Hollow fibers for hepatocyte encapsulation and transplantation: studies of survival and function in rats

Objectives, benefits and challenges of bioreactor systems for the clinical-scale expansion of T lymphocyte cells

Cell therapies based on T cell have gathered interest over the last decades for treatment of cancers, becoming recently the most investigated lineage for clinical trials. Although results of adoptive cell therapies are very promising, obtaining large batches of T cell at clinical scale is still challenging nowadays. We propose here a review study focusing on how bioreactor systems could increase expansion rates of T cell culture specifically towards efficient, reliable and reproducible cell therapies. After describing the specificities of T cell culture, in particular activation, phenotypical characterization and cell density considerations, we detail the main objectives of bioreactors in this context, namely scale-up, GMP-compliance and reduced time and costs. Then, we report recent advances on the different classes of bioreactor systems commonly investigated for non-adherent cell expansion, in comparison with the current "gold standard" of T cell culture (flasks and culture bag). Results obtained with hollow fibres, G-Rex® flasks, Wave bioreactor, multiple-step bioreactors, spinner flasks as well as original homemade designs are discussed to highlight advantages and drawbacks in regards to T cells' specificities. Although there is currently no consensus on an optimal bioreactor, overall, most systems reviewed here can improve T cell culture towards faster, easier and/or cheaper protocols. They also offer strong outlooks towards automation, process control and complete closed systems, which could be mandatory developments for a massive clinical breakthrough. However, proper controls are sometimes lacking to conclude clearly on the features leading to the progresses regarding cell expansion, and the field could benefit from process engineering methods, such as quality by design, to perform multi parameters studies and face these challenges.

Intrasplenic Transplantation of Encapsulated Cells: A Novel Approach to Cell Therapy

Cell therapy is likely to succeed clinically if cells survive at the transplantation site and are protected against immune rejection. We hypothesized that this could be achieved with intrasplenic transplantation of encapsulated cells because the cells would have instant access to oxygen and nutrients while being separated from the host immune system. In order to provide proof of the concept, primary rat hepatocytes and human hepatoblastoma-derived HepG2 cells were used as model cells. Rat hepatocytes were encapsulated in 100-kDa hollow fibers and cultured for up to 28 days. Rat spleens were implanted with hollow fibers that were either empty or contained 1 × 107 rat hepatocytes. Human HepG2 cells were encapsulated using alginate/poly-l-lysine (ALP) and also transplanted into the spleen; control rats were transplanted with free HepG2 cells. Blood human albumin levels were measured using Western blotting and spleen sections were immunostained for albumin. Hepatocytes in monolayer cultures remained viable for only 6–10 days, whereas the cells cultured in hollow fibers remained viable and produced albumin throughout the study period. Allogeneic hepatocytes transplanted in hollow fibers remained viable for 4 weeks (end of study). Free HepG2 transplants lost viability and function after 7 days, whereas encapsulated HepG2 cells remained viable and secreted human albumin at all time points studied. ALP capsules, with or without xenogeneic HepG2 cells, produced no local fibrotic response. These data indicate that intrasplenic transplantation of encapsulated cells results in excellent survival and function of the transplanted cells and that the proposed technique has the potential to allow transplantation of allo- and xenogeneic cells (e.g., pancreatic islets) without immunosuppression.

Implantable Biohybrid Artificial Organs

Biohybrid artificial organs encompass all devices which substitute for an organ or tissue function and incorporate both synthetic materials and living cells. This review concerns implantable immunoisolation devices in which the tissue is protected from immune rejection by enclosure within a semipermeable membrane. Two critical areas are discussed in detail: (i) Device design and performance as it relates to maintenance of cell viability and function. Attention is focussed on oxygen supply limitation and how it is affected by tissue density and the development of materials that induce neovascularization at the host tissue-membrane interface; and (ii) Protection from immune rejection. Our current knowledge of the mechanisms that may be operative in immune rejection in the presence of a semipermeable membrane barrier is limited. Nonetheless, recent studies shed light on the role played by membrane properties in preventing immune rejection, and many studies demonstrate substantial progress towards clinically useful implantable immunoisolation devices.

In Vitro and in Vivo Grafting of Xeno Pig Fetal Liver Fragments Using Ultrafiltration Membrane

Transplantation of xeno fetal liver fragments (FLF) could be an alternative or supplementary therapy for acute and chronic liver failure not resolved by routine medical therapies. However, the xenografts themselves are rejected by the host immune system. To overcome these problems, immunoisolate capsules with various cutoff points, from 50,000 (YM30) to 500,000 (ZM500) were tested for their protective effects on FLF graft survival. In an in vitro study, the capsule with the smallest cutoff size (YM30) had an excellent protective effect on the grafts it contained, and showed the lowest GOT values in the culture supernatant and the normal histological structure. In an in vivo study using rats, the same capsule enabled a FLF graft to survive as long as 21 days, even with severe IgG deposition on and within the graft. In another in vivo study, which used beagle dog, however, it did not improve the natural course of survival of the graft, which had totally degenerated by day 7. In conclusion, 1) Immunocapsules, especially those with the smallest cutoff values, impeded the infiltration of the (xeno) humoral attacking factor, but the blocking effect was not complete, as shown by the immunoglobulin (IgG) deposit on the grafts they contained. 2) The FLFs with capsules survived longer than those without capsules—only in rats, not in beagles. This difference may be attributable to the difference of the extent of humoral or nutritional response to the xenografts.

Supercritical fluid assisted process for the generation of cellulose acetate loaded structures, potentially useful for tissue engineering applications

Supercritical CO2 phase inversion offers an alternative to obtain solvent free structures with short processing times and preservation of the morphology. We prepared cellulose acetate structures loaded with drug (ibuprofen) to perform experiments at pressures and temperatures ranging between 150 and 250 bars and 35 and 55 °C. The structures were properly characterized by SEM, EDX and DSC; drug controlled release experiments were also performed. Analyses showed that the operating conditions strongly influenced the structure morphology, porosity and drug release profiles. Indeed, connected microparticles, nanofibrous networks and cellular membranes were produced, which have generated different drug release profiles.

Synthesis and in vitro characterizations of porous carboxymethyl cellulose-poly(ethylene oxide) hydrogel film

BACKGROUND

Cellulose and its derivatives such as carboxymethyl cellulose (CMC) have been employed as a biomaterial for their diverse applications such as tissue engineering, drug delivery and other medical materials. Porosity of the scaffolds has advantages in their applications to tissue engineering such as more cell adhesion and migration leading to better tissue regeneration. After synthesis of CMC-poly(ethylene oxide) (PEO) hydrogel by mixing the solutions of both CMC-acrylate and PEO-hexa-thiols, fabrication and evaluation of a CMC-PEO gel and its film in porous form have been made for its possible applications to tissue regeneration. Physicochemical and biological properties of both CMC-PEO hydrogel and porous films have been evaluated by using physicochemical assays by SEM, FTIR and swelling behaviors as well as in vitro assays of MTT, Neutral red, BrdU, gel covering and tissue ingrowth into the pores of the CMC-PEO gel films. Degradation of CMC-PEO hydrogel was also evaluated by treating with esterase over time.

RESULTS

Chemical grafting of acrylate to CMC was verified by analyses of both FTIR and NMR. CMC-PEO hydrogel was obtained by mixing two precursor polymer solutions of CMC-acrylate and PEO-hexa-thiols and by transforming into a porous CMC-PEO gel film by gas forming of ammonium bicarbonate particles. The fabricated hydrogel has swollen in buffer to more than 6 times and degraded by esterase. The results of in vitro assays of live and dead, MTT, BrdU, Neutral red and gel covering on the cells showed excellent cell compatibility of CMC-PEO hydrogel and porous gel films. Furthermore the porous films showed excellent in vitro adhesion and migration of cells into their pore channels as observed by H&E and MT stains.

CONCLUSIONS

Both CMC-PEO hydrogel and porous gel films showed excellent biocompatibility and were expected to be a good candidate scaffold for tissue engineering.

Liver tissue engineering and cell sources: issues and challenges

Liver diseases are of major concern as they now account for millions of deaths annually. As a result of the increased incidence of liver disease, many patients die on the transplant waiting list, before a donor organ becomes available. To meet the huge demand for donor liver, alternative approaches using liver tissue engineering principles are being actively pursued. Even though adult hepatocytes, the primary cells of the liver are most preferred for tissue engineering of liver, their limited availability, isolation from diseased organs, lack of in vitro propagation and deterioration of function acts as a major drawback to their use. Various approaches have been taken to prevent the functional deterioration of hepatocytes including the provision of an adequate extracellular matrix and co-culture with non-parenchymal cells of liver. Great progress has also been made to differentiate human stem cells to hepatocytes and to use them for liver tissue engineering applications. This review provides an overview of recent challenges, issues and cell sources with regard to liver tissue engineering.

Preparation, Characterization, and In Vitro and In Vivo Evaluation of Cellulose/Soy Protein Isolate Composite Sponges

A series of cellulose/soy protein isolate (SPI) sponges was prepared using a freeze-drying process. The effect of the SPI content on the structure of the sponges was characterized by Fourier transform infrared spectrometry (FT-IR), X-ray diffraction analysis (XRD) and scanning electron microscopy (SEM). It showed that the sponges were porous in structure, and that the size of the pores increased and the thickness of the pore walls decreased as the SPI content of the sponges increased. The biocompatibility and biodegradability of the sponges were evaluated in vitro and in vivo. The cell culture experiment and SEM observations showed that L929 fibroblast cells grew and spread well on the surface and cross-section of the composite sponges. The results from MTT (3-[4,5-dimethyl-2-thiazoly1]-2,5-diphenyl-2H-tetrazolium bromide) assay indicated that the cell viability of L929 cultured in extracts from SPI-containing sponges was higher than that from the pure cellulose sponge. The historical analysis and SEM observation revealed that the SPI-containing sponges implanted from 1 to 8 months in rats exhibited better in vivo biocompatibility and biodegradability than the pure cellulose sponge. This was due to the incorporation of SPI into cellulose and to the freeze-drying process which formed large pores and thin pore walls in the composite sponges, promoting the migration of cells and tissue into the sponges, leading to gradual fusing with the implants. The new cellulose/SPI sponges thus have potential applications as biomaterials with good biocompatibility and biodegradability.

Hypoxia leads to necrotic hepatocyte death

Hepatocyte transplantation is being investigated as a therapy for liver disease; however, its success has been limited by rapid death of the cells following transplantation. This study was dedicated to elucidating the mode of death responsible for loss of transplanted hepatocytes in order to guide future strategies for promoting their survival. Using a tissue engineering model, it was found that the environment within polymer scaffolds containing transplanted cells was hypoxic after 5 days in vivo, with (90 +/- 3)% of hepatocytes existing at pO(2) < 10 mmHg. The primary mode of hepatocyte death in response to hypoxic conditions of 0 or 2 vol % oxygen was then determined in vitro. Several assays for features of apoptosis and necrosis demonstrated that hepatocytes cultured in an anoxic environment died via necrosis, while culture at 2% oxygen inhibited proliferation. These results suggest it will not be possible to prevent hepatocyte death by interfering with the apoptotic process, and hypoxic conditions in the transplants must instead be addressed. The finding that the environment within cell transplantation scaffolds is hypoxic is likely applicable to many cell-based therapies, and a similar analysis of the primary mode of death for other cell types in response to hypoxia may be valuable in guiding future strategies for their transplantation.

Development of mammalian cell-enclosing calcium-alginate hydrogel fibers in a co-flowing stream

A jetting technique in a liquid-liquid co-flowing stream was applied to the preparation of mammalian cell-enclosing calcium-alginate (Ca-alg) hydrogel fibers of several hundred micrometers in cross-sectional diameter. One percent alginate aqueous solution was extruded from needles (270, 480, 940 microm inner diameter) into a co-flowing laminar stream of 100 mM aqueous calcium chloride solution. The extruded alginate solution was stretched by the CaCl(2) solution, which is known as a "jetting process", and the Ca-alg hydrogel fibers were formed by gelation of the alginate solution through the uptake of calcium ions in the CaCl(2) solution. The cross-sectional diameter of the hydrogel fibers could be controlled from approximately 100-800 microm by changing the velocities of the alginate and CaCl(2) solution, and the inner diameter of the needle. Approximately 95% of bovine carotid artery vascular endothelial cells remained alive after the process of preparing hydrogel fibers in a co-flowing stream, demonstrating that the cell-enclosing process scarcely influences the viability of the enclosed cells.

Coencapsulation of hepatocytes and bone marrow cells: In vitro and in vivo studies

Bioencapsulation of cells is one of the many areas of artificial cells being extensively investigated by centers around the world. This includes the bioencapsulation of hepatocytes. A number of methods have been developed to maintain the specific function and phenotype of the bioencapsulated hepatocytes for in vitro and in vivo applications. These include supplementation of factors in the culture medium; use of appropriate substrates and the co-cultivation of hepatocytes with other type of cells, the so called "feeder cells". These feeder cells can be of liver origin or non-liver origin. We have recently studied the role of bone marrow cells in the maintenance of hepatocytes viability and phenotype by using the coculture of hepatocytes with bone marrow cells (nucleated cells including stem cells), and the coencapsulation of hepatocytes with bone marrow stem cells. This way, the hepatocytes viability and specific function can be maintained significantly longer. In vivo studies of both syngeneic and xenogeneic transplantation show that the hepatocytes viability can be maintained longer when coencapsulated with bone marrow cells. Transplantation of coencapsulated hepatocytes and bone marrow cells enhances the ability of the hepatocytes in correcting congenital hyperbilirubinmia in Gunn rats. Both in vitro and in vivo studies show that bone marrow cells can enhance the viability and phenotype maintenance of hepatocytes. Thus, bone marrow cells play an important role as a new type of feeder cells for bioencapsulated hepatocytes for the cellular therapy of liver diseases.

Functional cardiac cell constructs on cellulose-based scaffolding

Cellulose and its derivatives have been successfully employed as biomaterials in various applications, including dialysis membranes, diffusion-limiting membranes in biosensors, in vitro hollow fibers perfusion systems, surfaces for cell expansion, etc. In this study, we tested the potential of cellulose acetate (CA) and regenerated cellulose (RC) scaffolds for growing functional cardiac cell constructs in culture. Specifically, we demonstrate that CA and RC surfaces are promoting cardiac cell growth, enhancing cell connectivity (gap junctions) and electrical functionality. Being optically clear and essentially non-autofluorescent, CA scaffolds did not interfere with functional optical measurements in the cell constructs. Molding to follow fine details or complex three-dimensional shapes are additional important characteristics for scaffold design in tissue engineering. Biodegradability can be controlled by hydrolysis, de-acetylization of CA and cytocompatible enzyme (cellulase) action, with glucose as a final product. Culturing of cardiac cells and growth of tissue-like cardiac constructs in vitro could benefit from the versatility and accessibility of cellulose scaffolds, combining good adhesion (comparable to the standard tissue-culture treated polystyrene), molding capabilities down to the nanoscale (comparable to the current favorite in soft lithography-polydimethylsiloxane) with controlled biodegradability.

Hepatic tissue engineering for adjunct and temporary liver support: critical technologies

The severe donor liver shortage, high cost, and complexity of orthotopic liver transplantation have prompted the search for alternative treatment strategies for end-stage liver disease, which would require less donor material, be cheaper, and less invasive. Hepatic tissue engineering encompasses several approaches to develop adjunct internal liver support methods, such as hepatocyte transplantation and implantable hepatocyte-based devices, as well as temporary extracorporeal liver support techniques, such as bioartificial liver assist devices. Many tissue engineered liver support systems have passed the "proof of principle" test in preclinical and clinical studies; however, they have not yet been found sufficiently reliably effective for routine clinical use. In this review we describe, from an engineering perspective, the progress and remaining challenges that must be resolved in order to develop the next generation of implantable and extracorporeal devices for adjunct or temporary liver assist.

Galactosylated PVDF membrane promotes hepatocyte attachment and functional maintenance

One of the major challenges in BLAD design is to develop functional substrates suitable for hepatocyte attachment and functional maintenance. In the present study, we designed a poly(vinylidene difluoride) (PVDF) surface coated with galactose-tethered Pluronic polymer. The galactose-derived Pluronic F68 (F68-Gal) was adsorbed on PVDF membrane through hydrophobic-hydrophobic interaction between PVDF and the polypropylene oxide segment in Pluronic. The galactose density on the modified PVDF surface increased with the concentration of the F68-Gal solution, reaching 15.4 nmol galactosyl groups per cm2 when a 1 mg/ml of F68-Gal solution was used. The adsorbed F68-Gal remained relatively stable in culture medium. Rat hepatocytes attachment efficiency on F68-Gal modified PVDF membrane was similar to that on collagen-coated surface. The attached hepatocytes on PVDF/F68-Gal membrane self-assembled into multi-cellular spheroids after 1 day of culture. These attached hepatocytes in spheroids exhibited higher cell functions such as albumin synthesis and P450 1A1 detoxification function compared to unmodified PVDF membrane and collagen-coated surface. These results suggest the potential of this galactose-immobilized PVDF membrane as a suitable substrate for hepatocyte culture.

In vitro model of a vascular stroma for the engineering of vascularized tissues

A major problem for the in vitro engineering of larger tissue equivalents like those required in reconstructive surgery is the lack of solutions for sufficient nutrition and oxygenation. The starting point of our investigation was the question of whether the principles of in vitro angiogenesis can be applied and utilized for tissue engineering. A soft tissue model was developed, consisting of human adipose tissue stromal cells and umbilical vein endothelial cells in a fibrin-microcarrier scaffold. Capillary-like structures were visualized using UEA-I-lectin labelling and confocal laser scanning microscopy. Length of capillary-like structures was measured in an image analysis system. Under serum-free culture conditions, maintenance of capillary-like structures was significantly increased in comparison to serum-containing cultures. The application of vascular endothelial growth factor (VEGF) resulted in a high initial angiogenic response; long-term stabilization of capillary-like structures could not be achieved, however supplementation with IGF-1 resulted in the highest values and the slightest decrease in length of capillary-like structures, so that the results could be interpreted as an improved stabilization.

Continuous interleukin-6 application in vivo via macroencapsulation of interleukin-6-expressing COS-7 cells induces massive gliosis

The inflammatory cytokine interleukin-6 (IL-6) was found in senile plaques of Alzheimer's patients and might be involved in the pathology of Parkinson's disease and multiple sclerosis. Interestingly, an astocytosis is also found in these neurodegenerative disorders. To evaluate the direct effects of IL-6 in vivo on glial cells, we created a new in vivo model. IL-6 and mock-transfected (control group) COS-7 cells were encapsulated in a poly-acryl-nitril membrane for implantation into the rat striatum. Afterward, the host immune reaction to the membrane without encapsulated cells and the biological action of IL-6-producing capsules was evaluated. Animals with an implanted membrane without cells showed a moderate astrocytosis 5 days after the operation. Furthermore, microglia and T-cells could be detected and after 30 days the astrocytosis decreased to a small layer around the membrane. In comparison to the control group, which received a sham operation, our results demonstrate that the response of glial cells is caused by the mechanical damage of the surgical procedure itself rather than due to the introduced membrane material. In contrast, we found a massive proliferation and activation of astrocytes and microglia after 10 days by IL-6-secreting capsules, indicating that IL-6 is involved in the induction of gliosis. Control animals that received encapsulated mock-transfected COS-7 cells showed only a weak response. These data point to an involvement of IL-6 in the proliferation and activation of glial cells as seen in neurodegenerative disorders.

Semiautomatic macroencapsulation of large numbers of porcine hepatocytes by coextrusion with a solution of AN69 polymer

We have previously demonstrated that allogenic and xenogenic hepatocytes macroencapsulated manually in AN-69 polymer and transplanted intra-peritoneally in rats remained viable for several weeks. However, this manual technique is inadequate to encapsulate several billions of hepatocytes which would be required to correct hepatic failure in big animals or humans. In the present study, we developed an original semiautomatic device in which isolated pig hepatocytes and the polymer solution containing 6% poly(acrylonitrile-sodium methallylsulfonate), 91% dimethylsulfoxide and 3% 0.9% NaCl solution were coextruded through a double-lumen spinneret. The extruded minitube (inner diameter: 1.8 mm, wall thickness: 0.07-0.1 mm) containing the encapsulated hepatocytes fell and coiled up in a 0.9% NaCl solution at 4 degrees C and was cut down in 4 m units containing about 120 million hepatocytes. This process allowed to encapsulate 50 million hepatocytes by minute with a preserved immediate cell viability (92 +/- 5%). To test prolonged cell viability after coextrusion, the minitubes were implanted intraperitoneally in rats. Three and seven days after implantation, they were explanted and analyzed. Cells were viable and well-preserved. Therefore, the semiautomatic device appears able to efficiently macroencapsulate in a limited time several billions of porcine hepatocytes which remain viable after transplantation in xenogenic conditions.

Factors affecting hepatocyte viability and CYPIA1 activity during encapsulation

Hepatocytes encapsulated in alginate-poly-1-lysine-alginate (APA) are used in transplantation studies and in bioartificial liver support systems. Loss of cell viability in the process of APA encapsulation is usually 20-30% while the effect on cytochrome CYP450 activity is rarely reported. This work investigates the negative influences on hepatocyte viability and CYPIA1 activity during APA encapsulation, and reports methods to alleviate these influences by incorporating certain reagents into the encapsulation solution. The results show that loss of hepatocyte viability and CYPIA1 activity was caused almost entirely by extracellular calcium toxicity rather than by mechanical damage (p < 0.05). Use of 10 mM instead of 100 mM calcium chloride (CaCl2) in the encapsulation process improved CYPIA1 activity (p < 0.05), but did not improve hepatocyte viability (p > 0.05) or result in satisfactory microcapsules. Hepatocyte viability was 25% higher (p < 0.05) in CaCl2 than in calcium lactate (CaLa) when the cells were gelled by contact with these calcium solutions at room temperature (RT). Hepatocyte viability showed little improvement by processing at 4 degrees C than at RT in CaCl2 (p > 0.05) but was 23% higher at 4 degrees C than at RT in CaLa (p < 0.05). Calcium used in the process of encapsulation caused cell necrosis rather than apoptosis. Addition of Dulbecco's modified Eagle's medium (containing 10% foetal bovine serum) or 20 mM fructose to the calcium solution did not improve cell survival. However, nifedipine at a final concentration of 25 mM modestly improved hepatocyte survival in solution containing 100 mM CaCl2 (p = 0.003). Glutathione and taurine in certain concentrations showed protective effects against loss of CYPIA1 activity (p < 0.05 and <0.01 respectively). In conclusion, to optimise the use of calcium during the process of encapsulation, CaCl2 is preferred to CaLa and inclusion of nifedipine, glutathione or taurine in 100 mM CaCl2 solution is recommended.

Growth of L929 cells on polymeric films prepared by Langmuir-Blodgett and casting methods

The growth and spreading of fibroblast, L929 cells, on various polymeric films prepared by the Langmuir-Blodgett (LB) and casting methods were investigated. L929 cells, which were cultivated on collagen and synthetic polymeric films prepared by the LB method, adhered and spread much more than those on synthetic films prepared by the casting method. This is explained by the fact that cell growth and cell spreading are suitable for L929 cells on the films having serum proteins that contain a high alpha-helix content, because LB films adsorbed those serum proteins estimated from the circular dichroism measurements of the films immersed in cell culture medium. An exponential relationship was observed from the plot of the cell density vs root mean square of roughness of the films, which is estimated by atomic force microscopy, whereas a linear relationship was observed from the plot of the spreading ratio vs the root mean square of roughness. It is suggested that the correlation between the cell growth or spreading ratio and surface roughness of the films where L929 cells were cultivated is considered to be more important than the correlation between the cell growth or spreading ratio and the contact angle of the films.

Method for measuring in vivo oxygen transport rates in a bioartificial organ

Oxygen transport is crucial for the proper functioning of a bioartificial organ. In many cases, the immunoisolation membrane used to protect the transplanted cells from the host's immune system can be a significant barrier to oxygen transport. A method is described for measuring the in vitro and in vivo oxygen transport characteristics of a planar immunoisolation membrane. The in vitro oxygen permeability of the membrane was found to equal 9.22 x 10(-4) cm/sec and was essentially the same as the in vivo value of 9.51 x 10(-4) cm/sec. The fact that the in vitro and in vivo membrane permeabilities are identical indicates that any fibrotic tissue adjacent to the immunoisolation membrane did not present a significant resistance to the transport of oxygen. The measured oxygen permeability was also found consistent with the solute permeabilities obtained in a previous study for larger molecules. Based on the oxygen permeability results, theoretical calculations for this particular membrane indicate that about 1,100 islets of Langerhans/cm2 of membrane area can be sustained at high tissue densities and only 660 islets/cm2 can be supported at low tissue densities.

Materials for immunoisolated cell transplantation

Encapsulated cell therapy provides site-specific continuous delivery of cell-synthesized molecules. Cell encapsulation therapy is based on the concept of immunoisolation. Foreign cells are surrounded with a semi-permeable membrane prior to transplantation to shield them from the host's natural defense system. This membrane is selectively permeable to transport of nutrients and therapeutic agents but relatively impermeable to larger molecules and cells of the hosts' immune system. Most encapsulation devices also utilize an internal matrix to keep cells suspended within the capsule. Proper choice of materials and materials processing techniques to formulate membrane and matrix components is essential to the success of these devices. A successful encapsulation device recreates the natural three-dimensional tissue environment that supports cell function and maintains cell viability. This review summarizes recent developments in materials development for cell encapsulation devices and highlights some ongoing challenges faced by those in the field.

Current trends in biocompatibility testing

Biocompatibility remains the central theme for biomaterials applications in medicine. It is generally accepted that this term means not only absence of a cytotoxic effect but also positive effects in the sense of biofunctionality, i.e. promotion of biological processes which further the intended aim of the application of a biomaterial. The national and international standards for testing regimes represent a lowest common denominator for such applications and do not necessarily ensure that optimal function will be achieved. The authors' thesis is that biocompatibility testing has scope for extensive development with respect to biofunctionality. The present paper reviews current trends in the in vitro aspects of biocompatibility testing. As well as a critical appraisal of the recent literature, future trends are also stressed, which the authors regard as essential for a meaningful integration of a modern biological approach into new developments in the material sciences. These include the application of modern techniques of cell and molecular biology, the concepts of tissue remodelling, hybrid organ development and encapsulated cell technology.

Culture materials affect ex vivo expansion of hematopoietic progenitor cells

Ex vivo expansion of hematopoietic cells is important for applications such as cancer treatment, gene therapy, and transfusion medicine. While cell culture systems are widely used to evaluate the biocompatibility of materials for implantation, the ability of materials to support proliferation of primary human cells in cultures for reinfusion into patients has not been addressed. We screened a variety of commercially available polymer (15 types), metal (four types), and glass substrates for their ability to support expansion of hematopoietic cells when cultured under conditions that would be encountered in a clinical setting. Cultures of peripheral blood (PB) CD34+ cells and mononuclear cells (MNC) were evaluated for expansion of total cells and colony-forming unit-granulocyte monocyte (CFU-GM; progenitors committed to the granulocyte and/or monocyte lineage). Human hematopoietic cultures in serum-free medium were found to be extremely sensitive to the substrate material. The only materials tested that supported expansion at or near the levels of polystyrene were tissue culture polystyrene, Teflon perfluoroalkoxy, Teflon fluorinated ethylene propylene, cellulose acetate, titanium, new polycarbonate, and new polymethylpentene. MNC were less sensitive to the substrate materials than the primitive CD34+ progenitors, although similar trends were seen for expansion of the two cell populations on the substrates tested. CFU-GM expansion was more sensitive to substrate materials than was total cell expansion. The detrimental effects of a number of the materials on hematopoietic cultures appear to be caused by protein adsorption and/or leaching of toxins. Factors such as cleaning, sterilization, and reuse significantly affected the performance of some materials as culture substrates. We also used PB CD34+ cell cultures to examine the biocompatibility of gas-permeable cell culture and blood storage bags and several types of tubing commonly used with biomedical equipment. While many of the culture bag materials gave satisfactory results, all of the tubing materials severely inhibited total cell and CFU-GM expansion. Taken together, our results show that many materials approved for blood contact or considered biocompatible are not suitable for use with hematopoietic cells cultured in serum-free medium. As hematopoietic cultures are scaled up for a variety of clinical applications, it will be essential to carefully examine the biocompatibility of all materials involved.

Encapsulated cell technology

The potential therapeutic applications of encapsulated cells are enormous. In the US alone, it has been estimated that nearly half-a-trillion dollars are spent each year to care for patients who suffer tissue loss or dysfunction. Over 6 million patients suffer from neurodegenerative disorders such as Alzheimer's disease and Parkinson's disease, over 14 million patients suffer from diabetes, and millions more from liver failure, hemophilia, and other diseases caused by the loss of specific vital cellular functions. It appears likely that by the end of the decade clinical trials of encapsulated cells to treat many of these diseases will become a reality. The Food and Drug Administration has already authorized studies to evaluate the safety and biological activity of several types of systems. A number of issues will have to be addressed, including the sourcing of raw materials, the design and building of manufacturing facilities, the scale-up and optimization process, storage and distribution of the product, and quality control.

Engineering challenges in cell-encapsulation technology

The use of implantable immunoisolation devices, in which the tissue is protected from immune rejection by enclosure within a semipermeable membrane or encapsulant, is one approach in the development of cell therapies. However, further research is required in the areas of: tissue supply from primary or cell-culture sources; maintenance of cell viability and function, its relationship to device design, and the role of, and factors affecting, oxygen-supply limitations; and, protection from immune rejection, especially in view of the mechanisms thought to operate in the presence of a semipermeable membrane, the properties of that membrane, and the implications for biology and device design.