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Garg A, Alfatease A, Hani U, Haider N, Akbar MJ, Talath S, Angolkar M, Paramshetti S, Osmani RAM, Gundawar R. Drug eluting protein and polysaccharides-based biofunctionalized fabric textiles- pioneering a new frontier in tissue engineering: An extensive review. Int J Biol Macromol 2024; 268:131605. [PMID: 38641284 DOI: 10.1016/j.ijbiomac.2024.131605] [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] [Received: 10/16/2023] [Revised: 03/20/2024] [Accepted: 04/12/2024] [Indexed: 04/21/2024]
Abstract
In the ever-evolving landscape of tissue engineering, medicated biotextiles have emerged as a game-changer. These remarkable textiles have garnered significant attention for their ability to craft tissue scaffolds that closely mimic the properties of natural tissues. This comprehensive review delves into the realm of medicated protein and polysaccharide-based biotextiles, exploring a diverse array of fabric materials. We unravel the intricate web of fabrication methods, ranging from weft/warp knitting to plain/stain weaving and braiding, each lending its unique touch to the world of biotextiles creation. Fibre production techniques, such as melt spinning, wet/gel spinning, and multicomponent spinning, are demystified to shed light on the magic behind these ground-breaking textiles. The biotextiles thus crafted exhibit exceptional physical and chemical properties that hold immense promise in the field of tissue engineering (TE). Our review underscores the myriad applications of drug-eluting protein and polysaccharide-based textiles, including TE, tissue repair, regeneration, and wound healing. Additionally, we delve into commercially available products that harness the potential of medicated biotextiles, paving the way for a brighter future in healthcare and regenerative medicine. Step into the world of innovation with medicated biotextiles-where science meets the art of healing.
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Affiliation(s)
- Ankitha Garg
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research (JSSAHER), Mysuru 570015, Karnataka, India
| | - Adel Alfatease
- Department of Pharmaceutics, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia.
| | - Umme Hani
- Department of Pharmaceutics, College of Pharmacy, King Khalid University, Abha 61421, Saudi Arabia.
| | - Nazima Haider
- Department of Pathology, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia
| | - Mohammad J Akbar
- Department of Pharmaceutics, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia.
| | - Sirajunisa Talath
- Department of Pharmaceutical Chemistry, RAK College of Pharmacy, RAK Medical and Health Sciences University, Ras Al Khaimah 11172, United Arab Emirates.
| | - Mohit Angolkar
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research (JSSAHER), Mysuru 570015, Karnataka, India
| | - Sharanya Paramshetti
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research (JSSAHER), Mysuru 570015, Karnataka, India
| | - Riyaz Ali M Osmani
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research (JSSAHER), Mysuru 570015, Karnataka, India.
| | - Ravi Gundawar
- Department of Pharmaceutical Quality Assurance, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal 576104, Karnataka, India.
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Sesa M, Holthusen H, Lamm L, Böhm C, Brepols T, Jockenhövel S, Reese S. Mechanical modeling of the maturation process for tissue-engineered implants: Application to biohybrid heart valves. Comput Biol Med 2023; 167:107623. [PMID: 37922603 DOI: 10.1016/j.compbiomed.2023.107623] [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] [Received: 07/09/2023] [Revised: 09/18/2023] [Accepted: 10/23/2023] [Indexed: 11/07/2023]
Abstract
The development of tissue-engineered cardiovascular implants can improve the lives of large segments of our society who suffer from cardiovascular diseases. Regenerative tissues are fabricated using a process called tissue maturation. Furthermore, it is highly challenging to produce cardiovascular regenerative implants with sufficient mechanical strength to withstand the loading conditions within the human body. Therefore, biohybrid implants for which the regenerative tissue is reinforced by standard reinforcement material (e.g. textile or 3d printed scaffold) can be an interesting solution. In silico models can significantly contribute to characterizing, designing, and optimizing biohybrid implants. The first step towards this goal is to develop a computational model for the maturation process of tissue-engineered implants. This paper focuses on the mechanical modeling of textile-reinforced tissue-engineered cardiovascular implants. First, an energy-based approach is proposed to compute the collagen evolution during the maturation process. Then, the concept of structural tensors is applied to model the anisotropic behavior of the extracellular matrix and the textile scaffold. Next, the newly developed material model is embedded into a special solid-shell finite element formulation with reduced integration. Finally, our framework is used to compute two structural problems: a pressurized shell construct and a tubular-shaped heart valve. The results show the ability of the model to predict collagen growth in response to the boundary conditions applied during the maturation process. Consequently, the model can predict the implant's mechanical response, such as the deformation and stresses of the implant.
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Affiliation(s)
- Mahmoud Sesa
- Institute of Applied Mechanics, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, 52074 Aachen, Germany.
| | - Hagen Holthusen
- Institute of Applied Mechanics, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, 52074 Aachen, Germany
| | - Lukas Lamm
- Institute of Applied Mechanics, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, 52074 Aachen, Germany
| | - Christian Böhm
- Biohybrid & Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, Forckenbeckstr. 55, 52074 Aachen, Germany
| | - Tim Brepols
- Institute of Applied Mechanics, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, 52074 Aachen, Germany
| | - Stefan Jockenhövel
- Biohybrid & Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, Forckenbeckstr. 55, 52074 Aachen, Germany
| | - Stefanie Reese
- Institute of Applied Mechanics, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, 52074 Aachen, Germany
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3
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Boehm CA, Donay C, Lubig A, Ruetten S, Sesa M, Fernández-Colino A, Reese S, Jockenhoevel S. Bio-Inspired Fiber Reinforcement for Aortic Valves: Scaffold Production Process and Characterization. Bioengineering (Basel) 2023; 10:1064. [PMID: 37760166 PMCID: PMC10525898 DOI: 10.3390/bioengineering10091064] [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: 08/14/2023] [Revised: 09/04/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
The application of tissue-engineered heart valves in the high-pressure circulatory system is still challenging. One possible solution is the development of biohybrid scaffolds with textile reinforcement to achieve improved mechanical properties. In this article, we present a manufacturing process of bio-inspired fiber reinforcement for an aortic valve scaffold. The reinforcement structure consists of polyvinylidene difluoride monofilament fibers that are biomimetically arranged by a novel winding process. The fibers were embedded and fixated into electrospun polycarbonate urethane on a cylindrical collector. The scaffold was characterized by biaxial tensile strength, bending stiffness, burst pressure and hemodynamically in a mock circulation system. The produced fiber-reinforced scaffold showed adequate acute mechanical and hemodynamic properties. The transvalvular pressure gradient was 3.02 ± 0.26 mmHg with an effective orifice area of 2.12 ± 0.22 cm2. The valves sustained aortic conditions, fulfilling the ISO-5840 standards. The fiber-reinforced scaffold failed in a circumferential direction at a stress of 461.64 ± 58.87 N/m and a strain of 49.43 ± 7.53%. These values were above the levels of tested native heart valve tissue. Overall, we demonstrated a novel manufacturing approach to develop a fiber-reinforced biomimetic scaffold for aortic heart valve tissue engineering. The characterization showed that this approach is promising for an in situ valve replacement.
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Affiliation(s)
- Christian A. Boehm
- Department of Biohybrid & Medical Textiles (BioTex), AME Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstr. 55, 52074 Aachen, Germany; (C.A.B.); (C.D.); (A.L.); (A.F.-C.)
| | - Christine Donay
- Department of Biohybrid & Medical Textiles (BioTex), AME Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstr. 55, 52074 Aachen, Germany; (C.A.B.); (C.D.); (A.L.); (A.F.-C.)
| | - Andreas Lubig
- Department of Biohybrid & Medical Textiles (BioTex), AME Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstr. 55, 52074 Aachen, Germany; (C.A.B.); (C.D.); (A.L.); (A.F.-C.)
| | - Stephan Ruetten
- Electron Microscopy Facility, University Hospital Aachen, Pauwelstr. 30, 52074 Aachen, Germany;
| | - Mahmoud Sesa
- Institute of Applied Mechanics, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, 52074 Aachen, Germany; (M.S.); (S.R.)
| | - Alicia Fernández-Colino
- Department of Biohybrid & Medical Textiles (BioTex), AME Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstr. 55, 52074 Aachen, Germany; (C.A.B.); (C.D.); (A.L.); (A.F.-C.)
| | - Stefanie Reese
- Institute of Applied Mechanics, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, 52074 Aachen, Germany; (M.S.); (S.R.)
| | - Stefan Jockenhoevel
- Department of Biohybrid & Medical Textiles (BioTex), AME Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstr. 55, 52074 Aachen, Germany; (C.A.B.); (C.D.); (A.L.); (A.F.-C.)
- Aachen-Maastricht Institute for Biobased Materials, Maastricht University at Chemelot Campus, Urmonderbaan 22, 6167 Geleen, The Netherlands
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Snyder Y, Jana S. Fibrin gel enhanced trilayer structure in cell-cultured constructs. Biotechnol Bioeng 2023; 120:1678-1693. [PMID: 36891782 PMCID: PMC10182258 DOI: 10.1002/bit.28371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/12/2022] [Accepted: 03/04/2023] [Indexed: 03/10/2023]
Abstract
Efficient cell seeding and subsequent support from a substrate ensure optimal cell growth and neotissue development during tissue engineering, including heart valve tissue engineering. Fibrin gel as a cell carrier may provide high cell seeding efficiency and adhesion property, improved cellular interaction, and structural support to enhance cellular growth in trilayer polycaprolactone (PCL) substrates that mimic the structure of native heart valve leaflets. This cell carrier gel coupled with a trilayer PCL substrate may enable the production of native-like cell-cultured leaflet constructs suitable for heart valve tissue engineering. In this study, we seeded valvular interstitial cells onto trilayer PCL substrates with fibrin gel as a cell carrier and cultured them for 1 month in vitro to determine if this gel can improve cell proliferation and production of extracellular matrix within the trilayer cell-cultured constructs. We observed that the fibrin gel enhanced cellular proliferation, their vimentin expression, and collagen and glycosaminoglycan production, leading to improved structure and mechanical properties of the developing PCL cell-cultured constructs. Fibrin gel as a cell carrier significantly improved the orientations of the cells and their produced tissue materials within trilayer PCL substrates that mimic the structure of native heart valve leaflets and, thus, may be highly beneficial for developing functional tissue-engineered leaflet constructs.
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Affiliation(s)
- Yuriy Snyder
- Department of Bioengineering, University of Missouri, Columbia, MO 65211, USA
| | - Soumen Jana
- Department of Bioengineering, University of Missouri, Columbia, MO 65211, USA
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Ingeniería de tejidos en población pediátrica: una esperanza para el tratamiento de enfermedades valvulares mitrales congénitas. CIRUGIA CARDIOVASCULAR 2023. [DOI: 10.1016/j.circv.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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6
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Voß K, Werner MP, Gesenhues J, Kučikas V, van Zandvoort M, Jockenhoevel S, Schmitz-Rode T, Abel D. Towards technically controlled bioreactor maturation of tissue-engineered heart valves. BIOMED ENG-BIOMED TE 2022; 67:461-470. [PMID: 36094469 DOI: 10.1515/bmt-2021-0379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 08/25/2022] [Indexed: 11/15/2022]
Abstract
Bioreactors are important tools for the pre-conditioning of tissue-engineered heart valves. The current state of the art mostly provides for timed, physical and biochemical stimulation in the bioreactor systems according to standard protocols (SOP). However, this does not meet to the individual biological variability of living tissue-engineered constructs. To achieve this, it is necessary to implement (i) sensory systems that detect the actual status of the implant and (ii) controllable bioreactor systems that allow patient-individualized pre-conditioning. During the maturation process, a pulsatile transvalvular flow of culture medium is generated within the bioreactor. For the improvement of this conditioning procedure, the relationship between the mechanical and biochemical stimuli and the corresponding tissue response has to be analyzed by performing reproducible and comparable experiments. In this work, a technological framework for maturation experiments of tissue-engineered heart valves in a pulsating bioreactor is introduced. The aim is the development of a bioreactor system that allows for continuous control and documentation of the conditioning process to increase reproducibility and comparability of experiments. This includes hardware components, a communication structure and software including online user communication and supervision. Preliminary experiments were performed with a tissue-engineered heart valve to evaluate the function of the new system. The results of the experiment proof the adequacy of the setup. Consequently, the concept is an important step for further research towards controlled maturation of tissue-engineered heart valves. The integration of molecular and histological sensor systems will be the next important step towards a fully automated, self-controlled preconditioning system.
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Affiliation(s)
- Kirsten Voß
- Institute of Automatic Control, RWTH Aachen, Aachen, Germany
| | - Maximilian P Werner
- Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - Jonas Gesenhues
- Institute of Automatic Control, RWTH Aachen, Aachen, Germany
| | - Vytautas Kučikas
- Institute for Molecular Cardiovascular Research, University Hospital RWTH Aachen, Aachen, Germany
| | - Marc van Zandvoort
- Institute for Molecular Cardiovascular Research, University Hospital RWTH Aachen, Aachen, Germany.,Department of Molecular Cell Biology, Institute for Cardiovascular Diseases, Maastricht University, Maastricht, Netherlands
| | - Stefan Jockenhoevel
- Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - Thomas Schmitz-Rode
- Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - Dirk Abel
- Institute of Automatic Control, RWTH Aachen, Aachen, Germany
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7
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Natural Polymers in Heart Valve Tissue Engineering: Strategies, Advances and Challenges. Biomedicines 2022; 10:biomedicines10051095. [PMID: 35625830 PMCID: PMC9139175 DOI: 10.3390/biomedicines10051095] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 12/04/2022] Open
Abstract
In the history of biomedicine and biomedical devices, heart valve manufacturing techniques have undergone a spectacular evolution. However, important limitations in the development and use of these devices are known and heart valve tissue engineering has proven to be the solution to the problems faced by mechanical and prosthetic valves. The new generation of heart valves developed by tissue engineering has the ability to repair, reshape and regenerate cardiac tissue. Achieving a sustainable and functional tissue-engineered heart valve (TEHV) requires deep understanding of the complex interactions that occur among valve cells, the extracellular matrix (ECM) and the mechanical environment. Starting from this idea, the review presents a comprehensive overview related not only to the structural components of the heart valve, such as cells sources, potential materials and scaffolds fabrication, but also to the advances in the development of heart valve replacements. The focus of the review is on the recent achievements concerning the utilization of natural polymers (polysaccharides and proteins) in TEHV; thus, their extensive presentation is provided. In addition, the technological progresses in heart valve tissue engineering (HVTE) are shown, with several inherent challenges and limitations. The available strategies to design, validate and remodel heart valves are discussed in depth by a comparative analysis of in vitro, in vivo (pre-clinical models) and in situ (clinical translation) tissue engineering studies.
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8
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Arthur Mueller KM, Mulderrig S, Najafian S, Hurvitz SB, Sodhani D, Mela P, Stapleton SE. Mesh manipulation for local structural property tailoring of medical warp-knitted textiles. J Mech Behav Biomed Mater 2022; 128:105117. [DOI: 10.1016/j.jmbbm.2022.105117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/30/2021] [Accepted: 02/03/2022] [Indexed: 11/25/2022]
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Tuladhar SR, Mulderrig S, Della Barbera M, Vedovelli L, Bottigliengo D, Tessari C, Jockenhoevel S, Gregori D, Thiene G, Korossis S, Mela P, Iop L, Gerosa G. Bioengineered percutaneous heart valves for transcatheter aortic valve replacement: a comparative evaluation of decellularised bovine and porcine pericardia. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 123:111936. [PMID: 33812574 DOI: 10.1016/j.msec.2021.111936] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 08/06/2020] [Accepted: 01/31/2021] [Indexed: 12/18/2022]
Abstract
Glutaraldehyde-treated, surgical bioprosthetic heart valves undergo structural degeneration within 10-15 years of implantation. Analogous preliminary results were disclosed for percutaneous heart valves (PHVs) realized with similarly-treated tissues. To improve long-term performance, decellularised scaffolds can be proposed as alternative fabricating biomaterials. The aim of this study was to evaluate whether bovine and porcine decellularised pericardia could be utilised to manufacture bioengineered percutaneous heart valves (bioPHVs) with adequate hydrodynamic performance and leaflet resistance to crimping damage. BioPHVs were fabricated by mounting acellular pericardia onto commercial stents. Independently from the pericardial species used for valve fabrication, bioPHVs satisfied the minimum hydrodynamic performance criteria set by ISO 5840-3 standards and were able to withstand a large spectrum of cardiac output conditions, also during extreme backpressure, without severe regurgitation, especially in the case of the porcine group. No macroscopic or microscopic leaflet damage was detected following bioPHV crimping. Bovine and porcine decellularized pericardia are both suitable alternatives to glutaraldehyde-treated tissues. Between the two types of pericardial species tested, the porcine tissue scaffold might be preferable to fabricate advanced PHV replacements for long-term performance. CONDENSED ABSTRACT: Current percutaneous heart valve replacements are formulated with glutaraldehyde-treated animal tissues, prone to structural degeneration. In order to improve long-term performance, bovine and porcine decellularised pericardia were utilised to manufacture bioengineered replacements, which demonstrated adequate hydrodynamic behaviour and resistance to crimping without leaflet architectural alteration.
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Affiliation(s)
- Sugat Ratna Tuladhar
- Cardiovascular Regenerative Medicine, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Shane Mulderrig
- Department of Biohybrid & Medical Textiles (BioTex), Institute for Applied Medical Engineering, Helmholtz Aachen, University Hospital RWTH Aachen, Aachen, Germany
| | - Mila Della Barbera
- Cardiovascular Pathology, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Luca Vedovelli
- Biostatistics, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Daniele Bottigliengo
- Biostatistics, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Chiara Tessari
- Cardiovascular Regenerative Medicine, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Stefan Jockenhoevel
- Department of Biohybrid & Medical Textiles (BioTex), Institute for Applied Medical Engineering, Helmholtz Aachen, University Hospital RWTH Aachen, Aachen, Germany
| | - Dario Gregori
- Biostatistics, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Gaetano Thiene
- Cardiovascular Pathology, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Sotiris Korossis
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany; Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, Hannover Medical School, Hannover, Germany
| | - Petra Mela
- Department of Biohybrid & Medical Textiles (BioTex), Institute for Applied Medical Engineering, Helmholtz Aachen, University Hospital RWTH Aachen, Aachen, Germany
| | - Laura Iop
- Cardiovascular Regenerative Medicine, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy; L.I.F.E.LA.B., CORIS, Veneto Region, Padua, Italy
| | - Gino Gerosa
- Cardiovascular Regenerative Medicine, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy; L.I.F.E.LA.B., CORIS, Veneto Region, Padua, Italy.
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Taghizadeh B, Ghavami L, Derakhshankhah H, Zangene E, Razmi M, Jaymand M, Zarrintaj P, Zarghami N, Jaafari MR, Moallem Shahri M, Moghaddasian A, Tayebi L, Izadi Z. Biomaterials in Valvular Heart Diseases. Front Bioeng Biotechnol 2020; 8:529244. [PMID: 33425862 PMCID: PMC7793990 DOI: 10.3389/fbioe.2020.529244] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 11/16/2020] [Indexed: 01/07/2023] Open
Abstract
Valvular heart disease (VHD) occurs as the result of valvular malfunction, which can greatly reduce patient's quality of life and if left untreated may lead to death. Different treatment regiments are available for management of this defect, which can be helpful in reducing the symptoms. The global commitment to reduce VHD-related mortality rates has enhanced the need for new therapeutic approaches. During the past decade, development of innovative pharmacological and surgical approaches have dramatically improved the quality of life for VHD patients, yet the search for low cost, more effective, and less invasive approaches is ongoing. The gold standard approach for VHD management is to replace or repair the injured valvular tissue with natural or synthetic biomaterials. Application of these biomaterials for cardiac valve regeneration and repair holds a great promise for treatment of this type of heart disease. The focus of the present review is the current use of different types of biomaterials in treatment of valvular heart diseases.
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Affiliation(s)
- Bita Taghizadeh
- Department of Medical Biotechnology, School of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Laleh Ghavami
- Laboratory of Biophysics and Molecular Biology, Department of Biophysics, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Hossein Derakhshankhah
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Zangene
- Department of Bioinformatics, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Mahdieh Razmi
- Department of Biochemistry, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Mehdi Jaymand
- Nano Drug Delivery Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Payam Zarrintaj
- Polymer Engineering Department, Faculty of Engineering, Urmia University, Urmia, Iran
| | - Nosratollah Zarghami
- Department of Medical Biotechnology, School of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmoud Reza Jaafari
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Matin Moallem Shahri
- Cardiology Department, Taleghani Trauma Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Lobat Tayebi
- Marquette University School of Dentistry, Milwaukee, WI, United States
| | - Zhila Izadi
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Regenerative Medicine, Cell Science Research Center, Academic Center for Education, Culture and Research (ACECR), Royan Institute for Stem Cell Biology and Technology, Tehran, Iran
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11
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Heim F. Heart valves from polymeric fibers: potential and limits. THE JOURNAL OF CARDIOVASCULAR SURGERY 2020; 61:586-595. [DOI: 10.23736/s0021-9509.20.11604-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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12
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Schäfer B, Emonts C, Glimpel N, Ruhl T, Obrecht AS, Jockenhoevel S, Gries T, Beier JP, Blaeser A. Warp-Knitted Spacer Fabrics: A Versatile Platform to Generate Fiber-Reinforced Hydrogels for 3D Tissue Engineering. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E3518. [PMID: 32785204 PMCID: PMC7475890 DOI: 10.3390/ma13163518] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/16/2022]
Abstract
Mesenchymal stem cells (MSCs) possess huge potential for regenerative medicine. For tissue engineering approaches, scaffolds and hydrogels are routinely used as extracellular matrix (ECM) carriers. The present study investigated the feasibility of using textile-reinforced hydrogels with adjustable porosity and elasticity as a versatile platform for soft tissue engineering. A warp-knitted poly (ethylene terephthalate) (PET) scaffold was developed and characterized with respect to morphology, porosity, and mechanics. The textile carrier was infiltrated with hydrogels and cells resulting in a fiber-reinforced matrix with adjustable biological as well as mechanical cues. Finally, the potential of this platform technology for regenerative medicine was tested on the example of fat tissue engineering. MSCs were seeded on the construct and exposed to adipogenic differentiation medium. Cell invasion was detected by two-photon microscopy, proliferation was measured by the PrestoBlue assay. Successful adipogenesis was demonstrated using Oil Red O staining as well as measurement of secreted adipokines. In conclusion, the given microenvironment featured optimal mechanical as well as biological properties for proliferation and differentiation of MSCs. Besides fat tissue, the textile-reinforced hydrogel system with adjustable mechanics could be a promising platform for future fabrication of versatile soft tissues, such as cartilage, tendon, or muscle.
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Affiliation(s)
- Benedikt Schäfer
- Department of Plastic Surgery, Hand Surgery-Burn Center, University Hospital RWTH Aachen, 52074 Aachen, Germany; (B.S.); (T.R.); (A.S.O.); (J.P.B.)
| | - Caroline Emonts
- Institut für Textiltechnik, RWTH Aachen University, 52062 Aachen, Germany; (C.E.); (N.G.); (T.G.)
| | - Nikola Glimpel
- Institut für Textiltechnik, RWTH Aachen University, 52062 Aachen, Germany; (C.E.); (N.G.); (T.G.)
| | - Tim Ruhl
- Department of Plastic Surgery, Hand Surgery-Burn Center, University Hospital RWTH Aachen, 52074 Aachen, Germany; (B.S.); (T.R.); (A.S.O.); (J.P.B.)
| | - Astrid S. Obrecht
- Department of Plastic Surgery, Hand Surgery-Burn Center, University Hospital RWTH Aachen, 52074 Aachen, Germany; (B.S.); (T.R.); (A.S.O.); (J.P.B.)
| | - Stefan Jockenhoevel
- Department of Biohybrid and Medical Textiles (BioTex), Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, 52074 Aachen, Germany;
| | - Thomas Gries
- Institut für Textiltechnik, RWTH Aachen University, 52062 Aachen, Germany; (C.E.); (N.G.); (T.G.)
| | - Justus P. Beier
- Department of Plastic Surgery, Hand Surgery-Burn Center, University Hospital RWTH Aachen, 52074 Aachen, Germany; (B.S.); (T.R.); (A.S.O.); (J.P.B.)
| | - Andreas Blaeser
- Institut für Textiltechnik, RWTH Aachen University, 52062 Aachen, Germany; (C.E.); (N.G.); (T.G.)
- Department of Biohybrid and Medical Textiles (BioTex), Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, 52074 Aachen, Germany;
- Institute for BioMedical Printing Technology, Technical University of Darmstadt, 64289 Darmstadt, Germany
- Centre for Synthetic Biology, Technical University of Darmstadt, 64289 Darmstadt, Germany
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13
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Gonzalez de Torre I, Alonso M, Rodriguez-Cabello JC. Elastin-Based Materials: Promising Candidates for Cardiac Tissue Regeneration. Front Bioeng Biotechnol 2020; 8:657. [PMID: 32695756 PMCID: PMC7338576 DOI: 10.3389/fbioe.2020.00657] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/27/2020] [Indexed: 11/15/2022] Open
Abstract
Stroke and cardiovascular episodes are still some of the most common diseases worldwide, causing millions of deaths and costing billions of Euros to healthcare systems. The use of new biomaterials with enhanced biological and physical properties has opened the door to new approaches in cardiovascular applications. Elastin-based materials are biomaterials with some of the most promising properties. Indeed, these biomaterials have started to yield good results in cardiovascular and angiogenesis applications. In this review, we explore the latest trends in elastin-derived materials for cardiac regeneration and the different possibilities that are being explored by researchers to regenerate an infarcted muscle and restore its normal function. Elastin-based materials can be processed in different manners to create injectable systems or hydrogel scaffolds that can be applied by simple injection or as patches to cover the damaged area and regenerate it. Such materials have been applied to directly regenerate the damaged cardiac muscle and to create complex structures, such as heart valves or new bio-stents that could help to restore the normal function of the heart or to minimize damage after a stroke. We will discuss the possibilities that elastin-based materials offer in cardiac tissue engineering, either alone or in combination with other biomaterials, in order to illustrate the wide range of options that are being explored. Moreover, although tremendous advances have been achieved with such elastin-based materials, there is still room for new approaches that could trigger advances in cardiac tissue regeneration.
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14
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Jiao Y, Li C, Liu L, Wang F, Liu X, Mao J, Wang L. Construction and application of textile-based tissue engineering scaffolds: a review. Biomater Sci 2020; 8:3574-3600. [PMID: 32555780 DOI: 10.1039/d0bm00157k] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Tissue engineering (TE) provides a practicable method for tissue and organ repair or substitution. As the most important component of TE, a scaffold plays a critical role in providing a growing environment for cell proliferation and functional differentiation as well as good mechanical support. And the restorative effects are greatly dependent upon the nature of the scaffold including the composition, morphology, structure, and mechanical performance. Medical textiles have been widely employed in the clinic for a long time and are being extensively investigated as TE scaffolds. However, unfortunately, the advantages of textile technology cannot be fully exploited in tissue regeneration due to the ignoring of the diversity of fabric structures. Therefore, this review focuses on textile-based scaffolds, emphasizing the significance of the fabric design and the resultant characteristics of cell behavior and extracellular matrix reconstruction. The structure and mechanical behavior of the fabrics constructed by various textile techniques for different tissue repairs are summarized. Furthermore, the prospect of structural design in the TE scaffold preparation was anticipated, including profiled fibers and some unique and complex textile structures. Hopefully, the readers of this review would appreciate the importance of structural design of the scaffold and the usefulness of textile-based TE scaffolds in tissue regeneration.
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Affiliation(s)
- Yongjie Jiao
- Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, Shanghai 201620, China.
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15
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Saidy NT, Wolf F, Bas O, Keijdener H, Hutmacher DW, Mela P, De-Juan-Pardo EM. Biologically Inspired Scaffolds for Heart Valve Tissue Engineering via Melt Electrowriting. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2019; 15:e1900873. [PMID: 31058444 DOI: 10.1002/smll.201900873] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/14/2019] [Indexed: 06/09/2023]
Abstract
Heart valves are characterized to be highly flexible yet tough, and exhibit complex deformation characteristics such as nonlinearity, anisotropy, and viscoelasticity, which are, at best, only partially recapitulated in scaffolds for heart valve tissue engineering (HVTE). These biomechanical features are dictated by the structural properties and microarchitecture of the major tissue constituents, in particular collagen fibers. In this study, the unique capabilities of melt electrowriting (MEW) are exploited to create functional scaffolds with highly controlled fibrous microarchitectures mimicking the wavy nature of the collagen fibers and their load-dependent recruitment. Scaffolds with precisely-defined serpentine architectures reproduce the J-shaped strain stiffening, anisotropic and viscoelastic behavior of native heart valve leaflets, as demonstrated by quasistatic and dynamic mechanical characterization. They also support the growth of human vascular smooth muscle cells seeded both directly or encapsulated in fibrin, and promote the deposition of valvular extracellular matrix components. Finally, proof-of-principle MEW trileaflet valves display excellent acute hydrodynamic performance under aortic physiological conditions in a custom-made flow loop. The convergence of MEW and a biomimetic design approach enables a new paradigm for the manufacturing of scaffolds with highly controlled microarchitectures, biocompatibility, and stringent nonlinear and anisotropic mechanical properties required for HVTE.
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Affiliation(s)
- Navid T Saidy
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, Queensland, 4059, Australia
- Department of Biohybrid & Medical Textiles (BioTex), AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstr. 55, 52074, Aachen, Germany
| | - Frederic Wolf
- Department of Biohybrid & Medical Textiles (BioTex), AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstr. 55, 52074, Aachen, Germany
| | - Onur Bas
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, Queensland, 4059, Australia
- ARC ITTC in Additive Biomanufacturing, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, Queensland, 4059, Australia
| | - Hans Keijdener
- Department of Biohybrid & Medical Textiles (BioTex), AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstr. 55, 52074, Aachen, Germany
| | - Dietmar W Hutmacher
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, Queensland, 4059, Australia
- ARC ITTC in Additive Biomanufacturing, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, Queensland, 4059, Australia
- Institute for Advanced Study, Technische Universität München, D-85748, Garching, Germany
| | - Petra Mela
- Department of Biohybrid & Medical Textiles (BioTex), AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstr. 55, 52074, Aachen, Germany
- Medical Materials and Medical Implant Design, Department of Mechanical Engineering, Technical University of Munich, Boltzmannstr. 15, 85748, Garching,
| | - Elena M De-Juan-Pardo
- Centre in Regenerative Medicine, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), 60 Musk Avenue, Kelvin Grove, Brisbane, Queensland, 4059, Australia
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16
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Sodhani D, Reese S, Aksenov A, Soğanci S, Jockenhövel S, Mela P, Stapleton SE. Fluid-structure interaction simulation of artificial textile reinforced aortic heart valve: Validation with an in-vitro test. J Biomech 2018; 78:52-69. [PMID: 30086860 DOI: 10.1016/j.jbiomech.2018.07.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 06/05/2018] [Accepted: 07/09/2018] [Indexed: 01/11/2023]
Abstract
Prosthetic heart valves deployed in the left heart (aortic and mitral) are subjected to harsh hemodynamical conditions. Most of the tissue engineered heart valves have been developed for the low pressure pulmonary position because of the difficulties in fabricating a mechanically strong valve, able to withstand the systemic circulation. This necessitates the use of reinforcing scaffolds, resulting in a tissue-engineered textile reinforced tubular aortic heart valve. Therefore, to better design these implants, material behaviour of the composite, valve kinematics and its hemodynamical response need to be evaluated. Experimental assessment can be immensely time consuming and expensive, paving way for numerical studies. In this work, the material properties obtained using the previously proposed multi-scale numerical method for textile composites was evaluated for its accuracy. An in silico immersed boundary (IB) fluid structure interaction (FSI) simulation emulating the in vitro experiment was set-up to evaluate and compare the geometric orifice area and flow rate for one beat cycle. Results from the in silico FSI simulation were found to be in good coherence with the in vitro test during the systolic phase, while mean deviation of approximately 9% was observed during the diastolic phase of a beat cycle. Merits and demerits of the in silico IB-FSI method for the presented case study has been discussed with the advantages outweighing the drawbacks, indicating the potential towards an effective use of this framework in the development and analysis of heart valves.
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Affiliation(s)
- Deepanshu Sodhani
- Institute of Applied Mechanics, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, 52074 Aachen, Germany.
| | - Stefanie Reese
- Institute of Applied Mechanics, RWTH Aachen University, Mies-van-der-Rohe-Str. 1, 52074 Aachen, Germany
| | - Andrey Aksenov
- Capvidia NV, Research Park Haasrode, Technologielaan 3, B-3001 Leuven, Belgium
| | - Sinan Soğanci
- Capvidia NV, Research Park Haasrode, Technologielaan 3, B-3001 Leuven, Belgium
| | - Stefan Jockenhövel
- Institute of Applied Medical Engineering, Helmholtz Institute & ITA-Institut for Textiltechnik, RWTH Aachen University, Pauwelsstr. 20, 52074 Aachen, Germany
| | - Petra Mela
- Institute of Applied Medical Engineering, Helmholtz Institute & ITA-Institut for Textiltechnik, RWTH Aachen University, Pauwelsstr. 20, 52074 Aachen, Germany
| | - Scott E Stapleton
- Dept. of Mechanical Engineering, University of Massachusetts Lowell, 1 University Avenue, Lowell, MA 01854, USA
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17
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FABRICA: A Bioreactor Platform for Printing, Perfusing, Observing, & Stimulating 3D Tissues. Sci Rep 2018; 8:7561. [PMID: 29765087 PMCID: PMC5953945 DOI: 10.1038/s41598-018-25663-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/17/2018] [Indexed: 12/11/2022] Open
Abstract
We are introducing the FABRICA, a bioprinter-agnostic 3D-printed bioreactor platform designed for 3D-bioprinted tissue construct culture, perfusion, observation, and analysis. The computer-designed FABRICA was 3D-printed with biocompatible material and used for two studies: (1) Flow Profile Study: perfused 5 different media through a synthetic 3D-bioprinted construct and ultrasonically analyzed the flow profile at increasing volumetric flow rates (VFR); (2) Construct Perfusion Study: perfused a 3D-bioprinted tissue construct for a week and compared histologically with a non-perfused control. For the flow profile study, construct VFR increased with increasing pump VFR. Water and other media increased VFR significantly while human and pig blood showed shallow increases. For the construct perfusion study, we confirmed more viable cells in perfused 3D-bioprinted tissue compared to control. The FABRICA can be used to visualize constructs during 3D-bioprinting, incubation, and to control and ultrasonically analyze perfusion, aseptically in real-time, making the FABRICA tunable for different tissues.
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18
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Gonzalez de Torre I, Weber M, Quintanilla L, Alonso M, Jockenhoevel S, Rodríguez Cabello JC, Mela P. Hybrid elastin-like recombinamer-fibrin gels: physical characterization and in vitro evaluation for cardiovascular tissue engineering applications. Biomater Sci 2018; 4:1361-70. [PMID: 27430365 DOI: 10.1039/c6bm00300a] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In the field of tissue engineering, the properties of the scaffolds are of crucial importance for the success of the application. Hybrid materials combine the properties of the different components that constitute them. In this study hybrid gels of Elastin-Like Recombinamer (ELR) and fibrin were prepared with a range of polymer concentrations and ELR-to-fibrin ratios. The correlation between SEM micrographs, porosities, swelling ratios and rheological properties was discussed and a poroelastic mechanism was suggested to explain the mechanical behavior of the hybrid gels. Applicability as scaffold materials for cardiovascular tissue engineering was shown by the realization of cell-laden matrixes which supported the synthesis of collagens as revealed by immunohistochemical analysis. As a proof of concept, a tissue-engineered heart valve was fabricated by injection moulding and cultivated in a bioreactor for 3 weeks under dynamic conditions. Tissue analysis revealed the production of collagen I and III, fundamental proteins for cardiovascular constructs.
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Affiliation(s)
- Israel Gonzalez de Torre
- BIOFORGE, CIBER-BBN, Campus "Miguel Delibes" Edificio LUCIA, Universidad de Valladolid, Paseo Belén 19, 47011, Valladolid, Spain and TECHNICAL PROTEINS NANOBIOTECHNOLOGY S.L., Campus "Miguel Delibes" Edificio CTTA, Universidad de Valladolid, Paseo Belén 9A, 47011, Valladolid, Spain
| | - Miriam Weber
- Tissue Engineering and Textile Implants, AME, Helmholtz Institute, RWTH Aachen University, Pauwelsstr. 20, 52074 Aachen, Germany
| | - Luis Quintanilla
- BIOFORGE, CIBER-BBN, Campus "Miguel Delibes" Edificio LUCIA, Universidad de Valladolid, Paseo Belén 19, 47011, Valladolid, Spain
| | - Matilde Alonso
- BIOFORGE, CIBER-BBN, Campus "Miguel Delibes" Edificio LUCIA, Universidad de Valladolid, Paseo Belén 19, 47011, Valladolid, Spain
| | - Stefan Jockenhoevel
- Tissue Engineering and Textile Implants, AME, Helmholtz Institute, RWTH Aachen University, Pauwelsstr. 20, 52074 Aachen, Germany
| | - José Carlos Rodríguez Cabello
- BIOFORGE, CIBER-BBN, Campus "Miguel Delibes" Edificio LUCIA, Universidad de Valladolid, Paseo Belén 19, 47011, Valladolid, Spain
| | - Petra Mela
- Tissue Engineering and Textile Implants, AME, Helmholtz Institute, RWTH Aachen University, Pauwelsstr. 20, 52074 Aachen, Germany
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19
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D'Amore A, Luketich SK, Raffa GM, Olia S, Menallo G, Mazzola A, D'Accardi F, Grunberg T, Gu X, Pilato M, Kameneva MV, Badhwar V, Wagner WR. Heart valve scaffold fabrication: Bioinspired control of macro-scale morphology, mechanics and micro-structure. Biomaterials 2018; 150:25-37. [PMID: 29031049 PMCID: PMC5988585 DOI: 10.1016/j.biomaterials.2017.10.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/19/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
Abstract
Valvular heart disease is currently treated with mechanical valves, which benefit from longevity, but are burdened by chronic anticoagulation therapy, or with bioprosthetic valves, which have reduced thromboembolic risk, but limited durability. Tissue engineered heart valves have been proposed to resolve these issues by implanting a scaffold that is replaced by endogenous growth, leaving autologous, functional leaflets that would putatively eliminate the need for anticoagulation and avoid calcification. Despite the diversity in fabrication strategies and encouraging results in large animal models, control over engineered valve structure-function remains at best partial. This study aimed to overcome these limitations by introducing double component deposition (DCD), an electrodeposition technique that employs multi-phase electrodes to dictate valve macro and microstructure and resultant function. Results in this report demonstrate the capacity of the DCD method to simultaneously control scaffold macro-scale morphology, mechanics and microstructure while producing fully assembled stent-less multi-leaflet valves composed of microscopic fibers. DCD engineered valve characterization included: leaflet thickness, biaxial properties, bending properties, and quantitative structural analysis of multi-photon and scanning electron micrographs. Quasi-static ex-vivo valve coaptation testing and dynamic organ level functional assessment in a pressure pulse duplicating device demonstrated appropriate acute valve functionality.
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Affiliation(s)
- Antonio D'Amore
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Fondazione RiMED, Italy; Dipartimento innovazione industriale e digitale (DIIT), Università di Palermo, Italy
| | - Samuel K Luketich
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Giuseppe M Raffa
- Istituto mediterraneo trapianti e terapie ad alta specializzazione (ISMETT), UPMC, Italy
| | - Salim Olia
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Artificial Heart Program, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Giorgio Menallo
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Antonino Mazzola
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Dipartimento innovazione industriale e digitale (DIIT), Università di Palermo, Italy
| | - Flavio D'Accardi
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Dipartimento innovazione industriale e digitale (DIIT), Università di Palermo, Italy
| | - Tamir Grunberg
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; ORT Braude College of Engineering, Israel
| | - Xinzhu Gu
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michele Pilato
- Istituto mediterraneo trapianti e terapie ad alta specializzazione (ISMETT), UPMC, Italy
| | - Marina V Kameneva
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Vinay Badhwar
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Dep. of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA
| | - William R Wagner
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
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20
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Hurtado-Aguilar LG, Mulderrig S, Moreira R, Hatam N, Spillner J, Schmitz-Rode T, Jockenhoevel S, Mela P. Ultrasound for In Vitro, Noninvasive Real-Time Monitoring and Evaluation of Tissue-Engineered Heart Valves. Tissue Eng Part C Methods 2017; 22:974-981. [PMID: 27673356 DOI: 10.1089/ten.tec.2016.0300] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Tissue-engineered heart valves are developed in bioreactors where biochemical and mechanical stimuli are provided for extracellular matrix formation. During this phase, the monitoring possibilities are limited by the need to maintain the sterility and integrity of the valve. Therefore, noninvasive and nondestructive techniques are required. As such, optical imaging is commonly used to verify valve's functionality in vitro. It provides important information (i.e., leaflet symmetry, geometric orifice area, and closing and opening times), which is, however, usually limited to a singular view along the central axis from the outflow side. In this study, we propose ultrasound as a monitoring method that, in contrast to established optical imaging, can assess the valve from different planes, scanning the whole three-dimensional geometry. We show the potential benefits associated with the application of ultrasound to bioreactors, in advancing heart valve tissue engineering from design to fabrication and in vitro maturation. Specifically, we demonstrate that additional information, otherwise unavailable, can be gained to evaluate the valve's functionality (e.g., coaptation length, and effective cusp height and shape). Furthermore, we show that Doppler techniques provide qualitative visualization and quantitative evaluation of the flow through the valve, in real time and throughout the whole in vitro fabrication phase.
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Affiliation(s)
- Luis G Hurtado-Aguilar
- 1 Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen , Aachen, Germany
| | - Shane Mulderrig
- 1 Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen , Aachen, Germany
| | - Ricardo Moreira
- 1 Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen , Aachen, Germany
| | - Nima Hatam
- 2 Department for Cardiothoracic and Vascular Surgery, University Hospital RWTH Aachen , Aachen, Germany
| | - Jan Spillner
- 2 Department for Cardiothoracic and Vascular Surgery, University Hospital RWTH Aachen , Aachen, Germany
| | - Thomas Schmitz-Rode
- 1 Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen , Aachen, Germany
| | - Stefan Jockenhoevel
- 1 Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen , Aachen, Germany .,3 Institute for Textile Engineering, RWTH Aachen University , Aachen, Germany
| | - Petra Mela
- 1 Department of Tissue Engineering and Textile Implants, AME-Helmholtz Institute for Biomedical Engineering, University Hospital RWTH Aachen , Aachen, Germany
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21
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Malischewski A, Moreira R, Hurtado L, Gesché V, Schmitz-Rode T, Jockenhoevel S, Mela P. Umbilical cord as human cell source for mitral valve tissue engineering - venous vs. arterial cells. ACTA ACUST UNITED AC 2017; 62:457-466. [PMID: 28453437 DOI: 10.1515/bmt-2016-0218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 03/01/2017] [Indexed: 11/15/2022]
Abstract
Around 2% of the population in developed nations are affected by mitral valve disease and available valvular replacements are not designed for the atrioventricular position. Recently our group developed the first tissue-engineered heart valve (TEHV) specifically designed for the mitral position - the TexMi valve. The valve recapitulates the main components of the native valve, i.e. annulus, asymmetric leaflets and the crucial chordae tendineae. In the present study, we evaluated the human umbilical cord as a clinically applicable cell source for the TexMi valve. Valves produced with cells isolated from human umbilical cord veins (HUVs) and human umbilical cord arteries (HUAs) were conditioned for 21 days in custom-made bioreactors and evaluated in terms of extracellular matrix (ECM) composition and mechanical properties. In addition, static cell-laden fibrin discs were molded to investigate cell-mediated tissue contraction and differences in ECM production. HUA and HUV cells were able to deliver functional valves with a rich ECM composed mainly of collagen. Particularly noteworthy was the synthesis of elastin, which has been observed rarely in TEHV. The elastin synthesis was significantly higher in TexMi valves produced with HUV cells and therefore the HUV is considered to be the preferred cell source.
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22
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Riedelová-Reicheltová Z, Brynda E, Riedel T. Fibrin nanostructures for biomedical applications. Physiol Res 2017; 65:S263-S272. [PMID: 27762592 DOI: 10.33549/physiolres.933428] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Fibrin is a versatile biopolymer that has been extensively used in tissue engineering. In this paper fibrin nanostructures prepared using a technique based on the catalytic effect of fibrin-bound thrombin are presented. This technique enables surface-attached thin fibrin networks to form with precisely regulated morphology without the development of fibrin gel in bulk solution. Moreover, the influence of changing the polymerization time, along with the antithrombin III and heparin concentrations on the morphology of fibrin nanostructures was explored. The binding of bioactive molecules (fibronectin, laminin, collagen, VEGF, bFGF, and heparin) to fibrin nanostructures was confirmed. These nanostructures can be used for the surface modification of artificial biomaterials designed for different biomedical applications (e.g. artificial vessels, stents, heart valves, bone and cartilage constructs, skin grafts, etc.) in order to promote the therapeutic outcome.
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Affiliation(s)
- Z Riedelová-Reicheltová
- Institute of Macromolecular Chemistry of the Czech Academy of Sciences, Prague, Czech Republic.
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23
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Liberski A, Ayad N, Wojciechowska D, Zielińska D, Struszczyk MH, Latif N, Yacoub M. Knitting for heart valve tissue engineering. Glob Cardiol Sci Pract 2016; 2016:e201631. [PMID: 29043276 PMCID: PMC5642840 DOI: 10.21542/gcsp.2016.31] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Knitting is a versatile technology which offers a large portfolio of products and solutions of interest in heart valve (HV) tissue engineering (TE). One of the main advantages of knitting is its ability to construct complex shapes and structures by precisely assembling the yarns in the desired position. With this in mind, knitting could be employed to construct a HV scaffold that closely resembles the authentic valve. This has the potential to reproduce the anisotropic structure that is characteristic of the heart valve with the yarns, in particular the 3-layered architecture of the leaflets. These yarns can provide oriented growth of cells lengthwise and consequently enable the deposition of extracellular matrix (ECM) proteins in an oriented manner. This technique, therefore, has a potential to provide a functional knitted scaffold, but to achieve that textile engineers need to gain a basic understanding of structural and mechanical aspects of the heart valve and in addition, tissue engineers must acquire the knowledge of tools and capacities that are essential in knitting technology. The aim of this review is to provide a platform to consolidate these two fields as well as to enable an efficient communication and cooperation among these two research areas.
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Affiliation(s)
- Albert Liberski
- Sidra Medical and Research Center, P.O. Box 26999, Doha, Qatar
| | - Nadia Ayad
- Mechanical Engineering and Material Science Department, Military Institute of Engineering (IME), Rio de Janeiro, RJ, Brazil
| | - Dorota Wojciechowska
- Lodz University of Technology, Faculty of Material Technologies and Textile Design, Department of Material and Commodity Sciences and Textile Metrology, ul. Zeromskiego 116, 90-924, Lodz, Poland
| | - Dorota Zielińska
- Institute of Security Technologies "Moratex" 3 M, Skłodowskiej-Curie Street 90-505 Lodz, Poland
| | - Marcin H Struszczyk
- Institute of Security Technologies "Moratex" 3 M, Skłodowskiej-Curie Street 90-505 Lodz, Poland
| | - Najma Latif
- Imperial College of Science and Technology, London, UK
| | - Magdi Yacoub
- Sidra Medical and Research Center, P.O. Box 26999, Doha, Qatar
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24
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Tissue-Engineered Tubular Heart Valves Combining a Novel Precontraction Phase with the Self-Assembly Method. Ann Biomed Eng 2016; 45:427-438. [DOI: 10.1007/s10439-016-1708-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 08/04/2016] [Indexed: 11/25/2022]
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25
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Reimer J, Syedain Z, Haynie B, Lahti M, Berry J, Tranquillo R. Implantation of a Tissue-Engineered Tubular Heart Valve in Growing Lambs. Ann Biomed Eng 2016; 45:439-451. [PMID: 27066787 DOI: 10.1007/s10439-016-1605-7] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/01/2016] [Indexed: 10/22/2022]
Abstract
Current pediatric heart valve replacement options are suboptimal because they are incapable of somatic growth. Thus, children typically have multiple surgeries to replace outgrown valves. In this study, we present the in vivo function and growth potential of our tissue-engineered pediatric tubular valve. The valves were fabricated by sewing two decellularized engineered tissue tubes together in a prescribed pattern using degradable sutures and subsequently implanted into the main pulmonary artery of growing lambs. Valve function was monitored using periodic ultrasounds after implantation throughout the duration of the study. The valves functioned well up to 8 weeks, 4 weeks beyond the suture strength half-life, after which their insufficiency index worsened. Histology from the explanted valves revealed extensive host cell invasion within the engineered root and commencing from the leaflet surfaces. These cells expressed multiple phenotypes, including endothelial, and deposited elastin and collagen IV. Although the tubes fused together along the degradable suture line as designed, the leaflets shortened compared to their original height. This shortening is hypothesized to result from inadequate fusion at the commissures prior to suture degradation. With appropriate commissure reinforcement, this novel heart valve may provide the somatic growth potential desired for a pediatric valve replacement.
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Affiliation(s)
- Jay Reimer
- Department of Biomedical Engineering, University of Minnesota, 312 Church St SE, Minneapolis, MN, 55455, USA
| | - Zeeshan Syedain
- Department of Biomedical Engineering, University of Minnesota, 312 Church St SE, Minneapolis, MN, 55455, USA
| | - Bee Haynie
- Department of Biomedical Engineering, University of Minnesota, 312 Church St SE, Minneapolis, MN, 55455, USA
| | - Matthew Lahti
- Experimental Surgical Services, University of Minnesota, Minneapolis, MN, USA
| | - James Berry
- Experimental Surgical Services, University of Minnesota, Minneapolis, MN, USA
| | - Robert Tranquillo
- Department of Biomedical Engineering, University of Minnesota, 312 Church St SE, Minneapolis, MN, 55455, USA. .,Department of Chemical Engineering and Material Science, University of Minnesota, Minneapolis, MN, USA.
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26
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Akbari M, Tamayol A, Bagherifard S, Serex L, Mostafalu P, Faramarzi N, Mohammadi MH, Khademhosseini A. Textile Technologies and Tissue Engineering: A Path Toward Organ Weaving. Adv Healthc Mater 2016; 5:751-66. [PMID: 26924450 PMCID: PMC4910159 DOI: 10.1002/adhm.201500517] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 09/07/2015] [Indexed: 12/14/2022]
Abstract
Textile technologies have recently attracted great attention as potential biofabrication tools for engineering tissue constructs. Using current textile technologies, fibrous structures can be designed and engineered to attain the required properties that are demanded by different tissue engineering applications. Several key parameters such as physiochemical characteristics of fibers, microarchitecture, and mechanical properties of the fabrics play important roles in the effective use of textile technologies in tissue engineering. This review summarizes the current advances in the manufacturing of biofunctional fibers. Different textile methods such as knitting, weaving, and braiding are discussed and their current applications in tissue engineering are highlighted.
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Affiliation(s)
- Mohsen Akbari
- Department of Medicine, Brigham and Women's Hospital, Biomaterials Innovation Research Center, Harvard Medical School, Cambridge, MA, 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
- Department of Mechanical Engineering, University of Victoria, Victoria, BC, V8P 5C2, Canada
| | - Ali Tamayol
- Department of Medicine, Brigham and Women's Hospital, Biomaterials Innovation Research Center, Harvard Medical School, Cambridge, MA, 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
| | - Sara Bagherifard
- Department of Medicine, Brigham and Women's Hospital, Biomaterials Innovation Research Center, Harvard Medical School, Cambridge, MA, 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Department of Mechanical Engineering, Politecnico di Milano, Milan, 20156, Italy
- David H. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Ludovic Serex
- Department of Medicine, Brigham and Women's Hospital, Biomaterials Innovation Research Center, Harvard Medical School, Cambridge, MA, 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Pooria Mostafalu
- Department of Medicine, Brigham and Women's Hospital, Biomaterials Innovation Research Center, Harvard Medical School, Cambridge, MA, 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
| | - Negar Faramarzi
- Department of Medicine, Brigham and Women's Hospital, Biomaterials Innovation Research Center, Harvard Medical School, Cambridge, MA, 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Mohammad Hossein Mohammadi
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Ali Khademhosseini
- Department of Medicine, Brigham and Women's Hospital, Biomaterials Innovation Research Center, Harvard Medical School, Cambridge, MA, 02139, USA
- Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
- Department of Physics, King Abdulaziz University, Jeddah, 21569, Saudi Arabia
- Department of Bioindustrial Technologies, College of Animal Bioscience and Technology, Konkuk University, Hwayang-dong, Gwangjin-gu, Seoul, 143-701, Republic of Korea
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Kehl D, Weber B, Hoerstrup SP. Bioengineered living cardiac and venous valve replacements: current status and future prospects. Cardiovasc Pathol 2016; 25:300-305. [PMID: 27167776 DOI: 10.1016/j.carpath.2016.03.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 02/19/2016] [Accepted: 03/08/2016] [Indexed: 12/13/2022] Open
Abstract
Valvular heart disease remains to be a major cause of death worldwide with increasing prevalence, mortality, and morbidity. Current heart valve replacements are associated with several limitations due to their nonviable nature. In this regard, heart valve tissue engineering has shown to represent a promising concept in order to overcome these limitations and replace diseased cardiac valves with living, autologous constructs. These bioengineered valves hold potential for in situ remodeling, growth, and repair throughout the patient's lifetime without the risk of thromboembolic complications and adverse immune responses. For the fabrication of tissue-engineered heart valves, several concepts have been established, the "classical" in vitro tissue engineering approach, the in situ tissue engineering approach, and alternative approaches including three-dimensional printing and electrospinning. Besides first attempts have been conducted in order to produce a tissue-engineered venous valve for the treatment of deep venous valve insufficiency. Here we review basic principals and current scientific status of valvular tissue engineering, including a critical discussion and outlook for the future.
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Affiliation(s)
- Debora Kehl
- Institute for Regenerative Medicine, University of Zurich Center for Therapy Development/Good Manufacturing Practice, Moussonstrasse 13, CH-8044 Zurich, Switzerland
| | - Benedikt Weber
- Institute for Regenerative Medicine, University of Zurich Center for Therapy Development/Good Manufacturing Practice, Moussonstrasse 13, CH-8044 Zurich, Switzerland
| | - Simon Philipp Hoerstrup
- Institute for Regenerative Medicine, University of Zurich Center for Therapy Development/Good Manufacturing Practice, Moussonstrasse 13, CH-8044 Zurich, Switzerland.
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28
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Aibibu D, Hild M, Wöltje M, Cherif C. Textile cell-free scaffolds for in situ tissue engineering applications. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2016; 27:63. [PMID: 26800694 PMCID: PMC4723636 DOI: 10.1007/s10856-015-5656-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 12/20/2015] [Indexed: 05/12/2023]
Abstract
In this article, the benefits offered by micro-fibrous scaffold architectures fabricated by textile manufacturing techniques are discussed: How can established and novel fiber-processing techniques be exploited in order to generate templates matching the demands of the target cell niche? The problems related to the development of biomaterial fibers (especially from nature-derived materials) ready for textile manufacturing are addressed. Attention is also paid on how biological cues may be incorporated into micro-fibrous scaffold architectures by hybrid manufacturing approaches (e.g. nanofiber or hydrogel functionalization). After a critical review of exemplary recent research works on cell-free fiber based scaffolds for in situ TE, including clinical studies, we conclude that in order to make use of the whole range of favors which may be provided by engineered fibrous scaffold systems, there are four main issues which need to be addressed: (1) Logical combination of manufacturing techniques and materials. (2) Biomaterial fiber development. (3) Adaption of textile manufacturing techniques to the demands of scaffolds for regenerative medicine. (4) Incorporation of biological cues (e.g. stem cell homing factors).
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Affiliation(s)
- Dilbar Aibibu
- Technische Universität Dresden, Fakultät Maschinenwesen, Institut für Textilmaschinen und Textile Hochleistungswerkstofftechnik, 01062, Dresden, Germany.
| | - Martin Hild
- Technische Universität Dresden, Fakultät Maschinenwesen, Institut für Textilmaschinen und Textile Hochleistungswerkstofftechnik, 01062, Dresden, Germany
| | - Michael Wöltje
- Technische Universität Dresden, Fakultät Maschinenwesen, Institut für Textilmaschinen und Textile Hochleistungswerkstofftechnik, 01062, Dresden, Germany
| | - Chokri Cherif
- Technische Universität Dresden, Fakultät Maschinenwesen, Institut für Textilmaschinen und Textile Hochleistungswerkstofftechnik, 01062, Dresden, Germany
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29
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Bioprinting a cardiac valve. Biotechnol Adv 2015; 33:1503-21. [DOI: 10.1016/j.biotechadv.2015.07.006] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 06/30/2015] [Accepted: 07/27/2015] [Indexed: 12/13/2022]
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30
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Kim K, Wagner WR. Non-invasive and Non-destructive Characterization of Tissue Engineered Constructs Using Ultrasound Imaging Technologies: A Review. Ann Biomed Eng 2015; 44:621-35. [PMID: 26518412 DOI: 10.1007/s10439-015-1495-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 10/23/2015] [Indexed: 12/14/2022]
Abstract
With the rapid expansion of biomaterial development and coupled efforts to translate such advances toward the clinic, non-invasive and non-destructive imaging tools to evaluate implants in situ in a timely manner are critically needed. The required multi-level information is comprehensive, including structural, mechanical, and biological changes such as scaffold degradation, mechanical strength, cell infiltration, extracellular matrix formation and vascularization to name a few. With its inherent advantages of non-invasiveness and non-destructiveness, ultrasound imaging can be an ideal tool for both preclinical and clinical uses. In this review, currently available ultrasound imaging technologies that have been applied in vitro and in vivo for tissue engineering and regenerative medicine are discussed and some new emerging ultrasound technologies and multi-modality approaches utilizing ultrasound are introduced.
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Affiliation(s)
- Kang Kim
- Center for Ultrasound Molecular Imaging and Therapeutics, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA. .,Heart and Vascular Institute, University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, 15213, USA. .,Department of Bioengineering, University of Pittsburgh School of Engineering, Pittsburgh, PA, 15213, USA. .,McGowan Institute for Regenerative Medicine, University of Pittsburgh and UPMC, Pittsburgh, PA, 15219, USA.
| | - William R Wagner
- Department of Bioengineering, University of Pittsburgh School of Engineering, Pittsburgh, PA, 15213, USA.,Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh and UPMC, Pittsburgh, PA, 15219, USA
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31
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Reimer JM, Syedain ZH, Haynie BHT, Tranquillo RT. Pediatric tubular pulmonary heart valve from decellularized engineered tissue tubes. Biomaterials 2015; 62:88-94. [PMID: 26036175 PMCID: PMC4490908 DOI: 10.1016/j.biomaterials.2015.05.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 05/14/2015] [Indexed: 01/07/2023]
Abstract
Pediatric patients account for a small portion of the heart valve replacements performed, but a pediatric pulmonary valve replacement with growth potential remains an unmet clinical need. Herein we report the first tubular heart valve made from two decellularized, engineered tissue tubes attached with absorbable sutures, which can meet this need, in principle. Engineered tissue tubes were fabricated by allowing ovine dermal fibroblasts to replace a sacrificial fibrin gel with an aligned, cell-produced collagenous matrix, which was subsequently decellularized. Previously, these engineered tubes became extensively recellularized following implantation into the sheep femoral artery. Thus, a tubular valve made from these tubes may be amenable to recellularization and, ideally, somatic growth. The suture line pattern generated three equi-spaced leaflets in the inner tube, which collapsed inward when exposed to back pressure, per tubular valve design. Valve testing was performed in a pulse duplicator system equipped with a secondary flow loop to allow for root distention. All tissue-engineered valves exhibited full leaflet opening and closing, minimal regurgitation (<5%), and low systolic pressure gradients (<2.5 mmHg) under pulmonary conditions. Valve performance was maintained under various trans-root pressure gradients and no tissue damage was evident after 2 million cycles of fatigue testing.
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Affiliation(s)
- Jay M Reimer
- Department of Biomedical Engineering, University of Minnesota, USA
| | | | - Bee H T Haynie
- Department of Biomedical Engineering, University of Minnesota, USA
| | - Robert T Tranquillo
- Department of Biomedical Engineering, University of Minnesota, USA; Department of Chemical Engineering and Material Science, University of Minnesota, USA.
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32
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Cheung DY, Duan B, Butcher JT. Current progress in tissue engineering of heart valves: multiscale problems, multiscale solutions. Expert Opin Biol Ther 2015; 15:1155-72. [PMID: 26027436 DOI: 10.1517/14712598.2015.1051527] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Heart valve disease is an increasingly prevalent and clinically serious condition. There are no clinically effective biological diagnostics or treatment strategies. The only recourse available is replacement with a prosthetic valve, but the inability of these devices to grow or respond biologically to their environments necessitates multiple resizing surgeries and life-long coagulation treatment, especially in children. Tissue engineering has a unique opportunity to impact heart valve disease by providing a living valve conduit, capable of growth and biological integration. AREAS COVERED This review will cover current tissue engineering strategies in fabricating heart valves and their progress towards the clinic, including molded scaffolds using naturally derived or synthetic polymers, decellularization, electrospinning, 3D bioprinting, hybrid techniques, and in vivo engineering. EXPERT OPINION Whereas much progress has been made to create functional living heart valves, a clinically viable product is not yet realized. The next leap in engineered living heart valves will require a deeper understanding of how the natural multi-scale structural and biological heterogeneity of the tissue ensures its efficient function. Related, improved fabrication strategies must be developed that can replicate this de novo complexity, which is likely instructive for appropriate cell differentiation and remodeling whether seeded with autologous stem cells in vitro or endogenously recruited cells.
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Affiliation(s)
- Daniel Y Cheung
- Cornell University, Department of Biomedical Engineering , Ithaca, NY , USA
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33
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Weber M, Gonzalez de Torre I, Moreira R, Frese J, Oedekoven C, Alonso M, Rodriguez Cabello CJ, Jockenhoevel S, Mela P. Multiple-Step Injection Molding for Fibrin-Based Tissue-Engineered Heart Valves. Tissue Eng Part C Methods 2015; 21:832-40. [PMID: 25654448 PMCID: PMC4523041 DOI: 10.1089/ten.tec.2014.0396] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Heart valves are elaborate and highly heterogeneous structures of the circulatory system. Despite the well accepted relationship between the structural and mechanical anisotropy and the optimal function of the valves, most approaches to create tissue-engineered heart valves (TEHVs) do not try to mimic this complexity and rely on one homogenous combination of cells and materials for the whole construct. The aim of this study was to establish an easy and versatile method to introduce spatial diversity into a heart valve fibrin scaffold. We developed a multiple-step injection molding process that enables the fabrication of TEHVs with heterogeneous composition (cell/scaffold material) of wall and leaflets without the need of gluing or suturing components together, with the leaflets firmly connected to the wall. The integrity of the valves and their functionality was proved by either opening/closing cycles in a bioreactor (proof of principle without cells) or with continuous stimulation over 2 weeks. We demonstrated the potential of the method by the two-step molding of the wall and the leaflets containing different cell lines. Immunohistology after stimulation confirmed tissue formation and demonstrated the localization of the different cell types. Furthermore, we showed the proof of principle fabrication of valves using different materials for wall (fibrin) and leaflets (hybrid gel of fibrin/elastin-like recombinamer) and with layered leaflets. The method is easy to implement, does not require special facilities, and can be reproduced in any tissue-engineering lab. While it has been demonstrated here with fibrin, it can easily be extended to other hydrogels.
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Affiliation(s)
- Miriam Weber
- 1 Department of Tissue Engineering and Textile Implants, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University , Aachen, Germany
| | | | - Ricardo Moreira
- 1 Department of Tissue Engineering and Textile Implants, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University , Aachen, Germany
| | - Julia Frese
- 1 Department of Tissue Engineering and Textile Implants, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University , Aachen, Germany
| | - Caroline Oedekoven
- 1 Department of Tissue Engineering and Textile Implants, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University , Aachen, Germany
| | - Matilde Alonso
- 2 G.I.R. Bioforge, University of Valladolid , CIBER-BBN, Valladolid, Spain
| | | | - Stefan Jockenhoevel
- 1 Department of Tissue Engineering and Textile Implants, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University , Aachen, Germany .,3 Institut für Textiltecknik, RWTH Aachen University , Aachen, Germany
| | - Petra Mela
- 1 Department of Tissue Engineering and Textile Implants, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University , Aachen, Germany
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34
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Nam SY, Ricles LM, Suggs LJ, Emelianov SY. Imaging strategies for tissue engineering applications. TISSUE ENGINEERING. PART B, REVIEWS 2015; 21:88-102. [PMID: 25012069 PMCID: PMC4322020 DOI: 10.1089/ten.teb.2014.0180] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 07/08/2014] [Indexed: 12/18/2022]
Abstract
Tissue engineering has evolved with multifaceted research being conducted using advanced technologies, and it is progressing toward clinical applications. As tissue engineering technology significantly advances, it proceeds toward increasing sophistication, including nanoscale strategies for material construction and synergetic methods for combining with cells, growth factors, or other macromolecules. Therefore, to assess advanced tissue-engineered constructs, tissue engineers need versatile imaging methods capable of monitoring not only morphological but also functional and molecular information. However, there is no single imaging modality that is suitable for all tissue-engineered constructs. Each imaging method has its own range of applications and provides information based on the specific properties of the imaging technique. Therefore, according to the requirements of the tissue engineering studies, the most appropriate tool should be selected among a variety of imaging modalities. The goal of this review article is to describe available biomedical imaging methods to assess tissue engineering applications and to provide tissue engineers with criteria and insights for determining the best imaging strategies. Commonly used biomedical imaging modalities, including X-ray and computed tomography, positron emission tomography and single photon emission computed tomography, magnetic resonance imaging, ultrasound imaging, optical imaging, and emerging techniques and multimodal imaging, will be discussed, focusing on the latest trends of their applications in recent tissue engineering studies.
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Affiliation(s)
- Seung Yun Nam
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas
- Department of Electrical and Computer Engineering, The University of Texas at Austin, Austin, Texas
| | - Laura M. Ricles
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas
| | - Laura J. Suggs
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas
| | - Stanislav Y. Emelianov
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas
- Department of Electrical and Computer Engineering, The University of Texas at Austin, Austin, Texas
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35
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Moreira R, Velz T, Alves N, Gesche VN, Malischewski A, Schmitz-Rode T, Frese J, Jockenhoevel S, Mela P. Tissue-engineered heart valve with a tubular leaflet design for minimally invasive transcatheter implantation. Tissue Eng Part C Methods 2014; 21:530-40. [PMID: 25380414 DOI: 10.1089/ten.tec.2014.0214] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Transcatheter aortic valve implantation of (nonviable) bioprosthetic valves has been proven a valid alternative to conventional surgical implantation in patients at high or prohibitive mortality risk. In this study we present the in vitro proof-of-principle of a newly developed tissue-engineered heart valve for minimally invasive implantation, with the ultimate aim of adding the unique advantages of a living tissue with regeneration capabilities to the continuously developing transcatheter technologies. The tube-in-stent is a fibrin-based tissue-engineered valve with a tubular leaflet design. It consists of a tubular construct sewn into a self-expandable nitinol stent at three commissural attachment points and along a circumferential line so that it forms three coaptating leaflets by collapsing under diastolic back pressure. The tubular constructs were molded with fibrin and human umbilical vein cells. After 3 weeks of conditioning in a bioreactor, the valves were fully functional with unobstructed opening (systolic phase) and complete closure (diastolic phase). Tissue analysis showed a homogeneous cell distribution throughout the valve's thickness and deposition of collagen types I and III oriented along the longitudinal direction. Immunohistochemical staining against CD31 and scanning electron microscopy revealed a confluent endothelial cell layer on the surface of the valves. After harvesting, the valves underwent crimping for 20 min to simulate the catheter-based delivery. This procedure did not affect the valvular functionality in terms of orifice area during systole and complete closure during diastole. No influence on the extracellular matrix organization, as assessed by immunohistochemistry, nor on the mechanical properties was observed. These results show the potential of combining tissue engineering and minimally invasive implantation technology to obtain a living heart valve with a simple and robust tubular design for transcatheter delivery. The effect of the in vivo remodeling on the functionality of the tube-in-stent valve remains to be tested.
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Affiliation(s)
- Ricardo Moreira
- 1Department of Tissue Engineering and Textile Implants, AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany
| | - Thaddaeus Velz
- 1Department of Tissue Engineering and Textile Implants, AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany
| | - Nuno Alves
- 1Department of Tissue Engineering and Textile Implants, AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany
| | | | - Axel Malischewski
- 1Department of Tissue Engineering and Textile Implants, AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany
| | - Thomas Schmitz-Rode
- 1Department of Tissue Engineering and Textile Implants, AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany
| | - Julia Frese
- 1Department of Tissue Engineering and Textile Implants, AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany
| | - Stefan Jockenhoevel
- 1Department of Tissue Engineering and Textile Implants, AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.,2Institut für Textiltechnik, RWTH Aachen University, Aachen, Germany
| | - Petra Mela
- 1Department of Tissue Engineering and Textile Implants, AME-Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany
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36
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Riopel M, Trinder M, Wang R. Fibrin, a scaffold material for islet transplantation and pancreatic endocrine tissue engineering. TISSUE ENGINEERING PART B-REVIEWS 2014; 21:34-44. [PMID: 24947304 DOI: 10.1089/ten.teb.2014.0188] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Fibrin is derived from fibrinogen during injury to produce a blood clot and thus promote wound repair. Composed of different domains, including Arg-Gly-Asp amino acid motifs, fibrin is used extensively as a hydrogel and sealant in the clinic. By binding to cell surface receptors like integrins and acting as a supportive 3D scaffold, fibrin has been useful in promoting cell differentiation, proliferation, function, and survival. In particular, fibrin has been able to maintain islet cell architecture, promote beta cell insulin secretion, and islet angiogenesis, as well as inducing a protective effect against cell death. During islet transplantation, fibrin improved neovascularization and islet function. These improvements resulted in reduced number of transplanted islets necessary to reverse diabetes. Therefore, fibrin, as a biocompatible and biodegradable scaffold, should be considered during subcutaneous islet transplantation and beta cell expansion in vitro to ensure maintenance of islet cell function, proliferation, and survival to develop effective cell-based therapies for the treatment of diabetes.
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Affiliation(s)
- Matthew Riopel
- 1 Children's Health Research Institute, London, Ontario, Canada
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37
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Duan B, Kapetanovic E, Hockaday LA, Butcher JT. Three-dimensional printed trileaflet valve conduits using biological hydrogels and human valve interstitial cells. Acta Biomater 2014; 10:1836-46. [PMID: 24334142 DOI: 10.1016/j.actbio.2013.12.005] [Citation(s) in RCA: 237] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 11/20/2013] [Accepted: 12/05/2013] [Indexed: 12/20/2022]
Abstract
Tissue engineering has great potential to provide a functional de novo living valve replacement, capable of integration with host tissue and growth. Among various valve conduit fabrication techniques, three-dimensional (3-D) bioprinting enables deposition of cells and hydrogels into 3-D constructs with anatomical geometry and heterogeneous mechanical properties. Successful translation of this approach, however, is constrained by the dearth of printable and biocompatible hydrogel materials. Furthermore, it is not known how human valve cells respond to these printed environments. In this study, 3-D printable formulations of hybrid hydrogels are developed, based on methacrylated hyaluronic acid (Me-HA) and methacrylated gelatin (Me-Gel), and used to bioprint heart valve conduits containing encapsulated human aortic valvular interstitial cells (HAVIC). Increasing Me-Gel concentration resulted in lower stiffness and higher viscosity, facilitated cell spreading, and better maintained HAVIC fibroblastic phenotype. Bioprinting accuracy was dependent upon the relative concentrations of Me-Gel and Me-HA, but when optimized enabled the fabrication of a trileaflet valve shape accurate to the original design. HAVIC encapsulated within bioprinted heart valves maintained high viability, and remodeled the initial matrix by depositing collagen and glyosaminoglycans. These findings represent the first rational design of bioprinted trileaflet valve hydrogels that regulate encapsulated human VIC behavior. The use of anatomically accurate living valve scaffolds through bioprinting may accelerate understanding of physiological valve cell interactions and progress towards de novo living valve replacements.
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Affiliation(s)
- B Duan
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA
| | - E Kapetanovic
- College of Human Ecology, Cornell University, Ithaca, NY, USA
| | - L A Hockaday
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA
| | - J T Butcher
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA.
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