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Vidal L, Lopez-Garzon M, Venegas V, Vila I, Domínguez D, Rodas G, Marotta M. A Novel Tendon Injury Model, Induced by Collagenase Administration Combined with a Thermo-Responsive Hydrogel in Rats, Reproduces the Pathogenesis of Human Degenerative Tendinopathy. Int J Mol Sci 2024; 25:1868. [PMID: 38339145 PMCID: PMC10855568 DOI: 10.3390/ijms25031868] [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: 12/22/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Patellar tendinopathy is a common clinical problem, but its underlying pathophysiology remains poorly understood, primarily due to the absence of a representative experimental model. The most widely used method to generate such a model is collagenase injection, although this method possesses limitations. We developed an optimized rat model of patellar tendinopathy via the ultrasound-guided injection of collagenase mixed with a thermo-responsive Pluronic hydrogel into the patellar tendon of sixty male Wistar rats. All analyses were carried out at 3, 7, 14, 30, and 60 days post-injury. We confirmed that our rat model reproduced the pathophysiology observed in human patients through analyses of ultrasonography, histology, immunofluorescence, and biomechanical parameters. Tendons that were injured by the injection of the collagenase-Pluronic mixture exhibited a significant increase in the cross-sectional area (p < 0.01), a high degree of tissue disorganization and hypercellularity, significantly strong neovascularization (p < 0.01), important changes in the levels of types I and III collagen expression, and the organization and presence of intra-tendinous calcifications. Decreases in the maximum rupture force and stiffness were also observed. These results demonstrate that our model replicates the key features observed in human patellar tendinopathy. Collagenase is evenly distributed, as the Pluronic hydrogel prevents its leakage and thus, damage to surrounding tissues. Therefore, this model is valuable for testing new treatments for patellar tendinopathy.
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Affiliation(s)
- Laura Vidal
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Maria Lopez-Garzon
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Vanesa Venegas
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Ingrid Vila
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - David Domínguez
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation, 08970 Sant Joan Despí, Spain
| | - Gil Rodas
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation, 08970 Sant Joan Despí, Spain
- Sports Medicine Unit, Hospital Clínic and Sant Joan de Déu, 08950 Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, 08007 Barcelona, Spain
| | - Mario Marotta
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
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Cao S, Wei Y, Bo R, Yun X, Xu S, Guan Y, Zhao J, Lan Y, Zhang B, Xiong Y, Jin T, Lai Y, Chang J, Zhao Q, Wei M, Shao Y, Quan Q, Zhang Y. Inversely engineered biomimetic flexible network scaffolds for soft tissue regeneration. SCIENCE ADVANCES 2023; 9:eadi8606. [PMID: 37756408 PMCID: PMC10530085 DOI: 10.1126/sciadv.adi8606] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023]
Abstract
Graft-host mechanical mismatch has been a longstanding issue in clinical applications of synthetic scaffolds for soft tissue regeneration. Although numerous efforts have been devoted to resolve this grand challenge, the regenerative performance of existing synthetic scaffolds remains limited by slow tissue growth (comparing to autograft) and mechanical failures. We demonstrate a class of rationally designed flexible network scaffolds that can precisely replicate nonlinear mechanical responses of soft tissues and enhance tissue regeneration via reduced graft-host mechanical mismatch. Such flexible network scaffold includes a tubular network frame containing inversely engineered curved microstructures to produce desired mechanical properties, with an electrospun ultrathin film wrapped around the network to offer a proper microenvironment for cell growth. Using rat models with sciatic nerve defects or Achilles tendon injuries, our network scaffolds show regenerative performances evidently superior to that of clinically approved electrospun conduit scaffolds and achieve similar outcomes to autologous nerve transplantation in prevention of target organ atrophy and recovery of static sciatic index.
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Affiliation(s)
- Shunze Cao
- AML, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
- Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing 100084, P.R. China
| | - Yu Wei
- Department of Orthopedic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100142, P.R. China
| | - Renheng Bo
- AML, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
- Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing 100084, P.R. China
| | - Xing Yun
- Department of Orthopedic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100142, P.R. China
| | - Shiwei Xu
- AML, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
- Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing 100084, P.R. China
| | - Yanjun Guan
- Department of Orthopedic Surgery, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing 100142, P.R. China
- Key Lab of Regenerative Medicine in Orthopedics, Chinese PLA General Hospital, Beijing 100142, Beijing, P.R. China
| | - Jianzhong Zhao
- AML, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
- Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing 100084, P.R. China
| | - Yu Lan
- AML, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
- Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing 100084, P.R. China
| | - Bin Zhang
- AML, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
| | - Yingjie Xiong
- Department of Orthopedic Surgery, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing 100142, P.R. China
- Key Lab of Regenerative Medicine in Orthopedics, Chinese PLA General Hospital, Beijing 100142, Beijing, P.R. China
| | - Tianqi Jin
- AML, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
- Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing 100084, P.R. China
| | - Yuchen Lai
- AML, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
- Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing 100084, P.R. China
| | - Jiahui Chang
- AML, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
| | - Qing Zhao
- Department of Orthopedic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100142, P.R. China
- Department of Orthopedic Surgery, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing 100142, P.R. China
- Key Lab of Regenerative Medicine in Orthopedics, Chinese PLA General Hospital, Beijing 100142, Beijing, P.R. China
| | - Min Wei
- Department of Orthopedic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100142, P.R. China
| | - Yue Shao
- AML, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
- Institute of Biomechanics and Medical Engineering, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
| | - Qi Quan
- Department of Orthopedic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing 100142, P.R. China
- Department of Orthopedic Surgery, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing 100142, P.R. China
- Key Lab of Regenerative Medicine in Orthopedics, Chinese PLA General Hospital, Beijing 100142, Beijing, P.R. China
| | - Yihui Zhang
- AML, Department of Engineering Mechanics, Tsinghua University, Beijing 100084, P.R. China
- Laboratory of Flexible Electronics Technology, Tsinghua University, Beijing 100084, P.R. China
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Wang X, Xu K, Mu L, Zhang X, Huang G, Xing M, Li Z, Wu J. Mussel-Derived Bioadaptive Artificial Tendon Facilitates the Cell Proliferation and Tenogenesis to Promote Tendon Functional Reconstruction. Adv Healthc Mater 2023; 12:e2203400. [PMID: 37462927 DOI: 10.1002/adhm.202203400] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 06/02/2023] [Indexed: 07/28/2023]
Abstract
Tendon injuries range from acute-related trauma to chronic-related injuries are prevalent and bring substantial pain, functional loss, and even disability to the patients. The management of tendon injuries is tricky due to the innate limited regenerative capability of the tendon. Currently, surgical intervention of tendon injuries with artificial tendons remains the standard of care. However, most of artificial tendons are manufactured with synthetic materials, which possess relatively poor biomimetic characteristics and inadequate inherent biodegradability, hence rendering limited cell proliferation and migration for tendon healing. To address these limitations, this work develops a mussel-derived artificial tendon based on double-cross-linked chitosan modification. In this design, decellularized artificial tendon serves as a natural biomimetic scaffold to facilitate the migration and adhesion of tendon repair cells. Additionally, as the cells proliferate, the artificial tendon can be degraded to facilitate tendon regeneration. Moreover, the chitosan cross-linking further enhances the mechanical strength of artificial tendon and offers a controllable degradation. The in vitro and in vivo experimental results demonstrate that mussel-derived artificial tendon not only accelerate the tendon functional reconstruction but also enable harmless clearance at postimplantation. The finding provides a promising alternative to conventional artificial tendons and spurs a new frontier to explore nature-derived artificial tendons.
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Affiliation(s)
- Xiaoyan Wang
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, China
- Department of Burn Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Kaige Xu
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, China
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Lan Mu
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Xiaoqi Zhang
- The Center for Drug Research and Development, Guangdong Pharmaceutical University, Guangzhou, Guangdong, 510006, People's Republic of China
| | - Guangtao Huang
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Malcolm Xing
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB, R3T 2N2, Canada
| | - Zhibin Li
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, China
| | - Jun Wu
- Department of Burn and Plastic Surgery, Shenzhen Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, 518035, China
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Li M, Pan G, Zhang H, Guo B. Hydrogel adhesives for generalized wound treatment: Design and applications. JOURNAL OF POLYMER SCIENCE 2022. [DOI: 10.1002/pol.20210916] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Meng Li
- State Key Laboratory for Mechanical Behavior of Materials, and Frontier Institute of Science and Technology Xi'an Jiaotong University Xi'an China
| | - Guoying Pan
- State Key Laboratory for Mechanical Behavior of Materials, and Frontier Institute of Science and Technology Xi'an Jiaotong University Xi'an China
| | - Hualei Zhang
- State Key Laboratory for Mechanical Behavior of Materials, and Frontier Institute of Science and Technology Xi'an Jiaotong University Xi'an China
| | - Baolin Guo
- State Key Laboratory for Mechanical Behavior of Materials, and Frontier Institute of Science and Technology Xi'an Jiaotong University Xi'an China
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research College of Stomatology, Xi'an Jiaotong University Xi'an China
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Pu W, Han Y, Yang M. Human decellularized adipose tissue hydrogels as a culture platform for human adipose-derived stem cell delivery. J Appl Biomater Funct Mater 2021; 19:2280800020988141. [PMID: 33926291 DOI: 10.1177/2280800020988141] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Adipose-derived stem cells (ADSCs) have been widely researched and used as a drug therapy in many fields like disease treatment and tissue engineering. However, ADSCs are susceptible to the surrounding environment. The emergence of acellular extracellular matrix provides a solution, which can serve as biomaterial scaffold as well as original ecological niche for the stem cells. Therefore, we propose the hypothesis that human decellularized adipose tissues (hDAT) are processed into injectable hydrogels and then mixed evenly with ADSCs. So that the ADSCs embedded-hydrogels could directly carry the stem cells to the appropriate sites. The hDAT hydrogel could provide microenvironmental protection for ADSCs. In this study, we successfully made human decellularized adipose tissue hydrogel (hDAT-gel), which was temperature-sensitive, liquid at 4°C and semi-solid at 37°C. When the ADSCs were embedded in hDAT-gel, they survived well and continued to grow well in layers. When the pre-gel containing ADSCs was injected subcutaneously into nude mice, the sample results after 15 min showed gelation occurred in situ. These results suggested that hDAT-gel could provide a culture platform for ADSCs delivery.
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Affiliation(s)
- Wenwen Pu
- Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Han
- Department of Plastic and Reconstructive Surgery, the First Medical Center, Chinese PLA (People's Liberation Army) General Hospital, Beijing, China
| | - Mingyong Yang
- Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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6
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Ning LJ, Zhang YJ, Zhang YJ, Zhu M, Ding W, Jiang YL, Zhang Y, Luo JC, Qin TW. Enhancement of Migration and Tenogenic Differentiation of Macaca Mulatta Tendon-Derived Stem Cells by Decellularized Tendon Hydrogel. Front Cell Dev Biol 2021; 9:651583. [PMID: 33987178 PMCID: PMC8111289 DOI: 10.3389/fcell.2021.651583] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/06/2021] [Indexed: 02/05/2023] Open
Abstract
Decellularized tendon hydrogel from human or porcine tendon has been manufactured and found to be capable of augmenting tendon repair in vivo. However, no studies have clarified the effect of decellularized tendon hydrogel upon stem cell behavior. In the present study, we developed a new decellularized tendon hydrogel (T-gel) from Macaca mulatta, and investigated the effect of T-gel on the proliferation, migration and tenogenic differentiation of Macaca mulatta tendon-derived stem cells (mTDSCs). The mTDSCs were first identified to have universal stem cell characteristics, including clonogenicity, expression of mesenchymal stem cell and embryonic stem cell markers, and multilineage differentiation potential. Decellularization of Macaca mulatta Achilles tendons was confirmed to be effective by histological staining and DNA quantification. The resultant T-gel exhibited highly porous structure or similar nanofibrous structure and approximately swelling ratio compared to the collagen gel (C-gel). Interestingly, stromal cell-derived factor-1 (SDF-1) and fibromodulin (Fmod) inherent in the native tendon extracellular matrix (ECM) microenvironment were retained and the values of SDF-1 and Fmod in the T-gel were significantly higher than those found in the C-gel. Compared with the C-gel, the T-gel was found to be cytocompatible with NIH-3T3 fibroblasts and displayed good histocompatibility when implanted into rat subcutaneous tissue. More importantly, it was demonstrated that the T-gel supported the proliferation of mTDSCs and significantly promoted the migration and tenogenic differentiation of mTDSCs compared to the C-gel. These findings indicated that the T-gel, with its retained nanofibrous structure and some bioactive factors of native tendon ECM microenvironment, represents a promising hydrogel for tendon regeneration.
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Affiliation(s)
- Liang-Ju Ning
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Ya-Jing Zhang
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Yan-Jing Zhang
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China.,Core Facility of West China Hospital, Sichuan University, Chengdu, China
| | - Min Zhu
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Wei Ding
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Yan-Lin Jiang
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Yi Zhang
- Core Facility of West China Hospital, Sichuan University, Chengdu, China
| | - Jing-Cong Luo
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Ting-Wu Qin
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
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7
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Franklin A, Gi Min J, Oda H, Kaizawa Y, Leyden J, Wang Z, Chang J, Fox PM. Homing of Adipose-Derived Stem Cells to a Tendon-Derived Hydrogel: A Potential Mechanism for Improved Tendon-Bone Interface and Tendon Healing. J Hand Surg Am 2020; 45:1180.e1-1180.e12. [PMID: 32605739 DOI: 10.1016/j.jhsa.2020.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 01/29/2020] [Accepted: 05/07/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE Tendons are difficult to heal owing to their hypocellularity and hypovascularity. Our laboratory has developed a tendon-derived hydrogel (tHG) that significantly improves tendon healing in an animal model. We hypothesized that a potential mechanism for improved healing with tHG is through the attraction of systemic stem cells. METHODS Homing of systemic adipose-derived stem cells (ADSCs) to tendon injuries was assessed with acute and chronic injury models. Injury sites were treated with saline or tHG, and animals given a tail vein injection (TVI) of labeled ADSCs 1 week after treatment. One week following TVI, rats were harvested for histology. To further evaluate a potential difference in homing to tHG, a subcutaneous injection (SQI) model was used. Rats were treated with an SQI of saline, silicone, ADSCs in media, tHG, tHG + fibroblasts (FBs), or tHG + ADSCs on day 0. One week after SQI, rats underwent TVI with labeled ADSCs. Samples were harvested 2 or 3 weeks after SQI for analysis. Flow cytometry confirmed homing in the SQI model. RESULTS Systemically delivered ADSCs homed to both acute tendon and chronic tendon-bone interface (TBI) injury sites. Despite their presence at the injury site, there was no difference in the number of macrophages, amount of cell proliferation, or angiogenesis 1 week after stem cell delivery. In an SQI model, ADSCs homed to tHG. There was no difference in the number of ADSCs homing to tHG alone versus tHG + ADSCs. However, there was an increase in the number of living cells, general immune cells, and T-cells present at tHG + ADSC versus tHG alone. CONCLUSIONS The ADSCs home to tendon injury sites and tHG. We believe the attraction of additional systemic ADSCs is one mechanism for improved tendon and TBI healing with tHG. CLINICAL RELEVANCE Treatment of tendon and TBI injuries with tHG can augment healing via homing of systemic stem cells.
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Affiliation(s)
- Austin Franklin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Jung Gi Min
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Hiroki Oda
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Yukitoshi Kaizawa
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Jacinta Leyden
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Zhen Wang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - James Chang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Paige M Fox
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
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8
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Hanai H, Jacob G, Nakagawa S, Tuan RS, Nakamura N, Shimomura K. Potential of Soluble Decellularized Extracellular Matrix for Musculoskeletal Tissue Engineering - Comparison of Various Mesenchymal Tissues. Front Cell Dev Biol 2020; 8:581972. [PMID: 33330460 PMCID: PMC7732506 DOI: 10.3389/fcell.2020.581972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/05/2020] [Indexed: 12/12/2022] Open
Abstract
Background It is well studied that preparations of decellularized extracellular matrix (ECM) obtained from mesenchymal tissues can function as biological scaffolds to regenerate injured musculoskeletal tissues. Previously, we reported that soluble decellularized ECMs derived from meniscal tissue demonstrated excellent biocompatibility and produced meniscal regenerate with native meniscal anatomy and biochemical characteristics. We therefore hypothesized that decellularized mesenchymal tissue ECMs from various mesenchymal tissues should exhibit tissue-specific bioactivity. The purpose of this study was to test this hypothesis using porcine tissues, for potential applications in musculoskeletal tissue engineering. Methods Nine types of porcine tissue, including cartilage, meniscus, ligament, tendon, muscle, synovium, fat pad, fat, and bone, were decellularized using established methods and solubilized. Although the current trend is to develop tissue specific decellularization protocols, we selected a simple standard protocol across all tissues using Triton X-100 and DNase/RNase after mincing to compare the outcome. The content of sulfated glycosaminoglycan (sGAG) and hydroxyproline were quantified to determine the biochemical composition of each tissue. Along with the concentration of several growth factors, known to be involved in tissue repair and/or maturation, including bFGF, IGF-1, VEGF, and TGF-β1. The effect of soluble ECMs on cell differentiation was explored by combining them with 3D collagen scaffold culturing human synovium derived mesenchymal stem cells (hSMSCs). Results The decellularization of each tissue was performed and confirmed both histologically [hematoxylin and eosin (H&E) and 4’,6-diamidino-2-phenylindole (DAPI) staining] and on the basis of dsDNA quantification. The content of hydroxyproline of each tissue was relatively unchanged during the decellularization process when comparing the native and decellularized tissue. Cartilage and meniscus exhibited a significant decrease in sGAG content. The content of hydroxyproline in meniscus-derived ECM was the highest when compared with other tissues, while sGAG content in cartilage was the highest. Interestingly, a tissue-specific composition of most of the growth factors was measured in each soluble decellularized ECM and specific differentiation potential was particularly evident in cartilage, ligament and bone derived ECMs. Conclusion In this study, soluble decellularized ECMs exhibited differences based on their tissue of origin and the present results are important going forward in the field of musculoskeletal regeneration therapy.
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Affiliation(s)
- Hiroto Hanai
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - George Jacob
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Orthopaedics, Tejasvini Hospital, Mangalore, India
| | - Shinichi Nakagawa
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
| | - Rocky S Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, United States.,Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Norimasa Nakamura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan.,Institute for Medical Science in Sports, Osaka Health Science University, Osaka, Japan.,Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan
| | - Kazunori Shimomura
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan
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9
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González-Quevedo D, Díaz-Ramos M, Chato-Astrain J, Sánchez-Porras D, Tamimi I, Campos A, Campos F, Carriel V. Improving the regenerative microenvironment during tendon healing by using nanostructured fibrin/agarose-based hydrogels in a rat Achilles tendon injury model. Bone Joint J 2020; 102-B:1095-1106. [PMID: 32731821 DOI: 10.1302/0301-620x.102b8.bjj-2019-1143.r2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AIMS Achilles tendon injuries are a frequent problem in orthopaedic surgery due to their limited healing capacity and the controversy surrounding surgical treatment. In recent years, tissue engineering research has focused on the development of biomaterials to improve this healing process. The aim of this study was to analyze the effect of tendon augmentation with a nanostructured fibrin-agarose hydrogel (NFAH) or genipin cross-linked nanostructured fibrin-agarose hydrogel (GP-NFAH), on the healing process of the Achilles tendon in rats. METHODS NFAH, GP-NFAH, and MatriDerm (control) scaffolds were generated (five in each group). A biomechanical and cell-biomaterial-interaction characterization of these biomaterials was then performed: Live/Dead Cell Viability Assay, water-soluble tetrazolium salt-1 (WST-1) assay, and DNA-released after 48 hours. Additionally, a complete section of the left Achilles tendon was made in 24 Wistar rats. Animals were separated into four treatment groups (six in each group): direct repair (Control), tendon repair with MatriDerm, or NFAH, or GP-NFAH. Animals were euthanized for further histological analyses after four or eight weeks post-surgery. The Achilles tendons were harvested and a histopathological analysis was performed. RESULTS Tensile test revealed that NFAH and GP-NFAH had significantly higher overall biomechanical properties compared with MatriDerm. Moreover, biological studies confirmed a high cell viability in all biomaterials, especially in NFAH. In addition, in vivo evaluation of repaired tendons using biomaterials (NFAH, GP-NFAH, and MatriDerm) resulted in better organization of the collagen fibres and cell alignment without clinical complications than direct repair, with a better histological score in GP-NFAH. CONCLUSION In this animal model we demonstrated that NFAH and GP-NFAH had the potential to improve tendon healing following a surgical repair. However, future studies are needed to determine the clinical usefulness of these engineered strategies. Cite this article: Bone Joint J 2020;102-B(8):1095-1106.
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Affiliation(s)
- David González-Quevedo
- Department of Orthopedic Surgery and Traumatology, Regional University Hospital of Málaga, Málaga, Spain.,University of Granada, Granada, Spain
| | - Miriam Díaz-Ramos
- Department of Histology (Tissue Engineering Group), University of Granada, Granada, Spain
| | - Jesús Chato-Astrain
- University of Granada, Granada, Spain.,Department of Histology (Tissue Engineering Group), University of Granada, Granada, Spain
| | - David Sánchez-Porras
- Department of Histology (Tissue Engineering Group), University of Granada, Granada, Spain
| | - Iskandar Tamimi
- Department of Orthopedic Surgery and Traumatology, Regional University Hospital of Málaga, Málaga, Spain
| | - Antonio Campos
- Department of Histology (Tissue Engineering Group), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs, Granada, Spain
| | - Fernando Campos
- Department of Histology (Tissue Engineering Group), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs, Granada, Spain
| | - Víctor Carriel
- Department of Histology (Tissue Engineering Group), University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs, Granada, Spain
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A Human-Derived, Collagen-Rich Hydrogel Augments Wound Healing in a Diabetic Animal Model. Ann Plast Surg 2020; 85:290-294. [PMID: 32349080 DOI: 10.1097/sap.0000000000002380] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Application of collagen products to wounds has been shown to improve wound healing. Using a collagen-based hydrogel (cHG) capable of cellular support previously developed by our laboratory, we hypothesize that our hydrogel will increase the speed of wound healing by providing a 3-dimensional framework for cellular support, increasing angiogenesis and cell-proliferation at the wound bed. METHODS Two, 10-mm excisional wounds were created over the dorsum of 12 male, genetically modified Zucker diabetic rats. Wounds were splinted open to limit healing by wound contracture. One wound was treated with an occlusive dressing (OD), whereas the adjacent wound was treated with an OD plus cHG. Occlusive dressings were changed every other day. Hydrogel was applied on day 2 and every 4 days after until complete wound closure. Rate of wound closure was monitored with digital photography every other day. Wounds were harvested at days 10 and 16 for histological and immunohistochemical analysis. RESULTS Wound closure was significantly faster in cHG-treated wounds compared with OD-treated wounds. By day 10, cHG-treated wounds achieved 63% wound closure, compared with 55% wound closure in OD-treated wounds (P < 0.05). By day 16, cHG-treated wounds achieved 84% wound closure, compared with 68% wound closure in OD-treated wounds (P < 0.05).Histologically, wound depth was not different between the cHG and OD groups on days 10 and 16. However, wound length was significantly less in the cHG group compared with the OD group (P < 0.05) consistent with digital photographic analysis. Immunohistochemical analysis for RECA-1 demonstrated that blood vessel density in the wound bed was 2.3 times higher in the cHG group compared with the OD group (P = 0.01) on day 16. Cell proliferation was 3.8 times higher in the cHG group versus the OD group (P < 0.05) on day 10. CONCLUSIONS Collagen-based hydrogel-treated wounds demonstrated significantly improved healing compared with control. The thermoresponsive feature of collagen hydrogel and its structural stability at body temperature demonstrate promising clinical potential as a vehicle for the delivery of therapeutic cells to the wound bed.
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Maruyama M, Wei L, Thio T, Storaci HW, Ueda Y, Yao J. The Effect of Mesenchymal Stem Cell Sheets on Early Healing of the Achilles Tendon in Rats. Tissue Eng Part A 2020; 26:206-213. [DOI: 10.1089/ten.tea.2019.0163] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Masahiro Maruyama
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Le Wei
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Timothy Thio
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Hunter W. Storaci
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Yusuke Ueda
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
| | - Jeffrey Yao
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California
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Kaizawa Y, Leyden J, Behn AW, Tulu US, Franklin A, Wang Z, Abrams G, Chang J, Fox PM. Human Tendon-Derived Collagen Hydrogel Significantly Improves Biomechanical Properties of the Tendon-Bone Interface in a Chronic Rotator Cuff Injury Model. J Hand Surg Am 2019; 44:899.e1-899.e11. [PMID: 30685142 DOI: 10.1016/j.jhsa.2018.11.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 09/10/2018] [Accepted: 11/28/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE Poor healing of the tendon-bone interface (TBI) after rotator cuff (RTC) tears leads to high rates of recurrent tear following repair. Previously, we demonstrated that an injectable, thermoresponsive, type I collagen-rich, decellularized human tendon-derived hydrogel (tHG) improved healing in an acute rat Achilles tendon injury model. The purpose of this study was to investigate whether tHG enhances the biomechanical properties of the regenerated TBI in a rat model of chronic RTC injury and repair. METHODS Tendon hydrogel was prepared from chemically decellularized human cadaveric flexor tendons. Eight weeks after bilateral resection of supraspinatus tendons, repair of both shoulders was performed. One shoulder was treated with a transosseous suture (control group) and the other was treated with a transosseous suture plus tHG injection at the repair site (tHG group). Eight weeks after repair, the TBIs were evaluated biomechanically, histologically, and via micro-computed tomography (CT). RESULTS Biomechanical testing revealed a larger load to failure, higher stiffness, higher energy to failure, larger strain at failure, and higher toughness in the tHG group versus control. The area of new cartilage formation was significantly larger in the tHG group. Micro-CT revealed no significant difference between groups in bone morphometry at the supraspinatus tendon insertion, although the tHG group was superior to the control. CONCLUSIONS Injection of tHG at the RTC repair site enhanced biomechanical properties and increased fibrocartilage formation at the TBI in a chronic injury model. CLINICAL RELEVANCE Treatment of chronic RTC injuries with tHG at the time of surgical treatment may improve outcomes after surgical repair.
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Affiliation(s)
- Yukitoshi Kaizawa
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Jacinta Leyden
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Anthony W Behn
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - U Serdar Tulu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA
| | - Austin Franklin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Zhen Wang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Geoffrey Abrams
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Palo Alto, CA
| | - James Chang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Paige M Fox
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University Medical Center, Palo Alto, CA; Division of Plastic and Reconstructive Surgery, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
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Extracellular matrix-based hydrogels obtained from human tissues: a work still in progress. Curr Opin Organ Transplant 2019; 24:604-612. [DOI: 10.1097/mot.0000000000000691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Toprakhisar B, Nadernezhad A, Bakirci E, Khani N, Skvortsov GA, Koc B. Development of Bioink from Decellularized Tendon Extracellular Matrix for 3D Bioprinting. Macromol Biosci 2018; 18:e1800024. [DOI: 10.1002/mabi.201800024] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 06/09/2018] [Indexed: 01/12/2023]
Affiliation(s)
- Burak Toprakhisar
- Faculty of Engineering and Natural Sciences; Sabanci University; Orhanli-Tuzla Istanbul 34956 Turkey
- 3D Bioprinting Laboratory; Sabanci University Nanotechnology Research and Application Center; Orhanli-Tuzla Istanbul 34956 Turkey
| | - Ali Nadernezhad
- Faculty of Engineering and Natural Sciences; Sabanci University; Orhanli-Tuzla Istanbul 34956 Turkey
- 3D Bioprinting Laboratory; Sabanci University Nanotechnology Research and Application Center; Orhanli-Tuzla Istanbul 34956 Turkey
| | - Ezgi Bakirci
- Faculty of Engineering and Natural Sciences; Sabanci University; Orhanli-Tuzla Istanbul 34956 Turkey
- 3D Bioprinting Laboratory; Sabanci University Nanotechnology Research and Application Center; Orhanli-Tuzla Istanbul 34956 Turkey
| | - Navid Khani
- Faculty of Engineering and Natural Sciences; Sabanci University; Orhanli-Tuzla Istanbul 34956 Turkey
- 3D Bioprinting Laboratory; Sabanci University Nanotechnology Research and Application Center; Orhanli-Tuzla Istanbul 34956 Turkey
| | - Gozde Akdeniz Skvortsov
- 3D Bioprinting Laboratory; Sabanci University Nanotechnology Research and Application Center; Orhanli-Tuzla Istanbul 34956 Turkey
- Sabanci University Nanotechnology Research and Application Center; Orhanli-Tuzla Istanbul 34956 Turkey
| | - Bahattin Koc
- Faculty of Engineering and Natural Sciences; Sabanci University; Orhanli-Tuzla Istanbul 34956 Turkey
- 3D Bioprinting Laboratory; Sabanci University Nanotechnology Research and Application Center; Orhanli-Tuzla Istanbul 34956 Turkey
- Faculty of Engineering and Natural Sciences; Sabanci University; Orhanli-Tuzla Istanbul 34956 Turkey
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Spang MT, Christman KL. Extracellular matrix hydrogel therapies: In vivo applications and development. Acta Biomater 2018; 68:1-14. [PMID: 29274480 DOI: 10.1016/j.actbio.2017.12.019] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/09/2017] [Accepted: 12/15/2017] [Indexed: 12/12/2022]
Abstract
Decellularized extracellular matrix (ECM) has been widely used for tissue engineering applications and is becoming increasingly versatile as it can take many forms, including patches, powders, and hydrogels. Following additional processing, decellularized ECM can form an inducible hydrogel that can be injected, providing for new minimally-invasive procedure opportunities. ECM hydrogels have been derived from numerous tissue sources and applied to treat many disease models, such as ischemic injuries and organ regeneration or replacement. This review will focus on in vivo applications of ECM hydrogels and functional outcomes in disease models, as well as discuss considerations for clinical translation. STATEMENT OF SIGNIFICANCE Extracellular matrix (ECM) hydrogel therapies are being developed to treat diseased or damaged tissues and organs throughout the body. Many ECM hydrogels are progressing from in vitro models to in vivo biocompatibility studies and functional models. There is significant potential for clinical translation of these therapies since one ECM hydrogel therapy is already in a Phase 1 clinical trial.
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Abstract
PURPOSE Previous work has characterized the development of a human tendon hydrogel capable of improving mechanical strength after tendon injury. Animal tendon hydrogel has not yet been described, but would prove beneficial due to the cost and ethical concerns associated with the use of human cadaveric tendon. This study details the manufacture and assesses the biocompatibility of porcine tendon hydrogel seeded with human adipoderived stem cells (ASCs). MATERIALS AND METHODS Porcine tendon was dissected from surrounding connective and muscle tissue and decellularized via 0.2% sodium dodecyl sulfate and 0.2% sodium dodecyl sulfate/ethylenediaminetetraacetic acid wash solutions before lyophilization. Tendon was milled and reconstituted by previously described methods. Decellularization was confirmed by hematoxylin-eosin staining, SYTO Green 11 nucleic acid dye, and DNeasy assay. The protein composition of milled tendon matrix before and after digestion was identified by mass spectrometry. Rheological properties were determined using an ARG2 rheometer. Biocompatibility was assessed by live/dead assay. The proliferation of human ASCs seeded in porcine and human hydrogel was measured by MTS assay. All experimental conditions were performed in triplicate. RESULTS Decellularization of porcine tendon was successful. Mass spectrometry showed that collagen composes one third of milled porcine tendon before and after pepsin digestion. Rheology demonstrated that porcine hydrogel maintains a fluid consistency over a range of temperatures, unlike human hydrogel, which tends to solidify. Live/dead staining revealed that human ASCs survive in hydrogel 7 days after seeding and retain spindle-like morphology. MTS assay at day 3 and day 5 showed that human ASC proliferation was marginally greater in human hydrogel. CONCLUSIONS After reconstitution and digestion, porcine hydrogel was capable of supporting growth of human ASCs. The minimal difference in proliferative capacity suggests that porcine tendon hydrogel may be an effective and viable alternative to human hydrogel for the enhancement of tendon healing.
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Rothrauff BB, Coluccino L, Gottardi R, Ceseracciu L, Scaglione S, Goldoni L, Tuan RS. Efficacy of thermoresponsive, photocrosslinkable hydrogels derived from decellularized tendon and cartilage extracellular matrix for cartilage tissue engineering. J Tissue Eng Regen Med 2017; 12:e159-e170. [PMID: 28486778 DOI: 10.1002/term.2465] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 03/07/2017] [Accepted: 05/04/2017] [Indexed: 11/11/2022]
Abstract
Tissue engineering using adult mesenchymal stem cells (MSCs), a promising approach for cartilage repair, is highly dependent on the nature of the matrix scaffold. Thermoresponsive, photocrosslinkable hydrogels were fabricated by functionalizing pepsin-soluble decellularized tendon and cartilage extracellular matrices (ECM) with methacrylate groups. Methacrylated gelatin hydrogels served as controls. When seeded with human bone marrow MSCs and cultured in chondrogenic medium, methacrylated ECM hydrogels experienced less cell-mediated contraction, as compared against non-methacrylated ECM hydrogels. However, methacrylation slowed or diminished chondrogenic differentiation of seeded MSCs, as determined through analyses of gene expression, biochemical composition and histology. In particular, methacrylated cartilage hydrogels supported minimal due to chondrogenesis over 42 weeks, as hydrogel disintegration beginning at day 14 presumably compromised cell-matrix interactions. As compared against methacrylated gelatin hydrogels, MSCs cultured in non-methacrylated ECM hydrogels exhibited comparable expression of chondrogenic genes (Sox9, Aggrecan and collagen type II) but increased collagen type I expression. Non-methacrylated cartilage hydrogels did not promote chondrogenesis to a greater extent than either non-methacrylated or methacrylated tendon hydrogels. Whereas methacrylated gelatin hydrogels supported relatively homogeneous increases in proteoglycan and collagen type II deposition throughout the construct over 42 days, ECM hydrogels possessed greater heterogeneity of staining intensity and construct morphology. These results do not support the utility of pepsin-solubilized cartilage and tendon hydrogels for cartilage tissue engineering over methacrylated gelatin hydrogels. Methacrylation of tendon and cartilage ECM hydrogels permits thermal- and light-induced polymerization but compromises chondrogenic differentiation of seeded MSCs.
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Affiliation(s)
- Benjamin B Rothrauff
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Luca Coluccino
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,Istituto Italiano di Tecnologia, Genoa, Italy.,IEIIT Institute, CNR-National Research Council of Italy, Genoa, Italy
| | - Riccardo Gottardi
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,Fondazione RiMED, Palermo, Italy
| | | | - Silvia Scaglione
- IEIIT Institute, CNR-National Research Council of Italy, Genoa, Italy
| | | | - Rocky S Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Rothrauff BB, Yang G, Tuan RS. Tissue-specific bioactivity of soluble tendon-derived and cartilage-derived extracellular matrices on adult mesenchymal stem cells. Stem Cell Res Ther 2017; 8:133. [PMID: 28583182 PMCID: PMC5460492 DOI: 10.1186/s13287-017-0580-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/02/2017] [Accepted: 05/08/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Biological scaffolds composed of tissue-derived extracellular matrix (ECM) can promote homologous (i.e., tissue-specific) cell differentiation through preservation of biophysical and biochemical motifs found in native tissues. Solubilized ECMs derived from decellularized tendon and cartilage have recently been promoted as tissue-specific biomaterials, but whether tissue-specific bioactivity is preserved following solubilization is unknown. This study explored the tissue-specific bioactivity of soluble decellularized tendon and cartilage ECMs on human bone marrow-derived mesenchymal stem cells (MSCs) presented across different culture microenvironments, including two-dimensional (2D) tissue culture plastic, aligned electrospun nanofibers, cell pellets, and cell-seeded photocrosslinkable hydrogels. METHODS Tendon and cartilage ECMs were decellularized using established methods and solubilized either via pepsin digestion or urea extraction. The effect of soluble ECMs on cell proliferation and differentiation was initially explored by supplementing basal medium of human MSCs cultured on 2D tissue culture plastic. In subsequent experiments, MSCs were cultured on aligned electrospun nanofibers, ascell pellets, or encapsulated within photocrosslinkable methacrylated gelatin (GelMA) hydrogels. Urea-extracted tendon and cartilage ECMs were added as supplements. RESULTS Pepsin-digested ECMs did not promote homologous differentiation in human MSCs, whether provided as a medium supplement or three-dimensional (3D) hydrogels. In contrast, urea-extracted ECMs tended to promote tissue-specific differentiation of MSCs cultured in 2D and 3D microenvironments. The application of the small molecule TGF-β signaling inhibitor SB-431542 largely negated the tissue-specific gene expression patterns mediated by tendon and cartilage ECMs. This suggests that the action of endogenous TGF-β was required, but was not sufficient, to impart tissue-specific bioactivity of urea-extracted ECMs. When urea-extracted cartilage ECM was incorporated within a photocurable GelMA hydrogel it independently enhanced chondrogenesis in encapsulated MSCs, and showed additive prochondrogenesis upon TGF-β supplementation in the medium. CONCLUSIONS Urea-extracted ECM fractions of decellularized tendon and cartilage are soluble supplements capable of enhancing tissue-specific differentiation of adult stem cells.
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Affiliation(s)
- Benjamin B Rothrauff
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Room 221, Pittsburgh, PA, 15219, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA
| | - Guang Yang
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Room 221, Pittsburgh, PA, 15219, USA
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA, 15219, USA
| | - Rocky S Tuan
- Center for Cellular and Molecular Engineering, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 450 Technology Drive, Room 221, Pittsburgh, PA, 15219, USA.
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA.
- Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA, 15219, USA.
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Lee SY, Kwon B, Lee K, Son YH, Chung SG. Therapeutic Mechanisms of Human Adipose-Derived Mesenchymal Stem Cells in a Rat Tendon Injury Model. Am J Sports Med 2017; 45:1429-1439. [PMID: 28291954 DOI: 10.1177/0363546517689874] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although survival of transplanted stem cells in vivo and differentiation of stem cells into tenocytes in vitro have been reported, there have been no in vivo studies demonstrating that mesenchymal stem cells (MSCs) could secrete their own proteins as differentiated tenogenic cells. Purpose/Hypothesis: Using a xenogeneic MSC transplantation model, we aimed to investigate whether MSCs could differentiate into the tenogenic lineage and secrete their own proteins. The hypothesis was that human MSCs would differentiate into the human tenogenic lineage and the cells would be able to secrete human-specific proteins in a rat tendon injury model. STUDY DESIGN Controlled laboratory study. METHODS The Achilles tendons of 57 Sprague Dawley rats received full-thickness rectangular defects. After the modeling, the defective tendons were randomly assigned to 3 groups: (1) cell group, implantation with human adipose-derived mesenchymal stem cells (hASCs) and fibrin glue (106 cells in 60 μL); (2) fibrin group, implantation with fibrin glue and same volume of cell media; and (3) sham group, identical surgical procedure without any treatment. Gross observation and biomechanical, histopathological, immunohistochemistry, and Western blot analyses were performed at 2 and 4 weeks after modeling. RESULTS hASCs implanted into the defective rat tendons were viable for 4 weeks as detected by immunofluorescence staining. Tendons treated with hASCs showed better gross morphological and biomechanical recovery than those in the fibrin and sham groups. Furthermore, the expression of both human-specific collagen type I and tenascin-C was significantly higher in the cell group than in the other 2 groups. CONCLUSION Transplantation of hASCs enhanced rat tendon healing biomechanically. hASCs implanted into the rat tendon defect model survived for at least 4 weeks and secreted human-specific collagen type I and tenascin-C. These findings suggest that transplanted MSCs may be able to differentiate into the tenogenic lineage and contribute their own proteins to tendon healing. CLINICAL RELEVANCE In tendon injury, MSCs can enhance tendon healing by secreting their own protein and have potential as a therapeutic option in human tendinopathy.
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Affiliation(s)
- Sang Yoon Lee
- Department of Physical Medicine & Rehabilitation, Chung-Ang University College of Medicine, Seoul, South Korea.,Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Bomi Kwon
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyoungbun Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea
| | - Young Hoon Son
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, South Korea
| | - Sun G Chung
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, South Korea.,Institute of Aging, Seoul National University, Seoul, South Korea.,Rheumatism Research Institute, Medical Research Center, Seoul National University, Seoul, South Korea
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Bottagisio M, Lovati AB. A review on animal models and treatments for the reconstruction of Achilles and flexor tendons. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:45. [PMID: 28155051 DOI: 10.1007/s10856-017-5858-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 01/19/2017] [Indexed: 06/06/2023]
Abstract
Tendon is a connective tissue mainly composed of collagen fibers with peculiar mechanical properties essential to functional movements. The increasing incidence of tendon traumatic injuries and ruptures-associated or not with the loss of tissue-falls on the growing interest in the field of tissue engineering and regenerative medicine. The use of animal models is mandatory to deepen the knowledge of the tendon healing response to severe damages or acute transections. Thus, the selection of preclinical models is crucial to ensure a successful translation of effective and safe innovative treatments to the clinical practice. The current review is focused on animal models of tendon ruptures and lacerations or defective injuries with large tissue loss that require surgical approaches or grafting procedures. Data published between 2000 and 2016 were examined. The analyzed articles were compiled from Pub Med-NCBI using search terms, including animal model(s) AND tendon augmentation OR tendon substitute(s) OR tendon substitution OR tendon replacement OR tendon graft(s) OR tendon defect(s) OR tendon rupture(s). This article presents the existing preclinical models - considering their advantages and disadvantages-in which translational progresses have been made by using bioactive sutures or tissue engineering that combines biomaterials with cells and growth factors to efficiently treat transections or large defects of Achilles and flexor tendons.
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Affiliation(s)
- Marta Bottagisio
- Cell and Tissue Engineering Laboratory, IRCCS Galeazzi Orthopaedic Institute, via R. Galeazzi 4, 20161, Milan, Italy
| | - Arianna B Lovati
- Cell and Tissue Engineering Laboratory, IRCCS Galeazzi Orthopaedic Institute, via R. Galeazzi 4, 20161, Milan, Italy.
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Extracellular matrix hydrogels from decellularized tissues: Structure and function. Acta Biomater 2017; 49:1-15. [PMID: 27915024 DOI: 10.1016/j.actbio.2016.11.068] [Citation(s) in RCA: 457] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/11/2016] [Accepted: 11/30/2016] [Indexed: 12/16/2022]
Abstract
Extracellular matrix (ECM) bioscaffolds prepared from decellularized tissues have been used to facilitate constructive and functional tissue remodeling in a variety of clinical applications. The discovery that these ECM materials could be solubilized and subsequently manipulated to form hydrogels expanded their potential in vitro and in vivo utility; i.e. as culture substrates comparable to collagen or Matrigel, and as injectable materials that fill irregularly-shaped defects. The mechanisms by which ECM hydrogels direct cell behavior and influence remodeling outcomes are only partially understood, but likely include structural and biological signals retained from the native source tissue. The present review describes the utility, formation, and physical and biological characterization of ECM hydrogels. Two examples of clinical application are presented to demonstrate in vivo utility of ECM hydrogels in different organ systems. Finally, new research directions and clinical translation of ECM hydrogels are discussed. STATEMENT OF SIGNIFICANCE More than 70 papers have been published on extracellular matrix (ECM) hydrogels created from source tissue in almost every organ system. The present manuscript represents a review of ECM hydrogels and attempts to identify structure-function relationships that influence the tissue remodeling outcomes and gaps in the understanding thereof. There is a Phase 1 clinical trial now in progress for an ECM hydrogel.
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Farnebo S, Farnebo L, Kim M, Woon C, Pham H, Chang J. Optimized Repopulation of Tendon Hydrogel: Synergistic Effects of Growth Factor Combinations and Adipose-Derived Stem Cells. Hand (N Y) 2017; 12:68-77. [PMID: 28082847 PMCID: PMC5207276 DOI: 10.1177/1558944715628005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Tendon-derived extracellular matrix (ECM) hydrogel has been shown to augment tendon healing in vivo. We hypothesized that reseeding of the gel with adipose-derived stem cells (ASCs) could further assist repopulation of the gel and that combinations of growth factors (GFs) would improve the survival of these cells after reseeding. Methods: A tendon-specific ECM solution was supplemented with varying concentrations of basic fibroblast growth factor (bFGF), insulin-like growth factor-1 (IGF-1), and platelet-derived growth factor-BB (PDGF-BB). Gels were then seeded with ASCs transfected with a green fluorescent protein/luciferin construct. Cell proliferation was determined using the MTT assay and histology, and GF and ASC augmented gels were injected into the back of Sprague Dawley rats. Bioluminescence of seeded gels was continuously followed after reseeding, and cell counts were performed after the gels were explanted at 14 days. Results: Synergistic effects of the GFs were seen, and an optimal combination was determined to be 10 ng/mL bFGF, 100 ng/mL IGF-1, and 100 ng/mL PDGF-BB (2.8-fold increase; P < .05). In vivo bioluminescence showed an improved initial survival of cells in gels supplemented with the optimal concentration of GF compared with the control group (10.6-fold increase at 8 days; P < .05). Cell counts of explants showed a dramatic endogenous repopulation of gels supplemented by GF + ASCs compared with both gels with GF but no ASCs (7.6-fold increase) and gels with ASCs but no GF (1.6-fold increase). Conclusion: Synergistic effects of GFs can be used to improve cellular proliferation of ASCs seeded to a tendon ECM gel. Reseeding with ASCs stimulates endogenous repopulation of the gel in vivo and may be used to further augment tendon healing.
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Affiliation(s)
- Simon Farnebo
- VA Palo Alto Health Care System, Livermore, CA, USA,Linköping University, Sweden,Simon Farnebo, Division of Plastic Surgery, Stanford University Medical Center, 770 Welch Road, Suite 400, Stanford, CA 94305, USA.
| | | | - Maxwell Kim
- VA Palo Alto Health Care System, Livermore, CA, USA,Stanford University, CA, USA
| | - Colin Woon
- VA Palo Alto Health Care System, Livermore, CA, USA,Stanford University, CA, USA
| | - Hung Pham
- VA Palo Alto Health Care System, Livermore, CA, USA,Stanford University, CA, USA
| | - James Chang
- VA Palo Alto Health Care System, Livermore, CA, USA,Stanford University, CA, USA
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24
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López-Nájera D, Rubio-Zaragoza M, Sopena-Juncosa JJ, Alentorn-Geli E, Cugat-Bertomeu R, Fernández-Sarmiento JA, Domínguez-Pérez JM, García-Balletbó M, Primo-Capella VJ, Carrillo-Poveda JM. Effects of plasma rich in growth factors (PRGF) on biomechanical properties of Achilles tendon repair. Knee Surg Sports Traumatol Arthrosc 2016; 24:3997-4004. [PMID: 26272059 DOI: 10.1007/s00167-015-3725-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/15/2015] [Indexed: 01/07/2023]
Abstract
PURPOSE To assess the biomechanical effects of intra-tendinous injections of PRGF on the healing Achilles tendon after repair in a sheep model. METHODS Thirty sheep were randomly assigned into one of the six groups depending on the type of treatment received (PRGF or placebo) and survival time (2, 4 and 8 weeks). The Achilles tendon injury was repaired by suturing the tendinous edges employing a three-loop pulley pattern. A trans-articular external fixation system was then used for immobilization. The PRGF or placebo was administered on a weekly basis completing a maximum of three infiltrations. The force, section and tension values were compared between the operated and healthy Achilles tendons across all groups. RESULTS The PRGF-treated tendons had higher force at 8 weeks compared with the placebo group (p = 0.007). Between 2 and 4 weeks, a significant increase in force in both the PRGF-treated tendon (p = 0.0027) and placebo group (p = 0.0095) occurred. No significant differences were found for section ratio between PRGF-treated tendons and the placebo group for any of the time periods evaluated. At 2 weeks, PRGF-treated tendons had higher tension ratio compared with placebo group tendons (p = 0.0143). Both PRGF and placebo treatments significantly improved the force (p < 0.001 and p = 0.0095, respectively) and tension (p = 0.009 and p = 0.0039, respectively) ratios at 8 weeks compared with 2 weeks. CONCLUSION The application of PRGF increases Achilles tendon repair strength at 8 weeks compared with the use of placebo. The use of PRGF does not modify section and tension ratios compared with placebo at 8 weeks. The tension ratio progressively increases between 2 and 8 weeks compared with the placebo.
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Affiliation(s)
- Diego López-Nájera
- García-Cugat Foundation, Barcelona, Spain. .,Instituto Veterinario de Ortopedia y Traumatología (IVOT), Barcelona, Spain. .,Clínica Veterinaria Gramenet, Hospital Veterinari Montigalà , Av dels Banús 1, Santa Coloma de Gramenet, Barcelona, Spain.
| | - Mónica Rubio-Zaragoza
- García-Cugat Foundation, Barcelona, Spain.,Departamento de Medicina y Cirugía Animal, Universidad CEU Cardenal Herrera, Valencia, Spain.,CEU-UCH Chair of Medicine and Regenerative Medicine, García-Cugat Foundation, Valencia, Spain
| | - Joaquín J Sopena-Juncosa
- García-Cugat Foundation, Barcelona, Spain.,Departamento de Medicina y Cirugía Animal, Universidad CEU Cardenal Herrera, Valencia, Spain.,CEU-UCH Chair of Medicine and Regenerative Medicine, García-Cugat Foundation, Valencia, Spain
| | - Eduard Alentorn-Geli
- Duke Sports Sciences Institute, Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
| | - Ramón Cugat-Bertomeu
- García-Cugat Foundation, Barcelona, Spain.,CEU-UCH Chair of Medicine and Regenerative Medicine, García-Cugat Foundation, Valencia, Spain.,Artroscopia GC, Hospital Quirón, Barcelona, Spain
| | - J Andrés Fernández-Sarmiento
- García-Cugat Foundation, Barcelona, Spain.,Departamento de Medicina y Cirugía Animal, Universidad de Córdoba, Córdoba, Spain
| | - Juan M Domínguez-Pérez
- García-Cugat Foundation, Barcelona, Spain.,Departamento de Medicina y Cirugía Animal, Universidad de Córdoba, Córdoba, Spain
| | - Montserrat García-Balletbó
- García-Cugat Foundation, Barcelona, Spain.,CEU-UCH Chair of Medicine and Regenerative Medicine, García-Cugat Foundation, Valencia, Spain.,Artroscopia GC, Hospital Quirón, Barcelona, Spain
| | - Víctor J Primo-Capella
- Health Care Technology Group, Biomedical Research Networking Center Bioengineering, Biomaterials, Nanomedicine (CIBER-BBN), Valencia, Spain.,Biomechanics Institute of Valencia (IBV), Universidad Politecnica de Valencia, Valencia, Spain
| | - José M Carrillo-Poveda
- García-Cugat Foundation, Barcelona, Spain.,Departamento de Medicina y Cirugía Animal, Universidad CEU Cardenal Herrera, Valencia, Spain.,CEU-UCH Chair of Medicine and Regenerative Medicine, García-Cugat Foundation, Valencia, Spain
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25
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Tissue Engineering of Tendons: A Comparison of Muscle-Derived Cells, Tenocytes, and Dermal Fibroblasts as Cell Sources. Plast Reconstr Surg 2016; 137:536e-544e. [PMID: 26910698 DOI: 10.1097/01.prs.0000479980.83169.31] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The rapid development of tendon tissue-engineering technology may offer an alternative graft for reconstruction of severe tendon losses. One critical factor for tendon tissue engineering is the optimization of seed cells. Little is known about the optimal cell source for engineered tendons. The aim of this study was to compare mouse muscle-derived cells, dermal fibroblasts, and tenocytes and determine the optimal cell source for tendon tissue engineering. METHODS Mouse muscle-derived cells, dermal fibroblasts, and tenocytes were isolated and cultured in vitro. At passage 1, cellular morphology, cell proliferation, and tenogenic marker expression were evaluated. After seeding on the polyglycolic acid scaffolds for 2 weeks in vitro and 12 weeks in vivo, histologic qualities, ultrastructure, and biomechanical characteristics were evaluated. RESULTS Proliferation and cellular morphology were similar for dermal fibroblasts and tenocytes, whereas muscle-derived cells proliferated faster than the other two groups. With regard to the phenotype difference between them, muscle-derived cells and tenocytes shared the gene expression of SCX, TNMD, GDF-8, and Col-I, but with MyoD gene expression only in muscle-derived cells. In contrast to dermal fibroblast and tenocyte constructed tendons, neotendon with muscle-derived cells exhibited better aligned collagen fibers, more mature collagen fibril structure, and stronger mechanical properties, whereas no significant difference in the dermal fibroblast and tenocyte groups was observed. CONCLUSION Although dermal fibroblasts are candidates for tendon tissue engineering because they are similar to tenocytes in proliferation and neotendon formation, muscle-derived cells appear to be the most suitable cells for further study and development of engineered tendon.
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Characteristics of Reconstituted Lyophilized Tendon Hydrogel: An Injectable Scaffold for Tendon Regeneration. Plast Reconstr Surg 2016; 137:843-851. [PMID: 26910664 DOI: 10.1097/01.prs.0000480012.41411.7c] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The authors have developed a tendon hydrogel that may be injected into the site of tendon injury to improve speed and strength of repair. The aim of this study was to compare the biological and physical properties of fresh, hydrated tendon hydrogel with its reconstituted lyophilized counterpart with the goal of increasing clinical feasibility. MATERIALS Hydrogel was prepared from fresh human cadaveric flexor tendon. Fresh gel was compared to gel aliquots that were lyophilized and reconstituted with sterile deionized water. Scanning electron microscopy was used to examine the microarchitecture of gelated samples. Rat adipose-derived stem cells were seeded in hydrogel, and cell viability was assessed after 7 days. MTS colorimetric assay was used to evaluate both the effect of prolonged storage on gel and the ability of reconstituted lyophilized hydrogel to activate platelet-rich plasma. The viability and proliferation of luciferase-transfected adipose-derived stem cells embedded within hydrogel in vivo was assessed by a bioluminescence in vivo imaging system. RESULTS Reconstituted lyophilized hydrogel demonstrated similar handling properties compared to fresh gel. Adipose-derived stem cells remained viable 7 days after reseeding in both conditions. Lyophilized hydrogel retained its ability to activate platelet-rich plasma and retained 95 percent of its maximal proliferative capacity at 30 days. The in vivo imaging system demonstrated similar cell proliferation, with signal persisting through day 13. CONCLUSIONS Reconstitution of lyophilized hydrogel stimulated cell proliferation and platelet-rich plasma activation to a greater degree than did fresh hydrogel. Efficacy after prolonged storage was also shown to be superior. Therefore, this lyophilized formulation of tendon hydrogel may have wider clinical applicability.
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Kraus TM, Imhoff FB, Reinert J, Wexel G, Wolf A, Hirsch D, Hofmann A, Stöckle U, Buchmann S, Tischer T, Imhoff AB, Milz S, Anton M, Vogt S. Stem cells and bFGF in tendon healing: Effects of lentiviral gene transfer and long-term follow-up in a rat Achilles tendon defect model. BMC Musculoskelet Disord 2016; 17:148. [PMID: 27048602 PMCID: PMC4822291 DOI: 10.1186/s12891-016-0999-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 03/25/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The influence of stem cells and lentiviral expression of basic fibroblastic growth factor (bFGF) on tendon healing and remodelling was investigated in an in-vivo long-term (12 weeks) rat Achilles tendon defect model. METHODS In sixty male Lewis rats, complete tendon defects (2.4 mm) were created and either left untreated (PBS) or treated by injection of stem cells lentivirally expressing the enhanced green fluorescence marker gene eGFP (MSC-LV-eGFP) or basic fibroblast growth factor bFGF (MSC-LV-bFGF). Tendons were harvested after 12 weeks and underwent biomechanical and (immuno)-histological analysis. RESULTS After 12 weeks the mean ultimate load to failure ratio (treated side to contralateral side) in biomechanical testing reached 97 % in the bFGF-group, 103 % in the eGFP-group and 112 % in the PBS-group. Also in the stiffness testing both MSC groups did not reach the results of the PBS group. Histologically, the MSC groups did not show better results than the control group. There were clusters of ossifications found in all groups. In immunohistology, only the staining collagen-type-I was strongly increased in both MSC groups in comparison to PBS control group. However, there were no significant differences in the (immuno)-histological results between both stem cell groups. CONCLUSION The biomechanical and (immuno)-histological results did not show positive effects of the MSC groups on tendon remodelling in a long-term follow-up. Interestingly, in later stages stem cells had hardly any effects on biomechanical results. This study inspires a critical and reflected use of stem cells in tendon healing.
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Affiliation(s)
- T M Kraus
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany. .,BG Trauma Center, Eberhard Karls University Tübingen, Tübingen, Germany.
| | - F B Imhoff
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - J Reinert
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - G Wexel
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - A Wolf
- Institute of Molecular Immunology/Experimental Oncology and Therapy Research, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - D Hirsch
- Institute of Molecular Immunology/Experimental Oncology and Therapy Research, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - A Hofmann
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - U Stöckle
- BG Trauma Center, Eberhard Karls University Tübingen, Tübingen, Germany
| | - S Buchmann
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - T Tischer
- Department of Orthopaedic Surgery, University of Rostock, Rostock, Germany
| | - A B Imhoff
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - S Milz
- Anatomische Anstalt, Ludwig Maximillians Universität, Munich, Germany
| | - M Anton
- Institute of Molecular Immunology/Experimental Oncology and Therapy Research, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany
| | - S Vogt
- Department for Sports Orthopaedics, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany.,Department of Sports Orthopaedics, Hessing Stiftung, Augsburg, Germany
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Chiou GJ, Crowe C, McGoldrick R, Hui K, Pham H, Chang J. Optimization of an injectable tendon hydrogel: the effects of platelet-rich plasma and adipose-derived stem cells on tendon healing in vivo. Tissue Eng Part A 2016; 21:1579-86. [PMID: 25625433 DOI: 10.1089/ten.tea.2014.0490] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Acute and chronic tendon injuries would benefit from stronger and more expeditious healing. We hypothesize that supplementation of a biocompatible tendon hydrogel with platelet-rich plasma (PRP) and adipose-derived stem cells (ASCs) would augment the tendon healing process. MATERIALS AND METHODS Using 55 Wistar rats, a full-thickness defect was created within the midsubstance of each Achilles tendon with the addition of one of five experimental conditions: (i) saline control (50-μL), (ii) tendon hydrogel (50-μL), (iii) tendon hydrogel (45-μL)+PRP (5-μL), (iv) tendon hydrogel (45-μL)+2×10(6)-ASCs/mL in phosphate buffered saline (5-μL), and (v) tendon hydrogel (45-μL)+2×10(6)-ASCs/mL in PRP (5-μL). Hydrogel was developed from decellularized, human cadaveric tendons. Fresh rat PRP was obtained per Amable et al.'s technique, and green fluorescent protein/luciferase-positive rat ASCs were utilized. Rats were sacrificed at weeks 1, 2, 4, and 8 after injury. Real-time in vivo bioluminescence imaging of groups with ASCs was performed. Upon sacrifice, Achilles tendons underwent biomechanical and histological evaluation. Comparisons across groups were analyzed using the two-sample Z-test for proportions and the Student's t-test for independent samples. Significance was set at p<0.05. RESULTS (i) Bioluminescence imaging demonstrated that total photon flux was significantly increased for hydrogel+PRP+ASCs, versus hydrogel+ASCs for each postoperative day imaged (p<0.03). (ii) Mean ultimate failure load (UFL) was increased for hydrogel augmented with PRP and/or ASCs versus hydrogel alone at week 2 (p<0.03). By week 4, hydrogel alone reached a similar mean UFL to hydrogel augmented with PRP and/or ASCs (p>0.3). However, at week 8, hydrogel with PRP and ASCs demonstrated increased strength over other groups (p<0.05), except for hydrogel with PRP (p=0.25). (iii) Upon histological analysis, Hematoxylin and Eosin staining showed increased extracellular matrix formation in groups containing PRP and increased cellularity in groups containing ASCs. Groups containing both PRP and ASCs demonstrated both of these characteristics. CONCLUSION PRP and ASCs are easily accessible bioactive products that have potentiating effects on tendon hydrogel. Augmentation with these two factors encourages earlier mechanical strength and functional restoration. Thus, biochemically, tendon hydrogel augmented with PRP and/or ASCs, serves as a promising therapeutic modality for augmenting the tendon healing process after injury.
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Affiliation(s)
- Grace Jane Chiou
- 1 Division of Plastic and Reconstructive Surgery, Stanford University Medical Center , Stanford, California
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Wang W, Zhang X, Chao NN, Qin TW, Ding W, Zhang Y, Sang JW, Luo JC. Preparation and characterization of pro-angiogenic gel derived from small intestinal submucosa. Acta Biomater 2016; 29:135-148. [PMID: 26472613 DOI: 10.1016/j.actbio.2015.10.013] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 10/01/2015] [Accepted: 10/09/2015] [Indexed: 02/05/2023]
Abstract
Gels derived from decellularized small intestinal submucosa (SIS) have been used to repair ischemic myocardium and deliver protein drug. However, their material properties and effects on cell behavior are not well understood, in part because of the difficulty of gelling in vitro. In this study, soluble SIS matrix, which was easily handled and could effectively gel, was successfully prepared using a modified method. Fourier transform infrared spectroscopy confirmed that the SIS gel contained not only collagen but also sulfated glycosaminoglycans (sGAGs). Interestingly, the sustained release of vascular endothelial growth factor and basic fibroblast growth factor within the SIS gel was detected, and no initial burst release was observed. The SIS gel was more capable of evoking neovascularization than collagen type I gel, as determined by tube formation experiments in human umbilical vein endothelial cells, the mouse aortic ring assay, and animal experiments. The upregulated expression of kinase insert domain receptor (KDR), Notch1, and Ang2, the key genes in angiogenesis that were evaluated in HUVECs seeded on the SIS gel, confirmed that angiogenesis bioactive factors contained in the SIS gel are indeed active and effective. The SIS gel significantly promoted neovascularization compared to the collagen type I gel in vivo. Histology revealed adequate host tissue response in engraftment both types of gels. Together, these data demonstrate that the SIS gel is a promising and attractive candidate for tissue engineering, especially in promoting vessel formation. STATEMENT OF SIGNIFICANCE The material properties of small intestinal submucosa (SIS) gel and the effect of these properties upon cell behavior are not well understood, in part due to the difficulty of gelling in vitro. In this study, soluble SIS matrix, which was easily handled and gelled was prepared using modified method. The material properties and biocompatibility of SIS gel were explored. The sustained release of growth factors from this gel was observed along with its degradation in vitro. The results demonstrate that the SIS gel promote angiogenesis in vitro and in vivo. The SIS gel biological properties suggest that the constituent ECM molecules released from the gel remain activity. These findings suggested that the SIS gel was a promising candidate for tissue engineering, especially in promoting vessel formation.
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