1
|
Dobrzyńska-Mizera M, Dodda JM, Liu X, Knitter M, Oosterbeek RN, Salinas P, Pozo E, Ferreira AM, Sadiku ER. Engineering of Bioresorbable Polymers for Tissue Engineering and Drug Delivery Applications. Adv Healthc Mater 2024:e2401674. [PMID: 39233521 DOI: 10.1002/adhm.202401674] [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: 05/06/2024] [Revised: 08/15/2024] [Indexed: 09/06/2024]
Abstract
Herein, the recent advances in the development of resorbable polymeric-based biomaterials, their geometrical forms, resorption mechanisms, and their capabilities in various biomedical applications are critically reviewed. A comprehensive discussion of the engineering approaches for the fabrication of polymeric resorbable scaffolds for tissue engineering, drug delivery, surgical, cardiological, aesthetical, dental and cardiovascular applications, are also explained. Furthermore, to understand the internal structures of resorbable scaffolds, representative studies of their evaluation by medical imaging techniques, e.g., cardiac computer tomography, are succinctly highlighted. This approach provides crucial clinical insights which help to improve the materials' suitable and viable characteristics for them to meet the highly restrictive medical requirements. Finally, the aspects of the legal regulations and the associated challenges in translating research into desirable clinical and marketable materials of polymeric-based formulations, are presented.
Collapse
Affiliation(s)
- Monika Dobrzyńska-Mizera
- Institute of Materials Technology, Polymer Division, Poznan University of Technology, Poznan, Poland
| | - Jagan Mohan Dodda
- New Technologies - Research Centre (NTC), University of West Bohemia, Univerzitní 8, Pilsen, 30100, Czech Republic
| | - Xiaohua Liu
- Chemical and Biomedical Engineering Department, University of Missouri, 1030 Hill Street, Columbia, Missouri, 65211, USA
| | - Monika Knitter
- Institute of Materials Technology, Polymer Division, Poznan University of Technology, Poznan, Poland
| | - Reece N Oosterbeek
- Department of Engineering Science, University of Oxford, Parks Road, Oxford, OX1 3PJ, UK
| | - Pablo Salinas
- Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Eduardo Pozo
- Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Ana Marina Ferreira
- School of Engineering, Newcastle University, Newcastle upon Tyne, Newcastle, NE1 7RU, UK
| | - Emmanuel Rotimi Sadiku
- Tshwane University of Technology, Department of Chemical, Metallurgical and Materials Engineering, Polymer Division & Institute for Nano Engineering Research (INER), Pretoria West Campus, Pretoria, South Africa
| |
Collapse
|
2
|
De Jesus Morales KJ, Santosa U, Brazhkina O, Rajurkar P, Jo H, Davis ME. A Biomimetic Leaflet Scaffold for Aortic Valve Remodeling. Adv Healthc Mater 2024; 13:e2303972. [PMID: 38692263 DOI: 10.1002/adhm.202303972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/28/2024] [Indexed: 05/03/2024]
Abstract
Heart valve disease poses a significant clinical challenge, especially in pediatric populations, due to the inability of existing valve replacements to grow or respond biologically to their microenvironment. Tissue-engineered heart valves (TEHVs) provide a solution by facilitating patient-specific models for self-repair and remodeling. In this study, a 3D-bioprinted TEHV is designed to emulate the trilayer leaflet structure of an aortic valve. A cell-laden hydrogel scaffold made from gelatin methacrylate and polyethylene glycol diacrylate (GelMA/PEGDA) incorporates valvular interstitial-like (VIC-like) cells, being reinforced with a layer of polycaprolactone (PCL). The composition of the hydrogel scaffold remains stable over 7 days, having increased mechanical strength compared to pure GelMA. The scaffold maintains VIC-like cell function and promotes extracellular matrix (ECM) protein expression up to 14 days under two dynamic culture conditions: shear stress and stretching; replicating heart valve behavior within a more physiological-like setting and suggesting remodeling potential via ECM synthesis. This TEHV offers a promising avenue for valve replacements, closely replicating the structural and functional attributes of a native aortic valve, leading to mechanical and biological integration through biomaterial-cellular interactions.
Collapse
Affiliation(s)
- Kenneth J De Jesus Morales
- Wallace H. Coulter Department of Biomedical Engineering, Emory University School of Medicine & Georgia Institute of Technology, Atlanta, GA, 30322, USA
| | - Utari Santosa
- Wallace H. Coulter Department of Biomedical Engineering, Emory University School of Medicine & Georgia Institute of Technology, Atlanta, GA, 30322, USA
| | - Olga Brazhkina
- Wallace H. Coulter Department of Biomedical Engineering, Emory University School of Medicine & Georgia Institute of Technology, Atlanta, GA, 30322, USA
| | - Pranshu Rajurkar
- Wallace H. Coulter Department of Biomedical Engineering, Emory University School of Medicine & Georgia Institute of Technology, Atlanta, GA, 30322, USA
| | - Hanjoong Jo
- Wallace H. Coulter Department of Biomedical Engineering, Emory University School of Medicine & Georgia Institute of Technology, Atlanta, GA, 30322, USA
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, 30322, USA
| | - Michael E Davis
- Wallace H. Coulter Department of Biomedical Engineering, Emory University School of Medicine & Georgia Institute of Technology, Atlanta, GA, 30322, USA
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, 30322, USA
- Children's Heart Research & Outcomes (HeRO) Center, Children's Healthcare of Atlanta & Emory University, Atlanta, GA, 30322, USA
| |
Collapse
|
3
|
Wu H, Chen N, Zheng T, Li L, Hu M, Qin Y, Guo G, Yang L, Wang Y. A strategy for mechanically integrating robust hydrogel-tissue hybrid to promote the anti-calcification and endothelialization of bioprosthetic heart valve. Regen Biomater 2024; 11:rbae003. [PMID: 38414796 PMCID: PMC10898858 DOI: 10.1093/rb/rbae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/09/2024] [Indexed: 02/29/2024] Open
Abstract
Bioprosthetic heart valve (BHV) replacement has been the predominant treatment for severe heart valve diseases over decades. Most clinically available BHVs are crosslinked by glutaraldehyde (GLUT), while the high toxicity of residual GLUT could initiate calcification, severe thrombosis, and delayed endothelialization. Here, we construed a mechanically integrating robust hydrogel-tissue hybrid to improve the performance of BHVs. In particular, recombinant humanized collagen type III (rhCOLIII), which was precisely customized with anti-coagulant and pro-endothelialization bioactivity, was first incorporated into the polyvinyl alcohol (PVA)-based hydrogel via hydrogen bond interactions. Then, tannic acid was introduced to enhance the mechanical performance of PVA-based hydrogel and interfacial bonding between the hydrogel layer and bio-derived tissue due to the strong affinity for a wide range of substrates. In vitro and in vivo experimental results confirmed that the GLUT-crosslinked BHVs modified by the robust PVA-based hydrogel embedded rhCOLIII and TA possessed long-term anti-coagulant, accelerated endothelialization, mild inflammatory response and anti-calcification properties. Therefore, our mechanically integrating robust hydrogel-tissue hybrid strategy showed the potential to enhance the service function and prolong the service life of the BHVs after implantation.
Collapse
Affiliation(s)
- Haoshuang Wu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610065, China
| | - Nuoya Chen
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610065, China
| | - Tiantian Zheng
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610065, China
| | - Li Li
- Institute of Clinical Pathology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Mengyue Hu
- College of Polymer Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Yumei Qin
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610065, China
| | - Gaoyang Guo
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610065, China
| | - Li Yang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610065, China
| | - Yunbing Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610065, China
| |
Collapse
|
4
|
Snyder Y, Jana S. Strategies for Development of Synthetic Heart Valve Tissue Engineering Scaffolds. PROGRESS IN MATERIALS SCIENCE 2023; 139:101173. [PMID: 37981978 PMCID: PMC10655624 DOI: 10.1016/j.pmatsci.2023.101173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
The current clinical solutions, including mechanical and bioprosthetic valves for valvular heart diseases, are plagued by coagulation, calcification, nondurability, and the inability to grow with patients. The tissue engineering approach attempts to resolve these shortcomings by producing heart valve scaffolds that may deliver patients a life-long solution. Heart valve scaffolds serve as a three-dimensional support structure made of biocompatible materials that provide adequate porosity for cell infiltration, and nutrient and waste transport, sponsor cell adhesion, proliferation, and differentiation, and allow for extracellular matrix production that together contributes to the generation of functional neotissue. The foundation of successful heart valve tissue engineering is replicating native heart valve architecture, mechanics, and cellular attributes through appropriate biomaterials and scaffold designs. This article reviews biomaterials, the fabrication of heart valve scaffolds, and their in-vitro and in-vivo evaluations applied for heart valve tissue engineering.
Collapse
Affiliation(s)
- Yuriy Snyder
- Department of Bioengineering, University of Missouri, Columbia, MO 65211, USA
| | - Soumen Jana
- Department of Bioengineering, University of Missouri, Columbia, MO 65211, USA
| |
Collapse
|
5
|
Abourehab MAS, Baisakhiya S, Aggarwal A, Singh A, Abdelgawad MA, Deepak A, Ansari MJ, Pramanik S. Chondroitin sulfate-based composites: a tour d'horizon of their biomedical applications. J Mater Chem B 2022; 10:9125-9178. [PMID: 36342328 DOI: 10.1039/d2tb01514e] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Chondroitin sulfate (CS), a natural anionic mucopolysaccharide, belonging to the glycosaminoglycan family, acts as the primary element of the extracellular matrix (ECM) of diverse organisms. It comprises repeating units of disaccharides possessing β-1,3-linked N-acetyl galactosamine (GalNAc), and β-1,4-linked D-glucuronic acid (GlcA), and exhibits antitumor, anti-inflammatory, anti-coagulant, anti-oxidant, and anti-thrombogenic activities. It is a naturally acquired bio-macromolecule with beneficial properties, such as biocompatibility, biodegradability, and immensely low toxicity, making it the center of attention in developing biomaterials for various biomedical applications. The authors have discussed the structure, unique properties, and extraction source of CS in the initial section of this review. Further, the current investigations on applications of CS-based composites in various biomedical fields, focusing on delivering active pharmaceutical compounds, tissue engineering, and wound healing, are discussed critically. In addition, the manuscript throws light on preclinical and clinical studies associated with CS composites. A short section on Chondroitinase ABC has also been canvassed. Finally, this review emphasizes the current challenges and prospects of CS in various biomedical fields.
Collapse
Affiliation(s)
- Mohammed A S Abourehab
- Department of Pharmaceutics, College of Pharmacy, Umm Al Qura University, Makkah 21955, Saudi Arabia. .,Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Minia University, Minia 11566, Egypt
| | - Shreya Baisakhiya
- Department of Biotechnology and Medical Engineering, National Institute of Technology Rourkela, Sector 1, Rourkela, Odisha 769008, India.,School of Chemical and Biotechnology, SASTRA Deemed University, Thanjavur, Tamil Nadu 613401, India
| | - Akanksha Aggarwal
- Delhi Institute of Pharmaceutical Sciences and Research, Delhi Pharmaceutical Sciences and Research University, New Delhi, 110017, India
| | - Anshul Singh
- Department of Chemistry, Baba Mastnath University, Rohtak-124021, India
| | - Mohamed A Abdelgawad
- Department of Pharmaceutical Chemistry, College of Pharmacy, Jouf University, Sakaka, Al Jouf 72341, Saudi Arabia
| | - A Deepak
- Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai 600128, Tamil Nadu, India.
| | - Mohammad Javed Ansari
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia
| | - Sheersha Pramanik
- Department of Biotechnology, Bhupat and Jyoti Mehta School of Biosciences, Indian Institute of Technology Madras, Chennai 600036, Tamil Nadu, India.
| |
Collapse
|
6
|
Li C, Zhou Y, Liu S, Guo R, Lu C, Yin D, Zhang Y, Xu X, Dong N, Shi J. Surface Modification of Decellularized Heart Valve by the POSS-PEG Hybrid Hydrogel to Prepare a Composite Scaffold Material with Anticalcification Potential. ACS APPLIED BIO MATERIALS 2022; 5:3923-3935. [PMID: 35867892 DOI: 10.1021/acsabm.2c00449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Tissue-engineered heart valves (TEHVs) are the most promising replacement for heart valve transplantation. Decellularized heart valve (DHV) is one of the most common scaffold materials for TEHVs. In actual clinical applications, the most widely used method for treating DHV is cross-linking it with glutaraldehyde, but this method could cause serious problems such as calcification. In this study, we introduced polyhedral oligomeric silsesquioxane (POSS) nanoparticles into a poly(ethylene glycol) (PEG) hydrogel to prepare a POSS-PEG hybrid hydrogel, and then coated them on the surface of DHV to prepare the composite scaffold. The chemical structures, microscopic morphologies, cell compatibilities, blood compatibilities, and anticalcification properties were further investigated. Experimental results showed that the composite scaffold had good blood compatibility and excellent cell compatibility and could promote cell adhesion and proliferation. In vivo and in vitro anticalcification experiments showed that the introduction of POSS nanoparticles could reduce the degree of calcification significantly and the composite scaffold had obvious anticalcification ability. The DHV surface-coated with the POSS-PEG hybrid hydrogel is an alternative scaffold material with anticalcification potential for an artificial heart valve, which provides an idea for the preparation of TEHVs.
Collapse
Affiliation(s)
- Chuang Li
- State Key Laboratory of Biocatalysis and Enzyme Engineering & Collaborative Innovation Center for Advanced Organic Chemical Materials Co-Constructed by the Province and Ministry, Hubei University, Wuhan 430062, China
| | - Ying Zhou
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Siju Liu
- State Key Laboratory of Biocatalysis and Enzyme Engineering & Collaborative Innovation Center for Advanced Organic Chemical Materials Co-Constructed by the Province and Ministry, Hubei University, Wuhan 430062, China
| | - Renqi Guo
- State Key Laboratory of Biocatalysis and Enzyme Engineering & Collaborative Innovation Center for Advanced Organic Chemical Materials Co-Constructed by the Province and Ministry, Hubei University, Wuhan 430062, China
| | - Cuifen Lu
- State Key Laboratory of Biocatalysis and Enzyme Engineering & Collaborative Innovation Center for Advanced Organic Chemical Materials Co-Constructed by the Province and Ministry, Hubei University, Wuhan 430062, China
| | - Dan Yin
- State Key Laboratory of Biocatalysis and Enzyme Engineering & Collaborative Innovation Center for Advanced Organic Chemical Materials Co-Constructed by the Province and Ministry, Hubei University, Wuhan 430062, China
| | - Yuhong Zhang
- State Key Laboratory of Biocatalysis and Enzyme Engineering & Collaborative Innovation Center for Advanced Organic Chemical Materials Co-Constructed by the Province and Ministry, Hubei University, Wuhan 430062, China
| | - Xu Xu
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Nianguo Dong
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jiawei Shi
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| |
Collapse
|
7
|
Natural Polymers in Heart Valve Tissue Engineering: Strategies, Advances and Challenges. Biomedicines 2022; 10:biomedicines10051095. [PMID: 35625830 PMCID: PMC9139175 DOI: 10.3390/biomedicines10051095] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 12/04/2022] Open
Abstract
In the history of biomedicine and biomedical devices, heart valve manufacturing techniques have undergone a spectacular evolution. However, important limitations in the development and use of these devices are known and heart valve tissue engineering has proven to be the solution to the problems faced by mechanical and prosthetic valves. The new generation of heart valves developed by tissue engineering has the ability to repair, reshape and regenerate cardiac tissue. Achieving a sustainable and functional tissue-engineered heart valve (TEHV) requires deep understanding of the complex interactions that occur among valve cells, the extracellular matrix (ECM) and the mechanical environment. Starting from this idea, the review presents a comprehensive overview related not only to the structural components of the heart valve, such as cells sources, potential materials and scaffolds fabrication, but also to the advances in the development of heart valve replacements. The focus of the review is on the recent achievements concerning the utilization of natural polymers (polysaccharides and proteins) in TEHV; thus, their extensive presentation is provided. In addition, the technological progresses in heart valve tissue engineering (HVTE) are shown, with several inherent challenges and limitations. The available strategies to design, validate and remodel heart valves are discussed in depth by a comparative analysis of in vitro, in vivo (pre-clinical models) and in situ (clinical translation) tissue engineering studies.
Collapse
|
8
|
Tandon I, Ozkizilcik A, Ravishankar P, Balachandran K. Aortic valve cell microenvironment: Considerations for developing a valve-on-chip. BIOPHYSICS REVIEWS 2021; 2:041303. [PMID: 38504720 PMCID: PMC10903420 DOI: 10.1063/5.0063608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/15/2021] [Indexed: 03/21/2024]
Abstract
Cardiac valves are sophisticated, dynamic structures residing in a complex mechanical and hemodynamic environment. Cardiac valve disease is an active and progressive disease resulting in severe socioeconomic burden, especially in the elderly. Valve disease also leads to a 50% increase in the possibility of associated cardiovascular events. Yet, valve replacement remains the standard of treatment with early detection, mitigation, and alternate therapeutic strategies still lacking. Effective study models are required to further elucidate disease mechanisms and diagnostic and therapeutic strategies. Organ-on-chip models offer a unique and powerful environment that incorporates the ease and reproducibility of in vitro systems along with the complexity and physiological recapitulation of the in vivo system. The key to developing effective valve-on-chip models is maintaining the cell and tissue-level microenvironment relevant to the study application. This review outlines the various components and factors that comprise and/or affect the cell microenvironment that ought to be considered while constructing a valve-on-chip model. This review also dives into the advancements made toward constructing valve-on-chip models with a specific focus on the aortic valve, that is, in vitro studies incorporating three-dimensional co-culture models that incorporate relevant extracellular matrices and mechanical and hemodynamic cues.
Collapse
Affiliation(s)
- Ishita Tandon
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas 72701, USA
| | - Asya Ozkizilcik
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas 72701, USA
| | - Prashanth Ravishankar
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas 72701, USA
| | - Kartik Balachandran
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas 72701, USA
| |
Collapse
|
9
|
Ground M, Waqanivavalagi S, Walker R, Milsom P, Cornish J. Models of immunogenicity in preclinical assessment of tissue engineered heart valves. Acta Biomater 2021; 133:102-113. [PMID: 34082103 DOI: 10.1016/j.actbio.2021.05.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 12/20/2022]
Abstract
Tissue engineered heart valves may one day offer an exciting alternative to traditional valve prostheses. Methods of construction vary, from decellularised animal tissue to synthetic hydrogels, but the goal is the same: the creation of a 'living valve' populated with autologous cells that may persist indefinitely upon implantation. Previous failed attempts in humans have highlighted the difficulty in predicting how a novel heart valve will perform in vivo. A significant hurdle in bringing these prostheses to market is understanding the immune reaction in the short and long term. With respect to innate immunity, the chronic remodelling of a tissue engineered implant by macrophages remains poorly understood. Also unclear are the mechanisms behind unknown antigens and their effect on the adaptive immune system. No silver bullet exists, rather researchers must draw upon a number of in vitro and in vivo models to fully elucidate the effect a host will exert on the graft. This review details the methods by which the immunogenicity of tissue engineered heart valves may be investigated and reveals areas that would benefit from more research. STATEMENT OF SIGNIFICANCE: Both academic and private institutions around the world are committed to the creation of a valve prosthesis that will perform safely upon implantation. To date, however, no truly non-immunogenic valves have emerged. This review highlights the importance of preclinical immunogenicity assessment, and summarizes the available techniques used in vitro and in vivo to elucidate the immune response. To the authors knowledge, this is the first review that details the immune testing regimen specific to a TEHV candidate.
Collapse
|
10
|
Chronic High Glucose Concentration Induces Inflammatory and Remodeling Changes in Valvular Endothelial Cells and Valvular Interstitial Cells in a Gelatin Methacrylate 3D Model of the Human Aortic Valve. Polymers (Basel) 2020; 12:polym12122786. [PMID: 33255639 PMCID: PMC7760928 DOI: 10.3390/polym12122786] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 12/17/2022] Open
Abstract
Calcific aortic valve disease (CAVD), a degenerative disease characterized by inflammation, fibrosis and calcification, is accelerated in diabetes. Hyperglycemia contributes to this process by mechanisms that still need to be uncovered. We have recently developed a 3D model of the human aortic valve based on gelatin methacrylate and revealed that high glucose (HG) induced osteogenic molecules and increased calcium deposits in a pro-osteogenic environment. To further understand the events leading to calcification in diabetic conditions in CAVD, we analyzed here the inflammatory and remodeling mechanisms induced by HG in our 3D model. We exposed valvular endothelial cells (VEC) and interstitial cells (VIC) to normal glucose (NG) or HG for 7 and 14 days, then we isolated and separated the cells by anti-CD31 immunomagnetic beads. The changes induced by HG in the 3D model were investigated by real-time polymerase chain reaction (RT-PCR), Western blot, enzyme-linked immunosorbent assay (ELISA) and immunofluorescence. Our results showed that HG induced expression of different cytokines, cell adhesion molecules and matrix metalloproteinases in VEC and VIC. In addition, protein kinase C was increased in VEC and VIC, indicating molecular mechanisms associated with HG induced inflammation and remodeling in both valvular cells. These findings may indicate new biomarkers and targets for therapy in diabetes associated with CAVD.
Collapse
|
11
|
Pohan G, Mattiassi S, Yao Y, Zaw AM, Anderson DE, Cutiongco MF, Hinds MT, Yim EK. Effect of Ethylene Oxide Sterilization on Polyvinyl Alcohol Hydrogel Compared with Gamma Radiation. Tissue Eng Part A 2020; 26:1077-1090. [PMID: 32264787 PMCID: PMC7580577 DOI: 10.1089/ten.tea.2020.0002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/06/2020] [Indexed: 12/21/2022] Open
Abstract
This study investigated the effects of terminal sterilization of polyvinyl alcohol (PVA) biomaterials using clinically translatable techniques, specifically ethylene oxide (EtO) and gamma (γ) irradiation. While a few studies have reported the possibility of sterilizing PVA with γ-radiation, the use of EtO sterilization of PVA requires additional study. PVA solutions were chemically crosslinked with trisodium trimetaphosphate and sodium hydroxide. The three experimental groups included untreated control, EtO, and γ-irradiation, which were tested for the degree of swelling and water content, and mechanical properties such as radial compliance, longitudinal tensile, minimum bend radius, burst pressure, and suture retention strength. In addition, samples were characterized with scanning electron microscopy, differential scanning calorimetry, X-ray photoelectron spectroscopy, and water contact angle measurements. Cell attachment was assessed using the endothelial cell line EA.hy926, and the sterilized PVA cytotoxicity was studied with a live/dead stain. Platelet and fibrin accumulation was measured using an ex vivo shunt baboon model. Finally, the immune responses of PVA implants were analyzed after a 21-day subcutaneous implantation in rats and a 30-day implantation in baboon. EtO sterilization reduced the PVA graft wall thickness, its degree of swelling, and water content compared with both γ-irradiated and untreated PVA. Moreover, EtO sterilization significantly reduced the radial compliance and increased Young's modulus. EtO did not change PVA hydrophilicity, while γ-irradiation increased the water contact angle of the PVA. Consequently, endothelial cell attachment on the EtO-sterilized PVA showed similar results to the untreated PVA, while cell attachment significantly improved on the γ-irradiated PVA. When exposing the PVA grafts to circulating whole blood, fibrin accumulation of EtO-sterilized PVA was found to be significantly lower than γ-irradiated PVA. The immune responses of γ-irradiated PVA, EtO-treated PVA, and untreated PVA were compared. Implanted EtO-treated PVA showed the least MAC387 reaction. The terminal sterilization methods in this study changed PVA hydrogel properties; nevertheless, based on the characterizations performed, both sterilization methods were suitable for sterilizing PVA. We concluded that EtO can be used as an alternative method to sterilize PVA hydrogel material. Impact statement Polyvinyl alcohol (PVA) hydrogels have been used for a variety of tissue replacements, including neural, cardiac, meniscal, cartilage, muscle, pancreatic, and ocular applications. In addition, PVA can be made into a tubular shape and used as a small-diameter vascular graft. Ethylene oxide (EtO) is one of the Food and Drug Administration-approved methods for sterilization, but its effect on PVA has not been studied extensively. The outcome of this study provides the effects of EtO and γ-irradiation of PVA grafts on both the material properties and the in vivo responses, particularly for vascular applications. Knowledge of these effects may ultimately improve the success rate of PVA vascular grafts.
Collapse
Affiliation(s)
- Grace Pohan
- Department of Chemical Engineering, University of Waterloo, Waterloo, Canada
| | - Sabrina Mattiassi
- Department of Chemical Engineering, University of Waterloo, Waterloo, Canada
| | - Yuan Yao
- Department of Chemical Engineering, University of Waterloo, Waterloo, Canada
| | - Aung Moe Zaw
- Department of Chemical Engineering, University of Waterloo, Waterloo, Canada
| | - Deirdre E.J. Anderson
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA
| | - Marie F.A. Cutiongco
- Mechanobiology Institute Singapore, National University of Singapore, Singapore, Singapore
| | - Monica T. Hinds
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA
| | - Evelyn K.F. Yim
- Department of Chemical Engineering, University of Waterloo, Waterloo, Canada
- Center for Biotechnology and Bioengineering, University of Waterloo, Waterloo, Canada
- Waterloo Institute for Nanotechnology, University of Waterloo, Waterloo, Canada
| |
Collapse
|
12
|
Ravishankar P, Ozkizilcik A, Husain A, Balachandran K. Anisotropic Fiber-Reinforced Glycosaminoglycan Hydrogels for Heart Valve Tissue Engineering. Tissue Eng Part A 2020; 27:513-525. [PMID: 32723024 DOI: 10.1089/ten.tea.2020.0118] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
This study investigates polymer fiber-reinforced protein-polysaccharide-based hydrogels for heart valve tissue engineering applications. Polycaprolactone and gelatin (3:1) blends were jet-spun to fabricate aligned fibers that possessed fiber diameters in the range found in the native heart valve. These fibers were embedded in methacrylated hydrogels made from gelatin, sodium hyaluronate, and chondroitin sulfate to create fiber-reinforced hydrogel composites (HCs). The fiber-reinforced gelatin glycosaminoglycan (GAG)-based HC possessed interconnected porous structures and porosity higher than fiber-only conditions. These fiber-reinforced HCs exhibited compressive modulus and biaxial mechanical behavior comparable to that of native porcine aortic valves. The fiber-reinforced HCs were able to swell higher and degraded less than the hydrogels. Elution studies revealed that less than 20% of incorporated gelatin methacrylate and GAGs were released over 2 weeks, with a steady-state release after the first day. When cultured with porcine valve interstitial cells (VICs), the fiber-reinforced composites were able to maintain higher cell viability compared with fiber-only samples. Quiescent VICs expressed alpha smooth muscle actin and calponin showing an activated phenotype, along with a few cells expressing the proliferation marker Ki67 and negative expression for RUNX2, an osteogenic marker. Our study demonstrated that compared with the hydrogels and fibers alone, combining both components can yield durable, reinforced composites that mimic heart valve mechanical behavior, while maintaining high cell viability and expressing positive activation as well as proliferation markers.
Collapse
Affiliation(s)
- Prashanth Ravishankar
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas, USA
| | - Asya Ozkizilcik
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas, USA
| | - Anushae Husain
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas, USA
| | - Kartik Balachandran
- Department of Biomedical Engineering, University of Arkansas, Fayetteville, Arkansas, USA
| |
Collapse
|
13
|
|
14
|
Oveissi F, Naficy S, Lee A, Winlaw D, Dehghani F. Materials and manufacturing perspectives in engineering heart valves: a review. Mater Today Bio 2020; 5:100038. [PMID: 32211604 PMCID: PMC7083765 DOI: 10.1016/j.mtbio.2019.100038] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 12/27/2022] Open
Abstract
Valvular heart diseases (VHD) are a major health burden, affecting millions of people worldwide. The treatments for such diseases rely on medicine, valve repair, and artificial heart valves including mechanical and bioprosthetic valves. Yet, there are countless reports on possible alternatives noting long-term stability and biocompatibility issues and highlighting the need for fabrication of more durable and effective replacements. This review discusses the current and potential materials that can be used for developing such valves along with existing and developing fabrication methods. With this perspective, we quantitatively compare mechanical properties of various materials that are currently used or proposed for heart valves along with their fabrication processes to identify challenges we face in creating new materials and manufacturing techniques to better mimick the performance of native heart valves.
Collapse
Key Words
- 3D printing
- Biofabrication
- Biomaterials
- E, Young's modulus
- Electrospinning
- Gal, galactose-α1,3-galactose
- GelMa, gelatin methacrylate
- HA, hyaluronic acid
- HAVIC, human aortic valvular interstitial cells
- MA-HA, methacrylated hyaluronic acid
- NeuGc, N-glycolylneuraminic acid
- P4HB, poly(4-hydroxybutyrate)
- PAAm, polyacrylamide
- PCE, polycitrate-(ε-polypeptide)
- PCL, polycaprolactone
- PE, polyethylene
- PEG, polyethylene glycol
- PEGDA, polyethylene glycol diacrylate
- PGA, poly(glycolic acid)
- PHA, poly(hydroxyalkanoate)
- PLA, polylactide
- PMMA, poly(methyl methacrylate)
- PPG, polypropylene glycol
- PTFE, polytetrafluoroethylene
- PU, polyurethane
- SIBS, poly(styrene-b-isobutylene-b-styrene)
- SMC, smooth muscle cells
- VHD, valvular heart disease
- VIC, aortic valve leaflet interstitial cells
- Valvular heart diseases
- dECM, decellularized extracellular matrix
- ePTFE, expanded PTFE
- xSIBS, crosslinked version of SIBS
- α-SMA, alpha-smooth muscle actin
Collapse
Affiliation(s)
- F. Oveissi
- School of Chemical and Biomolecular Engineering, The University of Sydney, Sydney, New South Wales, 2006, Australia
| | - S. Naficy
- School of Chemical and Biomolecular Engineering, The University of Sydney, Sydney, New South Wales, 2006, Australia
| | - A. Lee
- School of Chemical and Biomolecular Engineering, The University of Sydney, Sydney, New South Wales, 2006, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Health and Medicine, The University of Sydney, New South Wales, 2006, Australia
- Heart Centre for Children, The Children's Hospital at Westmead, New South Wales, 2145, Australia
| | - D.S. Winlaw
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Health and Medicine, The University of Sydney, New South Wales, 2006, Australia
- Heart Centre for Children, The Children's Hospital at Westmead, New South Wales, 2145, Australia
| | - F. Dehghani
- School of Chemical and Biomolecular Engineering, The University of Sydney, Sydney, New South Wales, 2006, Australia
| |
Collapse
|
15
|
Ouyang L, Dan Y, Shao Z, Yang S, Yang C, Liu G, Duan D. MMP-sensitive PEG hydrogel modified with RGD promotes bFGF, VEGF and EPC-mediated angiogenesis. Exp Ther Med 2019; 18:2933-2941. [PMID: 31572536 PMCID: PMC6755480 DOI: 10.3892/etm.2019.7885] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/26/2019] [Indexed: 12/17/2022] Open
Abstract
Traumatic soft tissue defects such as bedsores, chronic skin ulcers, limb necrosis, osteonecrosis and other ischemic orthopedic diseases are the most clinically intractable and common problems in orthopedics due to unsatisfactory conventional treatments. The present study designed poly(ethylene glycol; PEG) hydrogels with covalently binded arginylglycylaspartic acid (RGD). Endothelial progenitor cells (EPCs) were encapsulated in the modified hydrogel along with vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF). Results demonstrated that the modified hydrogel displayed good mechanical properties appropriate for a sustained release carrier. RGD modification significantly promoted EPC biocompatibility. VEGF and bFGF encapsulation enhanced the adhesion of EPCs, promoted the production of extracellular matrix and facilitated EPC proliferation. In addition, bFGF and VEGF induced angiogenesis. The combination of growth factors and EPCs in the hydrogel displayed a strong synergy to improve biocompatibility. The present results provided a potential novel treatment approach for soft tissue defects such as bone exposure, chronic skin ulcers, bedsores, limb necrosis, osteonecrosis and other ischemic diseases.
Collapse
Affiliation(s)
- Liu Ouyang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Yang Dan
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Shuhua Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Cao Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Guohui Liu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| | - Deyu Duan
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
| |
Collapse
|
16
|
Roosens A, Handoyo YP, Dubruel P, Declercq H. Impact of modified gelatin on valvular microtissues. J Tissue Eng Regen Med 2019; 13:771-784. [DOI: 10.1002/term.2825] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 10/30/2018] [Accepted: 02/13/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Annelies Roosens
- Department of Human Structure and Repair, Tissue Engineering GroupGhent University Ghent Belgium
| | | | - Peter Dubruel
- Polymer Chemistry and Biomaterials Research Group, Department of Organic and Macromolecular Chemistry, Centre of Macromolecular ChemistryGhent University Ghent Belgium
| | - Heidi Declercq
- Department of Human Structure and Repair, Tissue Engineering GroupGhent University Ghent Belgium
| |
Collapse
|
17
|
Nazir R, Bruyneel A, Carr C, Czernuszka J. Collagen type I and hyaluronic acid based hybrid scaffolds for heart valve tissue engineering. Biopolymers 2019; 110:e23278. [PMID: 30958569 DOI: 10.1002/bip.23278] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/13/2019] [Accepted: 03/21/2019] [Indexed: 12/13/2022]
Abstract
Tissue engineers have achieved limited success so far in designing an ideal scaffold for aortic valve; scaffolds lack in mechanical compatibility, appropriate degradation rate, and microstructural similarity. This paper, therefore, has demonstrated a carbodiimide-based sequential crosslinking technique to prepare aortic valve extracellular matrix mimicking (ECM) hybrid scaffolds from collagen type I and hyaluronic acid (HA), the building blocks of heart valve ECM, with tailorable crosslinking densities. Swelling studies revealed that crosslinking densities of parent networks increased with increasing the concentration of the crosslinking agents whereas crosslinking densities of hybrid scaffolds averaged from those of parent collagen and HA networks. Hybrid scaffolds also offered a wide range of pore size (66-126 μm) which fulfilled the criteria for valvular tissue regeneration. Scanning electron microscopy and images of Alcian blue-Periodic acid Schiff stained samples suggested that our crosslinking technique yielded an ECM mimicking microstructure with interlaced bands of collagen and HA in the hybrid scaffolds. The mutually reinforcing networks of collagen and HA also resulted in increased bending moduli up to 1660 kPa which spanned the range of natural aortic valves. Cardio sphere-derived cells (CDCs) from rat hearts showed that crosslinking density affected the available cell attachment sites on the surface of the scaffold. Increased bending moduli of CDCs seeded scaffolds up to two folds (2-6 kPa) as compared to the non-seeded scaffolds (1 kPa) suggested that an increase in crosslinking density of the scaffolds could not only increase the in vitro bending modulus but also prevented its disintegration in the cell culture medium.
Collapse
Affiliation(s)
- Rabia Nazir
- Department of Materials, University of Oxford, Oxford, UK.,Interdisciplinary Research Centre in Biomedical Materials (IRCBM), COMSATS University Islamabad (CUI), Lahore, Pakistan
| | - Arne Bruyneel
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Carolyn Carr
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Jan Czernuszka
- Department of Materials, University of Oxford, Oxford, UK
| |
Collapse
|
18
|
Portillo-Lara R, Spencer AR, Walker BW, Shirzaei Sani E, Annabi N. Biomimetic cardiovascular platforms for in vitro disease modeling and therapeutic validation. Biomaterials 2019; 198:78-94. [PMID: 30201502 PMCID: PMC11044891 DOI: 10.1016/j.biomaterials.2018.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 08/02/2018] [Accepted: 08/03/2018] [Indexed: 02/07/2023]
Abstract
Bioengineered tissues have become increasingly more sophisticated owing to recent advancements in the fields of biomaterials, microfabrication, microfluidics, genetic engineering, and stem cell and developmental biology. In the coming years, the ability to engineer artificial constructs that accurately mimic the compositional, architectural, and functional properties of human tissues, will profoundly impact the therapeutic and diagnostic aspects of the healthcare industry. In this regard, bioengineered cardiac tissues are of particular importance due to the extremely limited ability of the myocardium to self-regenerate, as well as the remarkably high mortality associated with cardiovascular diseases worldwide. As novel microphysiological systems make the transition from bench to bedside, their implementation in high throughput drug screening, personalized diagnostics, disease modeling, and targeted therapy validation will bring forth a paradigm shift in the clinical management of cardiovascular diseases. Here, we will review the current state of the art in experimental in vitro platforms for next generation diagnostics and therapy validation. We will describe recent advancements in the development of smart biomaterials, biofabrication techniques, and stem cell engineering, aimed at recapitulating cardiovascular function at the tissue- and organ levels. In addition, integrative and multidisciplinary approaches to engineer biomimetic cardiovascular constructs with unprecedented human and clinical relevance will be discussed. We will comment on the implementation of these platforms in high throughput drug screening, in vitro disease modeling and therapy validation. Lastly, future perspectives will be provided on how these biomimetic platforms will aid in the transition towards patient centered diagnostics, and the development of personalized targeted therapeutics.
Collapse
Affiliation(s)
- Roberto Portillo-Lara
- Department of Chemical Engineering, Northeastern University, Boston, USA; Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Zapopan, JAL, Mexico
| | - Andrew R Spencer
- Department of Chemical Engineering, Northeastern University, Boston, USA
| | - Brian W Walker
- Department of Chemical and Biomolecular Engineering, University of California- Los Angeles, Los Angeles, CA 90095, USA
| | - Ehsan Shirzaei Sani
- Department of Chemical and Biomolecular Engineering, University of California- Los Angeles, Los Angeles, CA 90095, USA
| | - Nasim Annabi
- Department of Chemical and Biomolecular Engineering, University of California- Los Angeles, Los Angeles, CA 90095, USA; Center for Minimally Invasive Therapeutics (C-MIT), University of California-Los Angeles, Los Angeles, CA, USA; Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA.
| |
Collapse
|
19
|
Jover E, Fagnano M, Angelini G, Madeddu P. Cell Sources for Tissue Engineering Strategies to Treat Calcific Valve Disease. Front Cardiovasc Med 2018; 5:155. [PMID: 30460245 PMCID: PMC6232262 DOI: 10.3389/fcvm.2018.00155] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 10/10/2018] [Indexed: 12/15/2022] Open
Abstract
Cardiovascular calcification is an independent risk factor and an established predictor of adverse cardiovascular events. Despite concomitant factors leading to atherosclerosis and heart valve disease (VHD), the latter has been identified as an independent pathological entity. Calcific aortic valve stenosis is the most common form of VDH resulting of either congenital malformations or senile “degeneration.” About 2% of the population over 65 years is affected by aortic valve stenosis which represents a major cause of morbidity and mortality in the elderly. A multifactorial, complex and active heterotopic bone-like formation process, including extracellular matrix remodeling, osteogenesis and angiogenesis, drives heart valve “degeneration” and calcification, finally causing left ventricle outflow obstruction. Surgical heart valve replacement is the current therapeutic option for those patients diagnosed with severe VHD representing more than 20% of all cardiac surgeries nowadays. Tissue Engineering of Heart Valves (TEHV) is emerging as a valuable alternative for definitive treatment of VHD and promises to overcome either the chronic oral anticoagulation or the time-dependent deterioration and reintervention of current mechanical or biological prosthesis, respectively. Among the plethora of approaches and stablished techniques for TEHV, utilization of different cell sources may confer of additional properties, desirable and not, which need to be considered before moving from the bench to the bedside. This review aims to provide a critical appraisal of current knowledge about calcific VHD and to discuss the pros and cons of the main cell sources tested in studies addressing in vitro TEHV.
Collapse
Affiliation(s)
- Eva Jover
- Bristol Medical School (Translational Health Sciences), Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
| | - Marco Fagnano
- Bristol Medical School (Translational Health Sciences), Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
| | - Gianni Angelini
- Bristol Medical School (Translational Health Sciences), Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
| | - Paolo Madeddu
- Bristol Medical School (Translational Health Sciences), Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
| |
Collapse
|
20
|
Peña B, Laughter M, Jett S, Rowland TJ, Taylor MRG, Mestroni L, Park D. Injectable Hydrogels for Cardiac Tissue Engineering. Macromol Biosci 2018; 18:e1800079. [PMID: 29733514 PMCID: PMC6166441 DOI: 10.1002/mabi.201800079] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 03/27/2018] [Indexed: 12/21/2022]
Abstract
In light of the limited efficacy of current treatments for cardiac regeneration, tissue engineering approaches have been explored for their potential to provide mechanical support to injured cardiac tissues, deliver cardio-protective molecules, and improve cell-based therapeutic techniques. Injectable hydrogels are a particularly appealing system as they hold promise as a minimally invasive therapeutic approach. Moreover, injectable acellular alginate-based hydrogels have been tested clinically in patients with myocardial infarction (MI) and show preservation of the left ventricular (LV) indices and left ventricular ejection fraction (LVEF). This review provides an overview of recent developments that have occurred in the design and engineering of various injectable hydrogel systems for cardiac tissue engineering efforts, including a comparison of natural versus synthetic systems with emphasis on the ideal characteristics for biomimetic cardiac materials.
Collapse
Affiliation(s)
- Brisa Peña
- Cardiovascular Institute, School of Medicine, Division of Cardiology, University of Colorado Denver Anschutz Medical Campus, 12700 E.19th Avenue, Bldg. P15, Aurora, CO, 80045, USA
| | - Melissa Laughter
- Bioengineering Department, University of Colorado Denver Anschutz Medical Campus, Bioscience 2 1270 E. Montview Avenue, Suite 100, Aurora, CO, 80045, USA
| | - Susan Jett
- Cardiovascular Institute, School of Medicine, Division of Cardiology, University of Colorado Denver Anschutz Medical Campus, 12700 E.19th Avenue, Bldg. P15, Aurora, CO, 80045, USA
| | - Teisha J Rowland
- Cardiovascular Institute, School of Medicine, Division of Cardiology, University of Colorado Denver Anschutz Medical Campus, 12700 E.19th Avenue, Bldg. P15, Aurora, CO, 80045, USA
| | - Matthew R G Taylor
- Cardiovascular Institute, School of Medicine, Division of Cardiology, University of Colorado Denver Anschutz Medical Campus, 12700 E.19th Avenue, Bldg. P15, Aurora, CO, 80045, USA
| | - Luisa Mestroni
- Cardiovascular Institute, School of Medicine, Division of Cardiology, University of Colorado Denver Anschutz Medical Campus, 12700 E.19th Avenue, Bldg. P15, Aurora, CO, 80045, USA
| | - Daewon Park
- Bioengineering Department, University of Colorado Denver Anschutz Medical Campus, Bioscience 2 1270 E. Montview Avenue, Suite 100, Aurora, CO, 80045, USA
| |
Collapse
|
21
|
Sheffield C, Meyers K, Johnson E, Rajachar RM. Application of Composite Hydrogels to Control Physical Properties in Tissue Engineering and Regenerative Medicine. Gels 2018; 4:E51. [PMID: 30674827 PMCID: PMC6209271 DOI: 10.3390/gels4020051] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 05/25/2018] [Accepted: 05/29/2018] [Indexed: 12/23/2022] Open
Abstract
The development of biomaterials for the restoration of the normal tissue structure⁻function relationship in pathological conditions as well as acute and chronic injury is an area of intense investigation. More recently, the use of tailored or composite hydrogels for tissue engineering and regenerative medicine has sought to bridge the gap between natural tissues and applied biomaterials more clearly. By applying traditional concepts in engineering composites, these hydrogels represent hierarchical structured materials that translate more closely the key guiding principles required for improved recovery of tissue architecture and functional behavior, including physical, mass transport, and biological properties. For tissue-engineering scaffolds in general, and more specifically in composite hydrogel materials, each of these properties provide unique qualities that are essential for proper augmentation and repair following disease and injury. The broad focus of this review is on physical properties in particular, static and dynamic mechanical properties provided by composite hydrogel materials and their link to native tissue architecture and, ultimately, tissue-specific applications for composite hydrogels.
Collapse
Affiliation(s)
- Cassidy Sheffield
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI 49931, USA.
| | - Kaylee Meyers
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI 49931, USA.
| | - Emil Johnson
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI 49931, USA.
| | - Rupak M Rajachar
- Department of Biomedical Engineering, Michigan Technological University, Houghton, MI 49931, USA.
| |
Collapse
|
22
|
Nachlas ALY, Li S, Jha R, Singh M, Xu C, Davis ME. Human iPSC-derived mesenchymal stem cells encapsulated in PEGDA hydrogels mature into valve interstitial-like cells. Acta Biomater 2018; 71:235-246. [PMID: 29505894 PMCID: PMC5907941 DOI: 10.1016/j.actbio.2018.02.025] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 02/06/2018] [Accepted: 02/22/2018] [Indexed: 02/07/2023]
Abstract
Despite recent advances in tissue engineered heart valves (TEHV), a major challenge is identifying a cell source for seeding TEHV scaffolds. Native heart valves are durable because valve interstitial cells (VICs) maintain tissue homeostasis by synthesizing and remodeling the extracellular matrix. This study demonstrates that induced pluripotent stem cells (iPSC)-derived mesenchymal stem cells (iMSCs) can be derived from iPSCs using a feeder-free protocol and then further matured into VICs by encapsulation within 3D hydrogels. The differentiation efficiency was characterized using flow cytometry, immunohistochemistry staining, and trilineage differentiation. Using our feeder-free differentiation protocol, iMSCs were differentiated from iPSCs and had CD90+, CD44+, CD71+, αSMA+, and CD45- expression. Furthermore, iMSCs underwent trilineage differentiation when cultured in induction media for 21 days. iMSCs were then encapsulated in poly(ethylene glycol)diacrylate (PEGDA) hydrogels grafted with adhesion peptide (RGDS) to promote remodeling and further maturation into VIC-like cells. VIC phenotype was assessed by the expression of alpha-smooth muscle actin (αSMA), vimentin, and collagen production after 28 days. When MSC-derived cells were encapsulated in PEGDA hydrogels that mimic the leaflet modulus, a decrease in αSMA expression and increase in vimentin was observed. In addition, iMSCs synthesized collagen type I after 28 days in 3D hydrogel culture. Thus, the results from this study suggest that iMSCs may be a promising cell source for TEHV. STATEMENT OF SIGNIFICANCE Developing a suitable cell source is a critical component for the success and durability of tissue engineered heart valves. The significance of this study is the generation of iPSCs-derived mesenchymal stem cells (iMSCs) that have the capacity to mature into valve interstitial-like cells when introduced into a 3D cell culture designed to mimic the layers of the valve leaflet. iMSCs were generated using a feeder-free protocol, which is one major advantage over other methods, as it is more clinically relevant. In addition to generating a potential new cell source for heart valve tissue engineering, this study also highlights the importance of a 3D culture environment to influence cell phenotype and function.
Collapse
Affiliation(s)
- Aline L Y Nachlas
- Wallace H Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
| | - Siyi Li
- Wallace H Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
| | - Rajneesh Jha
- Children's Heart Research & Outcomes (HeRO) Center, Children's Healthcare of Atlanta & Emory University, Atlanta, GA, USA; Division of Pediatric Cardiology, Department of Pediatrics, Emory University School of Medicine, USA
| | - Monalisa Singh
- Children's Heart Research & Outcomes (HeRO) Center, Children's Healthcare of Atlanta & Emory University, Atlanta, GA, USA; Division of Pediatric Cardiology, Department of Pediatrics, Emory University School of Medicine, USA
| | - Chunhui Xu
- Wallace H Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA; Children's Heart Research & Outcomes (HeRO) Center, Children's Healthcare of Atlanta & Emory University, Atlanta, GA, USA; Division of Pediatric Cardiology, Department of Pediatrics, Emory University School of Medicine, USA
| | - Michael E Davis
- Wallace H Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA; Children's Heart Research & Outcomes (HeRO) Center, Children's Healthcare of Atlanta & Emory University, Atlanta, GA, USA.
| |
Collapse
|
23
|
Zhu AS, Grande-Allen KJ. Heart valve tissue engineering for valve replacement and disease modeling. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2018. [DOI: 10.1016/j.cobme.2017.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
24
|
Fabrication of Hydrogel Materials for Biomedical Applications. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1077:197-224. [PMID: 30357691 DOI: 10.1007/978-981-13-0947-2_12] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Hydrogels are three-dimensional hydrophilic polymeric networks that can be made from a wide range of natural and synthetic polymers. This review discusses recent advanced engineering methods to fabricate hydrogels for biomedical applications with emphasis in cardiac constructs and wound healing. Layer-by-Layer (LbL) assembly offers a tissue-engineered construct with robust and highly ordered structures for cell proliferation and differentiation. Three-dimensional printings, including inkjet printing, fused deposition modeling, and stereolithographic apparatus, have been widely employed to fabricate complex structures (e.g., heart valves). Moreover, the state-of-the-art design of intelligent/stimulus-responsive hydrogels can be used for a wide range of biomedical applications, including drug delivery, glucose delivery, shape memory, wound dressings, and so on. In the future, an increasing number of hydrogels with tunable mechanical properties and versatile functions will be developed for biomedical applications by employing advanced engineering techniques with novel material design.
Collapse
|
25
|
Nachlas ALY, Li S, Davis ME. Developing a Clinically Relevant Tissue Engineered Heart Valve-A Review of Current Approaches. Adv Healthc Mater 2017; 6. [PMID: 29171921 DOI: 10.1002/adhm.201700918] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/25/2017] [Indexed: 11/08/2022]
Abstract
Tissue engineered heart valves (TEHVs) have the potential to address the shortcomings of current implants through the combination of cells and bioactive biomaterials that promote growth and proper mechanical function in physiological conditions. The ideal TEHV should be anti-thrombogenic, biocompatible, durable, and resistant to calcification, and should exhibit a physiological hemodynamic profile. In addition, TEHVs may possess the capability to integrate and grow with somatic growth, eliminating the need for multiple surgeries children must undergo. Thus, this review assesses clinically available heart valve prostheses, outlines the design criteria for developing a heart valve, and evaluates three types of biomaterials (decellularized, natural, and synthetic) for tissue engineering heart valves. While significant progress has been made in biomaterials and fabrication techniques, a viable tissue engineered heart valve has yet to be translated into a clinical product. Thus, current strategies and future perspectives are also discussed to facilitate the development of new approaches and considerations for heart valve tissue engineering.
Collapse
Affiliation(s)
- Aline L. Y. Nachlas
- Wallace H Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University Atlanta GA 30332 USA
| | - Siyi Li
- Wallace H Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University Atlanta GA 30332 USA
| | - Michael E. Davis
- Wallace H Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory University Atlanta GA 30332 USA
- Children's Heart Research & Outcomes (HeRO) Center Children's Healthcare of Atlanta & Emory University Atlanta GA 30322 USA
| |
Collapse
|
26
|
Lam NT, Lam H, Sturdivant NM, Balachandran K. Fabrication of a matrigel-collagen semi-interpenetrating scaffold for use in dynamic valve interstitial cell culture. ACTA ACUST UNITED AC 2017; 12:045013. [PMID: 28484097 DOI: 10.1088/1748-605x/aa71be] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The study of heart valve homeostatic and disease mechanisms are often limited by the challenges in simulating the in vivo milieu, where valve cells are surrounded by the extracellular matrix in a three-dimensional (3D) environment and experience multiple dynamic mechanical forces. Type I collagen is typically the most common 3D matrix used to culture valve cells in vitro. Unfortunately, this material has poor mechanical behavior due to an inherent propensity to compact significantly, unlike native valve leaflets. We hypothesized that incorporation of matrigel, which contains other heart valve-relevant matrix components such as type IV collagen and sulfated proteoglycans, to type I collagen would provide an appropriate physiological milieu for in vitro valve interstitial cell culture. Different semi-interpenetrating mixtures of collagen type I and matrigel were prepared and a thorough characterization of their physical, mechanical and biocompatibility properties was performed. We observed that the matrigel-collagen hydrogel was porous and degradable with tunable swelling behavior. Incorporation of matrigel not only enhanced the mechanical behavior of the composite hydrogel but also presented the cultured valve interstitial cells with a more enriched extracellular matrix network for in vitro culture. We showed that cells cultured in the composite hydrogel had comparable viability, proliferation and cell phenotype as compared with those in a collagen only gel. Importantly, the composite hydrogel was also amenable to in vitro cyclic stretching culture for 48 h. Overall, we report here the potential use of the matrigel-collagen hydrogel as a three dimensional scaffold for the dynamic mechanical culture of valve interstitial cells in vitro.
Collapse
Affiliation(s)
- Ngoc Thien Lam
- Cell and Molecular Biology Program, University of Arkansas, Fayetteville, AR 72701, United States of America
| | | | | | | |
Collapse
|
27
|
Capulli AK, Emmert MY, Pasqualini FS, Kehl D, Caliskan E, Lind JU, Sheehy SP, Park SJ, Ahn S, Weber B, Goss JA, Hoerstrup SP, Parker KK. JetValve: Rapid manufacturing of biohybrid scaffolds for biomimetic heart valve replacement. Biomaterials 2017; 133:229-241. [PMID: 28445803 PMCID: PMC5526340 DOI: 10.1016/j.biomaterials.2017.04.033] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 04/04/2017] [Accepted: 04/15/2017] [Indexed: 02/06/2023]
Abstract
Tissue engineered scaffolds have emerged as a promising solution for heart valve replacement because of their potential for regeneration. However, traditional heart valve tissue engineering has relied on resource-intensive, cell-based manufacturing, which increases cost and hinders clinical translation. To overcome these limitations, in situ tissue engineering approaches aim to develop scaffold materials and manufacturing processes that elicit endogenous tissue remodeling and repair. Yet despite recent advances in synthetic materials manufacturing, there remains a lack of cell-free, automated approaches for rapidly producing biomimetic heart valve scaffolds. Here, we designed a jet spinning process for the rapid and automated fabrication of fibrous heart valve scaffolds. The composition, multiscale architecture, and mechanical properties of the scaffolds were tailored to mimic that of the native leaflet fibrosa and assembled into three dimensional, semilunar valve structures. We demonstrated controlled modulation of these scaffold parameters and show initial biocompatibility and functionality in vitro. Valves were minimally-invasively deployed via transapical access to the pulmonary valve position in an ovine model and shown to be functional for 15 h.
Collapse
Affiliation(s)
- Andrew K Capulli
- Disease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Pierce Hall 321, Cambridge, MA, 02138, USA
| | - Maximillian Y Emmert
- Disease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Pierce Hall 321, Cambridge, MA, 02138, USA; Institute for Regenerative Medicine (IREM), University of Zurich, Center for Therapy Development/GMP, 13 Moussonstrasse, Zurich, 8044, CH, Switzerland; Clinic for Cardiac Surgery, University Hospital Zurich, 100 Ramistrasse, Zurich, 8091, CH, Switzerland
| | - Francesco S Pasqualini
- Disease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Pierce Hall 321, Cambridge, MA, 02138, USA; Institute for Regenerative Medicine (IREM), University of Zurich, Center for Therapy Development/GMP, 13 Moussonstrasse, Zurich, 8044, CH, Switzerland
| | - Debora Kehl
- Institute for Regenerative Medicine (IREM), University of Zurich, Center for Therapy Development/GMP, 13 Moussonstrasse, Zurich, 8044, CH, Switzerland
| | - Etem Caliskan
- Institute for Regenerative Medicine (IREM), University of Zurich, Center for Therapy Development/GMP, 13 Moussonstrasse, Zurich, 8044, CH, Switzerland; Clinic for Cardiac Surgery, University Hospital Zurich, 100 Ramistrasse, Zurich, 8091, CH, Switzerland
| | - Johan U Lind
- Disease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Pierce Hall 321, Cambridge, MA, 02138, USA
| | - Sean P Sheehy
- Disease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Pierce Hall 321, Cambridge, MA, 02138, USA
| | - Sung Jin Park
- Disease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Pierce Hall 321, Cambridge, MA, 02138, USA
| | - Seungkuk Ahn
- Disease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Pierce Hall 321, Cambridge, MA, 02138, USA
| | - Benedikt Weber
- Disease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Pierce Hall 321, Cambridge, MA, 02138, USA; Institute for Regenerative Medicine (IREM), University of Zurich, Center for Therapy Development/GMP, 13 Moussonstrasse, Zurich, 8044, CH, Switzerland
| | - Josue A Goss
- Disease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Pierce Hall 321, Cambridge, MA, 02138, USA
| | - Simon P Hoerstrup
- Disease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Pierce Hall 321, Cambridge, MA, 02138, USA; Institute for Regenerative Medicine (IREM), University of Zurich, Center for Therapy Development/GMP, 13 Moussonstrasse, Zurich, 8044, CH, Switzerland
| | - Kevin Kit Parker
- Disease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Sciences, Harvard University, 29 Oxford St, Pierce Hall 321, Cambridge, MA, 02138, USA.
| |
Collapse
|
28
|
Sherrell PC, Cieślar-Pobuda A, Ejneby MS, Sammalisto L, Gelmi A, de Muinck E, Brask J, Łos MJ, Rafat M. Rational Design of a Conductive Collagen Heart Patch. Macromol Biosci 2017; 17. [DOI: 10.1002/mabi.201600446] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/16/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Peter C. Sherrell
- Department of Biomedical Engineering; Linköping University; Linköping SE-581 83 Sweden
| | - Artur Cieślar-Pobuda
- Department of Clinical and Experimental Medicine; Linköping University; Linköping SE-581 83 Sweden
- Institute of Automatic Control; Silesian University of Technology; Gliwice 44-100 Poland
| | - Malin Silverå Ejneby
- Department of Clinical and Experimental Medicine; Linköping University; Linköping SE-581 83 Sweden
| | - Laura Sammalisto
- Department of Biomedical Engineering; Linköping University; Linköping SE-581 83 Sweden
| | - Amy Gelmi
- Department of Physics; Chemistry and Biology; Linköping University; Linköping SE-581 83 Sweden
| | - Ebo de Muinck
- Department of Medical and Health Sciences; and Division of Cardiovascular Medicine; Linköping University; Linköping SE-581 83 Sweden
| | - Johan Brask
- Department of Clinical and Experimental Medicine; Linköping University; Linköping SE-581 83 Sweden
| | - Marek J. Łos
- Malopolska Centre of Biotechnology; Jagiellonian University; Gronostajowa 7A str. 30-387 Kraków Poland
| | - Mehrdad Rafat
- Department of Biomedical Engineering; Linköping University; Linköping SE-581 83 Sweden
- LinkoCare Life Sciences AB; Linköping 583 30 Sweden
| |
Collapse
|
29
|
Moreira R, Neusser C, Kruse M, Mulderrig S, Wolf F, Spillner J, Schmitz-Rode T, Jockenhoevel S, Mela P. Tissue-Engineered Fibrin-Based Heart Valve with Bio-Inspired Textile Reinforcement. Adv Healthc Mater 2016; 5:2113-21. [PMID: 27377438 DOI: 10.1002/adhm.201600300] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 04/28/2016] [Indexed: 12/12/2022]
Abstract
The mechanical properties of tissue-engineered heart valves still need to be improved to enable their implantation in the systemic circulation. The aim of this study is to develop a tissue-engineered valve for the aortic position - the BioTexValve - by exploiting a bio-inspired composite textile scaffold to confer native-like mechanical strength and anisotropy to the leaflets. This is achieved by multifilament fibers arranged similarly to the collagen bundles in the native aortic leaflet, fixed by a thin electrospun layer directly deposited on the pattern. The textile-based leaflets are positioned into a 3D mould where the components to form a fibrin gel containing human vascular smooth muscle cells are introduced. Upon fibrin polymerization, a complete valve is obtained. After 21 d of maturation by static and dynamic stimulation in a custom-made bioreactor, the valve shows excellent functionality under aortic pressure and flow conditions, as demonstrated by hydrodynamic tests performed according to ISO standards in a mock circulation system. The leaflets possess remarkable burst strength (1086 mmHg) while remaining pliable; pronounced extracellular matrix production is revealed by immunohistochemistry and biochemical assay. This study demonstrates the potential of bio-inspired textile-reinforcement for the fabrication of functional tissue-engineered heart valves for the aortic position.
Collapse
Affiliation(s)
- Ricardo Moreira
- Department of Tissue Engineering and Textile Implant; AME-Helmholtz Institute for Biomedical Engineering; University Hospital RWTH Aachen; Pauwelsstr. 20 52074 Aachen Germany
| | - Christine Neusser
- Institute for Textile Engineering; RWTH Aachen University; Otto-Blumenthal-Str. 1 52074 Aachen Germany
| | - Magnus Kruse
- Institute for Textile Engineering; RWTH Aachen University; Otto-Blumenthal-Str. 1 52074 Aachen Germany
| | - Shane Mulderrig
- Department of Tissue Engineering and Textile Implant; AME-Helmholtz Institute for Biomedical Engineering; University Hospital RWTH Aachen; Pauwelsstr. 20 52074 Aachen Germany
| | - Frederic Wolf
- Department of Tissue Engineering and Textile Implant; AME-Helmholtz Institute for Biomedical Engineering; University Hospital RWTH Aachen; Pauwelsstr. 20 52074 Aachen Germany
| | - Jan Spillner
- Department for Cardiothoracic- and Vascular Surgery; University Hospital RWTH Aachen; Pauwelsstr. 30 52074 Aachen Germany
| | - Thomas Schmitz-Rode
- Department of Tissue Engineering and Textile Implant; AME-Helmholtz Institute for Biomedical Engineering; University Hospital RWTH Aachen; Pauwelsstr. 20 52074 Aachen Germany
| | - Stefan Jockenhoevel
- Department of Tissue Engineering and Textile Implant; AME-Helmholtz Institute for Biomedical Engineering; University Hospital RWTH Aachen; Pauwelsstr. 20 52074 Aachen Germany
- Institute for Textile Engineering; RWTH Aachen University; Otto-Blumenthal-Str. 1 52074 Aachen Germany
- Department of Tissue Engineering and Textile Implants; AME-Helmholtz Institute for Biomedical Engineering; University Hospital RWTH Aachen; Pauwelsstr. 20 52074 Aachen Germany
| | - Petra Mela
- Department of Tissue Engineering and Textile Implant; AME-Helmholtz Institute for Biomedical Engineering; University Hospital RWTH Aachen; Pauwelsstr. 20 52074 Aachen Germany
- Department of Tissue Engineering and Textile Implants; AME-Helmholtz Institute for Biomedical Engineering; University Hospital RWTH Aachen; Pauwelsstr. 20 52074 Aachen Germany
| |
Collapse
|
30
|
Lukas K, Thomas U, Gessner A, Wehner D, Schmid T, Schmid C, Lehle K. Plasma functionalization of polycarbonaturethane to improve endothelialization—Effect of shear stress as a critical factor for biocompatibility control. J Biomater Appl 2016; 30:1417-28. [DOI: 10.1177/0885328215626072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Medical devices made of polycarbonaturethane (PCU) combine excellent mechanical properties and little biological degradation, but restricted hemocompatibility. Modifications of PCU might reduce platelet adhesion and promote stable endothelialization. PCU was modified using gas plasma treatment, binding of hydrogels, and coupling of cell-active molecules (modified heparin, anti-thrombin III (ATIII), argatroban, fibronectin, laminin-nonapeptide, peptides with integrin-binding arginine-glycine-aspartic acid (RGD) motif). Biocompatibility was verified with static and dynamic cell culture techniques. Blinded analysis focused on improvement in endothelial cell (EC) adhesion/proliferation, anti-thrombogenicity, reproducible manufacturing process, and shear stress tolerance of ECs. EC adhesion and antithrombogenicity were achieved with 9/35 modifications. Additionally, 6/9 stimulated EC proliferation and 3/6 modification processes were highly reproducible for endothelialization. The latter modifications comprised immobilization of ATIII (A), polyethyleneglycole-diamine-hydrogel (E) and polyethylenimine-hydrogel connected with modified heparin (IH). Under sheer stress, only the IH modification improved EC adhesion within the graft. However, ECs did not arrange in flow direction and cell anchorage was restricted. Despite large variation in surface modification chemistry and improved EC adhesion under static culture conditions, additional introduction of shear stress foiled promising preliminary data. Therefore, biocompatibility testing required not only static tests but also usage of physiological conditions such as shear stress in the case of vascular grafts.
Collapse
Affiliation(s)
- Karin Lukas
- IMHR, Institute for Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | | | - André Gessner
- IMHR, Institute for Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | | | | | - Christof Schmid
- Department of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Karla Lehle
- Department of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany
| |
Collapse
|