185:276-283. [PMID: 30261427 DOI: 10.1016/j.biomaterials.2018.09.031] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 09/17/2018] [Indexed: 01/12/2023]
Abstract
Extensive circumferential tracheal defects remain a major challenging problem in the field of tracheal reconstruction. In this study, a tissue-engineered tracheal graft based on three-dimensional (3D) printing was developed for extensive circumferential tracheal reconstruction. A native trachea-mimetic bellows scaffold, a framework for a tissue-engineered tracheal graft, was indirectly 3D printed and reinforced with ring-shaped bands made from medical grade silicone rubber. A tissue-engineered tracheal graft was then created by stratifying tracheal mucosa decellularized extracellular matrix (tmdECM) hydrogel on the luminal surface of the scaffold and transferring human inferior turbinate mesenchymal stromal cell (hTMSC) sheets onto the tmdECM hydrogel layer. The tissue-engineered tracheal graft with critical length was anastomosed end-to-end to the native trachea and complete re-epithelialization was achieved on the entire luminal surface within 2 months in a rabbit model with no post-operative complications. With this successful result, the present study reports the preliminary potential of the tissue-engineered tracheal graft as a rational tissue engineering strategy for extensive circumferential tracheal reconstruction.
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Affiliation(s)
- Jeong Hun Park
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Ju Young Park
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, South Korea
| | - Inn-Chul Nam
- Department of Otolaryngology and HNS, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Minjun Ahn
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, South Korea
| | - Jae Yeon Lee
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, South Korea
| | - Seok Hwa Choi
- Veterinary Medical Center, Chungbuk National University, Cheongju, South Korea
| | - Sung Won Kim
- Department of Otolaryngology and HNS, College of Medicine, The Catholic University of Korea, Seoul, South Korea; Department of Biomedical Science, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
| | - Dong-Woo Cho
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, South Korea.
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28
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Linkov G, Hanifi A, Yousefi F, Tint D, Bolla S, Marchetti N, Soliman AMS, Pleshko N. Compositional Assessment of Human Tracheal Cartilage by Infrared Spectroscopy. Otolaryngol Head Neck Surg 2018; 158:688-694. [PMID: 29337647 DOI: 10.1177/0194599817752310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/15/2017] [Indexed: 10/15/2023]
Abstract
Objectives To assess the potential of infrared fiber-optic spectroscopy to evaluate the compositional properties of human tracheal cartilage. Study Design Laboratory-based study. Methods Twenty human cadaveric distal tracheas were harvested (age range 20-78 years; 6 females, 14 males) for compositional analysis. Histologic staining, Fourier transform infrared imaging spectroscopy data on collagen and proteoglycan (PG) content, and near-infrared (NIR) fiber-optic probe spectroscopic data that reflect protein and water content were evaluated. NIR fiber-optic probe data were also obtained from the proximal trachea in 4 human cadavers (age range 51-65 years; 2 females, 2 males) in situ for comparison to distal trachea spectral data. Results In the distal trachea cohort, the spectroscopic-determined ratio of PG/amide I, indicative of the relative amount of PG, was significantly higher in the tissues from the younger group compared to the older group (0.37 ± 0.08 vs 0.32 ± 0.05, P = .05). A principal component analysis of the NIR spectral data enabled separation of spectra based on tracheal location, likely due to differences in both protein and water content. The NIR-determined water content based on the 5200-cm-1 peak was significantly higher in the distal trachea compared to the proximal trachea ( P < .001). Conclusions Establishment of normative compositional values and further elucidating differences between the segments of trachea will enable more directed research toward appropriate compositional end points in regenerative medicine for tracheal repair.
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Affiliation(s)
- Gary Linkov
- 1 Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Arash Hanifi
- 2 Tissue Imaging and Spectroscopy Laboratory, Department of Bioengineer-ing, Temple University, Philadelphia, Pennsylvania, USA
| | - Farzad Yousefi
- 2 Tissue Imaging and Spectroscopy Laboratory, Department of Bioengineer-ing, Temple University, Philadelphia, Pennsylvania, USA
| | - Derrick Tint
- 1 Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Sudheer Bolla
- 3 Department of Thoracic Medicine & Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Nathanial Marchetti
- 3 Department of Thoracic Medicine & Surgery, Lewis Katz School of Medicine at 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
- 2 Tissue Imaging and Spectroscopy Laboratory, Department of Bioengineer-ing, Temple University, Philadelphia, Pennsylvania, USA
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29
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Zhao L, Sundaram S, Le AV, Huang AH, Zhang J, Hatachi G, Beloiartsev A, Caty MG, Yi T, Leiby K, Gard A, Kural MH, Gui L, Rocco KA, Sivarapatna A, Calle E, Greaney A, Urbani L, Maghsoudlou P, Burns A, DeCoppi P, Niklason LE. Engineered Tissue-Stent Biocomposites as Tracheal Replacements. Tissue Eng Part A 2017; 22:1086-97. [PMID: 27520928 DOI: 10.1089/ten.tea.2016.0132] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Here we report the creation of a novel tracheal construct in the form of an engineered, acellular tissue-stent biocomposite trachea (TSBT). Allogeneic or xenogeneic smooth muscle cells are cultured on polyglycolic acid polymer-metal stent scaffold leading to the formation of a tissue comprising cells, their deposited collagenous matrix, and the stent material. Thorough decellularization then produces a final acellular tubular construct. Engineered TSBTs were tested as end-to-end tracheal replacements in 11 rats and 3 nonhuman primates. Over a period of 8 weeks, no instances of airway perforation, infection, stent migration, or erosion were observed. Histological analyses reveal that the patent implants remodel adaptively with native host cells, including formation of connective tissue in the tracheal wall and formation of a confluent, columnar epithelium in the graft lumen, although some instances of airway stenosis were observed. Overall, TSBTs resisted collapse and compression that often limit the function of other decellularized tracheal replacements, and additionally do not require any cells from the intended recipient. Such engineered TSBTs represent a model for future efforts in tracheal regeneration.
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Affiliation(s)
- Liping Zhao
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Sumati Sundaram
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut.,2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Andrew V Le
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Angela H Huang
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Jiasheng Zhang
- 3 Department of Internal Medicine Cardiology, Yale University , New Haven, Connecticut
| | - Go Hatachi
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Arkadi Beloiartsev
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Michael G Caty
- 4 Section of Pediatric Surgery, Yale University , New Haven, Connecticut
| | - Tai Yi
- 5 Nationwide Children's Hospital Research Institute , Columbus, Ohio
| | - Katherine Leiby
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Ashley Gard
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Mehmet H Kural
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Liqiong Gui
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Kevin A Rocco
- 2 Department of Anesthesiology, Yale University , New Haven, Connecticut
| | - Amogh Sivarapatna
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Elizabeth Calle
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Allison Greaney
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut
| | - Luca Urbani
- 6 UCL Institute of Child Health and Great Ormond Street Hospital , UCL, London, United Kingdom
| | - Panagiotis Maghsoudlou
- 6 UCL Institute of Child Health and Great Ormond Street Hospital , UCL, London, United Kingdom
| | - Alan Burns
- 6 UCL Institute of Child Health and Great Ormond Street Hospital , UCL, London, United Kingdom .,7 Department of Clinical Genetics, Erasmus Medical Center , Rotterdam, The Netherlands
| | - Paolo DeCoppi
- 6 UCL Institute of Child Health and Great Ormond Street Hospital , UCL, London, United Kingdom
| | - Laura E Niklason
- 1 Department of Biomedical Engineering, Yale University , New Haven, Connecticut.,2 Department of Anesthesiology, Yale University , New Haven, Connecticut
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30
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Mansour A, Mezour MA, Badran Z, Tamimi F. * Extracellular Matrices for Bone Regeneration: A Literature Review. Tissue Eng Part A 2017; 23:1436-1451. [PMID: 28562183 DOI: 10.1089/ten.tea.2017.0026] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The gold standard material for bone regeneration is still autologous bone, a mesenchymal tissue that consists mainly of extracellular matrix (ECM) (90% v/v) and little cellular content (10% v/v). However, the fact that decellularized allogenic bone grafts often present a clinical performance comparable to autologous bone grafts demonstrates the crucial role of ECM in bone regeneration. For long, the mechanism by which bone allografts function was not clear, but recent research has unveiled many unique characteristics of ECM that seem to play a key role in tissue regeneration. This is further confirmed by the fact that synthetic biomaterials with composition and properties resembling bone ECM present excellent bone regeneration properties. In this context, ECM molecules such as glycosaminoglycans (GAGs) and self-assembly peptides (SAPs) can improve the performance of bone regeneration biomaterials. Moreover, decellularized ECM derived either from native tissues such as bone, cartilage, skin, and tooth germs or from cells such as osteoblasts, chondrocytes, and stem cells has shown promising results in bone regeneration applications. Understanding the role of ECM in bone regeneration is crucial for the development of the next generation of biomaterials for bone tissue engineering. In this sense, this review addresses the state-of-the-art on this subject matter.
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Affiliation(s)
- Alaa Mansour
- 1 Faculty of Dentistry, McGill University , Montreal, Canada
| | | | - Zahi Badran
- 1 Faculty of Dentistry, McGill University , Montreal, Canada .,2 Department of Periodontology (CHU/UIC 11, INSERM UMR 1229-RMeS), Faculty of Dental Surgery, University of Nantes , Nantes, France
| | - Faleh Tamimi
- 1 Faculty of Dentistry, McGill University , Montreal, Canada
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31
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Xu K, Kuntz LA, Foehr P, Kuempel K, Wagner A, Tuebel J, Deimling CV, Burgkart RH. Efficient decellularization for tissue engineering of the tendon-bone interface with preservation of biomechanics. PLoS One 2017; 12:e0171577. [PMID: 28170430 PMCID: PMC5295703 DOI: 10.1371/journal.pone.0171577] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/22/2017] [Indexed: 02/07/2023] Open
Abstract
Interfaces between tendon/ligament and bone (“entheses”) are highly specialized tissues that allow for stress transfer between mechanically dissimilar materials. Entheses show very low regenerative capacity resulting in high incidences of failure after surgical repair. Tissue engineering is a promising approach to recover functionality of entheses. Here, we established a protocol to decellularize porcine entheses as scaffolds for enthesis tissue engineering. Chemical detergents as well as physical treatments were investigated with regard to their efficiency to decellularize 2 mm thick porcine Achilles tendon entheses. A two-phase approach was employed: study 1 investigated the effect of various concentrations of sodium dodecyl sulfate (SDS) and t-octylphenoxypolyethoxy-ethanol (Triton X-100) as decellularization agents. The most efficient combination of SDS and Triton was then carried forward into study 2, where different physical methods, including freeze-thaw cycles, ultrasound, perfusion, and hydrostatic washing were used to enhance the decellularization effect. Cell counts, DNA quantification, and histology showed that washing with 0.5% SDS + 1% Triton X-100 for 72 h at room temperature could remove ~ 98% cells from the interface. Further investigation of physical methods proved that washing under 200 mmHg hydrostatic pressure shortened the detergent exposing time from 72 h to 48 h. Biomechanical tensile testing showed that the biomechanical features of treated samples were preserved. Washing under 200 mmHg hydrostatic pressure with 0.5% SDS + 1% Triton X-100 for 48 h efficiently decellularized entheses with preservation of matrix structure and biomechanical features. This protocol can be used to efficiently decellularize entheses as scaffolds for tissue engineering.
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Affiliation(s)
- Kai Xu
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany.,Department of Orthopedics, Tongji Hospital, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Lara A Kuntz
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Peter Foehr
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Katharina Kuempel
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Alexandra Wagner
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Jutta Tuebel
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Constantin V Deimling
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | - Rainer H Burgkart
- Department of Orthopaedics and Sportsorthopaedics, Klinikum rechts der Isar, Technical University of Munich (TUM), Munich, Germany
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32
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Butler CR, Hynds RE, Crowley C, Gowers KHC, Partington L, Hamilton NJ, Carvalho C, Platé M, Samuel ER, Burns AJ, Urbani L, Birchall MA, Lowdell MW, De Coppi P, Janes SM. Vacuum-assisted decellularization: an accelerated protocol to generate tissue-engineered human tracheal scaffolds. Biomaterials 2017; 124:95-105. [PMID: 28189871 PMCID: PMC5332556 DOI: 10.1016/j.biomaterials.2017.02.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/30/2017] [Accepted: 02/01/2017] [Indexed: 12/22/2022]
Abstract
Patients with large tracheal lesions unsuitable for conventional endoscopic or open operations may require a tracheal replacement but there is no present consensus of how this may be achieved. Tissue engineering using decellularized or synthetic tracheal scaffolds offers a new avenue for airway reconstruction. Decellularized human donor tracheal scaffolds have been applied in compassionate-use clinical cases but naturally derived extracellular matrix (ECM) scaffolds demand lengthy preparation times. Here, we compare a clinically applied detergent-enzymatic method (DEM) with an accelerated vacuum-assisted decellularization (VAD) protocol. We examined the histological appearance, DNA content and extracellular matrix composition of human donor tracheae decellularized using these techniques. Further, we performed scanning electron microscopy (SEM) and biomechanical testing to analyze decellularization performance. To assess the biocompatibility of scaffolds generated using VAD, we seeded scaffolds with primary human airway epithelial cells in vitro and performed in vivo chick chorioallantoic membrane (CAM) and subcutaneous implantation assays. Both DEM and VAD protocols produced well-decellularized tracheal scaffolds with no adverse mechanical effects and scaffolds retained the capacity for in vitro and in vivo cellular integration. We conclude that the substantial reduction in time required to produce scaffolds using VAD compared to DEM (approximately 9 days vs. 3–8 weeks) does not compromise the quality of human tracheal scaffold generated. These findings might inform clinical decellularization techniques as VAD offers accelerated scaffold production and reduces the associated costs.
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Affiliation(s)
- Colin R Butler
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK; Stem Cell and Regenerative Medicine Section, UCL Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - Robert E Hynds
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Claire Crowley
- Stem Cell and Regenerative Medicine Section, UCL Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - Kate H C Gowers
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Leanne Partington
- Department of Haematology, Royal Free Hospital and University College London, London, UK
| | - Nicholas J Hamilton
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Carla Carvalho
- Department of Haematology, Royal Free Hospital and University College London, London, UK
| | - Manuela Platé
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - Edward R Samuel
- Stem Cell and Regenerative Medicine Section, UCL Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - Alan J Burns
- Stem Cell and Regenerative Medicine Section, UCL Institute of Child Health and Great Ormond Street Hospital, London, UK; Department of Clinical Genetics, Erasmus MC, Rotterdam, Netherlands
| | - Luca Urbani
- Stem Cell and Regenerative Medicine Section, UCL Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - Martin A Birchall
- UCL Ear Institute, The Royal National Throat Nose and Ear Hospital, London, UK
| | - Mark W Lowdell
- Department of Haematology, Royal Free Hospital and University College London, London, UK
| | - Paolo De Coppi
- Stem Cell and Regenerative Medicine Section, UCL Institute of Child Health and Great Ormond Street Hospital, London, UK.
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
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33
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34
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Yan B, Zhang Z, Wang X, Ni Y, Liu Y, Liu T, Wang W, Xing H, Sun Y, Wang J, Li XF. PLGA-PTMC-Cultured Bone Mesenchymal Stem Cell Scaffold Enhances Cartilage Regeneration in Tissue-Engineered Tracheal Transplantation. Artif Organs 2016; 41:461-469. [PMID: 27925229 DOI: 10.1111/aor.12805] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 06/14/2016] [Accepted: 06/14/2016] [Indexed: 01/19/2023]
Abstract
The treatment of long-segment tracheal defect requires the transplantation of effective tracheal substitute, and the tissue-engineered trachea (TET) has been proposed as an ideal tracheal substitute. The major cause of the failure of segmental tracheal defect reconstruction by TET is airway collapse caused by the chondromalacia of TET cartilage. The key to maintain the TET structure is the regeneration of chondrocytes in cartilage, which can secrete plenty of cartilage matrices. To address the problem of the chondromalacia of TET cartilage, this study proposed an improved strategy. We designed a new cell sheet scaffold using the poly(lactic-co-glycolic acid) (PLGA) and poly(trimethylene carbonate) (PTMC) to make a porous membrane for seeding cells, and used the PLGA-PTMC cell-scaffold to pack the decellularized allogeneic trachea to construct a new type of TET. The TET was then implanted in the subcutaneous tissue for vascularization for 2 weeks. Orthotopic transplantation was then performed after implantation. The efficiency of the TET we designed was analyzed by histological examination and biomechanical analyses 4 weeks after surgery. Four weeks after surgery, both the number of chondrocytes and the amount of cartilage matrix were significantly higher than those contained in the traditional stem-cell-based TET. Besides, the coefficient of stiffness of TET was significantly larger than the traditional TET. This study provided a promising approach for the long-term functional reconstruction of long-segment tracheal defect, and the TET we designed had potential application prospects in the field of TET reconstruction.
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Affiliation(s)
- Bingyang Yan
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Zhipei Zhang
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Xiaoping Wang
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Yunfeng Ni
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Yongshi Liu
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Tao Liu
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Wuping Wang
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Hao Xing
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Ying Sun
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jian Wang
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Xiao-Fei Li
- Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
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35
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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: 53] [Impact Index Per Article: 6.6] [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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36
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Oberbauer E, Steffenhagen C, Wurzer C, Gabriel C, Redl H, Wolbank S. Enzymatic and non-enzymatic isolation systems for adipose tissue-derived cells: current state of the art. CELL REGENERATION (LONDON, ENGLAND) 2015; 4:7. [PMID: 26435835 PMCID: PMC4591586 DOI: 10.1186/s13619-015-0020-0] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/23/2015] [Indexed: 02/07/2023]
Abstract
In the past decade, adipose tissue became a highly interesting source of adult stem cells for plastic surgery and regenerative medicine. The isolated stromal vascular fraction (SVF) is a heterogeneous cell population including the adipose-derived stromal/stem cells (ASC), which showed regenerative potential in several clinical studies and trials. SVF should be provided in a safe and reproducible manner in accordance with current good manufacturing practices (cGMP). To ensure highest possible safety for patients, a precisely defined procedure with a high-quality control is required. Hence, an increasing number of adipose tissue-derived cell isolation systems have been developed. These systems aim for a closed, sterile, and safe isolation process limiting donor variations, risk for contaminations, and unpredictability of the cell material. To isolate SVF from adipose tissue, enzymes such as collagenase are used. Alternatively, in order to avoid enzymes, isolation systems using physical forces are available. Here, we provide an overview of known existing enzymatic and non-enzymatic adipose tissue-derived cell isolation systems, which are patented, published, or already on the market.
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Affiliation(s)
- Eleni Oberbauer
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Carolin Steffenhagen
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Christoph Wurzer
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Christian Gabriel
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
- Red Cross Blood Transfusion Service of Upper Austria, Linz, Austria
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Susanne Wolbank
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Center, Linz/Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
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37
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Weiss DJ, Elliott M, Jang Q, Poole B, Birchall M. Tracheal bioengineering: the next steps. Proceeds of an International Society of Cell Therapy Pulmonary Cellular Therapy Signature Series Workshop, Paris, France, April 22, 2014. Cytotherapy 2014; 16:1601-13. [PMID: 25457172 DOI: 10.1016/j.jcyt.2014.10.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/29/2014] [Accepted: 10/30/2014] [Indexed: 11/15/2022]
Abstract
There has been significant and exciting recent progress in the development of bioengineering approaches for generating tracheal tissue that can be used for congenital and acquired tracheal diseases. This includes a growing clinical experience in both pediatric and adult patients with life-threatening tracheal diseases. However, not all of these attempts have been successful, and there is ongoing discussion and debate about the optimal approaches to be used. These include considerations of optimal materials, particularly use of synthetic versus biologic scaffolds, appropriate cellularization of the scaffolds, optimal surgical approaches and optimal measure of both clinical and biologic outcomes. To address these issues, the International Society of Cell Therapy convened a first-ever meeting of the leading clinicians and tracheal biologists, along with experts in regulatory and ethical affairs, to discuss and debate the issues. A series of recommendations are presented for how to best move the field ahead.
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Affiliation(s)
- Daniel J Weiss
- Department of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Martin Elliott
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, United Kingdom
| | - Queenie Jang
- International Society for Cell Therapy, Vancouver, British Columbia, Canada
| | - Brian Poole
- International Society for Cell Therapy, Vancouver, British Columbia, Canada
| | - Martin Birchall
- Royal National Throat Nose, and Ear Hospital and University College London, London, United Kingdom.
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