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Wu Y, Chen X, Song P, Li R, Zhou Y, Wang Q, Shi J, Qiao W, Dong N. Functional Oxidized Hyaluronic Acid Cross-Linked Decellularized Heart Valves for Improved Immunomodulation, Anti-Calcification, and Recellularization. Adv Healthc Mater 2024; 13:e2303737. [PMID: 38560921 DOI: 10.1002/adhm.202303737] [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: 10/27/2023] [Revised: 03/09/2024] [Indexed: 04/04/2024]
Abstract
Tissue engineering heart valves (TEHVs) are expected to address the limitations of mechanical and bioprosthetic valves used in clinical practice. Decellularized heart valve (DHV) is an important scaffold of TEHVs due to its natural three-dimensional structure and bioactive extracellular matrix, but its mechanical properties and hemocompatibility are impaired. In this study, DHV is cross-linked with three different molecular weights of oxidized hyaluronic acid (OHA) by a Schiff base reaction and presented enhanced stability and hemocompatibility, which could be mediated by the molecular weight of OHA. Notably, DHV cross-linked with middle- and high-molecular-weight OHA could drive the macrophage polarization toward the M2 phenotype in vitro. Moreover, DHV cross-linked with middle-molecular-weight OHA scaffolds are further modified with RGD-PHSRN peptide (RPF-OHA/DHV) to block the residual aldehyde groups of the unreacted OHA. The results show that RPF-OHA/DHV not only exhibits anti-calcification properties, but also facilitates endothelial cell adhesion and proliferation in vitro. Furthermore, RPF-OHA/DHV shows excellent performance under an in vivo hemodynamic environment with favorable recellularization and immune regulation without calcification. The optimistic results demonstrate that OHA with different molecular weights has different cross-linking effects on DHV and that RPF-OHA/DHV scaffold with enhanced immune regulation, anti-calcification, and recellularization properties for clinical transformation.
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Affiliation(s)
- Yunlong Wu
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Xing Chen
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
- Department of Cardiovascular Surgery, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, 430071, China
| | - Peng Song
- School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
| | - Rui Li
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Ying Zhou
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Qin Wang
- School of Chemistry and Chemical Engineering, Huazhong University of Science and Technology, Wuhan, Hubei, 430074, China
| | - Jiawei Shi
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Weihua Qiao
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Nianguo Dong
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
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Robinson A, Nkansah A, Bhat S, Karnik S, Jones S, Fairley A, Leung J, Wancura M, Sacks MS, Dasi LP, Cosgriff-Hernandez E. Hydrogel-polyurethane fiber composites with enhanced microarchitectural control for heart valve replacement. J Biomed Mater Res A 2024; 112:586-599. [PMID: 38018452 DOI: 10.1002/jbm.a.37641] [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: 06/08/2023] [Revised: 09/22/2023] [Accepted: 10/24/2023] [Indexed: 11/30/2023]
Abstract
Polymeric heart valves offer the potential to overcome the limited durability of tissue based bioprosthetic valves and the need for anticoagulant therapy of mechanical valve replacement options. However, developing a single-phase material with requisite biological properties and target mechanical properties remains a challenge. In this study, a composite heart valve material was developed where an electrospun mesh provides tunable mechanical properties and a hydrogel coating confers an antifouling surface for thromboresistance. Key biological responses were evaluated in comparison to glutaraldehyde-fixed pericardium. Platelet and bacterial attachment were reduced by 38% and 98%, respectively, as compared to pericardium that demonstrated the antifouling nature of the hydrogel coating. There was also a notable reduction (59%) in the calcification of the composite material as compared to pericardium. A custom 3D-printed hydrogel coating setup was developed to make valve composites for device-level hemodynamic testing. Regurgitation fraction (9.6 ± 1.8%) and effective orifice area (1.52 ± 0.34 cm2 ) met ISO 5840-2:2021 requirements. Additionally, the mean pressure gradient was comparable to current clinical bioprosthetic heart valves demonstrating preliminary efficacy. Although the hemodynamic properties are promising, it is anticipated that the random microarchitecture will result in suboptimal strain fields and peak stresses that may accelerate leaflet fatigue and degeneration. Previous computational work has demonstrated that bioinspired fiber microarchitectures can improve strain homogeneity of valve materials toward improving durability. To this end, we developed advanced electrospinning methodologies to achieve polyurethane fiber microarchitectures that mimic or exceed the physiological ranges of alignment, tortuosity, and curvilinearity present in the native valve. Control of fiber alignment from a random fiber orientation at a normalized orientation index (NOI) 14.2 ± 6.9% to highly aligned fibers at a NOI of 85.1 ± 1.4%. was achieved through increasing mandrel rotational velocity. Fiber tortuosity and curvilinearity in the range of native valve features were introduced through a post-spinning annealing process and fiber collection on a conical mandrel geometry, respectively. Overall, these studies demonstrate the potential of hydrogel-polyurethane fiber composite as a heart valve material. Future studies will utilize the developed advanced electrospinning methodologies in combination with model-directed fabrication toward optimizing durability as a function of fiber microarchitecture.
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Affiliation(s)
- Andrew Robinson
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Abbey Nkansah
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Sanchita Bhat
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Shweta Karnik
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Sarah Jones
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Ashauntee Fairley
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Jonathan Leung
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Megan Wancura
- Department of Chemistry, The University of Texas at Austin, Austin, Texas, USA
| | - Michael S Sacks
- Department of Biomedical Engineering, The University of Texas at Austin, Austin, Texas, USA
- James T. Willerson Center for Cardiovascular Modeling and Simulation, The Oden Institute for Computational Engineering and Sciences, Austin, Texas, USA
- Department of Mechanical Engineering, The University of Texas at Austin, Austin, Texas, USA
| | - Lakshmi Prasad Dasi
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
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Liu Y, Chen C, Lu T, Liu S, Wu Z, Tang Z. Free-aldehyde neutralized and oligohyaluronan loaded bovine pericardium with improved anti-calcification and endothelialization for bioprosthetic heart valves. Front Bioeng Biotechnol 2023; 11:1138972. [PMID: 37077226 PMCID: PMC10106738 DOI: 10.3389/fbioe.2023.1138972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
The number of patients with valvular heart disease is increasing yearly, and valve replacement is the most effective treatment, during which bioprosthetic heart valves (BHVs) are the most widely used. Commercial BHVs are mainly prepared with glutaraldehyde (Glut) cross-linked bovine pericardial or porcine aortic valves, but the residual free aldehyde groups in these tissues can cause calcification and cytotoxicity. Moreover, insufficient glycosaminoglycans (GAGs) in tissues can further reduce biocompatibility and durability. However, the anti-calcification performance and biocompatibility might be improved by blocking the free aldehyde groups and increasing the GAGs content in Glut-crosslinked tissues. In our study, adipic dihydrazide (ADH) was used to neutralize the residual free aldehyde groups in tissues and provide sites to blind with oligohyaluronan (OHA) to increase the content of GAGs in tissues. The modified bovine pericardium was evaluated for its content of residual aldehyde groups, the amount of OHA loaded, physical/chemical characteristics, biomechanical properties, biocompatibility, and in vivo anticalcification assay and endothelialization effects in juvenile Sprague-Dawley rats. The results showed that ADH could completely neutralize the free aldehyde groups in the Glut-crosslinked bovine pericardium, the amount of OHA loaded increased and the cytotoxicity was reduced. Moreover, the in vivo results also showed that the level of calcification and inflammatory response in the modified pericardial tissue was significantly reduced in a rat subcutaneous implantation model, and the results from the rat abdominal aorta vascular patch repair model further demonstrated the improved capability of the modified pericardial tissues for endothelialization. Furthermore, more α-SMA+ smooth muscle cells and fewer CD68+ macrophages infiltrated in the neointima of the modified pericardial patch. In summary, blocking free-aldehydes and loading OHA improved the anti-calcification, anti-inflammation and endothelialization properties of Glut-crosslinked BHVs and in particularly, this modified strategy may be a promising candidate for the next-generation of BHVs.
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Affiliation(s)
- Yuhong Liu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Engineering Laboratory of Human Province for Cardiovascular Biomaterials, Changsha, Hunan, China
| | - Chunyang Chen
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Engineering Laboratory of Human Province for Cardiovascular Biomaterials, Changsha, Hunan, China
| | - Ting Lu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Engineering Laboratory of Human Province for Cardiovascular Biomaterials, Changsha, Hunan, China
| | - Sixi Liu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Engineering Laboratory of Human Province for Cardiovascular Biomaterials, Changsha, Hunan, China
| | - Zhongshi Wu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Engineering Laboratory of Human Province for Cardiovascular Biomaterials, Changsha, Hunan, China
- *Correspondence: Zhongshi Wu, ; Zhenjie Tang,
| | - Zhenjie Tang
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Engineering Laboratory of Human Province for Cardiovascular Biomaterials, Changsha, Hunan, China
- *Correspondence: Zhongshi Wu, ; Zhenjie Tang,
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Jiang Z, Wu Z, Deng D, Li J, Qi X, Song M, Liu Y, Wu Q, Xie X, Chen Z, Tang Z. Improved Cytocompatibility and Reduced Calcification of Glutaraldehyde-Crosslinked Bovine Pericardium by Modification With Glutathione. Front Bioeng Biotechnol 2022; 10:844010. [PMID: 35662844 PMCID: PMC9160462 DOI: 10.3389/fbioe.2022.844010] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/18/2022] [Indexed: 12/16/2022] Open
Abstract
Bioprosthetic heart valves (BHVs) used in clinics are fabricated via glutaraldehyde (GLUT) crosslinking, which results in cytotoxicity and causes eventual valve calcification after implantation into the human body; therefore, the average lifetime and application of BHVs are limited. To address these issues, the most commonly used method is modification with amino acids, such as glycine (GLY), which is proven to effectively reduce toxicity and calcification. In this study, we used the l-glutathione (GSH) in a new modification treatment based on GLUT-crosslinked bovine pericardium (BP) as the GLUT + GSH group, BPs crosslinked with GLUT as GLUT-BP (control group), and GLY modification based on GLUT-BP as the GLUT + GLY group. We evaluated the characteristics of BPs in different treatment groups in terms of biomechanical properties, cell compatibility, aldehyde group content detection, and the calcification content. Aldehyde group detection tests showed that the GSH can completely neutralize the residual aldehyde group of GLUT-BP. Compared with that of GLUT-BP, the endothelial cell proliferation rate of the GLUT + GSH group increased, while its hemolysis rate and the inflammatory response after implantation into the SD rat were reduced. The results show that GSH can effectively improve the cytocompatibility of the GLUT-BP tissue. In addition, the results of the uniaxial tensile test, thermal shrinkage temperature, histological and SEM evaluation, and enzyme digestion experiments proved that GSH did not affect the ECM stability and biomechanics of the GLUT-BP. The calcification level of GLUT-BP modified using GSH technology decreased by 80%, indicating that GSH can improve the anti-calcification performance of GLUT-BP. Compared with GLUT-GLY, GLUT + GSH yielded a higher cell proliferation rate and lower inflammatory response and calcification level. GSH can be used as a new type of anti-calcification agent in GLUT crosslinking biomaterials and is expected to expand the application domain for BHVs in the future.
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Affiliation(s)
- Zhenlin Jiang
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhongshi Wu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
- NHC Key Laboratory of Birth Defect for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, China
- *Correspondence: Zhongshi Wu, ; Zhenjie Tang,
| | - Dengpu Deng
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jiemin Li
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoke Qi
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Mingzhe Song
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuhong Liu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qiying Wu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xinlong Xie
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zeguo Chen
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhenjie Tang
- Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Laboratory of Cardiovascular Biomaterials, Changsha, China
- *Correspondence: Zhongshi Wu, ; Zhenjie Tang,
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Laughlin M, Kapales M, Thakali K, Girardot M, Jensen M. Glutaraldehyde fixation of venous valve tissue: A benchmark for alternative fixation methods. Phlebology 2022; 37:296-302. [DOI: 10.1177/02683555221077669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective Bioprosthetic venous valves have yet to achieve long-term patency due to issues with calcification following implantation that is influenced by current xenograft fixation methods, most notably glutaraldehyde. The goal of this study was to investigate the effects of glutaraldehyde fixation on the functional properties of venous tissue to establish a benchmark for the evaluation of alternative fixation methods. Methods The degree of crosslinking was evaluated by determining shrink temperature and the stability of tissue with pronase and collagenase digestion. Results Glutaraldehyde fixation of venous tissue was confirmed by a significant difference in the shrink temperature between fresh and glutaraldehyde treated samples. Significant differences in the amount of tissue remaining following digestion were observed for venous versus cardiac tissue. Conclusions This study demonstrates the importance of tissue-specific evaluation in the development of alternative xenograft fixation methods to improve outcomes with bioprosthetic venous valves.
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Affiliation(s)
- Megan Laughlin
- Department of Biomedical Engineering, University of Arkansas Fayetteville, Fayetteville, AR, USA
| | - Makenzie Kapales
- Department of Biomedical Engineering, University of Arkansas Fayetteville, Fayetteville, AR, USA
| | - Keshari Thakali
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Arkansas Children’s Nutrition Center, Little Rock, AR, USA
| | | | - Morten Jensen
- Department of Biomedical Engineering, University of Arkansas Fayetteville, Fayetteville, AR, USA
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Desai A, Ingham E, Berry HE, Fisher J, Jennings LM. The effect of decellularisation on the real time mechanical fatigue of porcine aortic heart valve roots. PLoS One 2022; 17:e0265763. [PMID: 35363787 PMCID: PMC8974965 DOI: 10.1371/journal.pone.0265763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 03/07/2022] [Indexed: 11/23/2022] Open
Abstract
Decellularised heart valve roots offer a promising option for heart valve replacement in young patients, having the potential to remodel and repair. Replacement heart valves have to undergo billions of opening and closing cycles throughout the patient’s lifetime. Therefore, understanding the effect of cyclic loading on decellularised heart valve roots is important prior to human implantation. The aim of this preliminary study was to investigate the influence of low concentration sodium dodecyl sulphate (SDS) decellularisation treatment on the in vitro real time mechanical fatigue of porcine aortic heart valve roots under physiological real time cyclic loading conditions. This required a specific real time in vitro method to be developed, since previous methods relied on accelerated testing, which is non-physiological, and not appropriate for valve replacement materials that exhibit time dependent characteristics. The effects of the real time fatigue on hydrodynamic function and mechanical properties of the heart valve roots were assessed. The mechanical fatigue of decellularised porcine aortic heart valve roots (n = 6) was assessed and compared to cellular porcine aortic heart valve roots (n = 6) in a modified Real time Wear Tester (RWT) at a physiological frequency and under cyclic pressure conditions for a maximum of 1.2 million cycles. Periodically, the heart valve roots were removed from the RWT to assess the influence of cyclic loading on valve competency (static leaflet closure). At the end of testing further hydrodynamic performance parameters were ascertained, along with determination of leaflet material properties. A real time mechanical fatigue assessment method was developed and applied; with two cellular and two decellularised porcine aortic leaflets in different heart valve roots showing tears in the belly region. The decellularised aortic heart valve roots exhibited comparative functionality to the cellular heart valve roots under in vitro static and pulsatile hydrodynamic conditions. However, the material properties of the decellularised aortic leaflets were significantly altered following cyclic fatigue assessment and showed increases in elastin and collagen phase slopes and ultimate tensile strength compared to the cellular porcine aortic leaflets in the circumferential direction. This preliminary study demonstrated that low concentration SDS decellularised porcine aortic heart valve roots can withstand physiological cyclic deformations up to 1.2 million cycles in a RWT whilst maintaining their overall hydrodynamic function and leaflet mechanical properties. This is the first full report of preclinical mechanical fatigue assessment of decellularised porcine aortic heart valve roots under physiological real time conditions.
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Affiliation(s)
- Amisha Desai
- Institute of Medical & Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, United Kingdom
| | - Eileen Ingham
- Institute of Medical & Biological Engineering, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Helen E. Berry
- Institute of Medical & Biological Engineering, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - John Fisher
- Institute of Medical & Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, United Kingdom
| | - Louise M. Jennings
- Institute of Medical & Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, United Kingdom
- * E-mail:
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Kim H, Choi KH, Sung SC, Kim YS. Effect of ethanol washing on porcine pulmonary artery wall decellularization using sodium dodecyl sulfate. Artif Organs 2022; 46:1281-1293. [PMID: 35107179 DOI: 10.1111/aor.14192] [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: 10/21/2021] [Revised: 12/19/2021] [Accepted: 01/24/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND To determine the effectiveness of ethanol (EtOH) washing on porcine pulmonary artery (PA) wall decellularization using sodium dodecyl sulfate (SDS), we compared three different washing methods (phosphate-buffered saline [PBS], pH 9 alkali, and EtOH washing). METHODS Fresh porcine PA walls were decellularized using 0.5% SDS and 0.5% sodium deoxycholate (SDC). The decellularized tissues were rinsed using three different washing techniques. Histological, biochemical, and mechanical analyses were conducted. Implantation into the subcutaneous tissue of rats and patch implantation into the carotid artery of dogs were performed as preliminary in vivo studies. RESULTS The decellularization protocol based on SDS and SDC effectively removed the cells. The major extracellular matrix (ECM) structures (collagen, elastic fiber, and glycosaminoglycan) were properly preserved with the 75% EtOH-washing method. Significantly reduced residual SDS content was identified in EtOH-washed tissues compared to that in the other methods. No significant difference in the mechanical strength test was observed between the washing methods, and the EtOH-washing method showed better results in the metabolic activity test compared to the PBS-washing method. In the rat study model, no acute rejection or massive calcification was observed. The in vivo preliminary canine study showed better cell repopulation in the EtOH-washed group. CONCLUSION EtOH washing of SDS-based decellularized porcine PA wall can reduce the residual SDS content and preserve ECM structures, especially the elastin content, and could also enhance cell repopulation after re-implantation.
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Affiliation(s)
- Hyungtae Kim
- Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kwang Ho Choi
- Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Si Chan Sung
- Department of Thoracic and Cardiovascular Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Young Suk Kim
- Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Biomedical Research Institute, Yangsan, Korea
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Allergic response to medical products in patients with alpha-gal syndrome. J Thorac Cardiovasc Surg 2021; 164:e411-e424. [PMID: 33933257 DOI: 10.1016/j.jtcvs.2021.03.100] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/20/2021] [Accepted: 03/23/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Galactose-α-1,3-galactose (alpha-gal) is a carbohydrate that is ubiquitously expressed in all mammals except for primates and humans. Patients can become sensitized to this antigen and develop alpha-gal syndrome (AGS), or a red meat allergy. Symptoms range from generalized gastroenteritis and malaise to anaphylaxis, and in endemic areas, the prevalence can be as high as 20%. Although AGS patients commonly avoid alpha-gal by avoiding meat, patients have also developed symptoms due to animal-derived medical products and devices. With the rise in transcatheter aortic valve replacement, we investigate the immunogenicity of common cardiac materials and valves. OBJECTIVE To assess the in vitro immunoglobulin E response toward common medical products, including cardiac patch materials and bioprosthetic valves in patients with AGS. METHODS Immunoblot and immunohistochemistry techniques were applied to assess immunoglobulin E reactivity to various mammalian derived tissues and medical products for patients with AGS. RESULTS AGS serum showed strong reactivity to all of the commercially available, nonhuman products tested, including various decellularized cardiac patch materials and bioprosthetic aortic valves. AGS serum did not react to tissues prepared using alpha-gal knockout pigs. CONCLUSIONS Despite commercial decellularization processes, alpha-gal continues to be present in animal-derived medical products, including bioprosthetic valves. Serum from patients with AGS demonstrates a strong affinity for these products in vitro. This may have serious potential implications for sensitized patients undergoing cardiac surgery, including early valve failure and accelerated coronary artery disease.
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Mu X, Agostinacchio F, Xiang N, Pei Y, Khan Y, Guo C, Cebe P, Motta A, Kaplan DL. Recent Advances in 3D Printing with Protein-Based Inks. Prog Polym Sci 2021; 115:101375. [PMID: 33776158 PMCID: PMC7996313 DOI: 10.1016/j.progpolymsci.2021.101375] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Three-dimensional (3D) printing is a transformative manufacturing strategy, allowing rapid prototyping, customization, and flexible manipulation of structure-property relationships. Proteins are particularly appealing to formulate inks for 3D printing as they serve as essential structural components of living systems, provide a support presence in and around cells and for tissue functions, and also provide the basis for many essential ex vivo secreted structures in nature. Protein-based inks are beneficial in vivo due to their mechanics, chemical and physical match to the specific tissue, and full degradability, while also to promoting implant-host integration and serving as an interface between technology and biology. Exploiting the biological, chemical, and physical features of protein-based inks can provide key opportunities to meet the needs of tissue engineering and regenerative medicine. Despite these benefits, protein-based inks impose nontrivial challenges to 3D printing such as concentration and rheological features and reconstitution of the structural hierarchy observed in nature that is a source of the robust mechanics and functions of these materials. This review introduces photo-crosslinking mechanisms and rheological principles that underpins a variety of 3D printing techniques. The review also highlights recent advances in the design, development, and biomedical utility of monolithic and composite inks from a range of proteins, including collagen, silk, fibrinogen, and others. One particular focus throughout the review is to introduce unique material characteristics of proteins, including amino acid sequences, molecular assembly, and secondary conformations, which are useful for designing printing inks and for controlling the printed structures. Future perspectives of 3D printing with protein-based inks are also provided to support the promising spectrum of biomedical research accessible to these materials.
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Affiliation(s)
- Xuan Mu
- Department of Biomedical Engineering, Tufts University, Medford, MA 02155, USA
| | - Francesca Agostinacchio
- Department of Biomedical Engineering, Tufts University, Medford, MA 02155, USA
- Department of Industrial Engineering, University of Trento, via Sommarive 9, Trento 38123, Italy
| | - Ning Xiang
- Department of Biomedical Engineering, Tufts University, Medford, MA 02155, USA
| | - Ying Pei
- Department of Biomedical Engineering, Tufts University, Medford, MA 02155, USA
- School of Materials Science and Engineering, Zhengzhou University, Zhengzhou 450001, China
| | - Yousef Khan
- Department of Biomedical Engineering, Tufts University, Medford, MA 02155, USA
| | - Chengchen Guo
- Department of Biomedical Engineering, Tufts University, Medford, MA 02155, USA
| | - Peggy Cebe
- Department of Physics and Astronomy, Tufts University, Medford, MA 02155, USA
| | - Antonella Motta
- Department of Industrial Engineering, University of Trento, via Sommarive 9, Trento 38123, Italy
| | - David L. Kaplan
- Department of Biomedical Engineering, Tufts University, Medford, MA 02155, USA
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Kim MS, Lee W, Kim KB, Lim HG, Kim YJ. A preclinical trial of perventricular pulmonary valve implantation: Pericardial versus aortic porcine valves mounted on self-expandable stent. Artif Organs 2020; 45:E89-E100. [PMID: 33090503 DOI: 10.1111/aor.13845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 09/03/2020] [Accepted: 10/08/2020] [Indexed: 11/29/2022]
Abstract
Perventricular pulmonary valve implantation (PPVI) of a xenograft valve can be a less invasive technique that avoids cardiopulmonary bypass in patients who require pulmonary valve replacement. We compared the hemodynamics, durability, and histologic changes between two different xenogenic valves (pericardial vs. aortic valve porcine xenografts) implanted into the pulmonary valve position using a PPVI technique and evaluated the safety and efficacy of PPVI as a preclinical study. In 18 sheep, pericardial (group porcine pericardial [PP], n = 9) or aortic valve (group porcine aortic valve [PAV], n = 9) xenogenic porcine valves manufactured as a stented valve were implanted using a PPVI technique. The porcine tissues were decellularized, alpha-galactosidase treated, fixed with glutaraldehyde after space-filler treatment, and detoxified to improve durability. Hemodynamic and immunohistochemical studies were performed after the implantation; radiologic and histologic studies were performed after a terminal procedure. All stented valves were positioned properly after the implantation, and echocardiography and cardiac catheterization demonstrated good hemodynamic state and function of the valves. All the anti-α-Gal IgM and IgG titers were below 0.3 optical density. Computed tomography of extracted valves demonstrated no significant differences in the degree of calcification between the two groups (P = .927). Microscopic findings revealed a minimal amount of calcification and no significant infiltration of macrophage or T-cell in both groups, regardless of the implantation duration. The PPVI is a feasible technique. Both stented valves made of PP and PAV showed no significant differences in hemodynamic profile, midterm durability, and degree of degenerative dystrophic calcification.
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Affiliation(s)
- Min-Seok Kim
- Department of Thoracic and Cardiovascular Surgery, Yonsei University Severance Hospital, Seoul, Korea
| | - Whal Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Ki-Bum Kim
- Department of Pediatrics, Seoul National University Hospital, Seoul, Korea
| | - Hong-Gook Lim
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea
| | - Yong Jin Kim
- Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Bucheon, Korea
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11
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Human P, Ofoegbu C, Ilsley H, Bezuidenhout D, de Villiers J, Williams DF, Zilla P. Decellularization and engineered crosslinking: a promising dual approach towards bioprosthetic heart valve longevity. Eur J Cardiothorac Surg 2020; 58:1192-1200. [DOI: 10.1093/ejcts/ezaa257] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/14/2020] [Accepted: 06/14/2020] [Indexed: 12/20/2022] Open
Abstract
Abstract
OBJECTIVES
While decellularization has previously significantly improved the durability of bioprosthetic tissue, remnant immunogenicity may yet necessitate masking through crosslinking. To alleviate the fears of reintroducing the risk of calcific degeneration, we investigated the application of rationally designed crosslinking chemistry, capable of abrogating mineralization in isolation, in decellularized tissue.
METHODS
Bovine and porcine pericardium were decellularized using the standard Triton X/sodium deoxycholate/DNAse/RNAse methodology and thereafter combined incrementally with components of a four-stage high-density dialdehyde-based fixation regimen. Mechanical properties prior to, and calcium levels following, subcutaneous implantation for 6 and 10 weeks in rats were assessed.
RESULTS
Enhanced four-stage crosslinking, independent of decellularization, or decellularization followed by any of the crosslinking regimens, achieved sustained, near-elimination of tissue calcification. Decellularization additionally resulted in significantly lower tissue stiffness and higher fatigue resistance in all groups compared to their non-decellularized counterparts.
CONCLUSIONS
The dual approach of combining decellularization with enhanced crosslinking chemistry in xenogeneic pericardial tissue offers much promise in extending bioprosthetic heart valve longevity.
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Affiliation(s)
- Paul Human
- Christiaan Barnard Department of Cardiothoracic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
- Cardiovascular Research Unit, University of Cape Town, Cape Town, South Africa
| | - Chima Ofoegbu
- Christiaan Barnard Department of Cardiothoracic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
- Strait Access Technologies (SAT), University of Cape Town, Cape Town, South Africa
| | - Helen Ilsley
- Cardiovascular Research Unit, University of Cape Town, Cape Town, South Africa
- Strait Access Technologies (SAT), University of Cape Town, Cape Town, South Africa
| | - Deon Bezuidenhout
- Cardiovascular Research Unit, University of Cape Town, Cape Town, South Africa
- Strait Access Technologies (SAT), University of Cape Town, Cape Town, South Africa
| | - Jandre de Villiers
- Strait Access Technologies (SAT), University of Cape Town, Cape Town, South Africa
| | - David F Williams
- Strait Access Technologies (SAT), University of Cape Town, Cape Town, South Africa
- Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Peter Zilla
- Christiaan Barnard Department of Cardiothoracic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
- Cardiovascular Research Unit, University of Cape Town, Cape Town, South Africa
- Strait Access Technologies (SAT), University of Cape Town, Cape Town, South Africa
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12
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Next-generation transcatheter aortic valve implantation. JTCVS OPEN 2020; 3:14-24. [PMID: 36003870 PMCID: PMC9390526 DOI: 10.1016/j.xjon.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 06/14/2020] [Accepted: 06/17/2020] [Indexed: 11/22/2022]
Abstract
Objective Transcatheter aortic valve implantation (TAVI) procedures are increasing rapidly, but the durability of tissue valve and periprocedural complications are not satisfactory. Immune reaction to the galactose-α-1,3 galactose β-1,4-N-acetylglucosamine (α-Gal) and conventional processing protocols of cardiac xenografts lead to calcification. Next-generation TAVI needs to be made with α-Gal–free xenografts by multiple anticalcification therapies to avoid immune rejection and enhance durability, and three-dimensional (3D) printing technology to improve the procedural safety. Methods Porcine pericardia were decellularized and immunologically modified with α-galactosidase. The pericardia were treated by space filler, crosslinked with glutaraldehyde in organic solvent, and detoxified. The sheep-specific nitinol (nickel–titanium memory alloy) wire backbone was made from a 3D-printed model for ovine aortic root. After it passed the fitting test, we manufactured a self-expandable stented valve with the porcine pericardia mounted on the customized nitinol wire–based stent. After in vitro circulation using customized silicone aortic root, we performed TAVI in 9 sheep and obtained hemodynamic, radiological, immunohistopathological, and biochemical results. Results The valve functioned well, with excellent stent fitting and good coronary flow under in vitro circulation. Sheep were sequentially scheduled to be humanely killed until 238 days after TAVI. Echocardiography and cardiac catheterization demonstrated good hemodynamic status and function of the aortic valve. The xenografts were well preserved without α-Gal immune reaction or calcification based on the immunological, radiographic, microscopic, and biochemical examinations. Conclusions We proved preclinical safety and efficacy for next-generation α-Gal–free TAVI with multiple anticalcification therapies and 3D-printing technology. A future clinical study is warranted based on these promising preclinical results.
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13
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Shaik TA, Alfonso-García A, Zhou X, Arnold KM, Haudenschild AK, Krafft C, Griffiths LG, Popp J, Marcu L. FLIm-Guided Raman Imaging to Study Cross-Linking and Calcification of Bovine Pericardium. Anal Chem 2020; 92:10659-10667. [PMID: 32598134 PMCID: PMC7539574 DOI: 10.1021/acs.analchem.0c01772] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Bovine pericardium (BP) is a vascular biomaterial used in cardiovascular surgery that is typically cross-linked for masking antigenicity and enhance stability. There is a need for biochemical evaluation of the tissue properties prior to implantation to ensure that quality and reliability standards are met. Here, engineered antigen removed BP (ARBP) that was cross-linked with 0.2% and 0.6% glutaraldehyde (GA), and further calcified in vitro to simulate graft calcifications upon implantation was characterized nondestructively using fluorescence lifetime imaging (FLIm) to identify regions of interest which were then assessed by Raman spectroscopy. We observed that the tissue fluorescence lifetime shortened, and that Raman bands at 856, 935, 1282, and 1682 cm-1 decreased, and at 1032 and 1627 cm-1 increased with increasing GA cross-linking. Independent classification analysis based on fluorescence lifetime and on Raman spectra discriminated between GA-ARBP and untreated ARBP with an accuracy of 91% and 66%, respectively. Pearson's correlation analysis showed a strong correlation between pyridinium cross-links measured with high-performance liquid chromatography and fluorescence lifetime measured at 380-400 nm (R = -0.76, p = 0.00094), as well as Raman bands at 856 cm-1 for hydroxy-proline (R = -0.68, p = 0.0056) and at 1032 cm-1 for hydroxy-pyridinium (R = 0.74, p = 0.0016). Calcified areas of GA cross-linked tissue showed characteristic hydroxyapatite (959 and 1038 cm-1) bands in the Raman spectrum and fluorescence lifetime shortened by 0.4 ns compared to uncalcified regions. FLIm-guided Raman imaging could rapidly identify degrees of cross-linking and detected calcified regions with high chemical specificity, an ability that can be used to monitor tissue engineering processes for applications in regenerative medicine.
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Affiliation(s)
- Tanveer Ahmed Shaik
- Leibniz Institute of Photonic Technology Jena e.V., Albert-Einstein-Strasse 9, 07745 Jena, Germany
| | - Alba Alfonso-García
- Department of Biomedical Engineering, University of California Davis, One Shields Avenue, Davis, California 95616, United States
| | - Xiangnan Zhou
- Department of Biomedical Engineering, University of California Davis, One Shields Avenue, Davis, California 95616, United States
| | - Katherine M Arnold
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, United States
| | - Anne K Haudenschild
- Department of Biomedical Engineering, University of California Davis, One Shields Avenue, Davis, California 95616, United States
| | - Christoph Krafft
- Leibniz Institute of Photonic Technology Jena e.V., Albert-Einstein-Strasse 9, 07745 Jena, Germany
| | - Leigh G Griffiths
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, United States
| | - Jürgen Popp
- Leibniz Institute of Photonic Technology Jena e.V., Albert-Einstein-Strasse 9, 07745 Jena, Germany
- Institute of Physical Chemistry and Abbe Center of Photonics, Friedrich Schiller University Jena, Helmholtzweg 4, 07743 Jena, Germany
| | - Laura Marcu
- Department of Biomedical Engineering, University of California Davis, One Shields Avenue, Davis, California 95616, United States
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14
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Abstract
Millions of patients with valvular heart disease have benefitted from heart valve replacement since the procedure was first introduced in the 1960s; however, there are still many patients who get early structural valve deterioration (SVD) of their bioprosthetic heart valves (BHV). BHV are porcine, bovine, or equine tissues that have been glutaraldehyde fixed to preserve the tissue and presumably make the tissue immunologically inert. These glutaraldehyde-fixed BHV with anti-calcification treatments last long periods of time in older adults but develop early SVD in younger patients. The consensus at present is that the early SVD in younger patients is due to more "wear and tear" of the valves and higher calcium turnover in younger patients. However, as younger patients likely have a more robust immune system than older adults, there is a new hypothesis that BHV xenografts may undergo xenograft rejection, and this may contribute to the early SVD seen in younger patients.At present, the technology to noninvasively study in vivo whether an implanted BHV in a human patient is undergoing rejection is not available. Thus, a small animal discordant xenotransplant model in young rodents (to match the young patient getting a pig/bovine/equine BHV) was developed to study whether the hypothesis that glutaraldehyde-fixed BHV undergo xenograft rejection had any merit. In this chapter, we describe our model and its merits and the results of our investigations. Our work provides clear evidence of xenograft rejection in glutaraldehyde-fixed tissue, and our small animal model offers an opportunity to study this process in detail.
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Affiliation(s)
- Rizwan A Manji
- Department of Surgery, University of Manitoba, Winnipeg, MB, Canada.
- Cardiac Sciences Program, I.H. Asper Clinical Research Institute, Winnipeg Regional Health Authority and St. Boniface Hospital, Winnipeg, MB, Canada.
| | - Jacqueline S Manji
- Cardiac Sciences Program, I.H. Asper Clinical Research Institute, Winnipeg Regional Health Authority and St. Boniface Hospital, Winnipeg, MB, Canada
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15
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Guo F, Liu Y, Jiao K, Yang R, Hou M, Zhang X. Artificial Heart Valves with Balanced Charged Networks Exhibiting Anti-Calcification Properties. ACS APPLIED BIO MATERIALS 2019; 3:838-847. [DOI: 10.1021/acsabm.9b00902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Feng Guo
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang, Liaoning 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Yunen Liu
- Department of Emergency Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning 110016, China
| | - Kai Jiao
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang, Liaoning 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Rui Yang
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang, Liaoning 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Mingxiao Hou
- Department of Emergency Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning 110016, China
| | - Xing Zhang
- Institute of Metal Research, Chinese Academy of Sciences, Shenyang, Liaoning 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei, Anhui 230026, China
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16
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Bhatia S, Singh A, Batra N, Singh J. Microbial production and biotechnological applications of α-galactosidase. Int J Biol Macromol 2019; 150:1294-1313. [PMID: 31747573 DOI: 10.1016/j.ijbiomac.2019.10.140] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/12/2019] [Accepted: 10/15/2019] [Indexed: 12/13/2022]
Abstract
α-Galactosidase, (E.C. 3.2.1.22) is an exoglycosidase that target galactooligosaccharides such as raffinose, melibiose, stachyose and branched polysaccharides like galactomannans and galacto-glucomannans by catalysing the hydrolysis of α-1,6 linked terminal galactose residues. The enzyme has been isolated and characterized from microbial, plant and animal sources. This ubiquitous enzyme possesses physiological significance and immense industrial potential. Optimization of the growth conditions and efficient purification strategies can lead to a significant increase in the enzyme production. To boost commercial productivity, cloning of novel α-galactosidase genes and their heterologous expression in suitable host has gained popularity. Enzyme immobilization leads to its greater reutilization, superior thermostability, pH tolerance and increased activity. The enzyme is well explored in food industry in the removal of raffinose family oligosaccharides (RFOs) in soymilk and sugar crystallization process. It also improves animal feed quality and biomass processing. Applications of the enzyme is in the area of biomedicine includes therapeutic advances in treatment of Fabry disease, blood group conversion and removal of α-gal type immunogenic epitopes in xenotransplantation. With considerable biotechnological applications, this enzyme has been vastly commercialized and holds greater future prospects.
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Affiliation(s)
- Sonu Bhatia
- Department of Biotechnology, Panjab University, Chandigarh, India
| | - Abhinashi Singh
- Department of Biotechnology, G.G.D.S.D. College, Sector-32-C, Chandigarh, India
| | - Navneet Batra
- Department of Biotechnology, G.G.D.S.D. College, Sector-32-C, Chandigarh, India
| | - Jagtar Singh
- Department of Biotechnology, Panjab University, Chandigarh, India.
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17
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Lee A, Hudson AR, Shiwarski DJ, Tashman JW, Hinton TJ, Yerneni S, Bliley JM, Campbell PG, Feinberg AW. 3D bioprinting of collagen to rebuild components of the human heart. Science 2019; 365:482-487. [DOI: 10.1126/science.aav9051] [Citation(s) in RCA: 725] [Impact Index Per Article: 145.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 06/05/2019] [Indexed: 12/11/2022]
Abstract
Collagen is the primary component of the extracellular matrix in the human body. It has proved challenging to fabricate collagen scaffolds capable of replicating the structure and function of tissues and organs. We present a method to 3D-bioprint collagen using freeform reversible embedding of suspended hydrogels (FRESH) to engineer components of the human heart at various scales, from capillaries to the full organ. Control of pH-driven gelation provides 20-micrometer filament resolution, a porous microstructure that enables rapid cellular infiltration and microvascularization, and mechanical strength for fabrication and perfusion of multiscale vasculature and tri-leaflet valves. We found that FRESH 3D-bioprinted hearts accurately reproduce patient-specific anatomical structure as determined by micro–computed tomography. Cardiac ventricles printed with human cardiomyocytes showed synchronized contractions, directional action potential propagation, and wall thickening up to 14% during peak systole.
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18
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When meat allergy meets cardiac surgery: A driver for humanized bioprosthesis. J Thorac Cardiovasc Surg 2017; 154:1326-1327. [DOI: 10.1016/j.jtcvs.2017.05.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 05/05/2017] [Indexed: 11/22/2022]
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19
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Soto ME, Salas JL, Vargas-Barron J, Marquez R, Rodriguez-Hernandez A, Bojalil-Parra R, Pérez-Torres I, Guarner-Lans V. Pre- and post-surgical evaluation of the inflammatory response in patients with aortic stenosis treated with different types of prosthesis. BMC Cardiovasc Disord 2017; 17:100. [PMID: 28410571 PMCID: PMC5391573 DOI: 10.1186/s12872-017-0526-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 03/30/2017] [Indexed: 12/17/2022] Open
Abstract
Background The inflammatory process in aortic valvular stenosis persists after surgery to replace the valve in almost half of the patients. No association has been found to its persistence. The main objective of this study was to evaluate the inflammatory response in patients with aortic stenosis through the determination of several biomarkers in plasma measured before and after the valvular replacement and to seek an association with the type of prosthesis used. Methods This is an observational study with a follow up of 6 months in subjects with severe aortic stenosis. Seric concentrations of TNFa, IL-1, IL-6 and ICAM and echocardiographic variables were quantified previous to the surgery and a week and 6 months after it. A group of control subjects paired by age and gender was included. Results Seventy-nine subjects were studied of which 57% were male; the average age was of 59 (± 11.4) years. Previous to surgery, the concentration of cytokines was higher in patients than in control subjects. A biological prosthesis was implanted in 48 patients and a mechanical prosthesis in 31. Both, types of prosthesis have components made of titanium. The echocardiograms 1 week and 6 months after the surgery showed a decrease in the mean aortic gradient and an increase in the valvular area (p = 0.001). Half of the patients still showed high proinflammatory cytokine levels. There were no differences according to the type of prosthesis implanted after adjustments for demographic variables, comorbidities and echocardiographic data. Conclusions The inflammatory response caused by both types of valvular prothesis at 6 months after implantation were similar. Both types of prosthesis are recommended, they had similarities in hemodynamic profiles registered with Doppler echocardiography. Age of the patient or the suitability use of anticoagulants determines the type of prosthesis to be used.
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Affiliation(s)
- Maria Elena Soto
- Immunology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano número 1, Colonia Sección XVI, Delegación Tlalpan, Mexico, CP 14080, Mexico.
| | - Jose Luis Salas
- Echocardiography Department, Instituto Nacional de Cardiología "Ignacio Chávez", Mexico, Mexico
| | - Jesus Vargas-Barron
- Investigation Department, Instituto Nacional de Cardiología "Ignacio Chávez", Mexico, Mexico
| | - Ricardo Marquez
- Immunology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano número 1, Colonia Sección XVI, Delegación Tlalpan, Mexico, CP 14080, Mexico
| | | | - Rafael Bojalil-Parra
- Immunology Department, Instituto Nacional de Cardiología "Ignacio Chávez", Juan Badiano número 1, Colonia Sección XVI, Delegación Tlalpan, Mexico, CP 14080, Mexico
| | - Israel Pérez-Torres
- Department of Pathology, Instituto Nacional de Cardiología "Ignacio Chavez", Mexico, Mexico
| | - Veronica Guarner-Lans
- Department of Physiology, Instituto Nacional de Cardiología "Ignacio Chávez", Mexico, Mexico
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20
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Thermus thermophilus as source of thermozymes for biotechnological applications: homologous expression and biochemical characterization of an α-galactosidase. Microb Cell Fact 2017; 16:28. [PMID: 28193276 PMCID: PMC5307791 DOI: 10.1186/s12934-017-0638-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 01/25/2017] [Indexed: 11/17/2022] Open
Abstract
Background The genus Thermus, which has been considered for a long time as a fruitful source of biotechnological relevant enzymes, has emerged more recently as suitable host to overproduce thermozymes. Among these, α-galactosidases are widely used in several industrial bioprocesses that require high working temperatures and for which thermostable variants offer considerable advantages over their thermolabile counterparts. Results Thermus thermophilus HB27 strain was used for the homologous expression of the TTP0072 gene encoding for an α-galactosidase (TtGalA). Interestingly, a soluble and active histidine-tagged enzyme was produced in larger amounts (5 mg/L) in this thermophilic host than in Escherichia coli (0.5 mg/L). The purified recombinant enzyme showed an optimal activity at 90 °C and retained more than 40% of activity over a broad range of pH (from 5 to 8). Conclusions TtGalA is among the most thermoactive and thermostable α-galactosidases discovered so far, thus pointing to T. thermophilus as cell factory for the recombinant production of biocatalysts active at temperature values over 90 °C. Electronic supplementary material The online version of this article (doi:10.1186/s12934-017-0638-4) contains supplementary material, which is available to authorized users.
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21
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Wong ML, Wong JL, Horn RM, Sannajust KC, Rice DA, Griffiths LG. Effect of Urea and Thiourea on Generation of Xenogeneic Extracellular Matrix Scaffolds for Tissue Engineering. Tissue Eng Part C Methods 2016; 22:700-7. [PMID: 27230226 DOI: 10.1089/ten.tec.2015.0552] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Effective solubilization of proteins by chaotropes in proteomic applications motivates their use in solubilization-based antigen removal/decellularization strategies. A high urea concentration has previously been reported to significantly reduce lipophilic antigen content of bovine pericardium (BP); however, structure and function of the resultant extracellular matrix (ECM) scaffold were compromised. It has been recently demonstrated that in vivo ECM scaffold fate is determined by two primary outcome measures as follows: (1) sufficient reduction in antigen content to avoid graft-specific adaptive immune responses and (2) maintenance of native ECM structural proteins to avoid graft-specific innate responses. In this work, we assessed residual antigenicity, ECM architecture, ECM content, thermal stability, and tensile properties of BP subjected to a gradient of urea concentrations to determine whether an intermediate concentration exists at which both antigenicity and structure-function primary outcome measures for successful in vivo scaffold outcome can simultaneously be achieved. Alteration in tissue structure-function properties at various urea concentrations with decreased effectiveness for antigen removal makes use of urea-mediated antigen removal unlikely to be suitable for functional scaffold generation.
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Affiliation(s)
- Maelene L Wong
- 1 Department of Veterinary Medicine and Epidemiology, University of California , Davis, Davis, California.,2 Department of Biomedical Engineering, University of California , Davis, Davis, California
| | - Janelle L Wong
- 1 Department of Veterinary Medicine and Epidemiology, University of California , Davis, Davis, California
| | - Rebecca M Horn
- 1 Department of Veterinary Medicine and Epidemiology, University of California , Davis, Davis, California
| | - Kimberley C Sannajust
- 1 Department of Veterinary Medicine and Epidemiology, University of California , Davis, Davis, California
| | - Dawn A Rice
- 1 Department of Veterinary Medicine and Epidemiology, University of California , Davis, Davis, California
| | - Leigh G Griffiths
- 1 Department of Veterinary Medicine and Epidemiology, University of California , Davis, Davis, California
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22
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Lee C, Lee CH, Kwak JG. Outcomes of redo pulmonary valve replacement for bioprosthetic pulmonary valve failure in 61 patients with congenital heart disease. Eur J Cardiothorac Surg 2016; 50:470-5. [DOI: 10.1093/ejcts/ezw037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 01/25/2016] [Indexed: 11/12/2022] Open
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Guided tissue regeneration in heart valve replacement: from preclinical research to first-in-human trials. BIOMED RESEARCH INTERNATIONAL 2015; 2015:432901. [PMID: 26495295 PMCID: PMC4606187 DOI: 10.1155/2015/432901] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 05/21/2015] [Indexed: 11/18/2022]
Abstract
Heart valve tissue-guided regeneration aims to offer a functional and viable alternative to current prosthetic replacements. Not requiring previous cell seeding and conditioning in bioreactors, such exceptional tissue engineering approach is a very fascinating translational regenerative strategy. After in vivo implantation, decellularized heart valve scaffolds drive their same repopulation by recipient's cells for a prospective autologous-like tissue reconstruction, remodeling, and adaptation to the somatic growth of the patient. With such a viability, tissue-guided regenerated conduits can be delivered as off-the-shelf biodevices and possess all the potentialities for a long-lasting resolution of the dramatic inconvenience of heart valve diseases, both in children and in the elderly. A review on preclinical and clinical investigations of this therapeutic concept is provided with evaluation of the issues still to be well deliberated for an effective and safe in-human application.
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24
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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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25
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Parolari A, Songia P, Myasoedova V, Poggio P. Re: development of a next-generation tissue valve using a glutaraldehyde-fixed porcine aortic valve treated with decellularization, α-galactosidase, space filler, organic solvent and detoxification. Eur J Cardiothorac Surg 2014; 48:114. [PMID: 25385220 DOI: 10.1093/ejcts/ezu432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Alessandro Parolari
- Unit for Clinical Research in Atherothrombosis, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Paola Songia
- Unit for the Study of Aortic, Valvular and Coronary Pathologies, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Veronika Myasoedova
- Unit for Clinical Research in Atherothrombosis, Centro Cardiologico Monzino IRCCS, Milan, Italy
| | - Paolo Poggio
- Unit for the Study of Aortic, Valvular and Coronary Pathologies, Centro Cardiologico Monzino IRCCS, Milan, Italy
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