Hydrogel-electrospun mesh composites for coronary artery bypass grafts

Nonlinear Elasticity of Blood Vessels and Vascular Grafts

The transplantation of vascular grafts has emerged as a prevailing approach to address vascular disorders. However, the development of small-diameter vascular grafts is still in progress, as they serve in a more complicated mechanical environment than their counterparts with larger diameters. The biocompatibility and functional characteristics of small-diameter vascular grafts have been well developed; however, mismatch in mechanical properties between the vascular grafts and native arteries has not been accomplished, which might facilitate the long-term patency of small-diameter vascular grafts. From a point of view in mechanics, mimicking the nonlinear elastic mechanical behavior exhibited by natural blood vessels might be the state-of-the-art in designing vascular grafts. This review centers on elucidating the nonlinear elastic behavior of natural blood vessels and vascular grafts. The biological functionality and limitations associated with as-reported vascular grafts are meticulously reviewed and the future trajectory for fabricating biomimetic small-diameter grafts is discussed. This review might provide a different insight from the traditional design and fabrication of artificial vascular grafts.

New dimensions of electrospun nanofiber material designs for biotechnological uses

Electrospinning technology has garnered wide attention over the past few decades in various biomedical applications including drug delivery, cell therapy, and tissue engineering. This technology can create nanofibers with tunable fiber diameters and functionalities. However, the 2D membrane nature of the nanofibers, as well as the rigidity and low porosity of electrospun fibers, lower their efficacy in tissue repair and regeneration. Recently, new avenues have been explored to resolve the challenges associated with 2D electrospun nanofiber membranes. This review discusses recent trends in creating different electrospun nanofiber microstructures from 2D nanofiber membranes by using various post-processing methods, as well as their biotechnological applications.

3D Polycaprolactone/Gelatin-Oriented Electrospun Scaffolds Promote Periodontal Regeneration

Periodontitis is a worldwide chronic inflammatory disease, where surgical treatment still shows an uncertain prognosis. To break through the dilemma of periodontal treatment, we fabricated a three-dimensional (3D) multilayered scaffold by stacking and fixing electrospun polycaprolactone/gelatin (PCL/Gel) fibrous membranes. The biomaterial displayed good hydrophilic and mechanical properties. Besides, we found human periodontal ligament stem cell (hPDLSC) adhesion and proliferation on it. The following scanning electron microscopy (SEM) and cytoskeleton staining results proved the guiding function of fibers to hPDLSCs. Then, we further analyzed periodontal regeneration-related proteins and mRNA expression between groups. In vivo results in a rat acute periodontal defect model confirmed that the topographic cues of materials could directly guide cellular orientation and might provide the prerequisite for further differentiation. In the aligned scaffold group, besides new bone regeneration, we also observed that angular concentrated fiber regeneration in the root surface of the defect is similar to the normal periodontal tissue. To sum up, we have constructed electrospun membrane-based 3D biological scaffolds, which provided a new treatment strategy for patients undergoing periodontal surgery.

The Construction of Biologically Relevant Fiber-Reinforced Hydrogel Geometries Using Air-Assisted Dual-Polarity Electrospinning

Fiber-reinforced hydrogels are a class of soft composite materials that has seen increased use across a wide variety of biomedical applications. However, existing fabrication techniques for these hydrogels are unable to realize biologically relevant macro/meso-scale geometries. To address this limitation, this paper presents a novel air-assisted, dual-polarity electrospinning printhead that converges high-strength electric fields, with low velocity air flow to remove the collector dependency seen with traditional far-field electrospinning setups. The use of this printhead, in conjunction with different configurations of deformable collection templates has resulted in the production of three classes of fiber-reinforced hydrogel prototype geometries, viz. (i) tubular geometries with bifurcations and meso-scale texturing; (ii) hollow, non-tubular geometries with single and dual-entrances; and (iii) 3D printed flat geometries with varying fiber density. All three classes of prototype geometries were mechanically characterized to have properties that were in line with those observed in living soft tissues. With the realization of this printhead, biologically relevant macro/meso-scale geometries can be realized using fiber-reinforced hydrogels to aid a wide array of biomedical applications.

Marrying the incompatible for better: Incorporation of hydrophobic payloads in superhydrophilic hydrogels

HYPOTHESIS

The entrapment of lyophobic in superhydrophilic hydrogels is challenging because of the intrinsic incompatibility between hydrophobic and hydrophilic molecules. To achieve such entrapment without affecting the hydrogel's formation, the electrospinning of nanodroplets or nanoparticles with a water-soluble polymer could reduce the incompatibility through the reduction of interfacial tension and the formation of a barrier film preventing coalescence or aggregation.

EXPERIMENTS

Nanodroplets or nanoparticles dispersion are electrospun in the presence of a hydrophilic polymer in hydrogel precursors. The dissolution of the hydrophilic nanofibers during electrospinning allows a redispersion of emulsion droplets and nanoparticles in the hydrogel's matrix.

FINDINGS

Superhydrophilic hydrogels with well-distributed hydrophobic nanodroplets or nanoparticles are obtained without detrimentally imparting the viscosity of hydrogel's precursors and the mechanical properties of the hydrogels. Compared with the incorporation of droplets without electrospinning, higher loadings of hydrophobic payload are achieved without premature leakage. This concept can be used to entrap hydrophobic agrochemicals, drugs, or antibacterial agents in simple hydrogels formulation.

3D Electrospun Nanofiber-Based Scaffolds: From Preparations and Properties to Tissue Regeneration Applications

Electrospun nanofibers have been frequently used for tissue engineering due to their morphological similarities with the extracellular matrix (ECM) and tunable chemical and physical properties for regulating cell behaviors and functions. However, most of the existing electrospun nanofibers have a closely packed two-dimensional (2D) membrane with the intrinsic shortcomings of limited cellular infiltration, restricted nutrition diffusion, and unsatisfied thickness. Three-dimensional (3D) electrospun nanofiber-based scaffolds can provide stem cells with 3D microenvironments and biomimetic fibrous structures. Thus, they have been demonstrated to be good candidates for in vivo repair of different tissues. This review summarizes the recent developments in 3D electrospun nanofiber-based scaffolds (ENF-S) for tissue engineering. Three types of 3D ENF-S fabricated using different approaches classified into electrospun nanofiber 3D scaffolds, electrospun nanofiber/hydrogel composite 3D scaffolds, and electrospun nanofiber/porous matrix composite 3D scaffolds are discussed. New functions for these 3D ENF-S and properties, such as facilitated cell infiltration, 3D fibrous architecture, enhanced mechanical properties, and tunable degradability, meeting the requirements of tissue engineering scaffolds were discovered. The applications of 3D ENF-S in cartilage, bone, tendon, ligament, skeletal muscle, nerve, and cardiac tissue regeneration are then presented with a discussion of current challenges and future directions. Finally, we give summaries and future perspectives of 3D ENF-S in tissue engineering and clinical transformation.

Biofabrication of tissue engineering vascular systems

Cardiovascular disease (CVD) is the leading cause of death among persons aged 65 and older in the United States and many other developed countries. Tissue engineered vascular systems (TEVS) can serve as grafts for CVD treatment and be used as in vitro model systems to examine the role of various genetic factors during the CVD progressions. Current focus in the field is to fabricate TEVS that more closely resembles the mechanical properties and extracellular matrix environment of native vessels, which depends heavily on the advance in biofabrication techniques and discovery of novel biomaterials. In this review, we outline the mechanical and biological design requirements of TEVS and explore the history and recent advances in biofabrication methods and biomaterials for tissue engineered blood vessels and microvascular systems with special focus on in vitro applications. In vitro applications of TEVS for disease modeling are discussed.

Recent Advances in Fiber-Hydrogel Composites for Wound Healing and Drug Delivery Systems

In the last decades, much research has been done to fasten wound healing and target-direct drug delivery. Hydrogel-based scaffolds have been a recurrent solution in both cases, with some reaching already the market, even though their mechanical stability remains a challenge. To overcome this limitation, reinforcement of hydrogels with fibers has been explored. The structural resemblance of fiber-hydrogel composites to natural tissues has been a driving force for the optimization and exploration of these systems in biomedicine. Indeed, the combination of hydrogel-forming techniques and fiber spinning approaches has been crucial in the development of scaffolding systems with improved mechanical strength and medicinal properties. In this review, a comprehensive overview of the recently developed fiber-hydrogel composite strategies for wound healing and drug delivery is provided. The methodologies employed in fiber and hydrogel formation are also highlighted, together with the most compatible polymer combinations, as well as drug incorporation approaches creating stimuli-sensitive and triggered drug release towards an enhanced host response.

Mechanical Assessment and Hyperelastic Modeling of Polyurethanes for the Early Stages of Vascular Graft Design

The material design of vascular grafts is required for their application in the health sector. The use of polyurethanes (PUs) in vascular grafts intended for application in the body appears to be adequate due to the fact that native tissues have similar properties as PUs. However, the influence of chemical structure on the biomechanics of PUs remains poorly described. The use of constitutive models, together with numerical studies, is a powerful tool for evaluating the mechanical behavior of materials under specific physiological conditions. Therefore, the aim of this study was to assess the mechanical properties of different PU mixtures formed by polycaprolactone diol, polyethylene glycol, and pentaerythritol using uniaxial tensile, strain sweep, and multistep creep-recovery tests. Evaluations of the properties were also recorded after samples had been soaked in phosphate-buffer saline (PBS) to simulate physiological conditions. A hyperelastic model based on the Mooney–Rivlin strain density function was employed to model the performance of PUs under physiological pressure and geometry conditions. The results show that the inclusion of polyethylene glycol enhanced viscous flow, while polycaprolactone diol increased the elastic behavior. Furthermore, tensile tests revealed that hydration had an important effect on the softening phenomenon. Additionally, after the hydration of PUs, the ultimate strength was similar to those reported for other vascular conduits. Lastly, hyperelastic models revealed that the compliance of the PUs showed a cyclic behavior within the tested time and pressure conditions and is affected by the material composition. However, the compliance was not affected by the geometry of the materials. These tests demonstrate that the materials whose compositions are 5–90–5 and 46.3–46.3–7.5 could be employed in the designs of vascular grafts for medical applications since they present the largest value of compliance, ultimate strength, and elongation at break in the range of reported blood vessels, thus indicating their suitability. Moreover, the polyurethanes were revealed to undergo softening after hydration, which could reduce the risk of vascular trauma.

Enhancement of the Mechanical Properties of Hydrogels with Continuous Fibrous Reinforcement

Reinforcing mechanically weak hydrogels with fibers is a promising route to obtain strong and tough materials for biomedical applications while retaining a favorable cell environment. The resulting hierarchical structure recreates structural elements of natural tissues such as articular cartilage, with fiber diameters ranging from the nano- to microscale. Through control of properties such as the fiber diameter, orientation, and porosity, it is possible to design materials which display the nonlinear, synergistic mechanical behavior observed in natural tissues. In order to fully exploit these advantages, it is necessary to understand the structure-property relationships in fiber-reinforced hydrogels. However, there are currently limited models which capture their complex mechanical properties. The majority of reported fiber-reinforced hydrogels contain fibers obtained by electrospinning, which allows for limited spatial control over the fiber scaffold and limits the scope for systematic mechanical testing studies. Nevertheless, new manufacturing techniques such as melt electrowriting and bioprinting have emerged, which allow for increased control over fiber deposition and the potential for future investigations on the effect of specific structural features on mechanical properties. In this review, we therefore explore the mechanics of fiber-reinforced hydrogels, and the evolution of their design and manufacture from replicating specific features of biological tissues to more complex structures, by taking advantage of design principles from both tough hydrogels and fiber-reinforced composites. By highlighting the overlap between these fields, it is possible to identify the remaining challenges and opportunities for the development of effective biomedical devices.

Organogel Coupled with Microstructured Electrospun Polymeric Nonwovens for the Effective Cleaning of Sensitive Surfaces

Hydrogels and organogels are widely used as cleaning materials, especially when a controlled solvent release is necessary to prevent substrate damage. This situation is often encountered in the personal care and electronic components fields and represents a challenge in restoration, where the removal of a thin layer of aged varnish from a painting may compromise the integrity of the painting itself. There is an urgent need for new and effective cleaning materials capable of controlling and limiting the use of solvents, achieving at the same time high cleaning efficacy. In this paper, new sandwich-like composites that fully address these requirements are developed by using an organogel (poly(3-hydroxybutyrate) + γ-valerolactone) in the core and two external layers of electrospun nonwovens made of continuous submicrometric fibers produced by electrospinning (either poly(vinyl alcohol) or polyamide 6,6). The new composite materials exhibit an extremely efficient cleaning action that results in the complete elimination of the varnish layer with a minimal amount of solvent adsorbed by the painting layer after the treatment. This demonstrates that the combined materials exert a superficial action that is of utmost importance to safeguard the painting. Moreover, we found that the electrospun nonwoven layers act as mechanically reinforcement components, greatly improving the bending resistance of organogels and their handling. The characterization of these innovative cleaning materials allowed us to propose a mechanism to explain their action: electrospun fibers play the leading role by slowing down the diffusion of the solvent and by conferring to the entire composite a microstructured rough superficial morphology, enabling to achieve outstanding cleaning performance.

Current challenges and future trends in manufacturing small diameter artificial vascular grafts in bioreactors

Cardiovascular diseases are a leading cause of death. Vascular surgery is mainly used to solve this problem. However, the generation of a functional and suitable substitute for small diameter (< 6 mm) displacement is challengeable. Moreover, synthetic prostheses, made of polyethylene terephthalate and extended polytetrafluoroethylene show have shown insufficient performance. Therefore, the challenges dominating the use of autografts have prevented their efficient use. Tissue engineering is highlighted in regenerative medicine perhaps in aiming to address the issue of end-stage organ failure. While organs and complex tissues require the vascular supply to support the graft survival and render the bioartificial organ role, vascular tissue engineering has shown to be a hopeful method for cell implantation by the production of tissues in vitro. Bioreactors are a salient point in vascular tissue engineering due to the capability for reproducible and controlled variations showing a new horizon in blood vessel substitution. This review strives to display the overview of current concepts in the development of small-diameter by using bioreactors. In this work, we show a critical look at different factors for developing small-diameter and give suggestions for future studies.

Novel 3D Hybrid Nanofiber Scaffolds for Bone Regeneration

Development of hybrid scaffolds and their formation methods occupies an important place in tissue engineering. In this paper, a novel method of 3D hybrid scaffold formation is presented as well as an explanation of the differences in scaffold properties, which were a consequence of different crosslinking mechanisms. Scaffolds were formed from 3D freeze-dried gelatin and electrospun poly(lactide-co-glicolide) (PLGA) fibers in a ratio of 1:1 w/w. In order to enhance osteoblast proliferation, the fibers were coated with hydroxyapatite nanoparticles (HAp) using sonochemical processing. All scaffolds were crosslinked using an EDC/NHS solution. The scaffolds' morphology was imaged using scanning electron microscopy (SEM). The chemical composition of the scaffolds was analyzed using several methods. Water absorption and mass loss investigations proved a higher crosslinking degree of the hybrid scaffolds than a pure gelatin scaffold, caused by additional interactions between gelatin, PLGA, and HAp. Additionally, mechanical properties of the 3D hybrid scaffolds were higher than traditional hydrogels. In vitro studies revealed that fibroblasts and osteoblasts proliferated and migrated well on the 3D hybrid scaffolds, and also penetrated their structure during the seven days of the experiment.

A Composite Hydrogel Scaffold Permits Self-Organization and Matrix Deposition by Cocultured Human Glomerular Cells

3D scaffolds provide cells with a spatial environment that more closely resembles that of in vivo tissue, when compared to 2D culture on a plastic substrate. However, many scaffolding materials commonly used in tissue engineering tend to exhibit anisotropic morphologies that exhibit a narrow range of fiber diameters and pore sizes, which do not recapitulate extracellular matrices. In this study, a fibrin hydrogel is formed within the interstitial spaces of an electrospun poly(glycolic) acid (PGA) monolith to generate a composite, bimodal scaffold for the coculture of kidney glomerular cell lines. This new scaffold exhibits multiple fiber morphologies, containing both PGA microfibers (14.5 ± 2 µm) and fibrin gel nanofibers (0.14 ± 0.09 µm), which increase the compressive Young's modulus beyond that of either of the constituents. The composite structure provides an enhanced 3D environment that increases proliferation and adhesion of immortalized human podocytes and glomerular endothelial cells. Moreover, the micro/nanoscale fibrous morphology promotes motility and reorganization of the glomerular cells into glomerulus-like structures, resulting in the deposition of organized collagen IV; the primary component of the glomerular basement membrane (GBM).

A direct 3D suspension near-field electrospinning technique for the fabrication of polymer nanoarrays

Near-field electrospinning (NFES) is widely recognized as a versatile nanofabrication method, one suitable for applications in tissue engineering. Rapid developments in this field have given rise to layered nanofibrous scaffolds. However, this electrostatic fabrication process is limited by the electric field inhibitory effects of polymer deposition. This leads to a major challenge: how to surpass this limitation on planar/layered constructs. While the current focus in this area largely lies with the investigation of new materials, techniques and increasing precision of NFES systems and patterning, exploration of complex collector substrates is often restricted by (i) available technology and (ii) access to complex electrode manufacturing tools. To achieve nanofiber arrays suspended in free space, this paper documents both the development of an integrated NFES system and the potential of standing electrodes manufactured via selective laser melting. This system was first tested by 2D patterning on planar silicon, using polyethylene oxide polymer solution. To demonstrate suspension NFES, two patterns operating within and around the standing electrodes produced high volume suspended nanoarrays. Image analysis of the arrays allowed for the assessment of fiber directionality and isotropy. By scanning electron microscopy, it was found that a mean fiber diameter of 310 nm of the arrays was achieved. Effectively manoeuvring between the electrode pillars required a precision automated system (unavailable off-the-shelf), developed in-house. This technique can be applied to the fabrication of nanofiber structures of sufficient volume for tissue engineering.

The quest for mechanically and biologically functional soft biomaterials via soft network composites

Developing multifunctional soft biomaterials capable of addressing all the requirements of the complex tissue regeneration process is a multifaceted problem. In order to tackle the current challenges, recent research efforts are increasingly being directed towards biomimetic design concepts that can be translated into soft biomaterials via advanced manufacturing technologies. Among those, soft network composites consisting of a continuous hydrogel matrix and a reinforcing fibrous network closely resemble native soft biological materials in terms of design and composition as well as physicochemical properties. This article reviews soft network composite systems with a particular emphasis on the design, biomaterial and fabrication aspects within the context of soft tissue engineering and drug delivery applications.

Current Strategies for the Manufacture of Small Size Tissue Engineering Vascular Grafts

Occlusive arterial disease, including coronary heart disease (CHD) and peripheral arterial disease (PAD), is the main cause of death, with an annual mortality incidence predicted to rise to 23.3 million worldwide by 2030. Current revascularization techniques consist of angioplasty, placement of a stent, or surgical bypass grafting. Autologous vessels, such as the saphenous vein and internal thoracic artery, represent the gold standard grafts for small-diameter vessels. However, they require invasive harvesting and are often unavailable. Synthetic vascular grafts represent an alternative to autologous vessels. These grafts have shown satisfactory long-term results for replacement of large- and medium-diameter arteries, such as the carotid or common femoral artery, but have poor patency rates when applied to small-diameter vessels, such as coronary arteries and arteries below the knee. Considering the limitations of current vascular bypass conduits, a tissue-engineered vascular graft (TEVG) with the ability to grow, remodel, and repair in vivo presents a potential solution for the future of vascular surgery. Here, we review the different methods that research groups have been investigating to create TEVGs in the last decades. We focus on the techniques employed in the manufacturing process of the grafts and categorize the approaches as scaffold-based (synthetic, natural, or hybrid) or self-assembled (cell-sheet, microtissue aggregation and bioprinting). Moreover, we highlight the attempts made so far to translate this new strategy from the bench to the bedside.

Compositions Including Synthetic and Natural Blends for Integration and Structural Integrity: Engineered for Different Vascular Graft Applications

Tissue engineering approaches for small-diameter arteries require a scaffold that simultaneously maintains patency by preventing thrombosis and intimal hyperplasia, maintains its structural integrity after grafting, and allows integration. While synthetic and extracellular matrix-derived materials can provide some of these properties individually, developing a scaffold that provides the balanced properties needed for vascular graft survival in the clinic has been particularly challenging. After 30 years of research, there are now several scaffolds currently in clinical trials. However, these products are either being investigated for large-diameter applications or they require pre-seeding of endothelial cells. This progress report identifies important challenges unique to engineering vascular grafts for high pressure arteries less than 4 mm in diameter (e.g., coronary artery), and discusses limitations with the current usage of the term "small-diameter." Next, the composition and processing techniques used for generating tissue engineered vascular grafts (TEVGs) are discussed, with a focus on the benefits of blended materials. Other scaffolds for non-tissue engineering approaches and stents are also briefly mentioned for comparison. Overall, this progress report discusses the importance of defining the most critical challenges for small diameter TEVGs, developing new scaffolds to provide these properties, and determining acceptable benchmarks for scaffold responses in the body.

Fabrication and Applications of Micro/Nanostructured Devices for Tissue Engineering

Nanotechnology allows the realization of new materials and devices with basic structural unit in the range of 1-100 nm and characterized by gaining control at the atomic, molecular, and supramolecular level. Reducing the dimensions of a material into the nanoscale range usually results in the change of its physiochemical properties such as reactivity, crystallinity, and solubility. This review treats the convergence of last research news at the interface of nanostructured biomaterials and tissue engineering for emerging biomedical technologies such as scaffolding and tissue regeneration. The present review is organized into three main sections. The introduction concerns an overview of the increasing utility of nanostructured materials in the field of tissue engineering. It elucidates how nanotechnology, by working in the submicron length scale, assures the realization of a biocompatible interface that is able to reproduce the physiological cell-matrix interaction. The second, more technical section, concerns the design and fabrication of biocompatible surface characterized by micro- and submicroscale features, using microfabrication, nanolithography, and miscellaneous nanolithographic techniques. In the last part, we review the ongoing tissue engineering application of nanostructured materials and scaffolds in different fields such as neurology, cardiology, orthopedics, and skin tissue regeneration.

Mechanical behavior of bilayered small-diameter nanofibrous structures as biomimetic vascular grafts

To these days, the production of a small diameter vascular graft (<6mm) with an appropriate and permanent response is still challenging. The mismatch in the grafts mechanical properties is one of the principal causes of failure, therefore their complete mechanical characterization is fundamental. In this work the mechanical response of electrospun bilayered small-diameter vascular grafts made of two different bioresorbable synthetic polymers, segmented poly(ester urethane) and poly(L-lactic acid), that mimic the biomechanical characteristics of elastin and collagen is investigated. A J-shaped response when subjected to internal pressure was observed as a cause of the nanofibrous layered structure, and the materials used. Compliance values were in the order of natural coronary arteries and very close to the bypass gold standard-saphenous vein. The suture retention strength and burst pressure values were also in the range of natural vessels. Therefore, the bilayered vascular grafts presented here are very promising for future application as small-diameter vessel replacements.

Bicomponent electrospun scaffolds to design extracellular matrix tissue analogs

In the last decade, bicomponent fibers have been proposed to fabricate bio-inspired systems for tissue repair, regenerative medicine, medical healthcare and clinical applications. In comparison with monocomponent fibers, key advantage concerns their ability of self-adapting to the physiological conditions through an extended pattern of signals--morphological, chemical and physical ones--confined at the single fiber level. Hydrophobic/hydrophilic phases may be variously organized by tuneable processing modes (i.e., blending, core/shell, interweaving) thus offering different benefits in terms of biological activity, fluid sorption and molecular transport properties (first generation). The possibility to efficiently graft cell-adhesive proteins and peptide sequences onto the fiber surface mediated by spacers or impregnating hydrogels allows to trigger cell late activities by a controlled and sustained release in vitro of specific biomolecules (i.e., morphogens, growth factors). Here, we introduce an overview of current approaches based on bicomponent fiber use as extra cellular matrix analogs with cell-instructive functions and hierarchal organization of living tissues.

The Tissue-Engineered Vascular Graft-Past, Present, and Future

Cardiovascular disease is the leading cause of death worldwide, with this trend predicted to continue for the foreseeable future. Common disorders are associated with the stenosis or occlusion of blood vessels. The preferred treatment for the long-term revascularization of occluded vessels is surgery utilizing vascular grafts, such as coronary artery bypass grafting and peripheral artery bypass grafting. Currently, autologous vessels such as the saphenous vein and internal thoracic artery represent the gold standard grafts for small-diameter vessels (<6 mm), outperforming synthetic alternatives. However, these vessels are of limited availability, require invasive harvest, and are often unsuitable for use. To address this, the development of a tissue-engineered vascular graft (TEVG) has been rigorously pursued. This article reviews the current state of the art of TEVGs. The various approaches being explored to generate TEVGs are described, including scaffold-based methods (using synthetic and natural polymers), the use of decellularized natural matrices, and tissue self-assembly processes, with the results of various in vivo studies, including clinical trials, highlighted. A discussion of the key areas for further investigation, including graft cell source, mechanical properties, hemodynamics, integration, and assessment in animal models, is then presented.

Fiber-reinforced hydrogel scaffolds for heart valve tissue engineering

Heart valve-related disorders are among the major causes of death worldwide. Although prosthetic valves are widely used to treat this pathology, current prosthetic grafts cannot grow with the patient while maintaining normal valve mechanical and hemodynamic properties. Tissue engineering may provide a possible solution to this issue through using biodegradable scaffolds and patients' own cells. Despite their similarity to heart valve tissue, most hydrogel scaffolds are not mechanically suitable for the dynamic stresses of the heart valve microenvironment. In this study, we integrated electrospun poly(glycerol sebacate) (PGS)-poly(ɛ-caprolactone) (PCL) microfiber scaffolds, which possess enhanced mechanical properties for heart valve engineering, within a hybrid hydrogel made from methacrylated hyaluronic acid and methacrylated gelatin. Sheep mitral valvular interstitial cells were encapsulated in the hydrogel and evaluated in hydrogel-only, PGS-PCL scaffold-only, and composite scaffold conditions. Although the cellular viability and metabolic activity were similar among all scaffold types, the presence of the hydrogel improved the three-dimensional distribution of mitral valvular interstitial cells. As seen by similar values in both the Young's modulus and the ultimate tensile strength between the PGS-PCL scaffolds and the composites, microfibrous scaffolds preserved their mechanical properties in the presence of the hydrogels. Compared to electrospun or hydrogel scaffolds alone, this combined system may provide a more suitable three-dimensional structure for generating scaffolds for heart valve tissue engineering.

Advancements in electrospinning of polymeric nanofibrous scaffolds for tissue engineering

Polymeric nanofibers have potential as tissue engineering scaffolds, as they mimic the nanoscale properties and structural characteristics of native extracellular matrix (ECM). Nanofibers composed of natural and synthetic polymers, biomimetic composites, ceramics, and metals have been fabricated by electrospinning for various tissue engineering applications. The inherent advantages of electrospinning nanofibers include the generation of substrata with high surface area-to-volume ratios, the capacity to precisely control material and mechanical properties, and a tendency for cellular in-growth due to interconnectivity within the pores. Furthermore, the electrospinning process affords the opportunity to engineer scaffolds with micro- to nanoscale topography similar to the natural ECM. This review describes the fundamental aspects of the electrospinning process when applied to spinnable natural and synthetic polymers; particularly, those parameters that influence fiber geometry, morphology, mesh porosity, and scaffold mechanical properties. We describe cellular responses to fiber morphology achieved by varying processing parameters and highlight successful applications of electrospun nanofibrous scaffolds when used to tissue engineer bone, skin, and vascular grafts.

Cell attachment to hydrogel-electrospun fiber mat composite materials

Hydrogels, electrospun fiber mats (EFMs), and their composites have been extensively studied for tissue engineering because of their physical and chemical similarity to native biological systems. However, while chemically similar, hydrogels and electrospun fiber mats display very different topographical features. Here, we examine the influence of surface topography and composition of hydrogels, EFMs, and hydrogel-EFM composites on cell behavior. Materials studied were composed of synthetic poly(ethylene glycol) (PEG) and poly(ethylene glycol)-poly(ε-caprolactone) (PEGPCL) hydrogels and electrospun poly(caprolactone) (PCL) and core/shell PCL/PEGPCL constituent materials. The number of adherent cells and cell circularity were most strongly influenced by the fibrous nature of materials (e.g., topography), whereas cell spreading was more strongly influenced by material composition (e.g., chemistry). These results suggest that cell attachment and proliferation to hydrogel-EFM composites can be tuned by varying these properties to provide important insights for the future design of such composite materials.

Electrospun Fiber - Hydrogel Composites for Nucleus Pulposus Tissue Engineering

New materials are needed to replace degenerated intervertebral disc tissue and to provide longer-term solutions for chronic back-pain. Replacement tissue potentially could be engineered by seeding cells into a scaffold that mimics the architecture of natural tissue. Many natural tissues, including the nucleus pulposus (the central region of the intervertebral disc) consist of collagen nanofibers embedded in a gel-like matrix. Recently it was shown that electrospun micro- or nano-fiber structures of considerable thickness can be produced by collecting fibers in an ethanol bath. Here, randomly aligned polycaprolactone electrospun fiber structures up to 50 mm thick are backfilled with alginate hydrogels to form novel composite materials that mimic the fiber-reinforced structure of the nucleus pulposus. The composites are characterized using both indentation and tensile testing. The composites are mechanically robust, exhibiting substantial strain-to-failure. The method presented here provides a way to create large biomimetic scaffolds that more closely mimic the composite structure of natural tissue.

Construction of a tubular scaffold that mimics J-shaped stress/strain mechanics using an innovative electrospinning technique

Soft tissues such as blood vessel, lung, ureter, skin, etc., possess mechanical behavior characterized by a "J"-shaped curve on a stress-strain diagram with a low-stiffness highly elastic zone giving rise to a high-stiffness zone. This mechanical behavior may be adaptive and protective against aneurysm formation in tissues whose primary loading is pressure-based. "J"-shaped behavior arises from the synergistic interplay of two main structural proteins: collagen and elastin. An innovative electrospinning technique has been utilized to form tubular scaffold composites with structural features reminiscent of the corrugated laminae seen in blood vessels. In doing so, tubular scaffolds have been fabricated with complex "J"-shaped behavior through the use of elastic polyurethane and reinforcing poly-glycolic acid (PGA) woven mesh. In these studies, corrugated laminae were formed on the 175 μm and 1.5 mm scale. Initial moduli were 0.5±0.17 MPa (mean±standard deviation) giving rise to stiffer moduli of 36.09±6.72 MPa at a strain of 1.31±0.15. Burst pressures were physiologically relevant at 3095±1016 mmHg. The toughness of these prototypes was 6.3±1.9 MJ/m(3). The ability to employ different materials and different formation parameters utilizing this technique promises the ability to match complex stress-strain behaviors in soft tissues with a high degree of fidelity.

Bioprinting of hybrid tissue constructs with tailorable mechanical properties

Tissue/organ printing aims to recapitulate the intrinsic complexity of native tissues. For a number of tissues, in particular those of musculoskeletal origin, adequate mechanical characteristics are an important prerequisite for their initial handling and stability, as well as long-lasting functioning. Hence, organized implants, possessing mechanical characteristics similar to the native tissue, may result in improved clinical outcomes of regenerative approaches. Using a bioprinter, grafts were constructed by alternate deposition of thermoplastic fibers and (cell-laden) hydrogels. Constructs of different shapes and sizes were manufactured and mechanical properties, as well as cell viability, were assessed. This approach yields novel organized viable hybrid constructs, which possess favorable mechanical characteristics, within the same range as those of native tissues. Moreover, the approach allows the use of multiple hydrogels and can thus produce constructs containing multiple cell types or bioactive factors. Furthermore, since the hydrogel is supported by the thermoplastic material, a broader range of hydrogel types can be used compared to bioprinting of hydrogels alone. In conclusion, we present an innovative and versatile approach for bioprinting, yielding constructs of which the mechanical stiffness provided by thermoplastic polymers can potentially be tailored, and combined specific cell placement patterns of multiple cell types embedded in a wide range of hydrogels.