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Uysal A, Cay F, Balcı S, Arat A. Initial Experience with the Derivo 2Heal Flow Diverter under Standard or Reduced-Dose Single Antiplatelet Therapy. AJNR Am J Neuroradiol 2024; 45:1038-1043. [PMID: 39025640 DOI: 10.3174/ajnr.a8292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/09/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND AND PURPOSE Flow diverters with surface modifications or coatings have been recently introduced to clinical practice with the expectation that they can reduce the rate of thromboembolic complications and residual aneurysms. The purpose of this study is to evaluate the utility of the Derivo 2Heal (D2H) device, a new fibrin and heparin-coated flow diverter. MATERIALS AND METHODS Patients treated by a single operator by using the D2H were retrospectively evaluated for demographic data, aneurysm characteristics, procedural variables, and follow-up data. All patients were treated by using a single D2H, monitored by platelet function testing and kept under single antiplatelet therapy with regular or half-dose clopidogrel or prasugrel after the procedure. RESULTS Twenty patients with 26 aneurysms were treated. Three presented acutely with subarachnoid hemorrhage. Adjunctive devices were used in 6 patients. There were no technical failures and 2 periprocedural self-limited nonthrombotic minor adverse events. During follow-up, 1 of the acutely ruptured aneurysms reruptured, and 1 patient had a visual TIA. All patients were doing well clinically (19 with mRS of 0 and 1 with 1) at the last follow-up after discharge. The rates of total occlusion on very early angiographic (MRA/CTA or DSA, mean: 2.4 months), DSA (mean: 5.8 months), and midterm angiographic (mean: 14.5 months) follow-up for all versus uncoiled aneurysms were 68% versus 70%, 77.8% versus 90.0%, and 91.7% versus 90.1%, respectively. CONCLUSIONS The absence of permanent neurologic deficits in the periprocedural period and favorable occlusion rates in this preliminary study suggest that the novel coating comprising fibrin and heparin may have the potential to increase the safety and efficacy of flow diversion and needs to be further studied by comparing the D2H device with its bare counterpart and other coated or surface-modified flow diverters.
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Affiliation(s)
- Aycan Uysal
- From the Hacettepe University Faculty of Medicine (A.U., F.C., S.B, A.A.), Ankara, Turkey
| | - Ferdi Cay
- From the Hacettepe University Faculty of Medicine (A.U., F.C., S.B, A.A.), Ankara, Turkey
| | - Sinan Balcı
- From the Hacettepe University Faculty of Medicine (A.U., F.C., S.B, A.A.), Ankara, Turkey
| | - Anıl Arat
- From the Hacettepe University Faculty of Medicine (A.U., F.C., S.B, A.A.), Ankara, Turkey
- Department of Neurosurgery (A.A.), Yale University, New Haven, Connecticut
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Nichay NR, Dokuchaeva AA, Kulyabin YY, Boyarkin EV, Kuznetsova EV, Rusakova YL, Murashov IS, Vaver AA, Bogachev-Prokophiev AV, Zhuravleva IY. Epoxy- versus Glutaraldehyde-Treated Bovine Jugular Vein Conduit for Pulmonary Valve Replacement: A Comparison of Morphological Changes in a Pig Model. Biomedicines 2023; 11:3101. [PMID: 38002101 PMCID: PMC10669752 DOI: 10.3390/biomedicines11113101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
Valved conduits are often required to replace pulmonary arteries (PA). A widely used Contegra device is made of bovine jugular vein (BJV), preserved with glutaraldehyde (GA) and iso-propanol. However, it has several drawbacks that may be attributed to its chemical treatment. We hypothesized that the use of an alternative preservation compound may significantly improve BJV conduit performance. This study aimed to compare the macroscopic and microscopic properties of the BJV treated with diepoxide (DE) and GA in a porcine model. Twelve DE-BJVs and four Contegra conduits were used for PA replacement in minipigs. To assess the isolated influence of GA, we included an additional control group-BJV treated with 0.625% GA (n = 4). The animals were withdrawn after 6 months of follow-up and the conduits were examined. Explanted DE-BJV had a soft elastic wall with no signs of thrombosis or calcification and good conduit integration, including myofibroblast germination, an ingrowth of soft connective tissue formations and remarkable neoangiogenesis. The inner surface of DE-BJVs was covered by a thin neointimal layer with a solid endothelium. Contegra grafts had a stiffer wall with thrombosis on the leaflets. Calcified foci, chondroid metaplasia, and hyalinosis were observed within the wall. The distal anastomotic sites had hyperplastic neointima, partially covered with the endothelium. The wall of GA-BJV was stiff and rigid with degenerative changes, a substantial amount of calcium deposits and dense fibrotic formations in adventitia. An irregular neointimal layer was presented in the anastomotic sites without endothelial cover in the GA BJV wall. These results demonstrate that DE treatment improves conduit integration and the endothelialization of the inner surface while preventing the mineralization of the BJV, which may reduce the risk of early conduit dysfunction.
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Affiliation(s)
- Nataliya R. Nichay
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
- Cardiovascular Department, Novosibirsk State Medical University, Ministry of Health of Russian Federation, 52 Krasny Prospect, Novosibirsk 630091, Russia
| | - Anna A. Dokuchaeva
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Yuriy Yu. Kulyabin
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Evgeniy V. Boyarkin
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Elena V. Kuznetsova
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Yanina L. Rusakova
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Ivan S. Murashov
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Andrey A. Vaver
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Alexander V. Bogachev-Prokophiev
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
| | - Irina Yu. Zhuravleva
- E. Meshalkin National Medical Research Center, Ministry of Health of Russian Federation, 15 Rechkunovskaya St., Novosibirsk 630055, Russia; (A.A.D.); (Y.Y.K.); (E.V.B.); (E.V.K.); (Y.L.R.); (I.S.M.); (A.A.V.); (A.V.B.-P.); (I.Y.Z.)
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Gao M, Ding X, Lian X, Yu W, Dong S, Wang B, Wang Y, Yu Y. Administration of a new nano delivery system coated with Tirofiban to prevent early thrombosis of vein graft. Perfusion 2023:2676591231163014. [PMID: 36959776 DOI: 10.1177/02676591231163014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
OBJECTIVE To verify the administration of a new nano delivery system coated with Tirofiban on preventing early thrombosis in vein graft. METHODS Forty New Zealand white rabbits were randomly divided into five groups with eight rabbits in each group. The rabbits of all groups underwent jugular vein transplantation, except group I with only neck opening and closing operation. Vein grafts of group II were preprocessed by intravenous injection of normal saline; group III were preprocessed by tirofiban alone; group IV were preprocessed by unloaded nanoparticles of PLGA-PEG; group V were preprocessed by PLGA-PEG coated with tirofiban. Coagulation and platelet function of peripheral and vein graft blood were detected at 1, 2, 4, 12 h and 1, 3, 7, 10, 14 days after operation. Patency rate of vein graft and blood flow index were measured by vascular ultrasound at third, seventh, 10th, and 14th days after operation; two rabbits in each group were randomly sacrificed at the corresponding time of detection. Pathological differences of vein grafts were observed by HE stainin. RESULTS The patency rate of vein grafts in group V was significantly higher than that in group II to IV. The platelet and platelet aggregation rate in group V were inhibited in vein graft blood significantly. The post-operative PT and APTT in vein graft blood in group V were increased obviously while the FBG, D-dimer and FDP were significantly inhibited. Except group I, the lumen loss rate of vein grafts in group V was significantly lower than that in other groups, and vein graft blood in group V had a significant lower expression of platelet P-selectin and GP IIb/IIIa receptor than that in other groups. CONCLUSION This study proves that PEG-PLGA coated with tirofiban can effectively prevent early vein graft stenosis from thrombosis by inhibition of platelet function, coagulation function.
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Affiliation(s)
- Mingxin Gao
- Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Xiaohang Ding
- Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Xiaodong Lian
- Key Laboratory of Advanced Light Conversion Materials and Biophotonics, Department of Chemistry, Renmin University of China, Beijing, China
| | - Wenyuan Yu
- Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Shuo Dong
- Department of Thoracic Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Bolin Wang
- Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
| | - Yapei Wang
- Key Laboratory of Advanced Light Conversion Materials and Biophotonics, Department of Chemistry, Renmin University of China, Beijing, China
| | - Yang Yu
- Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
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Flores-Milan G, Pressman E, Peto I, Ren Z, Guerrero WR, Mokin M. Factors associated with in-stent stenosis after cerebral aneurysm embolization using a Pipeline embolization device. Interv Neuroradiol 2022; 28:731-736. [PMID: 34894820 PMCID: PMC9706256 DOI: 10.1177/15910199211066368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/18/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Flow-diverting (FD) stents, with or without coiling, are a mainstay in endovascular treatment of intracranial aneurysms (IAs). One observed complication from flow diverter stent (FDS) insertion has been in-stent stenosis. Though previously studied in the short-term period, the long-term history of this complication has yet to be described. METHODS We performed a retrospective cohort study of consecutive IAs treated with Pipeline Embolization Device (PED), with or without coiling, at our centre between September 2014 and December 2018 that had at least one digital subtraction angiogram (DSA) during follow-up. In-stent stenosis was measured from DSA images, and associated patient and procedural characteristics were analysed. RESULTS 94 patients treated with PED for IA were identified. On initial DSA during follow-up, 52 patients (55.3%) had in-stent stenosis within the PED. Of these 52 patients, 17 had a second DSA during follow-up. In this 2nd DSA, improvement and/or stable in-stent stenosis was seen 16 patients (94.1%). One patient in this group had worsening in-stent stenosis had a vertebrobasilar junction FD stent. Of the patients without in-stent stenosis on initial DSA, 15 had a second DSA during follow-up. Only one of these patients (6.7%) had new appearance of in-stent stenosis (measuring 5%). Multivariate analysis found statin use to be predictive of in-stent stenosis (p = 0.020, Odds ratio = 0.279 and 95% confidence interval = 0.095-0.821). CONCLUSIONS In-stent stenosis after FDS placement was seen in 53.2% of cases, which had between 1-50% of stenosis. 82.4% had resolution/improvement of their stenosis. Statin use was protective of in-stent stenosis.
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Affiliation(s)
- Gabriel Flores-Milan
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
| | - Elliot Pressman
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
| | - Ivo Peto
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
| | - Zeguang Ren
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
| | - Waldo R. Guerrero
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
- Neurosciences Group, Tampa General Hospital, Tampa, FL, USA
| | - Maxim Mokin
- Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA
- Neurosciences Group, Tampa General Hospital, Tampa, FL, USA
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Fernandes A, Miéville A, Grob F, Yamashita T, Mehl J, Hosseini V, Emmert MY, Falk V, Vogel V. Endothelial-Smooth Muscle Cell Interactions in a Shear-Exposed Intimal Hyperplasia on-a-Dish Model to Evaluate Therapeutic Strategies. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2202317. [PMID: 35971167 PMCID: PMC9534971 DOI: 10.1002/advs.202202317] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Indexed: 05/25/2023]
Abstract
Intimal hyperplasia (IH) represents a major challenge following cardiovascular interventions. While mechanisms are poorly understood, the inefficient preventive methods incentivize the search for novel therapies. A vessel-on-a-dish platform is presented, consisting of direct-contact cocultures with human primary endothelial cells (ECs) and smooth muscle cells (SMCs) exposed to both laminar pulsatile and disturbed flow on an orbital shaker. With contractile SMCs sitting below a confluent EC layer, a model that successfully replicates the architecture of a quiescent vessel wall is created. In the novel IH model, ECs are seeded on synthetic SMCs at low density, mimicking reendothelization after vascular injury. Over 3 days of coculture, ECs transition from a network conformation to confluent 2D islands, as promoted by pulsatile flow, resulting in a "defected" EC monolayer. In defected regions, SMCs incorporated plasma fibronectin into fibers, increased proliferation, and formed multilayers, similarly to IH in vivo. These phenomena are inhibited under confluent EC layers, supporting therapeutic approaches that focus on endothelial regeneration rather than inhibiting proliferation, as illustrated in a proof-of-concept experiment with Paclitaxel. Thus, this in vitro system offers a new tool to study EC-SMC communication in IH pathophysiology, while providing an easy-to-use translational disease model platform for low-cost and high-content therapeutic development.
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Affiliation(s)
- Andreia Fernandes
- Laboratory of Applied MechanobiologyInstitute of Translational MedicineDepartment of Health Sciences and TechnologyETH Zurich8093ZurichSwitzerland
| | - Arnaud Miéville
- Laboratory of Applied MechanobiologyInstitute of Translational MedicineDepartment of Health Sciences and TechnologyETH Zurich8093ZurichSwitzerland
| | - Franziska Grob
- Laboratory of Applied MechanobiologyInstitute of Translational MedicineDepartment of Health Sciences and TechnologyETH Zurich8093ZurichSwitzerland
| | - Tadahiro Yamashita
- Laboratory of Applied MechanobiologyInstitute of Translational MedicineDepartment of Health Sciences and TechnologyETH Zurich8093ZurichSwitzerland
- Present address:
Department of System Design EngineeringKeio University108‐8345YokohamaJapan
| | - Julia Mehl
- Laboratory of Applied MechanobiologyInstitute of Translational MedicineDepartment of Health Sciences and TechnologyETH Zurich8093ZurichSwitzerland
- Present address:
Julius Wolff InstituteBerlin Institute of HealthCharité Universitätsmedizin Berlin10117BerlinGermany
| | - Vahid Hosseini
- Laboratory of Applied MechanobiologyInstitute of Translational MedicineDepartment of Health Sciences and TechnologyETH Zurich8093ZurichSwitzerland
| | - Maximilian Y. Emmert
- Department of Cardiovascular SurgeryCharité Universitätsmedizin Berlin10117BerlinGermany
- Department of Cardiothoracic and Vascular SurgeryGerman Heart Center Berlin13353BerlinGermany
- Institute for Regenerative Medicine (IREM)University of Zurich8006ZurichSwitzerland
| | - Volkmar Falk
- Department of Cardiovascular SurgeryCharité Universitätsmedizin Berlin10117BerlinGermany
- Department of Cardiothoracic and Vascular SurgeryGerman Heart Center Berlin13353BerlinGermany
- Department of Health Sciences and TechnologyETH Zurich8093ZurichSwitzerland
| | - Viola Vogel
- Laboratory of Applied MechanobiologyInstitute of Translational MedicineDepartment of Health Sciences and TechnologyETH Zurich8093ZurichSwitzerland
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Shan Y, Chen G, Shi Q, Huang J, Mi Y, Zhang W, Zhang H, Jia B. Heparin/Collagen-REDV Modification of Expanded Polytetrafluoroethylene Improves Regional Anti-thrombosis and Reduces Foreign Body Reactions in Local Tissues. Front Bioeng Biotechnol 2022; 10:916931. [PMID: 35992343 PMCID: PMC9386153 DOI: 10.3389/fbioe.2022.916931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 06/07/2022] [Indexed: 11/29/2022] Open
Abstract
Prosthetic implants of expanded polytetrafluoroethylene (ePTFE) in the cardiovascular system have a high failure rate over the long term because of thrombosis and intimal hyperplasia. Although multiple surface modification methods have been applied to improve the anti-thrombotic and in situ endothelialization abilities of ePTFE, none have delivered outstanding results in vivo. Our previous study combined heparin/collagen multilayers and REDV peptides to modify ePTFE, and the in-vitro results showed that modification ePTFE with heparin/collagen-REDV can promote the cytocompatibility and antiplatelet property. This study illustrated the physical change, selective endothelial cells capture ability, and in vivo performance in further. The physical test demonstrated that this modification improved the hydrophilicity, flexibility and strength of ePTFE. A competition experiment of co-cultured endothelial cells and vascular smooth muscle cells verified that the heparin/collagen-REDV modification had high specificity for endothelial cell capture. A rabbit animal model was constructed to evaluate the in vivo performance of modified ePTFE implanted in the right ventricular outflow tract. The results showed that heparin/collagen-REDV modification was safe, promoted endothelialization, and successfully achieved regional anti-thrombosis without influencing body-wide coagulation function. The pathologic manifestations and mRNA expression pattern in tissues in contact with modified ePTFE indicated that this modification method may reduce M2-type macrophage infiltration and the expression of genes related to immune and inflammatory responses. The heparin/collagen-REDV modification may lower the incidence of complications related to ePTFE implantation and has good prospects for clinical use.
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Affiliation(s)
| | | | | | | | | | | | | | - Bing Jia
- *Correspondence: Huifeng Zhang, ; Bing Jia,
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Rohringer S, Schneider KH, Eder G, Hager P, Enayati M, Kapeller B, Kiss H, Windberger U, Podesser BK, Bergmeister H. Chorion-derived extracellular matrix hydrogel and fibronectin surface coatings show similar beneficial effects on endothelialization of expanded polytetrafluorethylene vascular grafts. Mater Today Bio 2022; 14:100262. [PMID: 35509865 PMCID: PMC9059097 DOI: 10.1016/j.mtbio.2022.100262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 11/19/2022] Open
Abstract
The endothelium plays an important regulatory role for cardiovascular homeostasis. Rapid endothelialization of small diameter vascular grafts (SDVGs) is crucial to ensure long-term patency. Here, we assessed a human placental chorionic extracellular matrix hydrogel (hpcECM-gel) as coating material and compared it to human fibronectin in-vitro. hpcECM-gels were produced from placental chorion by decellularization and enzymatic digestion. Human umbilical vein endothelial cells (HUVECs) were seeded to non-, fibronectin- or hpcECM-gel-coated expanded polytetrafluorethylene (ePTFE) SDVGs. Coating efficiency as well as endothelial cell proliferation, migration and adhesion studies on grafts were performed. hpcECM-gel depicted high collagen and glycosaminoglycan content and neglectable DNA amounts. Laminin and fibronectin were both retained in the hpcECM-gel after the decellularization process. HUVEC as well as endothelial progenitor cell attachment were both significantly enhanced on hpcECM-gel coated grafts. HUVECs seeded to hpcECM-gel depicted significantly higher platelet endothelial cell adhesion molecule-1 (PECAM-1) expression in the perinuclear region. Cell retention to flow was enhanced on fibronectin and hpcECM-gel coated grafts. Since hpcECM-gel induced a significantly higher endothelial cell adhesion to ePTFE than fibronectin, it represents a possible alternative for SDVG modification to improve endothelialization.
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Affiliation(s)
- Sabrina Rohringer
- Medical University of Vienna, Center for Biomedical Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Karl H. Schneider
- Medical University of Vienna, Center for Biomedical Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Gabriela Eder
- Medical University of Vienna, Center for Biomedical Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Pia Hager
- Medical University of Vienna, Center for Biomedical Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Marjan Enayati
- Medical University of Vienna, Center for Biomedical Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Barbara Kapeller
- Medical University of Vienna, Center for Biomedical Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Herbert Kiss
- Medical University of Vienna, Department of Obstetrics and Gynaecology, Division of Obstetrics and Feto-Maternal Medicine, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Ursula Windberger
- Medical University of Vienna, Center for Biomedical Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Bruno K. Podesser
- Medical University of Vienna, Center for Biomedical Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Helga Bergmeister
- Medical University of Vienna, Center for Biomedical Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
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8
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Keshi E, Tang P, Weinhart M, Everwien H, Moosburner S, Seiffert N, Lommel M, Kertzscher U, Globke B, Reutzel-Selke A, Strücker B, Pratschke J, Sauer IM, Haep N, Hillebrandt KH. Surface modification of decellularized bovine carotid arteries with human vascular cells significantly reduces their thrombogenicity. J Biol Eng 2021; 15:26. [PMID: 34819102 PMCID: PMC8611970 DOI: 10.1186/s13036-021-00277-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since autologous veins are unavailable when needed in more than 20% of cases in vascular surgery, the production of personalized biological vascular grafts for implantation has become crucial. Surface modification of decellularized xenogeneic grafts with vascular cells to achieve physiological luminal coverage and eventually thromboresistance is an important prerequisite for implantation. However, ex vivo thrombogenicity testing remains a neglected area in the field of tissue engineering of vascular grafts due to a multifold of reasons. METHODS After seeding decellularized bovine carotid arteries with human endothelial progenitor cells and umbilical cord-derived mesenchymal stem cells, luminal endothelial cell coverage (LECC) was correlated with glucose and lactate levels on the cell supernatant. Then a closed loop whole blood perfusion system was designed. Recellularized grafts with a LECC > 50% and decellularized vascular grafts were perfused with human whole blood for 2 h. Hemolysis and complete blood count evaluation was performed on an hourly basis, followed by histological and immunohistochemical analysis. RESULTS While whole blood perfusion of decellularized grafts significantly reduced platelet counts, platelet depletion from blood resulting from binding to re-endothelialized grafts was insignificant (p = 0.7284). Moreover, macroscopic evaluation revealed thrombus formation only in the lumen of unseeded grafts and histological characterization revealed lack of CD41 positive platelets in recellularized grafts, thus confirming their thromboresistance. CONCLUSION In the present study we were able to demonstrate the effect of surface modification of vascular grafts in their thromboresistance in an ex vivo whole blood perfusion system. To our knowledge, this is the first study to expose engineered vascular grafts to human whole blood, recirculating at high flow rates, immediately after seeding.
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Affiliation(s)
- Eriselda Keshi
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Peter Tang
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Marie Weinhart
- Cluster of Excellence Matters of Activity. Image Space Material funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany's Excellence Strategy - EXC 2025 - 390648296, Berlin, Germany.,Institute of Chemistry and Biochemistry, Freie Universität Berlin, Takustr. 3, 14195, Berlin, Germany.,Institute of Physical Chemistry and Electrochemistry, Leibniz Universität Hannover, Hanover, Germany
| | - Hannah Everwien
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Simon Moosburner
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Nicolai Seiffert
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Michael Lommel
- Institute for Cardiovascular Computer-Assisted Medicine, Biofluid Mechanics Lab, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ulrich Kertzscher
- Institute for Cardiovascular Computer-Assisted Medicine, Biofluid Mechanics Lab, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Brigitta Globke
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Anja Reutzel-Selke
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Benjamin Strücker
- Department of General, Visceral and Transplant Surgery, Universitätsklinikum Münster, Münster, Germany
| | - Johann Pratschke
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.,Cluster of Excellence Matters of Activity. Image Space Material funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany's Excellence Strategy - EXC 2025 - 390648296, Berlin, Germany
| | - Igor Maximillian Sauer
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany. .,Cluster of Excellence Matters of Activity. Image Space Material funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany's Excellence Strategy - EXC 2025 - 390648296, Berlin, Germany.
| | - Nils Haep
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.,Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Karl Herbert Hillebrandt
- Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum, Experimental Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
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9
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Wacker M, Riedel J, Walles H, Scherner M, Awad G, Varghese S, Schürlein S, Garke B, Veluswamy P, Wippermann J, Hülsmann J. Comparative Evaluation on Impacts of Fibronectin, Heparin-Chitosan, and Albumin Coating of Bacterial Nanocellulose Small-Diameter Vascular Grafts on Endothelialization In Vitro. NANOMATERIALS 2021; 11:nano11081952. [PMID: 34443783 PMCID: PMC8398117 DOI: 10.3390/nano11081952] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/22/2021] [Accepted: 07/25/2021] [Indexed: 12/18/2022]
Abstract
In this study, we contrast the impacts of surface coating bacterial nanocellulose small-diameter vascular grafts (BNC-SDVGs) with human albumin, fibronectin, or heparin–chitosan upon endothelialization with human saphenous vein endothelial cells (VEC) or endothelial progenitor cells (EPC) in vitro. In one scenario, coated grafts were cut into 2D circular patches for static colonization of a defined inner surface area; in another scenario, they were mounted on a customized bioreactor and subsequently perfused for cell seeding. We evaluated the colonization by emerging metabolic activity and the preservation of endothelial functionality by water soluble tetrazolium salts (WST-1), acetylated low-density lipoprotein (AcLDL) uptake assays, and immune fluorescence staining. Uncoated BNC scaffolds served as controls. The fibronectin coating significantly promoted adhesion and growth of VECs and EPCs, while albumin only promoted adhesion of VECs, but here, the cells were functionally impaired as indicated by missing AcLDL uptake. The heparin–chitosan coating led to significantly improved adhesion of EPCs, but not VECs. In summary, both fibronectin and heparin–chitosan coatings could beneficially impact the endothelialization of BNC-SDVGs and might therefore represent promising approaches to help improve the longevity and reduce the thrombogenicity of BNC-SDVGs in the future.
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Affiliation(s)
- Max Wacker
- Department of Cardiothoracic Surgery, University Hospital Magdeburg, 39112 Magdeburg, Germany; (J.R.); (M.S.); (G.A.); (S.V.); (P.V.); (J.W.); (J.H.)
- Correspondence: ; Tel.: +49-391-67-14102
| | - Jan Riedel
- Department of Cardiothoracic Surgery, University Hospital Magdeburg, 39112 Magdeburg, Germany; (J.R.); (M.S.); (G.A.); (S.V.); (P.V.); (J.W.); (J.H.)
| | - Heike Walles
- Core Facility Tissue Engineering, Otto-Von-Guericke University Magdeburg, 39106 Magdeburg, Germany;
| | - Maximilian Scherner
- Department of Cardiothoracic Surgery, University Hospital Magdeburg, 39112 Magdeburg, Germany; (J.R.); (M.S.); (G.A.); (S.V.); (P.V.); (J.W.); (J.H.)
| | - George Awad
- Department of Cardiothoracic Surgery, University Hospital Magdeburg, 39112 Magdeburg, Germany; (J.R.); (M.S.); (G.A.); (S.V.); (P.V.); (J.W.); (J.H.)
| | - Sam Varghese
- Department of Cardiothoracic Surgery, University Hospital Magdeburg, 39112 Magdeburg, Germany; (J.R.); (M.S.); (G.A.); (S.V.); (P.V.); (J.W.); (J.H.)
| | - Sebastian Schürlein
- Department Tissue Engineering and Regenerative Medicine (TERM), University Hospital Würzburg, 97070 Würzburg, Germany;
| | - Bernd Garke
- Institute of Experimental Physics, Otto-Von-Guericke University Magdeburg, 39106 Magdeburg, Germany;
| | - Priya Veluswamy
- Department of Cardiothoracic Surgery, University Hospital Magdeburg, 39112 Magdeburg, Germany; (J.R.); (M.S.); (G.A.); (S.V.); (P.V.); (J.W.); (J.H.)
| | - Jens Wippermann
- Department of Cardiothoracic Surgery, University Hospital Magdeburg, 39112 Magdeburg, Germany; (J.R.); (M.S.); (G.A.); (S.V.); (P.V.); (J.W.); (J.H.)
| | - Jörn Hülsmann
- Department of Cardiothoracic Surgery, University Hospital Magdeburg, 39112 Magdeburg, Germany; (J.R.); (M.S.); (G.A.); (S.V.); (P.V.); (J.W.); (J.H.)
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10
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Gu Y, Tian C, Qin Y, Sun Y, Liu S, Li H, Duan X, Shu C, Ouyang C. The novel hybrid polycarbonate polyurethane / polyester three-layered large-diameter artificial blood vessel. J Biomater Appl 2021; 36:965-975. [PMID: 34284662 DOI: 10.1177/08853282211033415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The most common materials of artificial blood vessels are polyethylene terephthalate and polytetrafluoroethylene. But polycarbonate polyurethane (PCU) is an ideal material for vascular prostheses because of their excellent characteristics. As far as we know, our artificial blood vessel is the first type of hybrid PCU/polyester three-layered large-diameter artificial blood vessel in the world. OBJECTIVE The purpose of this preclinical animal experiment is to evaluate the hemocompatibility, histocompatibility, effectiveness, and safety of the three-layered large-diameter artificial blood vessel in sheep. METHODS The artificial blood vessels took place of the initial segments of the sheep's thoracic aorta by end-to-end anastomosis. RESULTS All of the 14 sheep are male, their average body weight (BW) was 30.57 ± 3.95 kg. All 14 artificial blood vessels successfully replaced the thoracic aortas. 5 sheep did not survive to the end of the experiment, while the remaining 9 sheep did. After the surgery, the blood biochemical and blood routine indicators fluctuate slightly within the normal range. The angiography showed that the implanted artificial blood vessels were unobstructed without obvious stenosis or expansion. 24 weeks after surgery, the lumen surfaces of the artificial blood vessels were covered by endothelia in different degrees, and the average endothelialization rate was 69.44% (range: 20% to 100%). CONCLUSIONS This artificial blood vessel is the first to use PCU in large-diameter artificial vascular grafts. It has excellent blood compatibility, wonderful biocompatibility, high endothelialization rate, and 100% patency.
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Affiliation(s)
- Yuanrui Gu
- Department of Vascular, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chen Tian
- Department of Vascular, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yilang Qin
- Department of Vascular, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yangxue Sun
- 2nd Department of Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sishi Liu
- Wuhan Yangsen Biotechnology Co., Ltd, Wuhan, China
| | - Huichai Li
- Wuhan Yangsen Biotechnology Co., Ltd, Wuhan, China
| | - Xuejing Duan
- Department of Pathology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chang Shu
- Department of Vascular, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Vascular Surgery, The Second Xiangya Hospital, Vascular Disease Institute, Central South University, Changsha, China
| | - Chenxi Ouyang
- Department of Vascular, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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11
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Xing Y, Gu Y, Guo L, Guo J, Xu Z, Xiao Y, Fang Z, Wang C, Feng ZG, Wang Z. Gelatin coating promotes in situ endothelialization of electrospun polycaprolactone vascular grafts. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2021; 32:1161-1181. [PMID: 33830866 DOI: 10.1080/09205063.2021.1909413] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Rapid endothelialization is crucial for in situ tissue engineering vascular grafts to prevent graft failure in the long-term. Gelatin is a promising nature material that can promote endothelial cells (ECs) adhesion, proliferation, and migration. In this study, the internal surface of electrospun polycaprolactone (PCL) vascular grafts was coated with gelatin. Endothelialization and vascular wall remolding were investigated by imaging and histological studies in the rat abdominal aorta replacement model. The endothelialization of heparinized gelatin-coated PCL (GP-H) vascular grafts was more rapid and complete than heparinized PCL (P-H) grafts. Intimal hyperplasia was milder in the GP-H vascular grafts than the P-H vascular grafts in the long-term. Meanwhile, smooth muscle cells (SMCs) and extracellular matrix (ECM) regeneration were better in the GP-H vascular grafts. By comparison, an aneurysm was observed in the P-H group in 6 months. Calcification was observed in both groups. All vascular grafts were patient after implantation in both groups. Our results showed that gelatin coating on the internal surface of PCL grafts is a simple and effective way to promote endothelialization. A more rapid endothelialization and complete endothelium can inhibit intimal hyperplasia in the long-term.
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Affiliation(s)
- Yuehao Xing
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yongquan Gu
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lianrui Guo
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jianming Guo
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zeqin Xu
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yonghao Xiao
- School of Materials Science and Engineering, Beijing Institute of Technology, Beijing, China
| | - Zhiping Fang
- School of Materials Science and Engineering, Beijing Institute of Technology, Beijing, China
| | - Cong Wang
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zeng-Guo Feng
- School of Materials Science and Engineering, Beijing Institute of Technology, Beijing, China
| | - Zhonggao Wang
- Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
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12
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Polymers and Nanoparticles for Statin Delivery: Current Use and Future Perspectives in Cardiovascular Disease. Polymers (Basel) 2021; 13:polym13050711. [PMID: 33652927 PMCID: PMC7956757 DOI: 10.3390/polym13050711] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/20/2021] [Accepted: 02/21/2021] [Indexed: 12/20/2022] Open
Abstract
Atherosclerosis-related coronary artery disease (CAD) is one of the leading sources of mortality and morbidity in the world. Primary and secondary prevention appear crucial to reduce CAD-related complications. In this scenario, statin treatment was shown to be clinically effective in the reduction of adverse events, but systemic administration provides suboptimal results. As an attempt to improve bioavailability and effectiveness, polymers and nanoparticles for statin delivery were recently investigated. Polymers and nanoparticles can help statin delivery and their effects by increasing oral bioavailability or enhancing target-specific interaction, leading to reduced vascular endothelial dysfunction, reduced intimal hyperplasia, reduced ischemia-reperfusion injury, increased cardiac regeneration, positive remodeling in the extracellular matrix, reduced neointimal growth and increased re-endothelization. Moreover, some innovative aspects described in other cardiovascular fields could be translated into the CAD scenario. Recent preclinical studies are underlining the effect of statins in the stimulation and differentiation of endogenous cardiac stem cells, as well as in targeting of local adverse conditions implicated in atherosclerosis, and statin delivery through poly-lactic-co-glycolic acid (PLGA) appears the most promising aspect of current research to enhance drug activity. The present review intends to summarize the current evidence about polymers and nanoparticles for statin delivery in the field of cardiovascular disease, trying to shed light on this topic and identify new avenues for future studies.
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13
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de Donato G, Benedetto F, Stilo F, Chiesa R, Palombo D, Pasqui E, Panzano C, Pulli R, Novali C, Silingardi R, Grego F, Palasciano G, Setacci C. Evaluation of Clinical Outcomes After Revascularization in Patients With Chronic Limb-Threatening Ischemia: Results From a Prospective National Cohort Study (RIVALUTANDO). Angiology 2021; 72:480-489. [PMID: 33406850 DOI: 10.1177/0003319720980619] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We evaluated the outcomes of revascularization in patients with chronic limb-threatening ischemia (CLTI) treated in real-world settings. This is a prospective multicenter cohort study with 12-month follow-up enrolling patients (n = 287) with CLTI undergoing open, endovascular, or hybrid lower extremity revascularization. The primary end point was amputation-free survival (AFS) at 12 months. Cox proportional analysis was used to determine independent predictors of amputation and restenosis. At 30 days, major adverse cardiovascular and major adverse limb events (MALE) rates were 3.1% and 2.1%, respectively. At 1 year, the overall survival rate was 88.8%, the AFS was 86.6%, and the primary patency was 70.5%. Freedom from MALE was 62.5%. After multivariate analysis, smoking (hazard ratio [HR] = 2.2, P = 0.04), renal failure (HR = 2.3, P = 0.03), Rutherford class (≥5) (HR = 3.2, P = 0.01), and below-the-knee disease (HR = 2.0, P = 0.05) were significant predictors of amputation; iloprost infusion (>10 vials) (HR = 0.64, P = 0.05) was a significant protective factor. Cilostazol administration (HR = 0.77, P = 0.05) was a significant protective factor for restenosis. Results from this prospective multicenter registry offer a consistent overview of clinical outcomes of CLTI patients at 1 year when adequately revascularized. Medical treatment, including statins, cilostazol and iloprost, were associated with improved 1-year freedom from restenosis and amputation.
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Affiliation(s)
| | | | - Francesco Stilo
- Vascular Surgery, University of Rome Campus Biomedico, Italy
| | - Roberto Chiesa
- Vascular Surgery, University of Milano San Rafael, Italy
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14
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Duijvelshoff R, Cabrera MS, Sanders B, Dekker S, Smits AIPM, Baaijens FPT, Bouten CVC. Transcatheter-Delivered Expandable Bioresorbable Polymeric Graft With Stenting Capacity Induces Vascular Regeneration. ACTA ACUST UNITED AC 2020; 5:1095-1110. [PMID: 33294741 PMCID: PMC7691284 DOI: 10.1016/j.jacbts.2020.09.005] [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: 05/11/2020] [Revised: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 01/22/2023]
Abstract
We designed a transcatheter balloon-expandable resorbable vascular graft with support capacity. After 2 months in vivo, grafts show native-like tissue reconstruction with endoluminal elastin. The concept convenes regenerative grafting, minimally invasive delivery, and clinical stenting.
As the next step in the translation of vascular tissue engineering, this study uniquely combines transcatheter delivery and in situ tissue regeneration using a novel bioresorbable electrospun polymer graft that can be implanted minimally invasively. Once delivered inside a small-diameter vessel, the electrospun microstructure supports the vessel wall, facilitates cellular infiltration, and guides organized tissue formation.
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Key Words
- BVS, bioresorbable vascular scaffold(s)
- ECM, extracellular matrix
- GPC, gel permeation chromatography
- Mw, weight-average molecular weight
- PBS, phosphate-buffered saline
- SEM, scanning electron microscopy
- SMA, smooth muscle actin
- SMC, smooth muscle cell
- T-TEVG, transcatheter tissue-engineered vascular graft
- TE, tissue engineering
- elastin
- regeneration
- tissue engineering
- transcatheter delivery
- vascular graft
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Affiliation(s)
- Renee Duijvelshoff
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.,Institute for Complex Molecular Systems, Eindhoven, the Netherlands
| | | | | | - Sylvia Dekker
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Anthal I P M Smits
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.,Institute for Complex Molecular Systems, Eindhoven, the Netherlands
| | - Frank P T Baaijens
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.,Institute for Complex Molecular Systems, Eindhoven, the Netherlands
| | - Carlijn V C Bouten
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.,Institute for Complex Molecular Systems, Eindhoven, the Netherlands
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15
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Che Man R, Sulaiman N, Ishak MF, Bt Hj Idrus R, Abdul Rahman MR, Yazid MD. The Effects of Pro-Inflammatory and Anti-Inflammatory Agents for the Suppression of Intimal Hyperplasia: An Evidence-Based Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217825. [PMID: 33114632 PMCID: PMC7672569 DOI: 10.3390/ijerph17217825] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/30/2020] [Accepted: 10/07/2020] [Indexed: 12/11/2022]
Abstract
Anti-atherogenic therapy is crucial in halting the progression of inflammation-induced intimal hyperplasia. The aim of this concise review was to methodically assess the recent findings of the different approaches, mainly on the recruitment of chemokines and/or cytokine and its effects in combating the intimal hyperplasia caused by various risk factors. Pubmed and Scopus databases were searched, followed by article selection based on pre-set inclusion and exclusion criteria. The combination of keywords used were monocyte chemoattractant protein-1 OR MCP-1 OR TNF-alpha OR TNF-α AND hyperplasia OR intimal hyperplasia OR neointimal hyperplasia AND in vitro. These keywords combination was incorporated in the study and had successfully identified 77 articles, with 22 articles were acquired from Pubmed, whereas 55 articles were obtained from Scopus. However, after title screening, only twelve articles meet the requirements of defined inclusion criteria. We classified the data into 4 different approaches, i.e., utilisation of natural product, genetic manipulation and protein inhibition, targeted drugs in clinical setting, and chemokine and cytokines induction. Most of the articles are working on genetic manipulation targeted on specific pathway to inhibit the pro-inflammatory factors expression. We also found that the utilisation of chemokine- and cytokine-related treatments are emerging throughout the years. However, there is no study utilising the combination of approaches that might give a better outcome in combating intimal hyperplasia. Hopefully, this concise review will provide an insight regarding the usage of different novel approaches in halting the progression of intimal hyperplasia, which serves as a key factor for the development of atherosclerosis in cardiovascular disease.
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Affiliation(s)
- Rohaina Che Man
- Centre for Tissue Engineering & Regenerative Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia; (R.C.M.); (N.S.); (M.F.I.); (R.B.H.I.)
| | - Nadiah Sulaiman
- Centre for Tissue Engineering & Regenerative Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia; (R.C.M.); (N.S.); (M.F.I.); (R.B.H.I.)
| | - Mohamad Fikeri Ishak
- Centre for Tissue Engineering & Regenerative Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia; (R.C.M.); (N.S.); (M.F.I.); (R.B.H.I.)
| | - Ruszymah Bt Hj Idrus
- Centre for Tissue Engineering & Regenerative Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia; (R.C.M.); (N.S.); (M.F.I.); (R.B.H.I.)
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
| | - Mohd Ramzisham Abdul Rahman
- Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia;
| | - Muhammad Dain Yazid
- Centre for Tissue Engineering & Regenerative Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia; (R.C.M.); (N.S.); (M.F.I.); (R.B.H.I.)
- Correspondence: ; Tel.: +603-9145-6995
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16
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Chan AHP, Filipe EC, Tan RP, Santos M, Yang N, Hung J, Feng J, Nazir S, Benn AJ, Ng MKC, Rnjak-Kovacina J, Wise SG. Altered processing enhances the efficacy of small-diameter silk fibroin vascular grafts. Sci Rep 2019; 9:17461. [PMID: 31767928 PMCID: PMC6877724 DOI: 10.1038/s41598-019-53972-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 11/06/2019] [Indexed: 01/24/2023] Open
Abstract
Current synthetic vascular grafts are not suitable for use in low-diameter applications. Silk fibroin is a promising natural graft material which may be an effective alternative. In this study, we compared two electrospun silk grafts with different manufacturing processes, using either water or hexafluoroisopropanol (HFIP) as solvent. This resulted in markedly different Young's modulus, ultimate tensile strength and burst pressure, with HFIP spun grafts observed to have thicker fibres, and greater stiffness and strength relative to water spun. Assessment in a rat abdominal aorta grafting model showed significantly faster endothelialisation of the HFIP spun graft relative to water spun. Neointimal hyperplasia in the HFIP graft also stabilised significantly earlier, correlated with an earlier SMC phenotype switch from synthetic to contractile, increasing extracellular matrix protein density. An initial examination of the macrophage response showed that HFIP spun conduits promoted an anti-inflammatory M2 phenotype at early timepoints while reducing the pro-inflammatory M1 phenotype relative to water spun grafts. These observations demonstrate the important role of the manufacturing process and physical graft properties in determining the physiological response. Our study is the first to comprehensively study these differences for silk in a long-term rodent model.
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Affiliation(s)
- Alex H P Chan
- The Heart Research Institute, 7 Eliza Street, Newtown, Sydney, NSW, 2042, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia
| | - Elysse C Filipe
- Garvan Institute of Medical Research & The Kinghorn Cancer Center, Sydney, NSW, 2010, Australia.,St Vincent's Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, NSW, 2010, Australia
| | - Richard P Tan
- The Heart Research Institute, 7 Eliza Street, Newtown, Sydney, NSW, 2042, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia
| | - Miguel Santos
- The Heart Research Institute, 7 Eliza Street, Newtown, Sydney, NSW, 2042, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia
| | - Nianji Yang
- The Heart Research Institute, 7 Eliza Street, Newtown, Sydney, NSW, 2042, Australia
| | - Juichien Hung
- The Heart Research Institute, 7 Eliza Street, Newtown, Sydney, NSW, 2042, Australia
| | - Jieyao Feng
- The Heart Research Institute, 7 Eliza Street, Newtown, Sydney, NSW, 2042, Australia
| | - Sidra Nazir
- The Heart Research Institute, 7 Eliza Street, Newtown, Sydney, NSW, 2042, Australia
| | - Alexander J Benn
- The Heart Research Institute, 7 Eliza Street, Newtown, Sydney, NSW, 2042, Australia
| | - Martin K C Ng
- Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2050, Australia
| | - Jelena Rnjak-Kovacina
- Graduate School of Biomedical Engineering, UNSW Sydney, Sydney, NSW, 2052, Australia.
| | - Steven G Wise
- The Heart Research Institute, 7 Eliza Street, Newtown, Sydney, NSW, 2042, Australia. .,Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia. .,School of Medical Sciences, Dept of Physiology, University of Sydney, Sydney, NSW, 2006, Australia. .,Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia.
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17
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Kim D, Chung JJ, Jung Y, Kim SH. The effect of Substance P/Heparin conjugated PLCL polymer coating of bioinert ePTFE vascular grafts on the recruitment of both ECs and SMCs for accelerated regeneration. Sci Rep 2019; 9:17083. [PMID: 31745143 PMCID: PMC6863833 DOI: 10.1038/s41598-019-53514-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 10/24/2019] [Indexed: 12/11/2022] Open
Abstract
Artificial vascular grafts consisting of ePTFE have been mainly used in clinics for the treatment of cardiovascular disease. However, artificial grafts can become clogged after a long time due to thrombosis, as graft maturation by endothelialization is limited. The strategy introduced in this study is to induce graft remodeling through interaction between the bioinert graft and the body. The Substance P (SP) and heparin were covalently conjugated with PLCL, an elastic biocompatible copolymer and the Substance P-conjugated PLCL (SP-PLCL) and/or heparin-conjugated PLCL (Hep-PLCL) were vacuum-coated onto ePTFE vascular grafts. To assess the effectiveness of the coating, coated samples were evaluated by implanting them subcutaneously into SD-Rats. Coatings allow grafts to be remodeled by creating a microenvironment where cells can grow by infiltrating into the grafts while also greatly enhancing angiogenesis. In particular, a double coating of Hep-PLCL and SP-PLCL (Hep/SP-PLCL) at four weeks showed markedly improved vascular remodeling through the recruitment of mesenchymal stem cells (MSCs), vascular cells (ECs, SMCs) and M2 macrophages. Based on these results, it is expected that when the Hep/SP-PLCL-coated ePTFE vascular grafts are implanted in situ, long-term patency will be assured due to the appropriate formation of an endothelial layer and smooth muscle cells in the grafts like native vessels.
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Affiliation(s)
- Donghak Kim
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
- Center for Biomaterials, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Justin J Chung
- Center for Biomaterials, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Youngmee Jung
- Center for Biomaterials, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
- Department of Biomedical Engineering, Korea University of Science and Technology (UST), Daejeon, 305-350, Republic of Korea
| | - Soo Hyun Kim
- KU-KIST Graduate School of Converging Science and Technology, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
- Center for Biomaterials, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea.
- Department of Biomedical Engineering, Korea University of Science and Technology (UST), Daejeon, 305-350, Republic of Korea.
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18
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Li W, Du D, Li Y. Id-1 Promotes Reendothelialization In The Early Phase After Vascular Injury Through Activation Of NFkB/survivin Signaling Pathway. Drug Des Devel Ther 2019; 13:3799-3811. [PMID: 31802852 PMCID: PMC6827526 DOI: 10.2147/dddt.s208707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 10/02/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) treatment can benefit patients, but also cause irreversible mechanical damage to the vascular endothelium, ultimately leading to restenosis of the target vessel. Thus, achieving rapid re-endothelialization and restoring the integrity of the vascular endothelium and function plays an important role in inhibiting neointimal hyperplasia and preventing restenosis. Id1 (inhibitor of DNA binding/differentiation factor 1) plays an important role in promoting cell proliferation and angiogenesis. STUDY OBJECTIVE This study aims to investigate the relationship between Id1 and NFκB/survivin signaling pathways and their role in injured vascular repair by establishing a rat carotid balloon injury model. METHODS The carotid artery model of rat balloon injury was established. The injured common carotid artery was obtained at different time points after vascular injury. RNA and protein were extracted and the mRNA and protein expression levels of Id1, NFκB and survivin were detected in vascular injury. The NFκB blocker BAY 11-7082 and survivin blocker YM155 were used and the effects of Id1, NFκB, survivin mRNA and protein expression, revascularization of blood vessels and neointimal responsiveness after vascular injury were observed in the vascular tissues of Ad-Id1 transfected balloon injury. RESULTS Id1, NFκB and survivin were expressed in injured rat carotid arteries. Overexpression of Id1 promoted re-endothelialization of injured vessels through NFκB/survivin signaling pathway, inhibited early vascular endometrial reactive hyperplasia; blocked NFκB the/survivin signaling pathway attenuates the re-endothelialization of Ad-Id1 and the early endothelium of Ad-Id1. Blocking the NFκB/survivin signaling pathway attenuates the re-endothelialization and early reactive hyperplasia of vascular intima of Ad-Id1. CONCLUSION NF-kappa B/survivin signaling pathway may play an important role in Id1 promoting vascular re-endothelialization, inhibiting neointimal hyperplasia and preventing vascular restenosis.
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Affiliation(s)
- Wei Li
- Department of Cardiology, Beijing100017, People’s Republic of China
| | - Dayong Du
- Department of Cardiology, Beijing100017, People’s Republic of China
| | - Yuntian Li
- Department of Cardiology, Beijing100017, People’s Republic of China
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19
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Jalaie H, Steitz J, Afify M, Barbati ME, Hoeft K, Assar MAM, Hermanns-Sachweh B, Tolba RH, Jacobs MJ, Schleimer K. In vivo endothelialization and neointimal hyperplasia assessment after angioplasty of sheep carotid artery with a novel polycarbonate polyurethane patch. J Biomater Appl 2019; 34:208-218. [PMID: 31088184 DOI: 10.1177/0885328219849368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Houman Jalaie
- 1 European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen, Germany
| | - Julia Steitz
- 2 Institute for Laboratory Animal Science, RWTH-Aachen University, Germany
| | - Mamdouh Afify
- 2 Institute for Laboratory Animal Science, RWTH-Aachen University, Germany.,3 Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Egypt
| | - Mohammad Esmaeil Barbati
- 1 European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen, Germany
| | - Konrad Hoeft
- 4 Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Germany
| | - Mona Ali Mahmoud Assar
- 2 Institute for Laboratory Animal Science, RWTH-Aachen University, Germany.,6 Institute for Pathology, RWTH-Aachen University, Germany
| | | | - Rene H Tolba
- 2 Institute for Laboratory Animal Science, RWTH-Aachen University, Germany
| | - Michael J Jacobs
- 1 European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen, Germany
| | - Karina Schleimer
- 1 European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen, Germany
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20
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Wang Y, Zhao D, Sheng J, Lu P. Local honokiol application inhibits intimal thickening in rabbits following carotid artery balloon injury. Mol Med Rep 2017; 17:1683-1689. [PMID: 29257208 PMCID: PMC5780111 DOI: 10.3892/mmr.2017.8076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 07/24/2017] [Indexed: 01/10/2023] Open
Abstract
Honokiol is a natural bioactive product with anti-tumor, anti-inflammatory, anti-oxidative, anti-angiogenic and neuroprotective properties. The present study aimed to investigate the effects of honokiol treatment on intimal thickening following vascular balloon injury. The current study determined that perivascular honokiol application reduced intimal thickening in rabbits 14 days after carotid artery injury, it may inhibit vascular smooth muscle cell (VSMCs) proliferation and reduce collagen deposition in local arteries. The findings of the presents study also suggested that honikiol may increase the mRNA expression levels of matrix metalloproteinase‑1 (MMP‑1), MMP‑2 and MMP‑9 and decrease tissue inhibitor of metalloproteinase‑1 (TIMP‑1) mRNA expression in the rabbit arteries. Additionally, perivascular honokiol application inhibited intimal thickening, possibly via inhibition of the phosphorylation of SMAD family member 2/3.
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Affiliation(s)
- Yu Wang
- Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - Danyang Zhao
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - Jing Sheng
- Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| | - Ping Lu
- Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
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21
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Schulz C, Vukićević R, Krüger-Genge A, Neffe AT, Lendlein A, Jung F. Monolayer formation and shear- resistance of human vein endothelial cells on gelatin-based hydrogels with tailorable elasticity and degradability. Clin Hemorheol Microcirc 2017; 64:699-710. [DOI: 10.3233/ch-168007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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22
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Liebler S, Grunert F, Thompson J, Wedel M, Schlosshauer B. Towards a biofunctionalized vascular prosthesis: immune cell trapping via a growth factor receptor. J Tissue Eng Regen Med 2016; 11:2699-2709. [PMID: 27225726 DOI: 10.1002/term.2165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 12/07/2015] [Accepted: 02/03/2016] [Indexed: 01/12/2023]
Abstract
To improve the clinical performance of vascular prostheses, which is inacceptably low for implants with small diameters (< 6 mm), biofunctionalization of synthetic implants by endothelialization has become a major, although still unreached, aim. In order to be able to recruit native endothelial progenitor cells (EPCs) to luminal implant surfaces from the blood stream, we generated monoclonal antibodies against the EPC-specific vascular endothelial growth factor receptor 2 (VEGFR-2). Employing the very efficient genetic immunization strategy, > 10 000 hybridoma clones were generated. Screening with various deletion mutants of VEGFR-2, 49 highly-specific monoclonal antibodies (mAbs) covering all seven Ig domains of VEGFR-2 were selected. mAb 9H10 was characterized in detail. Once immobilized on synthetic surfaces, mAb 9H10 allowed, within min, nearly 100-fold enrichment of VEGFR-2-expressing cells under continuous flow conditions. Cell trapping was cell-type specific and essentially not affected by competing VEGFR-2-negative cells. To exclude that the antibody would adversely modify receptor responses, four different in vitro assays were employed. Cell proliferation, angiogenic tube formation, acetylated low-density lipoprotein uptake and VEGFR-2 phosphorylation remained unaffected, suggesting that the antibody did not interfere with the receptor functioning of human umbilical vascular endothelial cells. The molecular and cellular characteristics make the selected monoclonal antibody a very promising tool for the biofunctionalization of vascular implants. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Sven Liebler
- Natural and Medical Sciences Institute (NMI), University of Tübingen, Reutlingen, Germany
| | | | | | - Miriam Wedel
- Natural and Medical Sciences Institute (NMI), University of Tübingen, Reutlingen, Germany
| | - Burkhard Schlosshauer
- Natural and Medical Sciences Institute (NMI), University of Tübingen, Reutlingen, Germany
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23
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Orynbayeva Z, Sensenig R, Polyak B. Metabolic and structural integrity of magnetic nanoparticle-loaded primary endothelial cells for targeted cell therapy. Nanomedicine (Lond) 2016; 10:1555-68. [PMID: 26008193 DOI: 10.2217/nnm.15.14] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
AIM To successfully translate magnetically mediated cell targeting from bench to bedside, there is a need to systematically assess the potential adverse effects of magnetic nanoparticles (MNPs) interacting with 'therapeutic' cells. Here, we examined in detail the effects of internalized polymeric MNPs on primary rat endothelial cells' structural intactness, metabolic integrity and proliferation potential. MATERIALS & METHODS The intactness of cytoskeleton and organelles was studied by fluorescent confocal microscopy, flow cytometry and high-resolution respirometry. RESULTS MNP-loaded primary endothelial cells preserve intact cytoskeleton and organelles, maintain normal rate of proliferation, calcium signaling and mitochondria energy metabolism. CONCLUSION This study provides supportive evidence that MNPs at doses necessary for targeting did not induce significant adverse effects on structural integrity and functionality of primary endothelial cells - potential cell therapy vectors.
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Affiliation(s)
- Zulfiya Orynbayeva
- 1Department of Surgery, Drexel University College of Medicine, Philadelphia, PA 19102, USA
| | - Richard Sensenig
- 2Department of Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Boris Polyak
- 1Department of Surgery, Drexel University College of Medicine, Philadelphia, PA 19102, USA
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24
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Vosen S, Rieck S, Heidsieck A, Mykhaylyk O, Zimmermann K, Bloch W, Eberbeck D, Plank C, Gleich B, Pfeifer A, Fleischmann BK, Wenzel D. Vascular Repair by Circumferential Cell Therapy Using Magnetic Nanoparticles and Tailored Magnets. ACS NANO 2016; 10:369-376. [PMID: 26736067 DOI: 10.1021/acsnano.5b04996] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Cardiovascular disease is often caused by endothelial cell (EC) dysfunction and atherosclerotic plaque formation at predilection sites. Also surgical procedures of plaque removal cause irreversible damage to the EC layer, inducing impairment of vascular function and restenosis. In the current study we have examined a potentially curative approach by radially symmetric re-endothelialization of vessels after their mechanical denudation. For this purpose a combination of nanotechnology with gene and cell therapy was applied to site-specifically re-endothelialize and restore vascular function. We have used complexes of lentiviral vectors and magnetic nanoparticles (MNPs) to overexpress the vasoprotective gene endothelial nitric oxide synthase (eNOS) in ECs. The MNP-loaded and eNOS-overexpressing cells were magnetic, and by magnetic fields they could be positioned at the vascular wall in a radially symmetric fashion even under flow conditions. We demonstrate that the treated vessels displayed enhanced eNOS expression and activity. Moreover, isometric force measurements revealed that EC replacement with eNOS-overexpressing cells restored endothelial function after vascular injury in eNOS(-/-) mice ex and in vivo. Thus, the combination of MNP-based gene and cell therapy with custom-made magnetic fields enables circumferential re-endothelialization of vessels and improvement of vascular function.
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Affiliation(s)
| | | | - Alexandra Heidsieck
- Zentralinstitut für Medizintechnik (IMETUM), TU München , München 85748, Germany
| | - Olga Mykhaylyk
- Institute of Experimental Oncology and Therapy Research, TU München , München 81675, Germany
| | | | - Wilhelm Bloch
- Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne , Cologne 50735, Germany
| | - Dietmar Eberbeck
- Physikalisch-Technische Bundesanstalt Berlin , Berlin 10587, Germany
| | - Christian Plank
- Institute of Experimental Oncology and Therapy Research, TU München , München 81675, Germany
| | - Bernhard Gleich
- Zentralinstitut für Medizintechnik (IMETUM), TU München , München 85748, Germany
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25
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Pang JH, Farhatnia Y, Godarzi F, Tan A, Rajadas J, Cousins BG, Seifalian AM. In situ Endothelialization: Bioengineering Considerations to Translation. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2015; 11:6248-64. [PMID: 26460851 DOI: 10.1002/smll.201402579] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 06/14/2015] [Indexed: 05/10/2023]
Abstract
Improving patency rates of current cardiovascular implants remains a major challenge. It is widely accepted that regeneration of a healthy endothelium layer on biomaterials could yield the perfect blood-contacting surface. Earlier efforts in pre-seeding endothelial cells in vitro demonstrated success in enhancing patency, but translation to the clinic is largely hampered due to its impracticality. In situ endothelialization, which aims to create biomaterial surfaces capable of self-endothelializing upon implantation, appears to be an extremely promising solution, particularly with the utilization of endothelial progenitor cells (EPCs). Nevertheless, controlling cell behavior in situ using immobilized biomolecules or physical patterning can be complex, thus warranting careful consideration. This review aims to provide valuable insight into the rationale and recent developments in biomaterial strategies to enhance in situ endothelialization. In particular, a discussion on the important bio-/nanoengineering considerations and lessons learnt from clinical trials are presented to aid the future translation of this exciting paradigm.
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Affiliation(s)
- Jun Hon Pang
- Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK
| | - Yasmin Farhatnia
- Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK
| | - Fatemeh Godarzi
- Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK
| | - Aaron Tan
- Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK
- UCL Medical School, University College London (UCL), London, UK
- Biomaterials & Advanced Drug Delivery Laboratory, Stanford School of Medicine, Stanford University, Stanford, California, USA
| | - Jayakumar Rajadas
- Biomaterials & Advanced Drug Delivery Laboratory, Stanford School of Medicine, Stanford University, Stanford, California, USA
| | - Brian G Cousins
- Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK
| | - Alexander M Seifalian
- Centre for Nanotechnology & Regenerative Medicine, Division of Surgery & Interventional Science, University College London (UCL), London, UK
- Royal Free Hospital, London, UK
- NanoRegMed Ltd, London, UK
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26
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Unterman S, Freiman A, Beckerman M, Abraham E, Stanley JR, Levy E, Artzi N, Edelman E. Tuning of collagen scaffold properties modulates embedded endothelial cell regulatory phenotype in repair of vascular injuries in vivo. Adv Healthc Mater 2015; 4:2220-8. [PMID: 26333178 PMCID: PMC4664078 DOI: 10.1002/adhm.201500457] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 07/31/2015] [Indexed: 01/08/2023]
Abstract
Perivascularly implanted matrix embedded endothelial cells (MEECs) are potent regulators of inflammation and intimal hyperplasia following vascular injuries. Endothelial cells (ECs) in collagen scaffolds adopt a reparative phenotype with significant therapeutic potential. Although the biology of MEECs is increasingly understood, tuning of scaffold properties to control cell-substrate interactions is less well-studied. It is hypothesized that modulating scaffold degradation would change EC phenotype. Scaffolds with differential degradation are prepared by cross-linking and predegradation. Vascular injury increases degradation and the presence of MEECs retards injury-mediated degradation. MEECs respond to differential scaffold properties with altered viability in vivo, suppressed smooth muscle cell (SMC) proliferation in vitro, and altered interleukin-6 and matrix metalloproteinase-9 expression. When implanted perivascularly to a murine carotid wire injury, tuned scaffolds change MEEC effects on vascular repair and inflammation. Live animal imaging enables real-time tracking of cell viability, inflammation, and scaffold degradation, affording an unprecedented understanding of interactions between cells, substrate, and tissue. MEEC-treated injuries improve endothelialization and reduce SMC hyperplasia over 14 d. These data demonstrate the potent role material design plays in tuning MEEC efficacy in vivo, with implications for the design of clinical therapies.
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Affiliation(s)
- Shimon Unterman
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Alina Freiman
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. Ort Braude College, Karmiel, Israel
| | - Margarita Beckerman
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. Ort Braude College, Karmiel, Israel
| | - Eytan Abraham
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - James R.L. Stanley
- CBSET, Inc., Concord Biomedical Sciences and Emerging Technologies, Lexington, MA 02421, USA
| | - Ela Levy
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. Ort Braude College, Karmiel, Israel
| | - Natalie Artzi
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. Department of Anesthesiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Elazer Edelman
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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27
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Lee MH, Kwon BJ, Koo MA, Jang EH, Seon GM, Park JC. Exovascular application of epigallocatechin-3-O-gallate-releasing electrospun poly(l-lactide glycolic acid) fiber sheets to reduce intimal hyperplasia in injured abdominal aorta. Biomed Mater 2015; 10:055010. [DOI: 10.1088/1748-6041/10/5/055010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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28
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Yang Y, Qi P, Yang Z, Huang N. Nitric oxide based strategies for applications of biomedical devices. BIOSURFACE AND BIOTRIBOLOGY 2015. [DOI: 10.1016/j.bsbt.2015.08.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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29
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Glynn JJ, Jones CM, Anderson DEJ, Pavcnik D, Hinds MT. In vivo assessment of two endothelialization approaches on bioprosthetic valves for the treatment of chronic deep venous insufficiency. J Biomed Mater Res B Appl Biomater 2015; 104:1610-1621. [PMID: 26316151 DOI: 10.1002/jbm.b.33507] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 08/06/2015] [Accepted: 08/14/2015] [Indexed: 12/28/2022]
Abstract
Chronic deep venous insufficiency is a debilitating disease with limited therapeutic interventions. A bioprosthetic venous valve could not only replace a diseased valve, but has the potential to fully integrate into the patient with a minimally invasive procedure. Previous work with valves constructed from small intestinal submucosa (SIS) showed improvements in patients' symptoms in clinical studies; however, substantial thickening of the implanted valve leaflets also occurred. As endothelial cells are key regulators of vascular homeostasis, their presence on the SIS valves may reduce the observed thickening. This work tested an off-the-shelf approach to capture circulating endothelial cells in vivo using biotinylated antikinase insert domain receptor antibodies in a suspended leaflet ovine model. The antibodies on SIS were oriented to promote cell capture and showed positive binding to endothelial cells in vitro; however, no differences were observed in leaflet thickness in vivo between antibody-modified and unmodified SIS. In an alternative approach, valves were pre-seeded with autologous endothelial cells and tested in vivo. Nearly all the implanted pre-seeded valves were patent and functioning; however, no statistical difference was observed in valve thickness with cell pre-seeding. Additional cell capture schemes or surface modifications should be examined to find an optimal method for encouraging SIS valve endothelialization to improve long-term valve function in vivo. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1610-1621, 2016.
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Affiliation(s)
- Jeremy J Glynn
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, 97239
| | - Casey M Jones
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, 97239.,Department of Chemistry, Lewis & Clark College, Portland, Oregon, 97219
| | - Deirdre E J Anderson
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, 97239
| | - Dusan Pavcnik
- Dotter Interventional Institute, Oregon Health & Science University, Portland, Oregon, 97239
| | - Monica T Hinds
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, 97239. .,Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, 97239. .,Department of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University, Beaverton, Oregon, 97006.
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30
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Bastijanic JM, Kligman FL, Marchant RE, Kottke-Marchant K. Dual biofunctional polymer modifications to address endothelialization and smooth muscle cell integration of ePTFE vascular grafts. J Biomed Mater Res A 2015; 104:71-81. [DOI: 10.1002/jbm.a.35541] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 07/10/2015] [Accepted: 07/14/2015] [Indexed: 01/02/2023]
Affiliation(s)
| | - Faina L. Kligman
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic; Cleveland Ohio
| | - Roger E. Marchant
- Department of Biomedical Engineering; Case Western Reserve University; Cleveland Ohio
| | - Kandice Kottke-Marchant
- Department of Biomedical Engineering; Case Western Reserve University; Cleveland Ohio
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic; Cleveland Ohio
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31
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Goh ET, Wong E, Farhatnia Y, Tan A, Seifalian AM. Accelerating in situ endothelialisation of cardiovascular bypass grafts. Int J Mol Sci 2014; 16:597-627. [PMID: 25551605 PMCID: PMC4307264 DOI: 10.3390/ijms16010597] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 12/19/2014] [Indexed: 12/18/2022] Open
Abstract
The patency of synthetic cardiovascular grafts in the long run is synonymous with their ability to inhibit the processes of intimal hyperplasia, thrombosis and calcification. In the human body, the endothelium of blood vessels exhibits characteristics that inhibit such processes. As such it is not surprising that research in tissue engineering is directed towards replicating the functionality of the natural endothelium in cardiovascular grafts. This can be done either by seeding the endothelium within the lumen of the grafts prior to implantation or by designing the graft such that in situ endothelialisation takes place after implantation. Due to certain difficulties identified with in vitro endothelialisation, in situ endothelialisation, which will be the focus of this article, has garnered interest in the last years. To promote in situ endothelialisation, the following aspects can be taken into account: (1) Endothelial progenital cell mobilization, adhesion and proliferation; (2) Regulating differentiation of progenitor cells to mature endothelium; (3) Preventing thrombogenesis and inflammation during endothelialisation. This article aims to review and compile recent developments to promote the in situ endothelialisation of cardiovascular grafts and subsequently improve their patency, which can also have widespread implications in the field of tissue engineering.
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Affiliation(s)
- Ee Teng Goh
- Centre for Nanotechnology & Regenerative Medicine, Research Department of Nanotechnology, UCL Division of Surgery & Interventional Science, University College London (UCL), London NW3 2QG, UK.
| | - Eleanor Wong
- Centre for Nanotechnology & Regenerative Medicine, Research Department of Nanotechnology, UCL Division of Surgery & Interventional Science, University College London (UCL), London NW3 2QG, UK.
| | - Yasmin Farhatnia
- Centre for Nanotechnology & Regenerative Medicine, Research Department of Nanotechnology, UCL Division of Surgery & Interventional Science, University College London (UCL), London NW3 2QG, UK.
| | - Aaron Tan
- Centre for Nanotechnology & Regenerative Medicine, Research Department of Nanotechnology, UCL Division of Surgery & Interventional Science, University College London (UCL), London NW3 2QG, UK.
| | - Alexander M Seifalian
- Centre for Nanotechnology & Regenerative Medicine, Research Department of Nanotechnology, UCL Division of Surgery & Interventional Science, University College London (UCL), London NW3 2QG, UK.
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Ghista DN, Kabinejadian F. Coronary artery bypass grafting hemodynamics and anastomosis design: a biomedical engineering review. Biomed Eng Online 2013; 12:129. [PMID: 24330653 PMCID: PMC3867628 DOI: 10.1186/1475-925x-12-129] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 12/10/2013] [Indexed: 12/24/2022] Open
Abstract
In this paper, coronary arterial bypass grafting hemodynamics and anastomosis designs are reviewed. The paper specifically addresses the biomechanical factors for enhancement of the patency of coronary artery bypass grafts (CABGs). Stenosis of distal anastomosis, caused by thrombosis and intimal hyperplasia (IH), is the major cause of failure of CABGs. Strong correlations have been established between the hemodynamics and vessel wall biomechanical factors and the initiation and development of IH and thrombus formation. Accordingly, several investigations have been conducted and numerous anastomotic geometries and devices have been designed to better regulate the blood flow fields and distribution of hemodynamic parameters and biomechanical factors at the distal anastomosis, in order to enhance the patency of CABGs. Enhancement of longevity and patency rate of CABGs can eliminate the need for re-operation and can significantly lower morbidity, and thereby reduces medical costs for patients suffering from coronary stenosis. This invited review focuses on various endeavors made thus far to design a patency-enhancing optimized anastomotic configuration for the distal junction of CABGs.
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Affiliation(s)
| | - Foad Kabinejadian
- Department of Biomedical Engineering, National University of Singapore, 9 Engineering Drive 1, Block EA #03-12, Singapore 117576, Singapore.
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Infusion of endothelial progenitor cells accelerates hematopoietic and immune reconstitution, and ameliorates the graft-versus-host disease after hematopoietic stem cell transplantation. Cell Biochem Biophys 2013; 64:213-22. [PMID: 22806343 DOI: 10.1007/s12013-012-9387-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Hematopoietic stem cells transplantation (HSCT) causes endothelial cell damage, disrupting hematopoietic microenviroment and leading to various complications. We hypothesized that infusion of endothelial progenitor cells (EPCs) may improve endothelium repair, facilitate hematopoietic reconstitution, and alleviate complications associated with HSCT. C57Bl6, and BALB/c mice received total body irradiation followed by infusion of C57Bl6-derived bone marrow (BM) cells, with or without concomitant infusion of C57Bl6-derived EPCs. The time course of hematopoietic and immune reconstitution and the severity of the graft-versus-host disease (GVHD) were monitored. Further, to confirm that EPCs promote endothelial cell recovery, HSCT mice were treated with anti-VE-cadherin antibody targeting the endothelium. The EPCs-treated mice exhibited accelerated recovery of BM vasculature, cellularity, hematopoietic stem and progenitor cell recovery, improved counts of lymphocyte subsets in peripheral blood, and facilitated spleen structure reconstruction. EPCs infusion also ameliorated the GVHD in the C57Bl6 → BALB/c allo-HSCT model. Systemic administration of anti-VE-cadherin antibody significantly delayed hematological and immune reconstitution in the EPCs-infused mice. In conclusion, our data demonstrate that infusion of EPCs augments the hematopoietic and immune reconstitution, and alleviates the GVHD. These findings further highlight the relationship between the microvascular recovery, hematopoietic and immune reconstitution, and the GVHD.
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Melchiorri AJ, Hibino N, Brandes ZR, Jonas RA, Fisher JP. Development and assessment of a biodegradable solvent cast polyester fabric small-diameter vascular graft. J Biomed Mater Res A 2013; 102:1972-1981. [PMID: 23852776 DOI: 10.1002/jbm.a.34872] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 06/28/2013] [Accepted: 07/08/2013] [Indexed: 01/22/2023]
Abstract
Adjusting the mechanical properties of polyester-based vascular grafts is crucial to achieving long-term success in vivo. Although previous studies using a fabric-based approach have achieved some success, a central issue with pure poly(lactic acid) (PLA) or poly(glycolic acid) (PGA) grafts sealed with poly(DL-caprolactone-co-lactic acid) (P(CL/LA)) has been stenosis. Intimal hyperplasia, a leading cause of stenosis, can be caused by the mechanical incompatibility of synthetic vascular grafts. Investigating the performance of poly(glycolic-co-lactic acid) (PGLA) grafts could lead to insight into whether graft stenosis stems from mechanical issues such as noncompliance and unfavorable degradation times. This could be achieved by examining grafts with tunable mechanical properties between the ranges of such properties in pure PGA and PLA-based grafts. In this study, we examined PGLA-based grafts sealed with different P(CL/LA) solutions to determine the PGLA-P(CL/LA) grafts' mechanical properties and tissue functionality. Cell attachment and proliferation on graft surfaces were also observed. For in vivo assessment, grafts were implanted in a mouse model. Mechanical properties and degradation times appeared adequate compared to recorded values of vessels used in autograft procedures. Initial neotissue formation was observed in the grafts and patency maintained during the pilot study. This study presents a ∼1-mm diameter degradable graft demonstrating suitable mechanical properties and in vivo pilot study success, enabling further investigation into the tuning of mechanical properties to reduce complications in degradable polyester fabric-based vascular grafts.
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Affiliation(s)
- Anthony J Melchiorri
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742
| | - Narutoshi Hibino
- Department of Cardiovascular Surgery, Children's National Medical Center, Washington, DC 20010
| | - Zachary R Brandes
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742
| | - Richard A Jonas
- Department of Cardiovascular Surgery, Children's National Medical Center, Washington, DC 20010
| | - John P Fisher
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742
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Wong CY, de Vries MR, Wang Y, van der Vorst JR, Vahrmeijer AL, van Zonneveld AJ, Roy-Chaudhury P, Rabelink TJ, Quax PHA, Rotmans JI. Vascular remodeling and intimal hyperplasia in a novel murine model of arteriovenous fistula failure. J Vasc Surg 2013; 59:192-201.e1. [PMID: 23684425 DOI: 10.1016/j.jvs.2013.02.242] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/06/2013] [Accepted: 02/21/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The arteriovenous fistula (AVF) still suffers from a high number of failures caused by insufficient outward remodeling and intimal hyperplasia (IH) formation from which the exact mechanism is largely unknown. A suitable animal model is of vital importance in the unraveling of the underlying pathophysiology. However, current murine models of AVF failure do not incorporate the surgical configuration that is commonly used in humans. Because the hemodynamic profile is one of the key determinants that play a role in vascular remodeling in the AVF, it is preferable to use this same configuration in an animal model. Here we describe a novel murine model of AVF failure in which the configuration (end-to-side) is similar to what is most frequently performed in humans. METHODS An AVF was created in 45 C57BL/6 mice by anastomosing the end of a branch of the external jugular vein to the side of the common carotid artery with interrupted sutures. The AVFs were harvested and analyzed histologically at days 7, 14, and 28. Identical veins of unoperated-on mice served as controls. Intravenous near-infrared fluorescent fluorophores were used to assess the patency of the fistula. RESULTS The patency rates at days 7, 14, and 28 days were 88%, 90%, and 50%, respectively. The mean circumference increased up to day 14, with a maximum 1.4-fold increase at day 7 compared with the control group (1.82 ± 0.7 vs 1.33 ± 0.3 mm; P = .443). Between days 14 and 28, the circumference remained constant (2.36 ± 0.2 vs 2.45 ± 0.2 mm; P = .996). At 7 days after surgery, the intimal area consisted mainly of an acellular layer that was structurally analogous to a focal adherent thrombus. Starting at 14 days after surgery, venous IH increased significantly compared with the unoperated-on group (14 days: 115,090 ± 22,594 μm(2), 28 days: 234,619 ± 47,828 μm(2), unoperated group: 2368 ± 1056 μm(2); P = .001 and P < .001, respectively) and was mainly composed of cells positive for α-smooth muscle actin. We observed leukocytes in the adventitial side of the vein at all time points. CONCLUSIONS Our novel murine AVF model, which incorporates a clinically relevant configuration of the anastomosis, displays similar features that are characteristic of failing human AVFs. Moreover, our findings suggest that coagulation and inflammation could both potentially play an important role in the formation of IH and subsequent AVF failure. Near-infrared fluoroscopy was a suitable alternative for conventional imaging techniques. This murine AVF-model is a valuable addition to the AVF animal model arsenal.
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Affiliation(s)
- Chun-Yu Wong
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Margreet R de Vries
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Yang Wang
- Division of Nephrology, University of Cincinnati, Cincinnati, Ohio
| | | | | | - Anton Jan van Zonneveld
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Ton J Rabelink
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul H A Quax
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands; Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Joris I Rotmans
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands.
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Melchiorri AJ, Hibino N, Fisher JP. Strategies and techniques to enhance the in situ endothelialization of small-diameter biodegradable polymeric vascular grafts. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:292-307. [PMID: 23252992 DOI: 10.1089/ten.teb.2012.0577] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Due to the lack of success in small-diameter (<6 mm) prosthetic vascular grafts, a variety of strategies have evolved utilizing a tissue-engineering approach. Much of this work has focused on enhancing the endothelialization of these grafts. A healthy, confluent endothelial layer provides dynamic control over homeo-stasis, influencing and preventing thrombosis and smooth muscle cell proliferation that can lead to intimal hyperplasia. Strategies to improve endothelialization of biodegradable polymeric grafts have encompassed both chemical and physical modifications to graft surfaces, many focusing on the recruitment of endothelial and endothelial progenitor cells. This review aims to provide a compilation of current and developing strategies that utilize in situ endothelialization to improve vascular graft outcomes, providing a context for the future directions of vascular tissue-engineering strategies that do not require preprocedural cell seeding.
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Affiliation(s)
- Anthony J Melchiorri
- Fischell Department of Bioengineering, University of Maryland, College Park, Maryland 20742, USA.
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Naghavi N, de Mel A, Alavijeh OS, Cousins BG, Seifalian AM. Nitric oxide donors for cardiovascular implant applications. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2013; 9:22-35. [PMID: 23136136 DOI: 10.1002/smll.201200458] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 06/13/2012] [Indexed: 06/01/2023]
Abstract
In an era of increased cardiovascular disease burden in the ageing population, there is great demand for devices that come in to contact with the blood such as heart valves, stents, and bypass grafts that offer life saving treatments. Nitric oxide (NO) elution from healthy endothelial tissue that lines the vessels maintains haemostasis throughout the vasculature. Surgical devices that release NO are desirable treatment options and N-diazeniumdiolates and S-nitrosothiols are recognized as preferred donor molecules. There is a keen interest to investigate newer methods by which NO donors can be retained within biomaterials so that their release and kinetic profiles can be optimized. A range of polymeric scaffolds incorporating microparticles and nanomaterials are presenting solutions to current challenges, and have been investigated in a range of clinical applications. This review outlines the application of NO donors for cardiovascular therapy using biomaterials that release NO locally to prevent thrombosis and intimal hyperplasia (IH) and enhance endothelialization in the fabrication of next generation cardiovascular device technology.
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Affiliation(s)
- Noora Naghavi
- UCL Centre for Nanotechnology & Regenerative Medicine, University College London, UK
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Cooke JP, Ghebremariam YT. Dietary nitrate, nitric oxide, and restenosis. J Clin Invest 2011; 121:1258-60. [PMID: 21436578 DOI: 10.1172/jci57193] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Endothelium-derived NO controls the contractility and growth state of the underlying vascular smooth muscle cells and regulates the interaction of the vessel wall with circulating blood elements. Acute injury of the vessel wall denudes the endothelial lining, removing homeostatic regulation and precipitating a wave of events leading to myointimal hyperplasia. In this issue of the JCI, Alef and colleagues provide evidence that in the injured vessel wall, the disruption of the NOS pathway is countered by induction of xanthine oxidoreductase, an enzyme capable of producing NO from nitrite. In addition, they link low dietary nitrite levels to increased severity of myointimal hyperplasia following vessel injury in mice.
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Affiliation(s)
- John P Cooke
- Stanford Cardiovascular Institute, Stanford, California 94305, USA
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Sauter A, Arthasana D, Dittmann H, Pritzkow M, Wiesinger B, Schmehl J, Brechtel K, Bantleon R, Claussen C, Kehlbach R. In vitro comparison of the antiproliferative effects of rhenium-186 and rhenium-188 on human aortic endothelial cells. Cardiovasc Intervent Radiol 2010; 34:816-23. [PMID: 21046387 DOI: 10.1007/s00270-010-0003-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 09/20/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE Rhenium-186 ((186)Re) and rhenium-188 ((188)Re) are promising radionuclides for the inhibition of restenosis after percutaneous transluminal angioplasty or other vascular interventions. Until now the maximal dose tolerance of endothelial cells has not been clearly known. MATERIALS AND METHODS To characterize the effects of local irradiation treatment, human aortic endothelial cells (ECs) were incubated with different doses of (186)Re and (188)Re. Two days after plating, ECs received treatment for a period of 5 days. The total radiation doses applied were 1, 4, 8, 16, and 32 Gy. On days 1, 3, 5, 7, and 12 after initial rhenium incubation, cell growth, clonogenic activity, cell-cycle distribution, and cytoskeletal architecture were evaluated. RESULTS From the first day on, a dose-dependent growth inhibition was observed. Cumulative doses of ≥32 Gy caused a weak colony formation and significant alterations in the cytoskeletal architecture. An increased fraction of cells in G2/M phase was seen for cumulative radiation doses of ≥16 Gy. Interestingly, there were no significant differences between (186)Re and (188)Re. CONCLUSION Even for low dose rates of β particles a dose-dependent proliferation inhibition of ECs is seen. Doses beyond 32 Gy alter the cytoskeletal architecture with possibly endothelial dysfunction and late thrombosis.
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Affiliation(s)
- Alexander Sauter
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Str. 3 72076, Tuebingen, Germany.
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