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Brown M, Okuyama H, Yamashita M, Tabrizian M, Li-Jessen NYK. Trends in Injectable Biomaterials for Vocal Fold Regeneration and Long-Term Augmentation. TISSUE ENGINEERING. PART B, REVIEWS 2024. [PMID: 39212941 DOI: 10.1089/ten.teb.2024.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Human vocal folds (VF), a pair of small, soft tissues in the larynx, have a layered mucosal structure with unique mechanical strength to support high-level tissue deformation by phonation. Severe pathological changes to VF have causes including surgery, trauma, age-related atrophy, and radiation, and lead to partial or complete communication loss and difficulty in breathing and swallowing. VF glottal insufficiency requires injectable VF biomaterials such as hyaluronan, calcium hydroxyapatite, and autologous fat to augment VF functions. Although these biomaterials provide an effective short-term solution, significant variations in patient response and requirements of repeat reinjection remain notable challenges in clinical practice. Tissue engineering strategies have been actively explored in the search of an injectable biomaterial that possesses the capacity to match native tissue's material properties while promoting permanent tissue regeneration. This review aims to assess the current status of biomaterial development in VF tissue engineering. The focus will be on examining state-of-the-art techniques including modification with bioactive molecules, cell encapsulation, composite materials, as well as, in situ crosslinking with click chemistry. We will discuss potential opportunities that can further leverage these engineering techniques in the advancement of VF injectable biomaterials.
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Affiliation(s)
- Mika Brown
- McGill University, Biomedical Engineering, Montreal, Quebec, Canada
- McGill University, Bioengineering, Montreal, Quebec, Canada;
| | - Hideaki Okuyama
- McGill University, School of Communication Sciences and Disorders, Montreal, Quebec, Canada;
| | - Masaru Yamashita
- Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Kagoshima, Japan;
| | - Maryam Tabrizian
- McGill University, Biomedical Engineering, Montreal, Quebec, Canada
- McGill University, Bioengineering, Montreal, Quebec, Canada
- McGill University, Faculty of Dentistry, Montreal, Quebec, Canada;
| | - Nicole Y K Li-Jessen
- McGill University, School of Communication Sciences and Disorders, Montreal, Quebec, Canada
- McGill University, Department of Otolaryngology - Head and Neck Surgery, Montreal, Quebec, Canada
- McGill University, Biomedical Engineering, Montreal, Quebec, Canada
- McGill University, Research Institute of McGill University Health Center, Montreal, Quebec, Canada;
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Stefanie Buchberger AM, Nitiu R, Pinther M, Graf S, Skodacek D, Regn S, Kreutzer K, Storck K. Fibrin Gel Suspended Autologous Chondrocytes as Cell-based Material for long-term Injection Laryngoplasty. Laryngoscope 2020; 131:E1624-E1632. [PMID: 33368380 DOI: 10.1002/lary.29300] [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: 04/27/2020] [Revised: 10/27/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Injection laryngoplasty of materials for unilateral vocal-fold paralysis has shown various results regarding the long-term stability of the injected material. We evaluated a fibrin-gel based cell suspension with autologous chondrocytes in-vitro and in-vivo as long-term-stable vocal-fold augmentation material in an animal model. STUDY DESIGN This study compises an in vitro cell-culture part as well as an in vivo animal study with New Zealand White Rabbits. METHODS In in-vitro experiments, auricular chondrocytes harvested from 24 New Zealand White Rabbits cadavers were cultivated in pellet cultures to evaluate cartilage formation for 4 weeks using long-term-stable fibrin gel as carrier. Injectability and injection volume for the laryngoplasty was determined in-vitro using harvested cadaveric larynxes. In-vivo 24 Rabbits were biopsied for elastic cartilage of the ear and autologous P1 cells were injected lateral of one vocal cord into the paraglottic space suspended in a long-term-stable fibrin gel. Histologic evaluation was performed after 2, 4, 12, and 24 weeks. RESULTS During 12-week pellet culture, we found extracellular matrix formation and weight-stable cartilage of mature appearance. In-vivo, mature cartilage was found in two larynxes (n = 6) at 4 weeks, in four (n = 6) at 12 weeks, and in five (n = 6) at 24 weeks mostly located in the paraglottic space and sometimes with spurs into the vocalis muscle. Surrounding tissue was often infiltrated with inflammatory cells. Material tended to dislocate through the cricothyroid space into the extraglottic surrounding tissue. CONCLUSIONS A cell-based approach with chondrocytes for permanent vocal-fold augmentation has not previously been reported. We have achieved the formation of structurally mature cartilage in the paraglottic space, but this is accompanied by difficulties with dislocated material, deformation of the augmentation, and inflammation. LEVEL OF EVIDENCE N/A Laryngoscope, 131:E1624-E1632, 2021.
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Affiliation(s)
- Anna Maria Stefanie Buchberger
- Department of Phoniatrics and Pedaudiology, Ear-Nose-Throat, Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Ramona Nitiu
- Department of Ear-Nose-Throat, Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Melina Pinther
- Department of Ear-Nose-Throat, Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Simone Graf
- Department of Phoniatrics and Pedaudiology, Ear-Nose-Throat, Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Daniel Skodacek
- Department of Ear-Nose-Throat, Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Sybille Regn
- Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Kilian Kreutzer
- Department of Maxillofacial Surgery, University clinic of the Charité Berlin, Berlin, Germany
| | - Katharina Storck
- Department of Ear-Nose-Throat, Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
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Choi YH, Kim SH, Kim IG, Lee JH, Kwon SK. Injectable basic fibroblast growth factor-loaded alginate/hyaluronic acid hydrogel for rejuvenation of geriatric larynx. Acta Biomater 2019; 89:104-114. [PMID: 30849562 DOI: 10.1016/j.actbio.2019.03.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/28/2019] [Accepted: 03/04/2019] [Indexed: 01/01/2023]
Abstract
Increase in the geriatric population has led to an increase in the number of elderly patients with laryngeal atrophy and dysfunction. Symptoms of voice change, dysphagia, and aspiration pneumonia negatively influence patient's health status, quality of life, and life span. Injection laryngoplasty used to treat laryngeal dysfunctions does not recover intrinsic functions of the larynx. Thus, we fabricated an injectable basic fibroblast growth factor (bFGF)-loaded alginate (ALG)/hyaluronic acid (HA) hydrogel for inducing rejuvenation of geriatric laryngeal muscles. Optimal in situ-forming bFGF-loaded ALG/HA hydrogel for injection laryngoplasty was prepared and the release profile of bFGF was analyzed. For in vivo analysis, the bFGF-loaded ALG/HA hydrogel was injected into the laryngeal muscles of 18-month-old Sprague-Dawley rats. The rejuvenation efficacy of bFGF-loaded ALG/HA hydrogel in geriatric laryngeal muscle tissues 4- and 12-weeks post-injection was evaluated by quantitative polymerase chain reaction (qPCR), histology, immune-fluorescence staining and functionality analysis. The bFGF-loaded ALG/HA hydrogel induced an increase in the expression of myogenic regulatory factor-related genes, hypertrophy of muscle fiber, proliferation of muscle satellite cells, and angiogenesis and decreased interstitial fibrosis. Administration of the bFGF-loaded ALG/HA hydrogel caused successful glottal gap closure. Thus, the bFGF-loaded ALG/HA hydrogel could be a promising candidate for laryngoplasty aimed at rejuvenating geriatric larynx. STATEMENT OF SIGNIFICANCE: In this manuscript, optimal in situ-forming bFGF-loaded ALG/HA hydrogel for injection laryngoplasty was prepared and the release profile of bFGF was analyzed. Herein, we introduced the materials and methods of injection laryngoplasty for geriatric rat experiment. In addition, we studied effects of bFGF-loaded ALG/HA hydrogel on the therapeutic rejuvenation of geriatric rat larynx. The bFGF-loaded ALG/HA hydrogel induced an increase in the expression of myogenic regulatory factor-related genes, hypertrophy of muscle fiber, proliferation of muscle satellite cells, and angiogenesis and decreased interstitial fibrosis. Furthermore, our functional analysis through the high-speed camera setup demonstrated that the administration of the bFGF-loaded ALG/HA hydrogel induced successful glottal gap closure. Thus, the bFGF-loaded ALG/HA hydrogel could be a promising candidate for injection laryngoplasty with therapeutic effects.
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Affiliation(s)
- Young Hwan Choi
- Department of Otorhinolaryngology-Head and Neck, Seoul National University Hospital, Seoul 03080, Republic of Korea; School of Chemical and Biological Engineering, Seoul National University, Seoul 08826, Republic of Korea
| | - Sae Hyun Kim
- Department of Advanced Materials and Chemical Engineering, Hannam University, Daejeon 34054, Republic of Korea
| | - In Gul Kim
- Department of Otorhinolaryngology-Head and Neck, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Jin Ho Lee
- Department of Advanced Materials and Chemical Engineering, Hannam University, Daejeon 34054, Republic of Korea.
| | - Seong Keun Kwon
- Department of Otorhinolaryngology-Head and Neck, Seoul National University Hospital, Seoul 03080, Republic of Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Choi YH, Ahn HJ, Park MR, Han MJ, Lee JH, Kwon SK. Dual growth factor-immobilized bioactive injection material for enhanced treatment of glottal insufficiency. Acta Biomater 2019; 86:269-279. [PMID: 30599245 DOI: 10.1016/j.actbio.2018.12.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/19/2018] [Accepted: 12/28/2018] [Indexed: 01/27/2023]
Abstract
With increasing demand for treatment of glottal insufficiency, several injection materials have been examined. However, biological resorption, degradation of injected materials, and the subsequent need to perform multiple injections still remain major clinical problems. In this study, we fabricated two different growth factor (GF) [single basic fibroblast growth factor (bFGF), single hepatocyte growth factor (HGF), or dual bFGF/HGF]-immobilized polycaprolactone (PCL)/Pluronic F127 microspheres. These materials were investigated for their potential use as bioactive injection laryngoplasty agents. HGF was found to be continuously released over 20 days and the bFGF was found to be continuously released over 25 days, as demonstrated by ELISA assay. Human vocal fold fibroblasts (hVFFs) showed significantly higher proliferative ability on dual GF-immobilized microspheres. GF-immobilized microspheres (bFGF, HGF, and dual GF) were injected into paralyzed vocal folds of New Zealand white rabbits. Through endoscopic observation and H&E staining, we identified that the microspheres remained localized at the injection site, resulting in constant volume augmentation of the paralyzed vocal fold without significant loss of the initial volume after 4 weeks. The expression of genes related to the extracellular matrix (ECM) in the vocal fold was upregulated by dual GF-immobilized microspheres. Furthermore, dual GF-immobilized microspheres inhibited muscle degeneration and upregulation of myogenic-related genes. In conclusion, dual GF-immobilized microspheres passively augmented the volume of the paralyzed vocal fold while actively inducing ECM synthesis at the injected vocal fold and preserving muscle tissue. Dual GF-immobilized microspheres could be a new and promising injection material for paralyzed vocal folds. STATEMENT OF SIGNIFICANCE: Limitation of prolonged augmentation of vocal fold and degeneration of vocal fold tissue still remain as major clinical problems in the treatment of vocal fold paralysis. Herein, we fabricated the polycaprolactone (PCL)/Pluronic F127 microspheres to augment volume of paralyzed vocal folds. On top of that, we additionally immobilized the growth factors (bFGF, HGF, or dual bFGF/HGF) on the surface of these microspheres. We highlight the efficacy of the dual GF-immobilized microspheres which augmented the volume of the paralyzed vocal fold passively, induced ECM synthesis actively at the injected vocal fold and preserved laryngeal muscle tissue. Our results suggest that the dual GF-immobilized microsphere could be a new promising injection material for injection laryngoplasty to treat paralyzed vocal fold.
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Affiliation(s)
- Young Hwan Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea; School of Chemical and Biological Engineering, Seoul National University, Seoul 08826, Republic of Korea
| | - Hee-Jin Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Mi Ri Park
- Department of Advanced Materials and Chemical Engineering, Hannam University, Daejeon, Republic of Korea
| | - Mi-Jung Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Ho Lee
- Department of Advanced Materials and Chemical Engineering, Hannam University, Daejeon, Republic of Korea.
| | - Seong Keun Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
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King RE, Lau HK, Zhang H, Sidhu I, Christensen MB, Fowler EW, Li L, Jia X, Kiick KL, Thibeault SL. Biocompatibility and Viscoelastic Properties of Injectable Resilin-Like Polypeptide and Hyaluronan Hybrid Hydrogels in Rabbit Vocal Folds. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2019; 5:373-386. [DOI: 10.1007/s40883-019-00094-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kim IG, Park MR, Choi YH, Choi JS, Ahn HJ, Kwon SK, Lee JH. Regeneration of Paralyzed Vocal Fold by the Injection of Plasmid DNA Complex-Loaded Hydrogel Bulking Agent. ACS Biomater Sci Eng 2019; 5:1497-1508. [DOI: 10.1021/acsbiomaterials.8b01541] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- In Gul Kim
- Department of Otorhinolaryngology—Head and Neck Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Mi Ri Park
- Department of Advanced Materials and Chemical Engineering, Hannam University, Daejeon 34054, Republic of Korea
| | - Young Hwan Choi
- Department of Otorhinolaryngology—Head and Neck Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Ji Suk Choi
- Department of Otorhinolaryngology—Head and Neck Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Hee-Jin Ahn
- Department of Otorhinolaryngology—Head and Neck Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Seong Keun Kwon
- Department of Otorhinolaryngology—Head and Neck Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea
| | - Jin Ho Lee
- Department of Advanced Materials and Chemical Engineering, Hannam University, Daejeon 34054, Republic of Korea
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Oldenburg MS, Ekbom DC, San Marina S, Voss S, Chen T, Garcia J, Janus JR. Preliminary results of tissue-engineered injection laryngoplasty material in a rabbit model. Laryngoscope 2017; 128:160-167. [PMID: 28895165 DOI: 10.1002/lary.26849] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 06/15/2017] [Accepted: 07/24/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVES/HYPOTHESIS Design and test a novel biomaterial for injection laryngoplasty aimed to increase the duration of effectiveness of micronized acellular dermis. STUDY DESIGN Animal model. METHODS Injection laryngoplasty was performed in three groups (n = 5) of New Zealand White rabbits. Acellular dermis was either used alone as a control (group 1), was combined with undifferentiated stem cells (group 2), or with predifferentiated chondrocytic cells (group 3). Groups 2 and 3 were supplemented with growth factors. Animals were sacrificed 4 and 12 weeks after laryngoplasty and histologic analysis was completed. The major outcome measure was volume of tissue remaining. RESULTS After 4 weeks, the mean volume of tissue remaining was 341 ± 89 mm3 , 295 ± 102 mm3 , and 133 ± 15 mm3 , for groups 1 to 3, respectively. At the 12-week time point, volumes were 62 ± 62 mm3 , 235 ± 35 mm3 , and 107 ± 99 mm3 . After 12 weeks, there was a significantly higher volume in group 2 compared to group 1 or 3 (P = .01, P = .04). Volumes between week 4 and week 12 were significantly lower in group 1 (P = .02), but not significantly different for groups 2 and 3 (P = .38, P = .74). Histologic evaluation revealed a robust lymphocytic infiltration in all cases as well as morphologic and immunophenotypic features suggestive of chondrogenic differentiation in a single animal. CONCLUSIONS Micronized acellular dermis combined with stem cells and growth factors showed significantly less resorption 12 weeks after injection laryngoplasty compared to micronized acellular dermis alone. Groups using novel tissue-engineered biomaterial showed a lower resorption rate over time compared with acellular dermis alone. LEVEL OF EVIDENCE NA. Laryngoscope, 128:160-167, 2018.
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Affiliation(s)
- Michael S Oldenburg
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Dale C Ekbom
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Serban San Marina
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Steve Voss
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Tiffany Chen
- Department of Anatomic Pathology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Joaquin Garcia
- Department of Anatomic Pathology, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
| | - Jeffery R Janus
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A
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Li L, Stiadle JM, Lau HK, Zerdoum AB, Jia X, Thibeault SL, Kiick KL. Tissue engineering-based therapeutic strategies for vocal fold repair and regeneration. Biomaterials 2016; 108:91-110. [PMID: 27619243 PMCID: PMC5035639 DOI: 10.1016/j.biomaterials.2016.08.054] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/29/2016] [Accepted: 08/31/2016] [Indexed: 01/01/2023]
Abstract
Vocal folds are soft laryngeal connective tissues with distinct layered structures and complex multicomponent matrix compositions that endow phonatory and respiratory functions. This delicate tissue is easily damaged by various environmental factors and pathological conditions, altering vocal biomechanics and causing debilitating vocal disorders that detrimentally affect the daily lives of suffering individuals. Modern techniques and advanced knowledge of regenerative medicine have led to a deeper understanding of the microstructure, microphysiology, and micropathophysiology of vocal fold tissues. State-of-the-art materials ranging from extracecullar-matrix (ECM)-derived biomaterials to synthetic polymer scaffolds have been proposed for the prevention and treatment of voice disorders including vocal fold scarring and fibrosis. This review intends to provide a thorough overview of current achievements in the field of vocal fold tissue engineering, including the fabrication of injectable biomaterials to mimic in vitro cell microenvironments, novel designs of bioreactors that capture in vivo tissue biomechanics, and establishment of various animal models to characterize the in vivo biocompatibility of these materials. The combination of polymeric scaffolds, cell transplantation, biomechanical stimulation, and delivery of antifibrotic growth factors will lead to successful restoration of functional vocal folds and improved vocal recovery in animal models, facilitating the application of these materials and related methodologies in clinical practice.
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Affiliation(s)
- Linqing Li
- Department of Materials Science and Engineering, University of Delaware, Newark, DE 19716, USA
| | - Jeanna M Stiadle
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI 53792, USA; Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Hang K Lau
- Department of Materials Science and Engineering, University of Delaware, Newark, DE 19716, USA
| | - Aidan B Zerdoum
- Department of Biomedical Engineering, University of Delaware, Newark, DE 19716, USA
| | - Xinqiao Jia
- Department of Materials Science and Engineering, University of Delaware, Newark, DE 19716, USA; Department of Biomedical Engineering, University of Delaware, Newark, DE 19716, USA; Delaware Biotechnology Institute, 15 Innovation Way, Newark, DE 19711, USA
| | - Susan L Thibeault
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI 53792, USA; Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI 53792, USA.
| | - Kristi L Kiick
- Department of Materials Science and Engineering, University of Delaware, Newark, DE 19716, USA; Department of Biomedical Engineering, University of Delaware, Newark, DE 19716, USA; Delaware Biotechnology Institute, 15 Innovation Way, Newark, DE 19711, USA.
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Wrona EA, Peng R, Amin MR, Branski RC, Freytes DO. Extracellular Matrix for Vocal Fold Lamina Propria Replacement: A Review. TISSUE ENGINEERING PART B-REVIEWS 2016; 22:421-429. [PMID: 27316784 DOI: 10.1089/ten.teb.2016.0015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The vocal folds (VFs) are exposed to a number of injurious stimuli that frequently lead to aberrant structural alterations and altered biomechanical properties that clinically manifest as voice disorders. Therapies to restore both structure and function of this delicate tissue are ideal. However, such methods have not been adequately developed. Our group and others hypothesize that tissue engineering and regenerative medicine approaches, previously described for other tissue systems, hold significant promise for the VFs. In this review, we explore the concept of tissue engineering as it relates to the VFs, as well as recent studies employing both naturally and synthetically derived biomaterials, including those from laryngeal and nonlaryngeal sources, in combination with stem cells for a tissue-engineered approach to VF repair.
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Affiliation(s)
- Emily A Wrona
- 1 UNC-Chapel Hill/NCSU Joint Department of Biomedical Engineering, North Carolina State University , Raleigh, North Carolina.,2 The New York Stem Cell Foundation Research Institute , New York, New York
| | - Robert Peng
- 3 Department of Otolaryngology-Head and Neck Surgery, NYU Voice Center, New York University School of Medicine , New York, New York
| | - Milan R Amin
- 3 Department of Otolaryngology-Head and Neck Surgery, NYU Voice Center, New York University School of Medicine , New York, New York
| | - Ryan C Branski
- 3 Department of Otolaryngology-Head and Neck Surgery, NYU Voice Center, New York University School of Medicine , New York, New York
| | - Donald O Freytes
- 1 UNC-Chapel Hill/NCSU Joint Department of Biomedical Engineering, North Carolina State University , Raleigh, North Carolina.,2 The New York Stem Cell Foundation Research Institute , New York, New York
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Li L, Mahara A, Tong Z, Levenson EA, McGann CL, Jia X, Yamaoka T, Kiick KL. Recombinant Resilin-Based Bioelastomers for Regenerative Medicine Applications. Adv Healthc Mater 2016; 5:266-75. [PMID: 26632334 PMCID: PMC4754112 DOI: 10.1002/adhm.201500411] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/15/2015] [Indexed: 12/22/2022]
Abstract
The outstanding elasticity, excellent resilience at high-frequency, and hydrophilic capacity of natural resilin have motivated investigations of recombinant resilin-based biomaterials as a new class of bio-elastomers in the engineering of mechanically active tissues. Accordingly, here the comprehensive characterization of modular resilin-like polypeptide (RLP) hydrogels is presented and their suitability as a novel biomaterial for in vivo applications is introduced. Oscillatory rheology confirmed that a full suite of the RLPs can be rapidly cross-linked upon addition of the tris(hydroxymethyl phosphine) cross-linker, achieving similar in situ shear storage moduli (20 k ± 3.5 Pa) across various material compositions. Uniaxial stress relaxation tensile testing of hydrated RLP hydrogels under cyclic loading and unloading showed negligible stress reduction and hysteresis, superior reversible extensibility, and high resilience with Young's moduli of 30 ± 7.4 kPa. RLP hydrogels containing MMP-sensitive domains are susceptible to enzymatic degradation by matrix metalloproteinase-1 (MMP-1). Cell culture studies revealed that RLP-based hydrogels supported the attachment and spreading (2D) of human mesenchymal stem cells and did not activate cultured macrophages. Subcutaneous transplantation of RLP hydrogels in a rat model, which to our knowledge is the first such reported in vivo analysis of RLP-based hydrogels, illustrated that these materials do not elicit a significant inflammatory response, suggesting their potential as materials for tissue engineering applications with targets of mechanically demanding tissues such as vocal fold and cardiovascular tissues.
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Affiliation(s)
- Linqing Li
- Department of Materials Science and Engineering, University of Delaware, Newark, DE, 19716, USA
| | - Atsushi Mahara
- Department of Biomedical Engineering, National Cerebral and Cardiovascular Center Research Institute, Fujishiro-dai Suita, Osaka, 565-8565, Japan
| | - Zhixiang Tong
- Department of Materials Science and Engineering, University of Delaware, Newark, DE, 19716, USA
| | - Eric A Levenson
- Department of Materials Science and Engineering, University of Delaware, Newark, DE, 19716, USA
| | - Christopher L McGann
- Department of Materials Science and Engineering, University of Delaware, Newark, DE, 19716, USA
| | - Xinqiao Jia
- Department of Materials Science and Engineering, Department of Biomedical Engineering, University of Delaware, Newark, DE, 19716, USA
| | - Tetsuji Yamaoka
- Department of Biomedical Engineering, National Cerebral and Cardiovascular Center Research Institute, Fujishiro-dai Suita, Osaka, 565-8565, Japan
| | - Kristi L Kiick
- Department of Materials Science and Engineering, Department of Biomedical Engineering, University of Delaware, Newark, DE, 19716, USA
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