Elastomeric core/shell nanofibrous cardiac patch as a biomimetic support for infarcted porcine myocardium

Fundamental characteristics of ultrasonic green formulations using Avena sativa L. extract-mediated gold nanoparticles and electroconductive nanofibers for cardiovascular nursing care

In the pursuit of novel approaches to address chronic heart failure and enhance cardiovascular nursing care, environmentally sustainable nanomaterials have taken center stage. Recent progress in regenerative medicine has opened doors for the use of biocompatible biomaterials that provide mechanical support to damaged heart tissue and facilitate electrical signaling. This study was dedicated to developing advanced electroconductive nanofibers by incorporating eco-friendly Avena sativa L. extract-mediated gold nanoparticles (AuNPs) into polyaniline to create an intricate cardiac patch. The AuNPs were synthesized through an environmentally friendly chemical process aided by ultrasonic conditions. Comprehensive physicochemical analyses, such as UV-Vis spectroscopy, SEM, TEM, DPPH assay, and XRD, were carried out to characterize the AuNPs. These AuNPs were then blended with a polycaprolactone/gelatin polymeric solution and electrospun to fabricate cardiac patches, which underwent thorough evaluation using various techniques. The resulting cardiac patch demonstrated excellent hemocompatibility, antioxidant properties, and cytocompatibility, offering a promising therapeutic approach for myocardial infarctions and the advancement of cardiovascular nursing care.

Therapeutic applications of exosomes in various diseases: A review

Exosomes (30-150 nm in diameter) a subset of extracellular vesicles, secreted by mostly all cells, have been gaining enormous recognition from the last decade. In recent times, several studies have included exosomes to design novel therapeutic applications along with their contribution to diagnostic evaluations and pathophysiological processes. Based on cell origin, they show diverse functions and characteristics. This article is classified into several sections that include exosomes biogenesis, isolation methods, and application as therapeutic tools, commercialized exosome products, clinical trials, benefits, and challenges faced in the progress of exosome-dependent therapeutics. This work aims to give a thorough review of the numerous studies where exosomes act as therapeutic tools in the treatment of various disorders including heart, kidney, liver, and lung illnesses. The clinical trials involving exosomes, their advantages, and hazards, and difficulties involved during storage and large-scale production, applications of nanotechnology in exosome research while applying for therapeutic applications, and future directions are summarized.

Biomaterials-based Approaches for Cardiac Regeneration

Cardiovascular disease is a prevalent cause of mortality and morbidity, largely due to the limited ability of cardiomyocytes to proliferate. Existing therapies for cardiac regeneration include cell-based therapies and bioactive molecules. However, delivery remains one of the major challenges impeding such therapies from having significant clinical impact. Recent advancements in biomaterials-based approaches for cardiac regeneration have shown promise in improving cardiac function, promoting angiogenesis, and reducing adverse immune response in both human clinical trials and animal studies. These advances in therapeutic delivery via extracellular vesicles, cardiac patches, and hydrogels have the potential to enable clinical impact of cardiac regeneration therapies.

The limited ability of cardiomyocytes to proliferate is a major cause of mortality and morbidity in cardiovascular diseases. There exist therapies for cardiac regeneration that are cell-based as well as that involve bioactive molecules. However, delivery remains one of the major challenges impeding such therapies from having clinical impact. Recent advancements in biomaterials-based approaches for cardiac regeneration have shown promise in clinical trials and animal studies in improving cardiac function, promoting angiogenesis, and reducing adverse immune response. This review will focus on current clinical studies of three contemporary biomaterials-based approaches for cardiac regeneration (extracellular vesicles, injectable hydrogels, and cardiac patches), remaining challenges and shortcomings to be overcome, and future directions for the use of biomaterials to promote cardiac regeneration.

Adhesive Tissue Engineered Scaffolds: Mechanisms and Applications

A variety of suture and bioglue techniques are conventionally used to secure engineered scaffold systems onto the target tissues. These techniques, however, confront several obstacles including secondary damages, cytotoxicity, insufficient adhesion strength, improper degradation rate, and possible allergic reactions. Adhesive tissue engineering scaffolds (ATESs) can circumvent these limitations by introducing their intrinsic tissue adhesion ability. This article highlights the significance of ATESs, reviews their key characteristics and requirements, and explores various mechanisms of action to secure the scaffold onto the tissue. We discuss the current applications of advanced ATES products in various fields of tissue engineering, together with some of the key challenges for each specific field. Strategies for qualitative and quantitative assessment of adhesive properties of scaffolds are presented. Furthermore, we highlight the future prospective in the development of advanced ATES systems for regenerative medicine therapies.

Poly(Glycerol Sebacate) in Biomedical Applications-A Review of the Recent Literature

Poly(glycerol sebacate) (PGS) continues to attract attention for biomedical applications owing to its favorable combination of properties. Conventionally polymerized by a two-step polycondensation of glycerol and sebacic acid, variations of synthesis parameters, reactant concentrations or by specific chemical modifications, PGS materials can be obtained exhibiting a wide range of physicochemical, mechanical, and morphological properties for a variety of applications. PGS has been extensively used in tissue engineering (TE) of cardiovascular, nerve, cartilage, bone and corneal tissues. Applications of PGS based materials in drug delivery systems and wound healing are also well documented. Research and development in the field of PGS continue to progress, involving mainly the synthesis of modified structures using copolymers, hybrid, and composite materials. Moreover, the production of self-healing and electroactive materials has been introduced recently. After almost 20 years of research on PGS, previous publications have outlined its synthesis, modification, properties, and biomedical applications, however, a review paper covering the most recent developments in the field is lacking. The present review thus covers comprehensively literature of the last five years on PGS-based biomaterials and devices focusing on advanced modifications of PGS for applications in medicine and highlighting notable advances of PGS based systems in TE and drug delivery.

Role of Block Copolymers in Tissue Engineering Applications

Research on synthesis, characterization, and understanding of novel properties of nanomaterials has led researchers to exploit their potential applications. When compared to other nanotechnologies described in the literature, electrospinning has received significant interest due to its ability to synthesize novel nanostructures (such as nanofibers, nanorods, nanotubes, etc.) with distinctive properties such as high surface-to-volume ratio, porosity, various morphologies such as fibers, tubes, ribbons, mesoporous and coated structures, and so on. Various materials such as polymers, ceramics, and composites have been fabricated using the electrospinning technique. Among them, polymers, especially block copolymers, are one of the useful and niche systems studied recently owing to their unique and fascinating properties in both solution and solid state due to thermodynamic incompatibility of the blocks, that results in microphase separation. Morphology and mechanical properties of electrospun block copolymers are intensely influenced by quantity and length of soft and hard segments. They are one of the best studied systems to fit numerous applications due to a broad variety of properties they display upon varying the composition ratio and molecular weight of blocks. In this review, the synthesis, fundamentals, electrospinning, and tissue engineering application of block copolymers are highlighted.

Designing Biomaterial Platforms for Cardiac Tissue and Disease Modeling

Heart disease is one of the leading causes of death in the world. There is a growing demand for in vitro cardiac models that can recapitulate the complex physiology of the cardiac tissue. These cardiac models can provide a platform to better understand the underlying mechanisms of cardiac development and disease and aid in developing novel treatment alternatives and platforms towards personalized medicine. In this review, a summary of engineered cardiac platforms is presented. Basic design considerations for replicating the heart's microenvironment are discussed considering the anatomy of the heart. This is followed by a detailed summary of the currently available biomaterial platforms for modeling the heart tissue in vitro. These in vitro models include 2D surface modified structures, 3D molded structures, porous scaffolds, electrospun scaffolds, bioprinted structures, and heart-on-a-chip devices. The challenges faced by current models and the future directions of in vitro cardiac models are also discussed. Engineered in vitro tissue models utilizing patients' own cells could potentially revolutionize the way we develop treatment and diagnostic alternatives.

Influence of pre-polymerisation atmosphere on the properties of pre- and poly(glycerol sebacate)

Poly(glycerol sebacate) (PGS) is a versatile biodegradable biomaterial on account of its adjustable mechanical properties as an elastomeric polyester. Nevertheless, it has shown dissimilar results when synthesised by different research groups under equivalent synthesis conditions. This lack of reproducibility proves how crucial it is to understand the effect of the parameters involved on its manufacturing and characterize the polymer networks obtained. Several studies have been conducted in recent years to understand the role of temperature, time, and the molar ratio of its monomers, while the influence of the atmosphere applied during its pre-polymerisation remained unknown. The results obtained here allow for a better understanding about the effect of inert (Ar and N₂) and oxidative (oxygen, dry air, and humid air) atmospheres on the extent of the reaction. The molecular pattern of intermediate pre-polymers and the gelation time and morphology of their corresponding cured PGS networks were studied as well. Overall, inert atmospheres promote a rather linear growth of macromers, with scarce branches, resulting in loose elastomers with long chains mainly crosslinked. Conversely, oxygen in the latter atmospheres promotes branching through secondary hydroxyl groups, leading to less-crosslinked 'defective' networks. In this way, the pre-polymerisation atmosphere could be used advantageously to adjust the reactivity of secondary hydroxyls, in order to modulate branching in the elastomeric PGS networks obtained to suit the properties required in a particular application.

Current advances in biodegradable synthetic polymer based cardiac patches

The number of people affected by heart disease such as coronary artery disease and myocardial infarction increases at an alarming rate each year. Currently, the methods to treat these diseases are restricted to lifestyle change, pharmaceuticals, and eventually heart transplant if the condition is severe enough. While these treatment options are the standard for caring for patients who suffer from heart disease, limited regenerative ability of the heart restricts the effectiveness of treatment and may lead to other heart-related health problems in the future. Because of the increasing need for more effective therapeutic technologies for treating diseased heart tissue, cardiac patches are now a large focus for researchers. The cardiac patches are designed to be integrated into the patients' natural tissue to introduce mechanical support and healing to the damaged areas. As a promising alternative, synthetic biodegradable polymer based biomaterials can be easily manipulated to customize material properties, as well as possess certain desired characteristics for cardiac patch use. This comprehensive review summarizes recent works on synthetic biodegradable cardiac patches implanted into infarcted animal models. In addition, this review describes the basic requirements that should be met for cardiac patch development, and discusses the inspirations to designing new biomaterials and technologies for cardiac patches.

A Comprehensive Review on Bio-Nanomaterials for Medical Implants and Feasibility Studies on Fabrication of Such Implants by Additive Manufacturing Technique

Nanomaterials have allowed significant breakthroughs in bio-engineering and medical fields. In the present paper a holistic assessment on diverse biocompatible nanocomposites are studied. Their compatibility with advanced fabrication methods such as additive manufacturing for the design of functional medical implants is also critically reviewed. The significance of nanocomposites and processing techniques is also envisaged comprehensively in regard with the needs and futures of implantable medical device industries.

Coatings Releasing the Relaxin Peptide Analogue B7-33 Reduce Fibrotic Encapsulation

The development of antifibrotic materials and coatings that can resist the foreign body response (FBR) continues to present a major hurdle in the advancement of current and next-generation implantable medical devices, biosensors, and cell therapies. From an implant perspective, the most important issue associated with the FBR is the prolonged inflammatory response leading to a collagenous capsule that ultimately blocks mass transport and communication between the implant and the surrounding tissue. Up to now, most attempts to reduce the capsule thickness have focused on providing surface coatings that reduce protein fouling and cell attachment. Here, we present an approach that is based on the sustained release of a peptide drug interfering with the FBR. In this study, the biodegradable polymer poly(lactic-co-glycolic) acid (PLGA) was used as a coating releasing the relaxin peptide analogue B7-33, which has been demonstrated to reduce organ fibrosis in animal models. While in vitro protein quantification was used to demonstrate controlled release of the antifibrotic peptide B7-33 from PLGA coatings, an in vitro reporter cell assay was used to demonstrate that B7-33 retains activity against the relaxin family peptide receptor 1 (RXFP1). Subcutaneous implantation of PLGA-coated polypropylene samples in mice with and without the peptide demonstrated a marked reduction in capsule thickness (49.2%) over a 6 week period. It is expected that this novel approach will open the door to a range of new and improved implantable medical devices.

Functional Protein-Based Bioinspired Nanomaterials: From Coupled Proteins, Synthetic Approaches, Nanostructures to Applications

Protein-based bioinspired nanomaterials (PBNs) combines the advantage of the size, shape, and surface chemistry of nanomaterials, the morphology and functions of natural materials, and the physical and chemical properties of various proteins. Recently, there are many exciting developments on biomimetic nanomaterials using proteins for different applications including, tissue engineering, drug delivery, diagnosis and therapy, smart materials and structures, and water collection and separation. Protein-based biomaterials with high biocompatibility and biodegradability could be modified to obtain the healing effects of natural organisms after injury by mimicking the extracellular matrix. For cancer and other diseases that are difficult to cure now, new therapeutic methods involving different kinds of biomaterials are studied. The nanomaterials with surface modification, which can achieve high drug loading, can be used as drug carriers to enhance target and trigger deliveries. For environment protection and the sustainability of the world, protein-based nanomaterials are also applied for water treatment. A wide range of contaminants from natural water source, such as organic dyes, oil substances, and multiple heavy ions, could be absorbed by protein-based nanomaterials. This review summarizes the formation and application of functional PBNs, and the details of their nanostructures, the proteins involved, and the synthetic approaches are addressed.

Exploring platelet lysate hydrogel-coated suture threads as biofunctional composite living fibers for cell delivery in tissue repair

To engineer functional tissue substitutes, it is required a multi-component, multi-scale approach that combines both physical, chemical and biological cues. Fiber-based techniques have been explored in the field of tissue engineering to produce structures recapitulating tissue architecture and mechanical properties. In this work, we engineered biofunctional composite living fibers (CLF) as multi-compartment fibers with a mechanically competent core and a hydrogel layer. For this purpose, commercial silk suture threads were coated with a platelet lysate (PL) hydrogel by first embedding the threads in a thrombin solution and then incubating in PL. The fabrication set-up was optimized and the biological performance was studied by encapsulating human adipose-derived stem cells (hASCs). The developed coating process rendered CLF with a homogenous PL hydrogel layer covering suture threads. Encapsulated hASCs were viable up to 14 d in culture and were able to align at the surface of the core fiber and deposit collagen types I and III. In summary, the study shows that PL-hASCs hydrogel coated suture threads represent a simple multi-compartment and multifunctional system, with PL hydrogel offering biofunctionality to guide the biological activities of encapsulated cells in addition to the replication of tissue-level mechanical support provided by the suture threads.

Evaluating the efficacy of tissue-engineered human amniotic membrane in the treatment of myocardial infarction

AIM

The aim of this study was to evaluate the efficacy of tissue-engineered amniotic membrane (AM) in the treatment of myocardial infarction lesions.

MATERIALS & METHODS

20 rats were subjected to coronary arterial ligation in order to induce myocardial infarction injury. Decellularized human AMs were seeded with 2 × 10⁵ adipose-derived mesenchymal stem cells and were implanted in the infarcted hearts.

RESULTS & CONCLUSION

Histological and immunohistochemical evaluations indicated the regeneration of cardiomyocytes and reduction of inflammation and fibrosis in the patch-implanted group compared with a control group, 14 days after the surgery. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate biotin nick-end labeling assay was suggestive for apoptosis reduction in the patch-implanted specimens. This study suggested that human AM can be developed into a novel treatment for treating postmyocardial infarction.

Functionally Improved Mesenchymal Stem Cells to Better Treat Myocardial Infarction

Myocardial infarction (MI) is one of the leading causes of death worldwide. Mesenchymal stem cell (MSC) transplantation is considered a promising approach and has made significant progress in preclinical studies and clinical trials for treating MI. However, hurdles including poor survival, retention, homing, and differentiation capacity largely limit the therapeutic effect of transplanted MSCs. Many strategies such as preconditioning, genetic modification, cotransplantation with bioactive factors, and tissue engineering were developed to improve the survival and function of MSCs. On the other hand, optimizing the hostile transplantation microenvironment of the host myocardium is also of importance. Here, we review the modifications of MSCs as well as the host myocardium to improve the efficacy of MSC-based therapy against MI.

Analysis of structure and properties of antibacterial vascular patch used in abdominal aorta aneurysm surgeries

BACKGROUND

Biocompatible materials are used for treatment of blood circulatory system diseases, especially abdominal aortic aneurysms. The most popular and often used are knitted and polymer vascular patches. The aim of this study was to optimize the manufacturing process of implantable materials, ensuring antibacterial activity useful for treating abdominal aorta aneurysms.

METHODS

The vascular patch was manufactured from Trevira® yarn. The parameters of the intermediate product and vascular patch were tested according to standard procedures.

RESULTS

The vascular patch, manufactured from microsilver-containing yarn, with crimps on the surface of the patch, has been found useful for treatment of abdominal aorta aneurysms. Introducing crimps on the surface of the patch resulted in reduction of water permeability and enabled cutting of the graft at various angles without fraying at the cut ends of the biomaterial. The final vascular patch was marked by a gradual release of silver within 48 hours.

CONCLUSIONS

On the basis of the performed test, it has been demonstrated that an implantable material for the treatment of abdominal aorta aneurysms was obtained, and that it can be considered as an alternative for currently used vascular patches. The final vascular patch was marked by a gradual release of silver during the first period of incubation. The antibacterial properties of the final product were confirmed by observation of a significant reduction in the number of Staphylococcus aureus and Klebsiella pneumoniae bacterial colonies.

Mesenchymal Stem Cell-Based Therapy for Cardiovascular Disease: Progress and Challenges

Administration of mesenchymal stem cells (MSCs) to diseased hearts improves cardiac function and reduces scar size. These effects occur via the stimulation of endogenous repair mechanisms, including regulation of immune responses, tissue perfusion, inhibition of fibrosis, and proliferation of resident cardiac cells, although rare events of transdifferentiation into cardiomyocytes and vascular components are also described in animal models. While these improvements demonstrate the potential of stem cell therapy, the goal of full cardiac recovery has yet to be realized in either preclinical or clinical studies. To reach this goal, novel cell-based therapeutic approaches are needed. Ongoing studies include cell combinations, incorporation of MSCs into biomaterials, or pre-conditioning or genetic manipulation of MSCs to boost their release of paracrine factors, such as exosomes, growth factors, microRNAs, etc. All of these approaches can augment therapeutic efficacy. Further study of the optimal route of administration, the correct dose, the best cell population(s), and timing for treatment are parameters that still need to be addressed in order to achieve the goal of complete cardiac regeneration. Despite significant progress, many challenges remain.

Fibers for hearts: A critical review on electrospinning for cardiac tissue engineering

Cardiac cell therapy holds a real promise for improving heart function and especially of the chronically failing myocardium. Embedding cells into 3D biodegradable scaffolds may better preserve cell survival and enhance cell engraftment after transplantation, consequently improving cardiac cell therapy compared with direct intramyocardial injection of isolated cells. The primary objective of a scaffold used in tissue engineering is the recreation of the natural 3D environment most suitable for an adequate tissue growth. An important aspect of this commitment is to mimic the fibrillar structure of the extracellular matrix, which provides essential guidance for cell organization, survival, and function. Recent advances in nanotechnology have significantly improved our capacities to mimic the extracellular matrix. Among them, electrospinning is well known for being easy to process and cost effective. Consequently, it is becoming increasingly popular for biomedical applications and it is most definitely the cutting edge technique to make scaffolds that mimic the extracellular matrix for industrial applications. Here, the desirable physico-chemical properties of the electrospun scaffolds for cardiac therapy are described, and polymers are categorized to natural and synthetic.Moreover, the methods used for improving functionalities by providing cells with the necessary chemical cues and a more in vivo-like environment are reported.

Tissue Engineering Strategies for Myocardial Regeneration: Acellular Versus Cellular Scaffolds?

Heart disease remains one of the leading causes of death in industrialized nations with myocardial infarction (MI) contributing to at least one fifth of the reported deaths. The hypoxic environment eventually leads to cellular death and scar tissue formation. The scar tissue that forms is not mechanically functional and often leads to myocardial remodeling and eventual heart failure. Tissue engineering and regenerative medicine principles provide an alternative approach to restoring myocardial function by designing constructs that will restore the mechanical function of the heart. In this review, we will describe the cellular events that take place after an MI and describe current treatments. We will also describe how biomaterials, alone or in combination with a cellular component, have been used to engineer suitable myocardium replacement constructs and how new advanced culture systems will be required to achieve clinical success.

Multi-functional electrospun nanofibres for advances in tissue regeneration, energy conversion & storage, and water treatment

This Tutorial Review focuses on recent applications of electrospun materials in tissue regeneration, energy conversion & storage, and water treatment areas.

Biomimetic approaches for cell implantation to the restoration of infarcted myocardium

Compelling evidences accumulated over the years have proven stem cells as a promising source for regenerative medicine. However, the inadequacy with the design of delivery modalities has prolonged the research in realizing an ideal cell-based approach for the regeneration of infarcted myocardium. Currently, some modest improvements in cardiac function have been documented in clinical trials with stem cell treatments, although regenerating a fully functional myocardium remains a dream for cardiac surgeons. This review provides an overview on the significance of stem cell therapy, the current attempts to resolve the drawbacks with the cell implantation approach and the various stratagems adopted with electrospun hybrid nanofibers for implementation in myocardial regenerative therapy.