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Electrically conductive scaffolds mimicking the hierarchical structure of cardiac myofibers. Sci Rep 2023; 13:2863. [PMID: 36804588 PMCID: PMC9938142 DOI: 10.1038/s41598-023-29780-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/10/2023] [Indexed: 02/19/2023] Open
Abstract
Electrically conductive scaffolds, mimicking the unique directional alignment of muscle fibers in the myocardium, are fabricated using the 3D printing micro-stereolithography technique. Polyethylene glycol diacrylate (photo-sensitive polymer), Irgacure 819 (photo-initiator), curcumin (dye) and polyaniline (conductive polymer) are blended to make the conductive ink that is crosslinked using free radical photo-polymerization reaction. Curcumin acts as a liquid filter and prevents light from penetrating deep into the photo-sensitive solution and plays a central role in the 3D printing process. The obtained scaffolds demonstrate well defined morphology with an average pore size of 300 ± 15 μm and semi-conducting properties with a conductivity of ~ 10-6 S/m. Cyclic voltammetry analyses detect the electroactivity and highlight how the electron transfer also involve an ionic diffusion between the polymer and the electrolyte solution. Scaffolds reach their maximum swelling extent 30 min after immersing in the PBS at 37 °C and after 4 weeks they demonstrate a slow hydrolytic degradation rate typical of polyethylene glycol network. Conductive scaffolds display tunable conductivity and provide an optimal environment to the cultured mouse cardiac progenitor cells.
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2
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Carotenuto F, Fiaschini N, Di Nardo P, Rinaldi A. Towards a Material-by-Design Approach to Electrospun Scaffolds for Tissue Engineering Based on Statistical Design of Experiments (DOE). MATERIALS (BASEL, SWITZERLAND) 2023; 16:1539. [PMID: 36837169 PMCID: PMC9961090 DOI: 10.3390/ma16041539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Electrospinning bears great potential for the manufacturing of scaffolds for tissue engineering, consisting of a porous mesh of ultrafine fibers that effectively mimic the extracellular matrix (ECM) and aid in directing stem cell fate. However, for engineering purposes, there is a need to develop material-by-design approaches based on predictive models. In this methodological study, a rational methodology based on statistical design of experiments (DOE) is discussed in detail, yielding heuristic models that capture the linkage between process parameters (Xs) of the electrospinning and scaffold properties (Ys). Five scaffolds made of polycaprolactone are produced according to a 22-factorial combinatorial scheme where two Xs, i.e., flow rate and applied voltage, are varied between two given levels plus a center point. The scaffolds were characterized to measure a set of properties (Ys), i.e., fiber diameter distribution, porosity, wettability, Young's modulus, and cell adhesion on murine myoblast C1C12 cells. Simple engineering DOE models were obtained for all Ys. Each Y, for example, the biological response, can be used as a driver for the design process, using the process-property model of interest for accurate interpolation within the design domain, enabling a material-by-design strategy and speeding up the product development cycle. The implications are also illustrated in the context of the design of multilayer scaffolds with microstructural gradients and controlled properties of each layer. The possibility of obtaining statistical models correlating between diverse output properties of the scaffolds is highlighted. Noteworthy, the featured DOE approach can be potentially merged with artificial intelligence tools to manage complexity and it is applicable to several fields including 3D printing.
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Affiliation(s)
- Felicia Carotenuto
- Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy
- CIMER-Centro di Ricerca Interdipartimentale di Medicina Rigenerativa, Università degli Studi di Roma "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy
| | | | - Paolo Di Nardo
- Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy
- CIMER-Centro di Ricerca Interdipartimentale di Medicina Rigenerativa, Università degli Studi di Roma "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy
| | - Antonio Rinaldi
- SSPT-PROMAS-MATPRO Laboratory, ENEA—Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Via Anguillarese 301, 00123 Rome, Italy
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3
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Terranova ML. Key Challenges in Diamond Coating of Titanium Implants: Current Status and Future Prospects. Biomedicines 2022; 10:biomedicines10123149. [PMID: 36551907 PMCID: PMC9775193 DOI: 10.3390/biomedicines10123149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
Over past years, the fabrication of Ti-based permanent implants for fracture fixation, joint replacement and bone or tooth substitution, has become a routine task. However, it has been found that some degradation phenomena occurring on the Ti surface limits the life or the efficiency of the artificial constructs. The task of avoiding such adverse effects, to prevent microbial colonization and to accelerate osteointegration, is being faced by a variety of approaches in order to adapt Ti surfaces to the needs of osseous tissues. Among the large set of biocompatible materials proposed as an interface between Ti and the hosting tissue, diamond has been proven to offer bioactive and mechanical properties able to match the specific requirements of osteoblasts. Advances in material science and implant engineering are now enabling us to produce micro- or nano-crystalline diamond coatings on a variety of differently shaped Ti constructs. The aim of this paper is to provide an overview of the research currently ongoing in the field of diamond-coated orthopedic Ti implants and to examine the evolution of the concepts that are accelerating the full transition of such technology from the laboratory to clinical applications.
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Affiliation(s)
- Maria Letizia Terranova
- Dipartimento di Scienze e Tecnologie Chimiche, Università di Roma Tor Vergata, Via della Ricerca Scientifica, 00133 Roma, Italy; or
- Centro di Ricerca Interdipartimentale di Medicina Rigenerativa (CIMER), Università di Roma Tor Vergata, Via della Ricerca Scientifica, 00133 Roma, Italy
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4
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Carotenuto F, Politi S, Ul Haq A, De Matteis F, Tamburri E, Terranova ML, Teodori L, Pasquo A, Di Nardo P. From Soft to Hard Biomimetic Materials: Tuning Micro/Nano-Architecture of Scaffolds for Tissue Regeneration. MICROMACHINES 2022; 13:mi13050780. [PMID: 35630247 PMCID: PMC9144100 DOI: 10.3390/mi13050780] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 03/30/2022] [Accepted: 05/13/2022] [Indexed: 11/23/2022]
Abstract
Failure of tissues and organs resulting from degenerative diseases or trauma has caused huge economic and health concerns around the world. Tissue engineering represents the only possibility to revert this scenario owing to its potential to regenerate or replace damaged tissues and organs. In a regeneration strategy, biomaterials play a key role promoting new tissue formation by providing adequate space for cell accommodation and appropriate biochemical and biophysical cues to support cell proliferation and differentiation. Among other physical cues, the architectural features of the biomaterial as a kind of instructive stimuli can influence cellular behaviors and guide cells towards a specific tissue organization. Thus, the optimization of biomaterial micro/nano architecture, through different manufacturing techniques, is a crucial strategy for a successful regenerative therapy. Over the last decades, many micro/nanostructured biomaterials have been developed to mimic the defined structure of ECM of various soft and hard tissues. This review intends to provide an overview of the relevant studies on micro/nanostructured scaffolds created for soft and hard tissue regeneration and highlights their biological effects, with a particular focus on striated muscle, cartilage, and bone tissue engineering applications.
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Affiliation(s)
- Felicia Carotenuto
- Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università Degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy;
- Department of Fusion and Technologies for Nuclear Safety and Security, Diagnostic and Metrology (FSN-TECFIS-DIM), ENEA, CR Frascati, 00044 Rome, Italy; (S.P.); (L.T.); (A.P.)
- Centro di Ricerca Interdipartimentale di Medicina Rigenerativa (CIMER), Università Degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (F.D.M.); (E.T.); (M.L.T.)
- Correspondence: (F.C.); (P.D.N.)
| | - Sara Politi
- Department of Fusion and Technologies for Nuclear Safety and Security, Diagnostic and Metrology (FSN-TECFIS-DIM), ENEA, CR Frascati, 00044 Rome, Italy; (S.P.); (L.T.); (A.P.)
- Dipartimento di Scienze e Tecnologie Chimiche, Università Degli Studi di Roma “Tor Vergata”, Via della Ricerca Scientifica, 00133 Rome, Italy
| | - Arsalan Ul Haq
- Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università Degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy;
- Centro di Ricerca Interdipartimentale di Medicina Rigenerativa (CIMER), Università Degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (F.D.M.); (E.T.); (M.L.T.)
| | - Fabio De Matteis
- Centro di Ricerca Interdipartimentale di Medicina Rigenerativa (CIMER), Università Degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (F.D.M.); (E.T.); (M.L.T.)
- Dipartimento Ingegneria Industriale, Università Degli Studi di Roma “Tor Vergata”, Via del Politecnico, 00133 Roma, Italy
| | - Emanuela Tamburri
- Centro di Ricerca Interdipartimentale di Medicina Rigenerativa (CIMER), Università Degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (F.D.M.); (E.T.); (M.L.T.)
- Dipartimento di Scienze e Tecnologie Chimiche, Università Degli Studi di Roma “Tor Vergata”, Via della Ricerca Scientifica, 00133 Rome, Italy
| | - Maria Letizia Terranova
- Centro di Ricerca Interdipartimentale di Medicina Rigenerativa (CIMER), Università Degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (F.D.M.); (E.T.); (M.L.T.)
- Dipartimento di Scienze e Tecnologie Chimiche, Università Degli Studi di Roma “Tor Vergata”, Via della Ricerca Scientifica, 00133 Rome, Italy
| | - Laura Teodori
- Department of Fusion and Technologies for Nuclear Safety and Security, Diagnostic and Metrology (FSN-TECFIS-DIM), ENEA, CR Frascati, 00044 Rome, Italy; (S.P.); (L.T.); (A.P.)
- Centro di Ricerca Interdipartimentale di Medicina Rigenerativa (CIMER), Università Degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (F.D.M.); (E.T.); (M.L.T.)
| | - Alessandra Pasquo
- Department of Fusion and Technologies for Nuclear Safety and Security, Diagnostic and Metrology (FSN-TECFIS-DIM), ENEA, CR Frascati, 00044 Rome, Italy; (S.P.); (L.T.); (A.P.)
| | - Paolo Di Nardo
- Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università Degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy;
- Centro di Ricerca Interdipartimentale di Medicina Rigenerativa (CIMER), Università Degli Studi di Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy; (F.D.M.); (E.T.); (M.L.T.)
- Correspondence: (F.C.); (P.D.N.)
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5
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Santos ARMP, Jang Y, Son I, Kim J, Park Y. Recapitulating Cardiac Structure and Function In Vitro from Simple to Complex Engineering. MICROMACHINES 2021; 12:mi12040386. [PMID: 33916254 PMCID: PMC8067203 DOI: 10.3390/mi12040386] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 12/12/2022]
Abstract
Cardiac tissue engineering aims to generate in vivo-like functional tissue for the study of cardiac development, homeostasis, and regeneration. Since the heart is composed of various types of cells and extracellular matrix with a specific microenvironment, the fabrication of cardiac tissue in vitro requires integrating technologies of cardiac cells, biomaterials, fabrication, and computational modeling to model the complexity of heart tissue. Here, we review the recent progress of engineering techniques from simple to complex for fabricating matured cardiac tissue in vitro. Advancements in cardiomyocytes, extracellular matrix, geometry, and computational modeling will be discussed based on a technology perspective and their use for preparation of functional cardiac tissue. Since the heart is a very complex system at multiscale levels, an understanding of each technique and their interactions would be highly beneficial to the development of a fully functional heart in cardiac tissue engineering.
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Affiliation(s)
| | | | | | - Jongseong Kim
- Correspondence: (J.K.); (Y.P.); Tel.: +82-10-8858-7260 (J.K.); +82-10-4260-6460 (Y.P.)
| | - Yongdoo Park
- Correspondence: (J.K.); (Y.P.); Tel.: +82-10-8858-7260 (J.K.); +82-10-4260-6460 (Y.P.)
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6
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Carotenuto F, Teodori L, Maccari AM, Delbono L, Orlando G, Di Nardo P. Turning regenerative technologies into treatment to repair myocardial injuries. J Cell Mol Med 2019; 24:2704-2716. [PMID: 31568640 PMCID: PMC7077550 DOI: 10.1111/jcmm.14630] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/28/2019] [Accepted: 07/23/2019] [Indexed: 02/06/2023] Open
Abstract
Regenerative therapies including stem cell treatments hold promise to allow curing patients affected by severe cardiac muscle diseases. However, the clinical efficacy of stem cell therapy remains elusive, so far. The two key roadblocks that still need to be overcome are the poor cell engraftment into the injured myocardium and the limited knowledge of the ideal mixture of bioactive factors to be locally delivered for restoring heart function. Thus, therapeutic strategies for cardiac repair are directed to increase the retention and functional integration of transplanted cells in the damaged myocardium or to enhance the endogenous repair mechanisms through cell‐free therapies. In this context, biomaterial‐based technologies and tissue engineering approaches have the potential to dramatically impact cardiac translational medicine. This review intends to offer some consideration on the cell‐based and cell‐free cardiac therapies, their limitations and the possible future developments.
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Affiliation(s)
- Felicia Carotenuto
- Centro Interdipartimentale di Medicina Rigenerativa, Università di Roma Tor Vergata, Rome, Italy.,Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università di Roma Tor Vergata, Rome, Italy.,Diagnostics and Metrology (FSN-TECFIS-DIM), ENEA, C.R. Frascati, Rome, Italy
| | - Laura Teodori
- Diagnostics and Metrology (FSN-TECFIS-DIM), ENEA, C.R. Frascati, Rome, Italy
| | - Anna Maria Maccari
- Centro Interdipartimentale di Medicina Rigenerativa, Università di Roma Tor Vergata, Rome, Italy.,Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università di Roma Tor Vergata, Rome, Italy
| | - Luciano Delbono
- Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Giuseppe Orlando
- Wake Forest University School of Medicine, Winston Salem, NC, USA.,Department of Surgery, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Paolo Di Nardo
- Centro Interdipartimentale di Medicina Rigenerativa, Università di Roma Tor Vergata, Rome, Italy.,Dipartimento di Scienze Cliniche e Medicina Traslazionale, Università di Roma Tor Vergata, Rome, Italy.,I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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7
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Padhi A, Nain AS. ECM in Differentiation: A Review of Matrix Structure, Composition and Mechanical Properties. Ann Biomed Eng 2019; 48:1071-1089. [PMID: 31485876 DOI: 10.1007/s10439-019-02337-7] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 07/30/2019] [Indexed: 12/22/2022]
Abstract
Stem cell regenerative potential owing to the capacity to self-renew as well as differentiate into other cell types is a promising avenue in regenerative medicine. Stem cell niche not only provides physical scaffolding but also possess instructional capacity as it provides a milieu of biophysical and biochemical cues. Extracellular matrix (ECM) has been identified as a major dictator of stem cell lineage, thus understanding the structure of in vivo ECM pertaining to specific tissue differentiation will aid in devising in vitro strategies to improve the differentiation efficiency. In this review, we summarize details about the native architecture, composition and mechanical properties of in vivo ECM of the early embryonic stages and the later adult stages. Native ECM from adult tissues categorized on their origin from respective germ layers are discussed while engineering techniques employed to facilitate differentiation of stem cells into particular lineages are noted. Overall, we emphasize that in vitro strategies need to integrate tissue specific ECM biophysical cues for developing accurate artificial environments for optimizing stem cell differentiation.
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Affiliation(s)
- Abinash Padhi
- Department of Mechanical Engineering, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Amrinder S Nain
- Department of Mechanical Engineering, Virginia Tech, Blacksburg, VA, 24061, USA.
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8
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Abstract
Cell migration is a fundamental process in biological systems, playing an important role for diverse physiological processes. Cells often exhibit directed migration in a specific direction in response to various types of cues. In particular, cells are able to sense the rigidity of surrounding environments and then migrate toward stiffer regions. To understand this mechanosensitive behavior called durotaxis, several computational models have been developed. However, most of the models employed cell decision making to recapitulate durotactic behaviors, significantly limiting insights provided from these studies. In this study, we developed a computational biomechanical model without any cell decision making to illuminate intrinsic mechanisms of durotactic behaviors of cells migrating on a two-dimensional substrate. The model consists of a simplified cell generating contractile forces and a deformable substrate coarse-grained into an irregular triangulated mesh. Using the model, we demonstrated that durotactic behaviors emerge from purely mechanical interactions between the cell and the underlying substrate. We investigated how durotactic migration is regulated by biophysical properties of the substrate, including elasticity, viscosity, and stiffness profile.
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Affiliation(s)
- Abdel-Rahman Hassan
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, Indiana 47907, United States
| | - Thomas Biel
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, Indiana 47907, United States
| | - Taeyoon Kim
- Weldon School of Biomedical Engineering, Purdue University, 206 S. Martin Jischke Drive, West Lafayette, Indiana 47907, United States
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9
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Oliver-De La Cruz J, Nardone G, Vrbsky J, Pompeiano A, Perestrelo AR, Capradossi F, Melajová K, Filipensky P, Forte G. Substrate mechanics controls adipogenesis through YAP phosphorylation by dictating cell spreading. Biomaterials 2019; 205:64-80. [PMID: 30904599 DOI: 10.1016/j.biomaterials.2019.03.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 03/01/2019] [Accepted: 03/10/2019] [Indexed: 12/21/2022]
Abstract
The mechanoregulated proteins YAP/TAZ are involved in the adipogenic/osteogenic switch of mesenchymal stem cells (MSCs). MSC fate decision can be unbalanced by controlling substrate mechanics, in turn altering the transmission of tension through cell cytoskeleton. MSCs have been proposed for orthopedic and reconstructive surgery applications. Thus, a tight control of their adipogenic potential is required in order to avoid their drifting towards fat tissue. Substrate mechanics has been shown to drive MSC commitment and to regulate YAP/TAZ protein shuttling and turnover. The mechanism by which YAP/TAZ co-transcriptional activity is mechanically regulated during MSC fate acquisition is still debated. Here, we design few bioengineering tools suited to disentangle the contribution of mechanical from biological stimuli to MSC adipogenesis. We demonstrate that the mechanical repression of YAP happens through its phosphorylation, is purely mediated by cell spreading downstream of substrate mechanics as dictated by dimensionality. YAP repression is sufficient to prompt MSC adipogenesis, regardless of a permissive biological environment, TEAD nuclear presence or focal adhesion stabilization. Finally, by harnessing the potential of YAP mechanical regulation, we propose a practical example of the exploitation of adipogenic transdifferentiation in tumors.
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Affiliation(s)
- Jorge Oliver-De La Cruz
- International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic; Competence Center for Mechanobiology in Regenerative Medicine, INTERREG ATCZ133, Brno, Czech Republic
| | - Giorgia Nardone
- International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic
| | - Jan Vrbsky
- International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic
| | - Antonio Pompeiano
- International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic
| | - Ana Rubina Perestrelo
- International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic
| | - Francesco Capradossi
- International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic
| | - Katarína Melajová
- International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic
| | | | - Giancarlo Forte
- International Clinical Research Center (FNUSA-ICRC), St. Anne's University Hospital, Brno, Czech Republic; Competence Center for Mechanobiology in Regenerative Medicine, INTERREG ATCZ133, Brno, Czech Republic; Department of Biomaterials Science, Institute of Dentistry, University of Turku, Turku, Finland.
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10
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Wang L, Wu S, Cao G, Fan Y, Dunne N, Li X. Biomechanical studies on biomaterial degradation and co-cultured cells: mechanisms, potential applications, challenges and prospects. J Mater Chem B 2019; 7:7439-7459. [DOI: 10.1039/c9tb01539f] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This review provides a comprehensive overview of biomechanical studies on biomaterial degradation and co-cultured cells as well as valuable biomechanical ideas on how to design or optimize cell biomaterial co-culture system.
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Affiliation(s)
- Lu Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education
- School of Biological Science and Medical Engineering
- Beihang University
- Beijing 100083
- China
| | - Shuai Wu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education
- School of Biological Science and Medical Engineering
- Beihang University
- Beijing 100083
- China
| | - Guangxiu Cao
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education
- School of Biological Science and Medical Engineering
- Beihang University
- Beijing 100083
- China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education
- School of Biological Science and Medical Engineering
- Beihang University
- Beijing 100083
- China
| | - Nicholas Dunne
- Centre for Medical Engineering Research
- School of Mechanical and Manufacturing Engineering
- Dublin City University
- Dublin 9
- Ireland
| | - Xiaoming Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education
- School of Biological Science and Medical Engineering
- Beihang University
- Beijing 100083
- China
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11
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Boffito M, Di Meglio F, Mozetic P, Giannitelli SM, Carmagnola I, Castaldo C, Nurzynska D, Sacco AM, Miraglia R, Montagnani S, Vitale N, Brancaccio M, Tarone G, Basoli F, Rainer A, Trombetta M, Ciardelli G, Chiono V. Surface functionalization of polyurethane scaffolds mimicking the myocardial microenvironment to support cardiac primitive cells. PLoS One 2018; 13:e0199896. [PMID: 29979710 PMCID: PMC6034803 DOI: 10.1371/journal.pone.0199896] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 06/15/2018] [Indexed: 11/28/2022] Open
Abstract
Scaffolds populated with human cardiac progenitor cells (CPCs) represent a therapeutic opportunity for heart regeneration after myocardial infarction. In this work, square-grid scaffolds are prepared by melt-extrusion additive manufacturing from a polyurethane (PU), further subjected to plasma treatment for acrylic acid surface grafting/polymerization and finally grafted with laminin-1 (PU-LN1) or gelatin (PU-G) by carbodiimide chemistry. LN1 is a cardiac niche extracellular matrix component and plays a key role in heart formation during embryogenesis, while G is a low-cost cell-adhesion protein, here used as a control functionalizing molecule. X-ray photoelectron spectroscopy analysis shows nitrogen percentage increase after functionalization. O1s and C1s core-level spectra and static contact angle measurements show changes associated with successful functionalization. ELISA assay confirms LN1 surface grafting. PU-G and PU-LN1 scaffolds both improve CPC adhesion, but LN1 functionalization is superior in promoting proliferation, protection from apoptosis and expression of differentiation markers for cardiomyocytes, endothelial and smooth muscle cells. PU-LN1 and PU scaffolds are biodegraded into non-cytotoxic residues. Scaffolds subcutaneously implanted in mice evoke weak inflammation and integrate with the host tissue, evidencing a significant blood vessel density around the scaffolds. PU-LN1 scaffolds show their superiority in driving CPC behavior, evidencing their promising role in myocardial regenerative medicine.
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Affiliation(s)
- Monica Boffito
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Franca Di Meglio
- Department of Public Health, University of Naples ‘Federico II’, Naples, Italy
| | - Pamela Mozetic
- Department of Engineering, Tissue Engineering Unit, Università Campus Bio-Medico di Roma, Rome, Italy
- Center for Translational Medicine, International Clinical Research Center, St.Anne’s University Hospital, Brno, Czechia
| | - Sara Maria Giannitelli
- Department of Engineering, Tissue Engineering Unit, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Irene Carmagnola
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Clotilde Castaldo
- Department of Public Health, University of Naples ‘Federico II’, Naples, Italy
| | - Daria Nurzynska
- Department of Public Health, University of Naples ‘Federico II’, Naples, Italy
| | - Anna Maria Sacco
- Department of Public Health, University of Naples ‘Federico II’, Naples, Italy
| | - Rita Miraglia
- Department of Public Health, University of Naples ‘Federico II’, Naples, Italy
| | - Stefania Montagnani
- Department of Public Health, University of Naples ‘Federico II’, Naples, Italy
| | - Nicoletta Vitale
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Mara Brancaccio
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Guido Tarone
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Francesco Basoli
- Department of Engineering, Tissue Engineering Unit, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Alberto Rainer
- Department of Engineering, Tissue Engineering Unit, Università Campus Bio-Medico di Roma, Rome, Italy
- Institute for Photonics and Nanotechnology, National Research Council, Rome, Italy
| | - Marcella Trombetta
- Department of Engineering, Tissue Engineering Unit, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Gianluca Ciardelli
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Valeria Chiono
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
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12
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Martino F, Perestrelo AR, Vinarský V, Pagliari S, Forte G. Cellular Mechanotransduction: From Tension to Function. Front Physiol 2018; 9:824. [PMID: 30026699 PMCID: PMC6041413 DOI: 10.3389/fphys.2018.00824] [Citation(s) in RCA: 511] [Impact Index Per Article: 85.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 06/12/2018] [Indexed: 12/15/2022] Open
Abstract
Living cells are constantly exposed to mechanical stimuli arising from the surrounding extracellular matrix (ECM) or from neighboring cells. The intracellular molecular processes through which such physical cues are transformed into a biological response are collectively dubbed as mechanotransduction and are of fundamental importance to help the cell timely adapt to the continuous dynamic modifications of the microenvironment. Local changes in ECM composition and mechanics are driven by a feed forward interplay between the cell and the matrix itself, with the first depositing ECM proteins that in turn will impact on the surrounding cells. As such, these changes occur regularly during tissue development and are a hallmark of the pathologies of aging. Only lately, though, the importance of mechanical cues in controlling cell function (e.g., proliferation, differentiation, migration) has been acknowledged. Here we provide a critical review of the recent insights into the molecular basis of cellular mechanotransduction, by analyzing how mechanical stimuli get transformed into a given biological response through the activation of a peculiar genetic program. Specifically, by recapitulating the processes involved in the interpretation of ECM remodeling by Focal Adhesions at cell-matrix interphase, we revise the role of cytoskeleton tension as the second messenger of the mechanotransduction process and the action of mechano-responsive shuttling proteins converging on stage and cell-specific transcription factors. Finally, we give few paradigmatic examples highlighting the emerging role of malfunctions in cell mechanosensing apparatus in the onset and progression of pathologies.
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Affiliation(s)
- Fabiana Martino
- Center for Translational Medicine, International Clinical Research Center, St. Anne’s University Hospital, Brno, Czechia
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czechia
- Competence Center for Mechanobiology in Regenerative Medicine, INTERREG ATCZ133, Brno, Czechia
| | - Ana R. Perestrelo
- Center for Translational Medicine, International Clinical Research Center, St. Anne’s University Hospital, Brno, Czechia
| | - Vladimír Vinarský
- Center for Translational Medicine, International Clinical Research Center, St. Anne’s University Hospital, Brno, Czechia
- Competence Center for Mechanobiology in Regenerative Medicine, INTERREG ATCZ133, Brno, Czechia
| | - Stefania Pagliari
- Center for Translational Medicine, International Clinical Research Center, St. Anne’s University Hospital, Brno, Czechia
| | - Giancarlo Forte
- Center for Translational Medicine, International Clinical Research Center, St. Anne’s University Hospital, Brno, Czechia
- Competence Center for Mechanobiology in Regenerative Medicine, INTERREG ATCZ133, Brno, Czechia
- Department of Biomaterials Science, Institute of Dentistry, University of Turku, Turku, Finland
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13
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Hasan A, Soliman S, El Hajj F, Tseng YT, Yalcin HC, Marei HE. Fabrication and In Vitro Characterization of a Tissue Engineered PCL-PLLA Heart Valve. Sci Rep 2018; 8:8187. [PMID: 29844329 PMCID: PMC5974353 DOI: 10.1038/s41598-018-26452-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 04/25/2018] [Indexed: 11/25/2022] Open
Abstract
Heart valve diseases are among the leading causes of cardiac failure around the globe. Nearly 90,000 heart valve replacements occur in the USA annually. Currently, available options for heart valve replacement include bioprosthetic and mechanical valves, both of which have severe limitations. Bioprosthetic valves can last for only 10-20 years while patients with mechanical valves always require blood-thinning medications throughout the remainder of the patient's life. Tissue engineering has emerged as a promising solution for the development of a viable, biocompatible and durable heart valve; however, a human implantable tissue engineered heart valve is yet to be achieved. In this study, a tri-leaflet heart valve structure is developed using electrospun polycaprolactone (PCL) and poly L-lactic acid (PLLA) scaffolds, and a set of in vitro testing protocol has been developed for routine manufacturing of tissue engineered heart valves. Stress-strain curves were obtained for mechanical characterization of different valves. The performances of the developed valves were hemodynamically tested using a pulse duplicator, and an echocardiography machine. Results confirmed the superiority of the PCL-PLLA heart valve compared to pure PCL or pure PLLA. The developed in vitro test protocol involving pulse duplicator and echocardiography tests have enormous potential for routine application in tissue engineering of heart valves.
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Affiliation(s)
- Anwarul Hasan
- Department of Mechanical and Industrial Engineering, College of Engineering, Qatar University, Doha, Qatar.
| | | | - Fatima El Hajj
- Biomedical Engineering, Faculty of Engineering and Architecture, American University of Beirut, Beirut, 11-0236, Lebanon
| | - Yuan-Tsan Tseng
- Division of Qatar Cardiovascular Research Center, Sidra Medicine, Doha, Qatar
- Imperial College, NHLI, Heart Science Centre, Harefield, Middlesex, UB9 6JH, United Kingdom
| | - Huseyin C Yalcin
- Biomedical Research Center, Qatar University, Doha, PO Box 2713, Qatar
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14
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Ciocci M, Mochi F, Carotenuto F, Di Giovanni E, Prosposito P, Francini R, De Matteis F, Reshetov I, Casalboni M, Melino S, Di Nardo P. Scaffold-in-Scaffold Potential to Induce Growth and Differentiation of Cardiac Progenitor Cells. Stem Cells Dev 2017; 26:1438-1447. [DOI: 10.1089/scd.2017.0051] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Matteo Ciocci
- Department of Chemical Sciences and Technology, University of Rome Tor Vergata, Rome, Italy
| | - Federico Mochi
- Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy
| | - Felicia Carotenuto
- Center for Regenerative Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emilia Di Giovanni
- Department of Chemical Sciences and Technology, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Prosposito
- Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy
- Center for Regenerative Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Roberto Francini
- Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy
- Center for Regenerative Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fabio De Matteis
- Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy
- Center for Regenerative Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Igor Reshetov
- Center for Regenerative Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Plastic Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Mauro Casalboni
- Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy
- Center for Regenerative Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Sonia Melino
- Department of Chemical Sciences and Technology, University of Rome Tor Vergata, Rome, Italy
- Center for Regenerative Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Di Nardo
- Center for Regenerative Medicine, University of Rome Tor Vergata, Rome, Italy
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
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15
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O'Neill HS, O'Sullivan J, Porteous N, Ruiz-Hernandez E, Kelly HM, O'Brien FJ, Duffy GP. A collagen cardiac patch incorporating alginate microparticles permits the controlled release of hepatocyte growth factor and insulin-like growth factor-1 to enhance cardiac stem cell migration and proliferation. J Tissue Eng Regen Med 2017; 12:e384-e394. [PMID: 27943590 DOI: 10.1002/term.2392] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 11/17/2016] [Accepted: 12/06/2016] [Indexed: 12/25/2022]
Abstract
Cardiac stem cells (CSCs) represent a logical cell type to exploit as a regenerative treatment option for tissue damage accrued as a result of a myocardial infarction. However, the isolation and expansion of CSCs prior to cell transplantation is time consuming, costly and invasive, and the reliability of cell expansion may also prove to be a major obstacle in the clinical application of CSC-based transplantation therapy after a myocardial infarction. In order to overcome this, we propose the incorporation of growth factor-eluting alginate microparticles into collagen-based scaffolds as an implantable biomaterial to promote the recruitment and expansion of CSCs in the myocardium. In order to obtain scaffolds able to enhance the motogenic and proliferative potential of CSCs, the aim of this work was to achieve a sustained delivery of both hepatocyte growth factor and insulin-like growth factor-1. Both proteins were initially encapsulated in alginate microparticles by spray drying and subsequently incorporated into a collagen scaffold. Microparticles were seen to homogeneously distribute through the interconnected scaffold pore structure. The resulting scaffolds were capable of extending the release of both proteins up to 15 days, a three-fold increase over non-encapsulated proteins embedded in the scaffolds. In vitro assays with isolated CSCs demonstrated that the sustained release of both bioactive proteins resulted in an increased motogenic and proliferative effect. As presently practiced, the isolation and expansion of CSCs for autologous cell transplantation is slow, expensive and difficult to attain. Thus, there is a need for strategies to specifically activate in situ the intrinsic cardiac regenerative potential represented by the CSCs using combinations of growth factors obviating the need for cell transplantation. By favouring the natural regenerative capability of CSCs, it is hypothesized that the cardiac patch presented here will result in positive therapeutic outcomes in MI and heart failure patients in the future. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Hugh S O'Neill
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin (TCD), Dublin, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland.,School of Pharmacy, RCSI, Dublin, Ireland
| | - Janice O'Sullivan
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin (TCD), Dublin, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland
| | - Niamh Porteous
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin (TCD), Dublin, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland
| | - Eduardo Ruiz-Hernandez
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin (TCD), Dublin, Ireland
| | - Helena M Kelly
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.,School of Pharmacy, RCSI, Dublin, Ireland
| | - Fergal J O'Brien
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin (TCD), Dublin, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland
| | - Garry P Duffy
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin (TCD), Dublin, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland.,Anatomy, School of Medicine, College of Medicine Nursing and Health Sciences, National University of Ireland Galway, Ireland
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16
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A Hyper-Crosslinked Carbohydrate Polymer Scaffold Facilitates Lineage Commitment and Maintains a Reserve Pool of Proliferating Cardiovascular Progenitors. Transplant Direct 2017; 3:e153. [PMID: 28573188 PMCID: PMC5441984 DOI: 10.1097/txd.0000000000000667] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 02/12/2017] [Indexed: 12/17/2022] Open
Abstract
Background Cardiovascular progenitor cells (CPCs) have been cultured on various scaffolds to resolve the challenge of cell retention after transplantation and to improve functional outcome after cell-based cardiac therapy. Previous studies have reported successful culture of fully differentiated cardiomyocytes on scaffolds of various types, and ongoing efforts are focused on optimizing the mix of cardiomyocytes and endothelial cells as well as on the identification of a source of progenitors capable of reversing cardiovascular damage. A scaffold culture that fosters cell differentiation into cardiomyocytes and endothelial cells while maintaining a progenitor reserve would benefit allogeneic cell transplantation. Methods Isl-1 + c-Kit + CPCs were isolated as clonal populations from human and sheep heart tissue. After hyper-crosslinked carbohydrate polymer scaffold culture, cells were assessed for differentiation, intracellular signaling, cell cycling, and growth factor/chemokine expression using real time polymerase chain reaction, flow cytometry, immunohistochemistry, and calcium staining. Results Insulin-like growth factor 1, hepatocyte growth factor, and stromal cell derived factor 1α paracrine factors were induced, protein kinase B signaling was activated, extracellular signal-regulated kinase phosphorylation was reduced and differentiation into both cardiomyocytes and endothelial cells was induced by scaffold-based cell culture. Interestingly, movement of CPCs out of the G1 phase of the cell cycle and increased expression of pluripotency genes PLOU5F1 (Oct4) and T (Brachyury) within a portion of the cultured population occurred, which suggests the maintenance of a progenitor population. Two-color immunostaining and 3-color fluorescence-activated cell sorting analysis confirmed the presence of both Isl-1 expressing undifferentiated cells and differentiated cells identified by troponin T and von Willebrand factor expression. Ki-67 labeling verified the presence of proliferating cells that remained in situ alongside the differentiated functional derivatives. Conclusions Cloned Isl-1 + c-kit + CPCs maintained on a hyper-cross linked polymer scaffold retain dual potential for proliferation and differentiation, providing a scaffold-based stem cell source for transplantation of committed and proliferating cardiovascular progenitors for functional testing in preclinical models of cell-based repair.
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17
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Choi MY, Kim JT, Lee WJ, Lee Y, Park KM, Yang YI, Park KD. Engineered extracellular microenvironment with a tunable mechanical property for controlling cell behavior and cardiomyogenic fate of cardiac stem cells. Acta Biomater 2017; 50:234-248. [PMID: 28063988 DOI: 10.1016/j.actbio.2017.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/26/2016] [Accepted: 01/01/2017] [Indexed: 12/12/2022]
Abstract
Endogenous cardiac stem cells (CSCs) are known to play a certain role in the myocardial homeostasis of the adult heart. The extracellular matrix (ECM) surrounding CSCs provides mechanical signals to regulate a variety of cell behaviors, yet the impact in the adult heart of these mechanical properties of ECM on CSC renewal and fate decisions is mostly unknown. To elucidate CSC mechanoresponses at the individual cell and myocardial level, we used the sol-to-gel transitional gelatin-poly(ethylene glycol)-tyramine (GPT) hydrogel with a tunable mechanical property to construct a three-dimensional (3D) matrix for culturing native myocardium and CSCs. The elastic modulus of the GPT hydrogel was controlled by adjusting cross-linking density using hydrogen peroxide. The GPT hydrogel showed an ability to transduce integrin-mediated signals into the myocardium and to permit myocardial homeostatic processes in vitro, including CSC migration and proliferation into the hydrogel from the myocardium. Decreasing the elastic modulus of the hydrogel resulted in upregulation of phosphorylated integrin-mediated signaling molecules in CSCs, which were associated with significant increases in cell spreading, migration, and proliferation of CSCs in a modulus-dependent manner. However, increasing the elastic modulus of hydrogel induced the arrest of cell growth but led to upregulation of cardiomyocyte-associated mRNAs in CSCs. This work demonstrates that tunable 3D-engineered microenvironments created by GPT hydrogel are able to control CSC behavior and to direct cardiomyogenic fate. Our system may also be appropriate for studying the mechanoresponse of CSCs in a 3D context as well as for developing therapeutic strategies for in situ myocardial regeneration. STATEMENT OF SIGNIFICANCE The extracellular matrix (ECM) provides a physical framework of myocardial niches in which endogenous cardiac stem cells (CSCs) reside, renew, differentiate, and replace cardiac cells. Interactions between ECM and CSCs might be critical for the maintenance of myocardial homeostasis in the adult heart. Yet most studies done so far have used irrelevant cell types and have been performed at the individual cell level, none able to reflect the in vivo situation. By the use of a chemically defined hydrogel to create a tunable 3D microenvironment, we succeeded in controlling CSC behavior at the myocardial and individual cell level and directing the cardiomyogenic fate. Our work may provide insight into the design of biomaterials for in situ myocardial regeneration as well as for tissue engineering.
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18
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Whang M, Kim J. Synthetic hydrogels with stiffness gradients for durotaxis study and tissue engineering scaffolds. Tissue Eng Regen Med 2016; 13:126-139. [PMID: 30603392 PMCID: PMC6170857 DOI: 10.1007/s13770-016-0026-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 03/02/2016] [Accepted: 03/03/2016] [Indexed: 12/21/2022] Open
Abstract
Migration of cells along the right direction is of paramount importance in a number of in vivo circumstances such as immune response, embryonic developments, morphogenesis, and healing of wounds and scars. While it has been known for a while that spatial gradients in chemical cues guide the direction of cell migration, the significance of the gradient in mechanical cues, such as stiffness of extracellular matrices (ECMs), in directed migration of cells has only recently emerged. With advances in synthetic chemistry, micro-fabrication techniques, and methods to characterize mechanical properties at a length scale even smaller than a single cell, synthetic ECMs with spatially controlled stiffness have been created with variations in design parameters. Since then, the synthetic ECMs have served as platforms to study the migratory behaviors of cells in the presence of the stiffness gradient of ECM and also as scaffolds for the regeneration of tissues. In this review, we highlight recent studies in cell migration directed by the stiffness gradient, called durotaxis, and discuss the mechanisms of durotaxis. We also summarize general methods and design principles to create synthetic ECMs with the stiffness gradients and, finally, conclude by discussing current limitations and future directions of synthetic ECMs for the study of durotaxis and the scaffold for tissue engineering.
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Affiliation(s)
- Minji Whang
- Department of Chemical and Biomolecular Engineering, Sogang University, Seoul, Korea
| | - Jungwook Kim
- Department of Chemical and Biomolecular Engineering, Sogang University, Seoul, Korea
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19
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Lo YP, Liu YS, Rimando MG, Ho JHC, Lin KH, Lee OK. Three-dimensional spherical spatial boundary conditions differentially regulate osteogenic differentiation of mesenchymal stromal cells. Sci Rep 2016; 6:21253. [PMID: 26884253 PMCID: PMC4756701 DOI: 10.1038/srep21253] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 01/20/2016] [Indexed: 01/09/2023] Open
Abstract
The spatial boundary condition (SBC) arising from the surrounding microenvironment imposes specific geometry and spatial constraints that affect organogenesis and tissue homeostasis. Mesenchymal stromal cells (MSCs) sensitively respond to alterations of mechanical cues generated from the SBC. However, mechanical cues provided by a three-dimensional (3D) environment are deprived in a reductionist 2D culture system. This study investigates how SBC affects osteogenic differentiation of MSCs using 3D scaffolds with monodispersed pores and homogenous spherical geometries. MSCs cultured under SBCs with diameters of 100 and 150 μm possessed the greatest capability of osteogenic differentiation. This phenomenon was strongly correlated with MSC morphology, organization of actin cytoskeleton, and distribution of focal adhesion involving α2 and α5 integrins. Further silencing either α2 or α5 integrin significantly reduced the above mentioned mechanosensitivity, indicating that the α2 and α5 integrins as mechano-sensitive molecules mediate MSCs' ability to provide enhanced osteogenic differentiation in response to different spherical SBCs. Taken together, the findings provide new insights regarding how MSCs respond to mechanical cues from the surrounding microenvironment in a spherical SBC, and such biophysical stimuli should be taken into consideration in tissue engineering and regenerative medicine in conjunction with biochemical cues.
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Affiliation(s)
- Yin-Ping Lo
- Program in Molecular Medicine, National Yang-Ming University and Academia Sinica, Taipei 11221, Taiwan
| | - Yi-Shiuan Liu
- Stem Cell Research Center, National Yang-Ming University, Taipei 11221, Taiwan
| | - Marilyn G Rimando
- Taiwan International Graduate Program in Molecular Medicine, National Yang-Ming University and Academia Sinica, Taipei 11221, Taiwan
| | - Jennifer Hui-Chun Ho
- Center for Stem Cell Research, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan.,Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei 11031, Taiwan.,Department of Ophthalmology, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Keng-Hui Lin
- Institute of Physics, Academia Sinica, Taipei 11529, Taiwan
| | - Oscar K Lee
- Taipei City Hospital, Taipei 10341, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei 11221, Taiwan.,Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
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20
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He XL, Zhao YX, Ge LL, An HQ, Su Y, Jin ZL, Wei DS, Chen L. Micropatterned fabrication of chitosan-based thermoresponsive membranes for improving cell adhesion and gene expression. J BIOACT COMPAT POL 2016. [DOI: 10.1177/0883911515623080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A simple, rapid, and economical method to fabricate micropatterned thermoresponsive chitosan membranes was developed. Porous polystyrene films were prepared by liquid-induced phase separation. The size of pores on polystyrene films could be regulated by adjusting the composition of coagulation bath and changing the solvent evaporation rate. Subsequently, chitosan-based thermoresponsive membranes with island protrusions were fabricated using porous polystyrene films as templates. The effects of the micropatterns on the behaviors of mouse fibroblast L929 were investigated. The presence of micropatterns altered the cell cycle distribution and enhanced the gene expression of cyclin D1 and integrin β1. The micro-convex surface could promote the adhesion and proliferation of L929 cells. These results provided valuable guidance to design appropriate topographic surfaces for tissue engineering applications.
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Affiliation(s)
- Xiao-Ling He
- School of Environment and Chemical Engineering, Tianjin Polytechnic University, Tianjin, China
- State Key Laboratory of Separation Membranes and Membrane Processes, Tianjin Key Laboratory of Fiber Modification and Functional Fiber, Tianjin Polytechnic University, Tianjin, China
| | - Yu-Xin Zhao
- School of Environment and Chemical Engineering, Tianjin Polytechnic University, Tianjin, China
| | - Li-Li Ge
- School of Environment and Chemical Engineering, Tianjin Polytechnic University, Tianjin, China
| | - Hui-qin An
- School of Environment and Chemical Engineering, Tianjin Polytechnic University, Tianjin, China
| | - Yu Su
- School of Environment and Chemical Engineering, Tianjin Polytechnic University, Tianjin, China
| | - Zhen-Li Jin
- School of Environment and Chemical Engineering, Tianjin Polytechnic University, Tianjin, China
| | - Dong-Sheng Wei
- College of Life Sciences, Nankai University, Tianjin, China
| | - Li Chen
- State Key Laboratory of Separation Membranes and Membrane Processes, Tianjin Key Laboratory of Fiber Modification and Functional Fiber, Tianjin Polytechnic University, Tianjin, China
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21
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Chun YW, Voyles DE, Rath R, Hofmeister LH, Boire TC, Wilcox H, Lee JH, Bellan LM, Hong CC, Sung HJ. Differential responses of induced pluripotent stem cell-derived cardiomyocytes to anisotropic strain depends on disease status. J Biomech 2015; 48:3890-6. [PMID: 26476764 DOI: 10.1016/j.jbiomech.2015.09.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/10/2015] [Accepted: 09/24/2015] [Indexed: 10/22/2022]
Abstract
Primary dilated cardiomyopathy (DCM) is a non-ischemic heart disease with impaired pumping function of the heart. In this study, we used human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) from a healthy volunteer and a primary DCM patient to investigate the impact of DCM on iPSC-CMs׳ responses to different types of anisotropic strain. A bioreactor system was established that generates cardiac-mimetic forces of 150 kPa at 5% anisotropic cyclic strain and 1 Hz frequency. After confirming cardiac induction of the iPSCs, it was determined that fibronectin was favorable to other extracellular matrix protein coatings (gelatin, laminin, vitronectin) in terms of viable cell area and density, and was therefore selected as the coating for further study. When iPSC-CMs were exposed to three strain conditions (no strain, 5% static strain, and 5% cyclic strain), the static strain elicited significant induction of sarcomere components in comparison to other strain conditions. However, this induction occurred only in iPSC-CMs from a healthy volunteer ("control iPSC-CMs"), not in iPSC-CMs from the DCM patient ("DCM iPSC-CMs"). The donor type also significantly influenced gene expressions of cell-cell and cell-matrix interaction markers in response to the strain conditions. Gene expression of connexin-43 (cell-cell interaction) had a higher fold change in healthy versus diseased iPSC-CMs under static and cyclic strain, as opposed to integrins α-5 and α-10 (cell-matrix interaction). In summary, our iPSC-CM-based study to model the effects of different strain conditions suggests that intrinsic, genetic-based differences in the cardiomyocyte responses to strain may influence disease manifestation in vivo.
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Affiliation(s)
- Young Wook Chun
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA; Division of Cardiovascular Medicine, Vanderbilt Medical Center, Nashville, TN 37232, USA
| | - David E Voyles
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Rutwik Rath
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Lucas H Hofmeister
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Timothy C Boire
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Henry Wilcox
- Department of Biochemistry and Cellular and Molecular Biology, University of Tennessee, Knoxville, TN 37996, USA
| | - Jae Han Lee
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Leon M Bellan
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA; Department of Mechanical Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Charles C Hong
- Division of Cardiovascular Medicine, Vanderbilt Medical Center, Nashville, TN 37232, USA; Research Medicine, Veterans Affairs TVHS, Nashville, TN 37212, USA.
| | - Hak-Joon Sung
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA; Division of Cardiovascular Medicine, Vanderbilt Medical Center, Nashville, TN 37232, USA.
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22
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Gori M, Trombetta M, Santini D, Rainer A. Tissue engineering and microRNAs: future perspectives in regenerative medicine. Expert Opin Biol Ther 2015. [DOI: 10.1517/14712598.2015.1071349] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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23
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Holt-Casper D, Theisen JM, Moreno AP, Warren M, Silva F, Grainger DW, Bull DA, Patel AN. Novel xeno-free human heart matrix-derived three-dimensional scaffolds. J Transl Med 2015; 13:194. [PMID: 26084398 PMCID: PMC4505384 DOI: 10.1186/s12967-015-0559-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 06/02/2015] [Indexed: 12/05/2022] Open
Abstract
Rationale Myocardial infarction (MI) results in damaged heart tissue which can progress to severely reduce cardiac function, leading to death. Recent studies have injected dissociated, suspended cardiac cells into coronary arteries to restore function with limited results attributed to poor cell retention and cell death. Extracellular matrix (ECM) injected into damaged cardiac tissue sites show some promising effects. However, combined use of human cardiac ECM and cardiac cells may produce superior benefits to restore cardiac function. Objective This study was designed to assess use of new three-dimensional human heart ECM-derived scaffolds to serve as vehicles to deliver cardiac-derived cells directly to damaged heart tissue and improve cell retention at these sites while also providing biomechanical support and attracting host cell recruitment. Methods and Results ECM-derived porous protein scaffolds were fabricated from human heart tissues. These scaffolds were designed to carry, actively promote and preserve cardiac cell phenotype, viability and functional retention in tissue sites. ECM scaffolds were optimized and were seeded with human cardiomyocytes, cultured and subsequently implanted ex vivo onto infarcted murine epicardium. Seeded human cardiomyocytes readily adhered to human cardiac-derived ECM scaffolds and maintained representative phenotypes including expression of cardiomyocyte-specific markers, and remained electrically synchronous within the scaffold in vitro. Ex vivo, cardiomyocyte-seeded ECM scaffolds spontaneously adhered and incorporated into murine ventricle. Conclusions Decellularized human cardiac tissue-derived 3D ECM scaffolds are effective delivery vehicles for human cardiac cells to directly target ischemic heart tissue and warrant further studies to assess their therapeutic potential in restoring essential cardiac functions. Electronic supplementary material The online version of this article (doi:10.1186/s12967-015-0559-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dolly Holt-Casper
- Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, 84112, USA. .,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Jeff M Theisen
- Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, 84112, USA. .,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Alonso P Moreno
- Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, 84112-5000, USA. .,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Mark Warren
- Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, 84112-5000, USA. .,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Francisco Silva
- Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, 84112, USA. .,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT, 84112, USA.
| | - David W Grainger
- Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, 84112-5000, USA. .,Department of Bioengineering, University of Utah, Salt Lake City, UT, 84112, USA. .,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT, 84112, USA.
| | - David A Bull
- Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, 84112, USA. .,Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, 84112-5000, USA. .,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Amit N Patel
- Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, 84112, USA. .,Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT, 84112-5000, USA. .,Department of Pharmaceutics and Pharmaceutical Chemistry, University of Utah, Salt Lake City, UT, 84112, USA. .,University of Utah, 30 N 1900 E SOM 3c127, Salt Lake City, UT, 84132, USA.
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24
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Deng B, Deng W, Xiao P, Zeng K, Zhang S, Zhang H, Deng DY, Yang Y. Nonadherent culture method downregulates stem cell antigen-1 expression in mouse bone marrow mesenchymal stem cells. Exp Ther Med 2015; 10:31-36. [PMID: 26170908 DOI: 10.3892/etm.2015.2457] [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: 06/05/2014] [Accepted: 03/05/2015] [Indexed: 12/13/2022] Open
Abstract
Mesenchymal stem cells (MSCs) are primarily isolated by their adherence to plastic and their in vitro growth characteristics. Expansion of these cells from an adherent culture is the only method to obtain a sufficient number of cells for use in clinical practice and research. However, little is known with regard to the effect of adherence to plastic on the phenotype of the cells. In the present study, bone marrow CD45-CD31-CD44- stem cell antigen (Sca)-1+ MSCs were sorted by flow cytometry and expanded in adherent cultures. The expression levels of the adhesion molecule, Sca-1, in the adherent cultures were compared with those from nonadherent cultures at different time points. The flow cytometry results indicated that the expression levels of Sca-1 decreased in the MSCs in the nonadherent cultures grown in ultra-low-adherent plates. Furthermore, the result was confirmed by quantitative polymerase chain reaction at the same time points. Therefore, the results demonstrated that the loss of plastic adherence downregulated the expression of Sca-1. The observations may provide novel insights into the molecular mechanisms underlying plastic adherent culture.
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Affiliation(s)
- Baoping Deng
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Weiping Deng
- Department of Gastroenterology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China
| | - Pingnan Xiao
- Center for Hematology and Regenerative Medicine (HERM), Karolinska Institute, Stockholm SE-141 86, Sweden
| | - Kuan Zeng
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Shining Zhang
- Department of Nuclear Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Hongwu Zhang
- Department of Transfer Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China
| | - David Yb Deng
- Department of Transfer Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China
| | - Yanqi Yang
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510120, P.R. China
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25
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Walkey C, Das S, Seal S, Erlichman J, Heckman K, Ghibelli L, Traversa E, McGinnis JF, Self WT. Catalytic Properties and Biomedical Applications of Cerium Oxide Nanoparticles. ENVIRONMENTAL SCIENCE. NANO 2015; 2:33-53. [PMID: 26207185 PMCID: PMC4508017 DOI: 10.1039/c4en00138a] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Cerium oxide nanoparticles (Nanoceria) have shown promise as catalytic antioxidants in the test tube, cell culture models and animal models of disease. However given the reactivity that is well established at the surface of these nanoparticles, the biological utilization of Nanoceria as a therapeutic still poses many challenges. Moreover the form that these particles take in a biological environment, such as the changes that can occur due to a protein corona, are not well established. This review aims to summarize the existing literature on biological use of Nanoceria, and to raise questions about what further study is needed to apply this interesting catalytic material to biomedical applications. These questions include: 1) How does preparation, exposure dose, route and experimental model influence the reported effects of Nanoceria in animal studies? 2) What are the considerations to develop Nanoceria as a therapeutic agent in regards to these parameters? 3) What biological targets of reactive oxygen species (ROS) and reactive nitrogen species (RNS) are relevant to this targeting, and how do these properties also influence the safety of these nanomaterials?
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Affiliation(s)
- Carl Walkey
- Integrated Nanotechnology and Biomedical Sciences Laboratory, Terrence Donnelly Building, University of Toronto, 160 College St., Toronto, ON M5S 3G9, Canada
| | - Soumen Das
- Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center, University of Central Florida, Orlando, FL, US
| | - Sudipta Seal
- Advanced Materials Processing and Analysis Centre, Nanoscience Technology Center, University of Central Florida, Orlando, FL, US
| | - Joseph Erlichman
- Department of Biology, St. Lawrence University, Johnson Hall of Science, 23 Romoda Drive, Canton, NY 13617
| | - Karin Heckman
- Department of Biology, St. Lawrence University, Johnson Hall of Science, 23 Romoda Drive, Canton, NY 13617
| | - Lina Ghibelli
- Department of Biology, Università di Roma Tor Vergata, Via della Ricerca Scientifica, 00133 Roma, Italy
| | - Enrico Traversa
- King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - James F McGinnis
- Dean A. McGee Eye Institute, Department of Ophthalmology, 608 Stanton L. Young, Blvd., Oklahoma City, OK 73126
| | - William T Self
- Burnett School of Biomedical Science, College of Medicine, University of Central Florida, Orlando, Florida 32816
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26
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Zhu B, Li W, Lewis RV, Segre CU, Wang R. E-spun composite fibers of collagen and dragline silk protein: fiber mechanics, biocompatibility, and application in stem cell differentiation. Biomacromolecules 2014; 16:202-13. [PMID: 25405355 PMCID: PMC4294589 DOI: 10.1021/bm501403f] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
![]()
Biocomposite
matrices with high mechanical strength, high stability,
and the ability to direct matrix-specific stem cell differentiation
are essential for the reconstruction of lesioned tissues in tissue
engineering and cell therapeutics. Toward this end, we used the electrospinning
technique to fabricate well-aligned composite fibers from collagen
and spider dragline silk protein, obtained from the milk of transgenic
goats, mimicking the native extracellular matrix (ECM) on a similar
scale. Collagen and the dragline silk proteins were found to mix homogeneously
at all ratios in the electrospun (E-spun) fibers. As a result, the
ultimate tensile strength and elasticity of the fibers increased monotonically
with silk percentage, whereas the stretchability was slightly reduced.
Strikingly, we found that the incorporation of silk proteins to collagen
dramatically increased the matrix stability against excessive fiber
swelling and shape deformation in cell culture medium. When human
decidua parietalis placental stem cells (hdpPSCs) were seeded on the
collagen–silk matrices, the matrices were found to support
cell proliferation at a similar rate as that of the pure collagen
matrix, but they provided cell adhesion with reduced strengths and
induced cell polarization at varied levels. Matrices containing 15
and 30 wt % silk in collagen (CS15, CS30) were found to induce a level
of neural differentiation comparable to that of pure collagen. In
particular, CS15 matrix induced the highest extent of cell polarization
and promoted the development of extended 1D neural filaments strictly
in-line with the aligned fibers. Taking the increased mechanical strength
and fiber stability into consideration, CS15 and CS30 E-spun fibers
offer better alternatives to pure collagen fibers as scaffolds that
can be potentially utilized in neural tissue repair and the development
of future nanobiodevices.
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Affiliation(s)
- Bofan Zhu
- Department of Biological and Chemical Sciences, ‡Department of Physics, Illinois Institute of Technology , Chicago, Illinois 60616, United States
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27
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Jadczyk T, Faulkner A, Madeddu P. Stem cell therapy for cardiovascular disease: the demise of alchemy and rise of pharmacology. Br J Pharmacol 2014; 169:247-68. [PMID: 22712727 DOI: 10.1111/j.1476-5381.2012.01965.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Regenerative medicine holds great promise as a way of addressing the limitations of current treatments of ischaemic disease. In preclinical models, transplantation of different types of stem cells or progenitor cells results in improved recovery from ischaemia. Furthermore, experimental studies indicate that cell therapy influences a spectrum of processes, including neovascularization and cardiomyogenesis as well as inflammation, apoptosis and interstitial fibrosis. Thus, distinct strategies might be required for specific regenerative needs. Nonetheless, clinical studies have so far investigated a relatively small number of options, focusing mainly on the use of bone marrow-derived cells. Rapid clinical translation resulted in a number of small clinical trials that do not have sufficient power to address the therapeutic potential of the new approach. Moreover, full exploitation has been hindered so far by the absence of a solid theoretical framework and inadequate development plans. This article reviews the current knowledge on cell therapy and proposes a model theory for interpretation of experimental and clinical outcomes from a pharmacological perspective. Eventually, with an increased association between cell therapy and traditional pharmacotherapy, we will soon need to adopt a unified theory for understanding how the two practices additively interact for a patient's benefit.
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Affiliation(s)
- T Jadczyk
- Third Division of Cardiology, Medical University of Silesia, Katovice, Poland
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28
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Gong T, Zhao K, Yang G, Li J, Chen H, Chen Y, Zhou S. The control of mesenchymal stem cell differentiation using dynamically tunable surface microgrooves. Adv Healthc Mater 2014; 3:1608-19. [PMID: 24648133 DOI: 10.1002/adhm.201300692] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 02/20/2014] [Indexed: 12/18/2022]
Abstract
Many studies have demonstrated the potential to modulate stem cell differentiation by using static material substrate surfaces. However, cells actually grow in a dynamically diverse microenvironment in vivo. The regulated signals to the differentiation provided by these materials should not be passive or static but be active and dynamic. To mimic the endogenous cell culture microenvironment, a novel system is designed to realize the dynamic change of the surface geometries as well as a resultant mechanical force using a thermally activated four-stage shape memory polymer. The parallel microgroove surface patterns are fabricated via thermal embossing lithography on the polymer substrate surface. The dynamic microgroove surfaces accompanying with the mechanical force can effectively and significantly regulate the shape and the cytoskeletal arrangement of rBMSC compared with the static patterned and non-patterned surfaces. Cellular and molecular analyses reveal that the spatiotemporally programmed regulation of cell shape is more viable to coax lineage-specific differentiation of stem cell in contrast to the general reports with the static surfaces. Therefore, this study provides a facile strategy in designing and manufacturing an artificial substrate with a mimic natural cellular environment to precisely direct the cell differentiation.
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Affiliation(s)
- Tao Gong
- Key Laboratory of Advanced Technologies of Materials; Ministry of Education; School of Materials Science and Engineering; Southwest Jiaotong University; Chengdu 610031 China
| | - Kun Zhao
- Key Laboratory of Advanced Technologies of Materials; Ministry of Education; School of Materials Science and Engineering; Southwest Jiaotong University; Chengdu 610031 China
| | - Guang Yang
- Key Laboratory of Advanced Technologies of Materials; Ministry of Education; School of Materials Science and Engineering; Southwest Jiaotong University; Chengdu 610031 China
| | - Jinrong Li
- Key Laboratory of Advanced Technologies of Materials; Ministry of Education; School of Materials Science and Engineering; Southwest Jiaotong University; Chengdu 610031 China
| | - Hongmei Chen
- Key Laboratory of Advanced Technologies of Materials; Ministry of Education; School of Materials Science and Engineering; Southwest Jiaotong University; Chengdu 610031 China
| | - Yuping Chen
- Key Laboratory of Advanced Technologies of Materials; Ministry of Education; School of Materials Science and Engineering; Southwest Jiaotong University; Chengdu 610031 China
| | - Shaobing Zhou
- Key Laboratory of Advanced Technologies of Materials; Ministry of Education; School of Materials Science and Engineering; Southwest Jiaotong University; Chengdu 610031 China
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29
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Valente M, Nascimento DS, Cumano A, Pinto-do-Ó P. Sca-1+ cardiac progenitor cells and heart-making: a critical synopsis. Stem Cells Dev 2014; 23:2263-73. [PMID: 24926741 DOI: 10.1089/scd.2014.0197] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The identification, in the adult, of cardiomyocyte turnover events and of cardiac progenitor cells (CPCs) has revolutionized the field of cardiovascular medicine. However, the low rate of CPCs differentiation events reported both in vitro and in vivo, even after injury, raised concerns on the biological significance of these subsets. In this Comprehensive Review, we discuss the current understanding of cardiac Lin(-)Sca-1(+) cells in light of what is also known for cellular compartments with similar phenotypes in other organs. The Lin(-)Sca-1(+) heart subset is heterogeneous and displays a mesenchymal profile, characterized by a limited ability to generate cardiomyocytes in vitro and in vivo, even after injury. There is no evidence for Sca-1 expression in embryonic cardiovascular progenitors. In other organs, Sca-1 expression is mainly observed on mesoderm-derived cells, although it is not restricted to stem/progenitor cell populations. It is urgent to determine, at a single cell level, to which extent cardiac Lin(-)Sca-1(+) cells overlap with the fibroblast compartment.
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Affiliation(s)
- Mariana Valente
- 1 Stem-Cell Microenvironments in Repair/Regeneration Team, Microenvironments for NewTherapies Group, INEB-Instituto Nacional de Engenharia Biomédica, Universidade do Porto , Porto, Portugal
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30
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Abstract
Although the adult mammalian heart was once believed to be a post-mitotic organ without any capacity for regeneration, recent findings have challenged this dogma. A modified view assigns to the mammalian heart a measurable capacity for regeneration throughout life. The ultimate goals of the cardiac regeneration field have been pursued by multiple strategies, including understanding the developmental biology of cardiomyocytes and cardiac stem and progenitor cells, applying chemical genetics, and engineering biomaterials and delivery methods that facilitate cell transplantation. Successful stimulation of endogenous regenerative capacity in injured adult mammalian hearts can benefit from studies of natural cardiac regeneration.
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Affiliation(s)
- Aurora Bernal
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), C/Melchor Fernández Almagro, 3, 28029 Madrid, Spain
| | - Beatriz G. Gálvez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), C/Melchor Fernández Almagro, 3, 28029 Madrid, Spain
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31
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Seyedmahmoud R, Mozetic P, Rainer A, Giannitelli SM, Basoli F, Trombetta M, Traversa E, Licoccia S, Rinaldi A. A primer of statistical methods for correlating parameters and properties of electrospun poly(l-lactide) scaffolds for tissue engineering-PART 2: Regression. J Biomed Mater Res A 2014; 103:103-14. [DOI: 10.1002/jbm.a.35183] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 03/19/2014] [Indexed: 12/20/2022]
Affiliation(s)
- Rasoul Seyedmahmoud
- Department of Chemical Science and Technology and NAST Center; University of Rome Tor Vergata; Rome Italy
| | - Pamela Mozetic
- Tissue Engineering Laboratory, CIR-Center of Integrated Research, Università Campus Bio-Medico di Roma; Rome Italy
| | - Alberto Rainer
- Tissue Engineering Laboratory, CIR-Center of Integrated Research, Università Campus Bio-Medico di Roma; Rome Italy
| | - Sara Maria Giannitelli
- Tissue Engineering Laboratory, CIR-Center of Integrated Research, Università Campus Bio-Medico di Roma; Rome Italy
| | - Francesco Basoli
- Department of Chemical Science and Technology and NAST Center; University of Rome Tor Vergata; Rome Italy
| | - Marcella Trombetta
- Tissue Engineering Laboratory, CIR-Center of Integrated Research, Università Campus Bio-Medico di Roma; Rome Italy
| | - Enrico Traversa
- Department of Chemical Science and Technology and NAST Center; University of Rome Tor Vergata; Rome Italy
- Division of Physical Sciences and Engineering; King Abdullah University of Science and Technology (KAUST); Thuwal 23955-6900 Kingdom of Saudi Arabia
| | - Silvia Licoccia
- Department of Chemical Science and Technology and NAST Center; University of Rome Tor Vergata; Rome Italy
| | - Antonio Rinaldi
- Department of Chemical Science and Technology and NAST Center; University of Rome Tor Vergata; Rome Italy
- ENEA,CR Casaccia; Via Anguillarese 301, Santa Maria di Galeria Rome Italy
- International Research Center for Mathematics & Mechanics of Complex Systems, University of L'Aquila; Via S. Pasquale, Cisterna di Latina (LT) Italy
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32
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Mosqueira D, Pagliari S, Uto K, Ebara M, Romanazzo S, Escobedo-Lucea C, Nakanishi J, Taniguchi A, Franzese O, Di Nardo P, Goumans MJ, Traversa E, Pinto-do-Ó P, Aoyagi T, Forte G. Hippo pathway effectors control cardiac progenitor cell fate by acting as dynamic sensors of substrate mechanics and nanostructure. ACS NANO 2014; 8:2033-2047. [PMID: 24483337 DOI: 10.1021/nn4058984] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Stem cell responsiveness to extracellular matrix (ECM) composition and mechanical cues has been the subject of a number of investigations so far, yet the molecular mechanisms underlying stem cell mechano-biology still need full clarification. Here we demonstrate that the paralog proteins YAP and TAZ exert a crucial role in adult cardiac progenitor cell mechano-sensing and fate decision. Cardiac progenitors respond to dynamic modifications in substrate rigidity and nanopattern by promptly changing YAP/TAZ intracellular localization. We identify a novel activity of YAP and TAZ in the regulation of tubulogenesis in 3D environments and highlight a role for YAP/TAZ in cardiac progenitor proliferation and differentiation. Furthermore, we show that YAP/TAZ expression is triggered in the heart cells located at the infarct border zone. Our results suggest a fundamental role for the YAP/TAZ axis in the response of resident progenitor cells to the modifications in microenvironment nanostructure and mechanics, thereby contributing to the maintenance of myocardial homeostasis in the adult heart. These proteins are indicated as potential targets to control cardiac progenitor cell fate by materials design.
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Affiliation(s)
- Diogo Mosqueira
- Biomaterials Unit, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Tsukuba, Japan
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33
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Seyedmahmoud R, Rainer A, Mozetic P, Maria Giannitelli S, Trombetta M, Traversa E, Licoccia S, Rinaldi A. A primer of statistical methods for correlating parameters and properties of electrospun poly(l-lactide) scaffolds for tissue engineering-PART 1: Design of experiments. J Biomed Mater Res A 2014; 103:91-102. [DOI: 10.1002/jbm.a.35153] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 01/28/2014] [Accepted: 02/18/2014] [Indexed: 01/15/2023]
Affiliation(s)
- Rasoul Seyedmahmoud
- Department of Chemical Science and Technology and NAST Center; University of Rome Tor Vergata; 00133 Rome Italy
| | - Alberto Rainer
- Tissue Engineering Laboratory; CIR-Center of Integrated Research, Università Campus Bio-Medico di Roma; 00128 Rome Italy
| | - Pamela Mozetic
- Tissue Engineering Laboratory; CIR-Center of Integrated Research, Università Campus Bio-Medico di Roma; 00128 Rome Italy
| | - Sara Maria Giannitelli
- Tissue Engineering Laboratory; CIR-Center of Integrated Research, Università Campus Bio-Medico di Roma; 00128 Rome Italy
| | - Marcella Trombetta
- Tissue Engineering Laboratory; CIR-Center of Integrated Research, Università Campus Bio-Medico di Roma; 00128 Rome Italy
| | - Enrico Traversa
- Department of Chemical Science and Technology and NAST Center; University of Rome Tor Vergata; 00133 Rome Italy
- Division of Physical Sciences and Engineering, King Abdullah University of Science and Technology (KAUST); Thuwal 23955-6900 Kingdom of Saudi Arabia
| | - Silvia Licoccia
- Department of Chemical Science and Technology and NAST Center; University of Rome Tor Vergata; 00133 Rome Italy
| | - Antonio Rinaldi
- Department of Chemical Science and Technology and NAST Center; University of Rome Tor Vergata; 00133 Rome Italy
- ENEA, CR Casaccia, Via Anguillarese 301; Santa Maria di Galeria, 00123 Rome Italy
- International Research Center for Mathematics & Mechanics of Complex Systems, University of L'Aquila; Via S. Pasquale, 04012 Cisterna di Latina (LT) Italy
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34
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Anionic polymers and 10nm Fe3O4@UA wound dressings support human foetal stem cells normal development and exhibit great antimicrobial properties. Int J Pharm 2014; 463:146-54. [DOI: 10.1016/j.ijpharm.2013.08.026] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 08/21/2013] [Indexed: 11/24/2022]
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35
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Cheng Q, Harris GM, Blais MO, Rutledge K, Jabbarzadeh E. Alignment of Carbon Nanotubes: An Approach to Modulate Cell Orientation and Asymmetry. NANO LIFE 2014; 4:1450002. [PMID: 27170837 PMCID: PMC4861238 DOI: 10.1142/s1793984414500020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Stem cells offer a promising tool in tissue engineering strategies, as their differentiated derivatives can be used to reconstruct most biological tissues. These approaches rely on controlling the biophysical cues that tune the ultimate fate of cells. In this context, significant effort has gone to parse out the role of conflicting matrix-elicited signals (e.g., topography and elasticity) in regulation of macroscopic characteristics of cells (e.g., shape and polarity). A critical hurdle, however, lies in our inability to recapitulate the nanoscale spatiotemporal pattern of these signals. The study presented in this manuscript took an initial step to overcome this challenge by developing a carbon nanotube (CNT)-based substrate for nanoresolution control of focal adhesion formation and cell alignment. The utility of this system was studied using human umbilical vascular endothelial cells (HUVECs) and human embryonic stem cells (hESCs) at a single cell level. Our results demonstrated the ability to control cell orientation by merely controlling the alignment of focal adhesions at a nanoscale size. Our long-term vision is to use these nanoengineered substrates to mimic cell orientation in earlier development and explore the role of polarity in asymmetric division and lineage specification of dividing cells.
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Affiliation(s)
- Qingsu Cheng
- Biomedical Engineering Program, University of South Carolina, SC 29208, USA
| | - Greg M. Harris
- Department of Chemical Engineering Program, University of South Carolina, SC 29208, USA
| | - Marc-Olivier Blais
- Department of Chemical Engineering Program, University of South Carolina, SC 29208, USA
| | - Katy Rutledge
- Department of Chemical Engineering Program, University of South Carolina, SC 29208, USA
| | - Ehsan Jabbarzadeh
- Biomedical Engineering Program, University of South Carolina, SC 29208, USA
- Department of Chemical Engineering Program, University of South Carolina, SC 29208, USA
- Department of Orthopaedic Surgery, University of South Carolina, SC 29208, USA
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36
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Orza AI, Mihu C, Soritau O, Diudea M, Florea A, Matei H, Balici S, Mudalige T, Kanarpardy GK, Biris AS. Multistructural biomimetic substrates for controlled cellular differentiation. NANOTECHNOLOGY 2014; 25:065102. [PMID: 24434767 DOI: 10.1088/0957-4484/25/6/065102] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Multidimensional scaffolds are considered to be ideal candidates for regenerative medicine and tissue engineering based on their potential to provide an excellent microenvironment and direct the fate of the cultured cells. More recently, the use of stem cells in medicine has opened a new technological opportunity for controlled tissue formation. However, the mechanism through which the substrate directs the differentiation of stem cells is still rather unclear. Data concerning its specific surface chemistry, topology, and its signaling ability need to be further understood and analyzed. In our study, atomic force microscopy was used to study the stiffness, roughness, and topology of the collagen (Coll) and metallized collagen (MC) substrates, proposed as an excellent substrate for regenerative medicine. The importance of signaling molecules was studied by constructing a new hybrid signaling substrate that contains both collagen and laminin extracellular matrix (ECM) proteins. The cellular response-such as attachment capability, proliferation and cardiac and neuronal phenotype expression on the metallized and non-metallized hybrid substrates (collagen + laminin)-was studied using MTT viability assay and immunohistochemistry studies. Our findings indicate that such hybrid materials could play an important role in the regeneration of complex tissues.
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Affiliation(s)
- Anamaria I Orza
- Center for Integrative Nanotechnology Sciences, University of Arkansas at Little Rock, 2801 South University Avenue, Little Rock, AR 72204, USA. The Oncology Institute, Prof. Dr. I. Chiricuta, Republicii, No. 34-36, RO-400015, Cluj-Napoca, Romania
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37
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Freire AG, Nascimento DS, Forte G, Valente M, Resende TP, Pagliari S, Abreu C, Carvalho I, Di Nardo P, Pinto-do-Ó P. Stable phenotype and function of immortalized Lin-Sca-1+ cardiac progenitor cells in long-term culture: a step closer to standardization. Stem Cells Dev 2014; 23:1012-26. [PMID: 24367889 DOI: 10.1089/scd.2013.0305] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Putative cardiac progenitor cells (CPCs) have been identified in the myocardium and are regarded as promising candidates for cardiac cell-based therapies. Although two distinct populations of CPCs reached the clinical setting, more detailed studies are required to portray the optimal cell type and therapeutic setting to drive robust cell engraftment and cardiomyogenesis after injury. Owing to the scarcity of the CPCs and the need for reproducibility, the generation of faithful cellular models would facilitate this scrutiny. Here, we evaluate whether immortalized Lin(-)Sca-1(+) CPCs (iCPC(Sca-1)) represent their native-cell counterpart, thereby constituting a robust in vitro model system for standardized investigation in the cardiac field. iCPC(Sca-1) were established in vitro as plastic adherent cells endowed with robust self-renewal capacity while preserving a stable phenotype in long-term culture. iCPC(Sca-1) differentiated into cardiomyocytic-, endothelial-, and smooth muscle-like cells when subjected to appropriate stimuli. The cell line consistently displayed features of Lin(-)Sca-1(+) CPCs in vitro, as well as in vivo after intramyocardial delivery in the onset of myocardial infarction (MI). Transplanted iCPC(Sca-1) significantly attenuated the functional and anatomical alterations caused by MI while promoting neovascularization. iCPC(Sca-1) are further shown to engraft, establish functional connections, and differentiate in loco into cardiomyocyte- and vasculature-like cells. These data validate iCPC(Sca-1) as an in vitro model system for Lin(-)Sca-1(+) progenitors and for systematic dissection of mechanisms underlying CPC subsets engraftment/differentiation in vivo. Moreover, iCPC(Sca-1) can be regarded as a ready-to-use CPCs source for pre-clinical bioengineering studies toward the development of novel strategies for restoration of the damaged myocardium.
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Affiliation(s)
- Ana G Freire
- 1 INEB-Instituto de Engenharia Biomédica, Universidade do Porto , Porto, Portugal
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Chiono V, Mozetic P, Boffito M, Sartori S, Gioffredi E, Silvestri A, Rainer A, Giannitelli SM, Trombetta M, Nurzynska D, Di Meglio F, Castaldo C, Miraglia R, Montagnani S, Ciardelli G. Polyurethane-based scaffolds for myocardial tissue engineering. Interface Focus 2014; 4:20130045. [PMID: 24501673 DOI: 10.1098/rsfs.2013.0045] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Bi-layered scaffolds with a 0°/90° lay-down pattern were prepared by melt-extrusion additive manufacturing (AM) using a poly(ester urethane) (PU) synthesized from poly(ε-caprolactone) diol, 1,4-butandiisocyanate and l-lysine ethyl ester dihydrochloride chain extender. Rheological analysis and differential scanning calorimetry of the starting material showed that compression moulded PU films were in the molten state at a higher temperature than 155°C. The AM processing temperature was set at 155°C after verifying the absence of PU thermal degradation phenomena by isothermal thermogravimetry analysis and rheological characterization performed at 165°C. Scaffolds highly reproduced computer-aided design geometry and showed an elastomeric-like behaviour which is promising for applications in myocardial regeneration. PU scaffolds supported the adhesion and spreading of human cardiac progenitor cells (CPCs), whereas they did not stimulate CPC proliferation after 1-14 days culture time. In the future, scaffold surface functionalization with bioactive peptides/proteins will be performed to specifically guide CPC behaviour.
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Affiliation(s)
- Valeria Chiono
- Department of Mechanical and Aerospace Engineering , Politecnico di Torino , Corso Duca degli Abruzzi 24, Turin , Italy
| | - Pamela Mozetic
- Tissue Engineering Laboratory , Università 'Campus Bio-Medico di Roma' , Via Alvaro del Portillo 21, Rome , Italy
| | - Monica Boffito
- Department of Mechanical and Aerospace Engineering , Politecnico di Torino , Corso Duca degli Abruzzi 24, Turin , Italy
| | - Susanna Sartori
- Department of Mechanical and Aerospace Engineering , Politecnico di Torino , Corso Duca degli Abruzzi 24, Turin , Italy
| | - Emilia Gioffredi
- Department of Mechanical and Aerospace Engineering , Politecnico di Torino , Corso Duca degli Abruzzi 24, Turin , Italy
| | - Antonella Silvestri
- Department of Mechanical and Aerospace Engineering , Politecnico di Torino , Corso Duca degli Abruzzi 24, Turin , Italy
| | - Alberto Rainer
- Tissue Engineering Laboratory , Università 'Campus Bio-Medico di Roma' , Via Alvaro del Portillo 21, Rome , Italy
| | - Sara Maria Giannitelli
- Tissue Engineering Laboratory , Università 'Campus Bio-Medico di Roma' , Via Alvaro del Portillo 21, Rome , Italy
| | - Marcella Trombetta
- Tissue Engineering Laboratory , Università 'Campus Bio-Medico di Roma' , Via Alvaro del Portillo 21, Rome , Italy
| | - Daria Nurzynska
- Department of Public Health , University of Naples 'Federico II' , Via Pansini 5, Naples , Italy
| | - Franca Di Meglio
- Department of Public Health , University of Naples 'Federico II' , Via Pansini 5, Naples , Italy
| | - Clotilde Castaldo
- Department of Public Health , University of Naples 'Federico II' , Via Pansini 5, Naples , Italy
| | - Rita Miraglia
- Department of Public Health , University of Naples 'Federico II' , Via Pansini 5, Naples , Italy
| | - Stefania Montagnani
- Department of Public Health , University of Naples 'Federico II' , Via Pansini 5, Naples , Italy
| | - Gianluca Ciardelli
- Department of Mechanical and Aerospace Engineering , Politecnico di Torino , Corso Duca degli Abruzzi 24, Turin , Italy
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Giannitelli SM, Accoto D, Trombetta M, Rainer A. Current trends in the design of scaffolds for computer-aided tissue engineering. Acta Biomater 2014; 10:580-94. [PMID: 24184176 DOI: 10.1016/j.actbio.2013.10.024] [Citation(s) in RCA: 206] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 09/28/2013] [Accepted: 10/22/2013] [Indexed: 02/07/2023]
Abstract
Advances introduced by additive manufacturing have significantly improved the ability to tailor scaffold architecture, enhancing the control over microstructural features. This has led to a growing interest in the development of innovative scaffold designs, as testified by the increasing amount of research activities devoted to the understanding of the correlation between topological features of scaffolds and their resulting properties, in order to find architectures capable of optimal trade-off between often conflicting requirements (such as biological and mechanical ones). The main aim of this paper is to provide a review and propose a classification of existing methodologies for scaffold design and optimization in order to address key issues and help in deciphering the complex link between design criteria and resulting scaffold properties.
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Affiliation(s)
- S M Giannitelli
- Tissue Engineering Laboratory, CIR - Center for Integrated Research, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128 Rome, Italy
| | - D Accoto
- Biomedical Robotics and Biomicrosystems Laboratory, CIR - Center for Integrated Research, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128 Rome, Italy
| | - M Trombetta
- Tissue Engineering Laboratory, CIR - Center for Integrated Research, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128 Rome, Italy
| | - A Rainer
- Tissue Engineering Laboratory, CIR - Center for Integrated Research, Università Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128 Rome, Italy.
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40
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Forte G, Pagliari S, Pagliari F, Ebara M, Di Nardo P, Aoyagi T. Towards the generation of patient-specific patches for cardiac repair. Stem Cell Rev Rep 2014; 9:313-25. [PMID: 22006278 DOI: 10.1007/s12015-011-9325-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cardiovascular diseases represent the main cause of morbidity and mortality worldwide. Millions of people are affected by such diseases in the industrialized countries, with hundreds of thousands new cases diagnosed every year. Among cardiac diseases, heart failure is the most common end-stage pathology, leading to impaired cardiac output and cardiac performance as a result of the irreversible loss of contractile cardiomyocytes. Tissue engineering holds the promise to provide personalized solutions to the problem of cardiac muscle repair. Indeed, the identification of little reservoirs of stem and progenitor cells within every body district opened new perspectives to the setup of patient-specific protocols for cardiac diseases. Nonetheless, the results of the first pre-clinical and clinical trials in which adult stem/progenitor cells were adopted pointed at the route of delivery to the injured organ as well as at the cell source as the main issues for cardiac tissue engineers. In fact, when adult stem cells were directly injected into the myocardium or delivered through bloodstream to the heart, no or few cells could be found engrafted within host tissue few days after the administration. Renewed enthusiasm was generated by the techniques set up to enrich cardiomyocytes obtained by embryonic stem cells and by the recent disclosure of the protocols to obtain reprogrammed pluripotent cells or reprogrammed cardiomyocytes out of patients' own somatic cells. In this context, additional efforts to setup efficient systems to deliver stem cells to the injured site are required. The application of forefront technologies to fabricate synthetic and hybrid scaffolds to be employed as cell delivery systems and the acknowledgement that surface physical, mechanical, chemical properties can exert specific effects on stem cells per se prompted new enthusiasm in the field. In this respect, a cardiac-specific scaffold should be able to comply with cardiac muscle architecture, be deformable as to indulge and possibly sustain cardiac contraction. As expected, such a scaffold should favor stem cell electromechanical coupling with host tissue, while promoting the vascularization of the newly-formed tissue.
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Affiliation(s)
- Giancarlo Forte
- Biomaterials Unit, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), 1-1 Namiki, Tsukuba, 305-0044, Japan.
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Wen Z, Mai Z, Zhang H, Chen Y, Geng D, Zhou S, Wang J. Local activation of cardiac stem cells for post-myocardial infarction cardiac repair. J Cell Mol Med 2014; 16:2549-63. [PMID: 22613044 PMCID: PMC4118225 DOI: 10.1111/j.1582-4934.2012.01589.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The prognosis of patients with myocardial infarction (MI) and resultant chronic heart failure remains extremely poor despite continuous advancements in optimal medical therapy and interventional procedures. Animal experiments and clinical trials using adult stem cell therapy following MI have shown a global improvement of myocardial function. The emergence of stem cell transplantation approaches has recently represented promising alternatives to stimulate myocardial regeneration. Regarding their tissue-specific properties, cardiac stem cells (CSCs) residing within the heart have advantages over other stem cell types to be the best cell source for cell transplantation. However, time-consuming and costly procedures to expanse cells prior to cell transplantation and the reliability of cell culture and expansion may both be major obstacles in the clinical application of CSC-based transplantation therapy after MI. The recognition that the adult heart possesses endogenous CSCs that can regenerate cardiomyocytes and vascular cells has raised the unique therapeutic strategy to reconstitute dead myocardium via activating these cells post-MI. Several strategies, such as growth factors, mircoRNAs and drugs, may be implemented to potentiate endogenous CSCs to repair infarcted heart without cell transplantation. Most molecular and cellular mechanism involved in the process of CSC-based endogenous regeneration after MI is far from understanding. This article reviews current knowledge opening up the possibilities of cardiac repair through CSCs activation in situ in the setting of MI.
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Affiliation(s)
- Zhuzhi Wen
- Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
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42
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Tallawi M, Rai R, R-Gleixner M, Roerick O, Weyand M, Roether JA, Schubert DW, Kozlowska A, Fray ME, Merle B, Göken M, Aifantis K, Boccaccini AR. Poly(glycerol sebacate)\Poly(butylene succinate-dilinoleate) Blends as Candidate Materials for Cardiac Tissue Engineering. ACTA ACUST UNITED AC 2013. [DOI: 10.1002/masy.201300114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- M. Tallawi
- Institute of Biomaterials; Department of Materials Science and Engineering; University of Erlangen-Nuremberg; 91058 Erlangen Germany
| | - R. Rai
- Institute of Biomaterials; Department of Materials Science and Engineering; University of Erlangen-Nuremberg; 91058 Erlangen Germany
| | - M. R-Gleixner
- Department of Cardiac Surgery; University of Erlangen-Nuremberg; 91054 Erlangen Germany
| | - O. Roerick
- Department of Cardiac Surgery; University of Erlangen-Nuremberg; 91054 Erlangen Germany
| | - M. Weyand
- Department of Cardiac Surgery; University of Erlangen-Nuremberg; 91054 Erlangen Germany
| | - J. A. Roether
- Institute of Polymeric Materials; Department of Materials Science and Engineering; University of Erlangen-Nuremberg; 91058 Erlangen Germany
| | - D. W. Schubert
- Institute of Polymeric Materials; Department of Materials Science and Engineering; University of Erlangen-Nuremberg; 91058 Erlangen Germany
| | - A. Kozlowska
- Polymer Institute; Division of Biomaterials and Microbiological Technologies; West Pomeranian University of Technology; Szczecin Poland
| | - M. El Fray
- Polymer Institute; Division of Biomaterials and Microbiological Technologies; West Pomeranian University of Technology; Szczecin Poland
| | - B. Merle
- Institute of General Materials Properties; Department of Materials Science and Engineering; University of Erlangen-Nuremberg; 91058 Erlangen Germany
| | - M. Göken
- Institute of General Materials Properties; Department of Materials Science and Engineering; University of Erlangen-Nuremberg; 91058 Erlangen Germany
| | - K. Aifantis
- Lab of Mechanics and Materials; School of Engineering; Aristotle University of Thessaloniki; 54124 Thessaloniki Greece
| | - A. R. Boccaccini
- Institute of Biomaterials; Department of Materials Science and Engineering; University of Erlangen-Nuremberg; 91058 Erlangen Germany
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The effect of bioartificial constructs that mimic myocardial structure and biomechanical properties on stem cell commitment towards cardiac lineage. Biomaterials 2013; 35:92-104. [PMID: 24099712 DOI: 10.1016/j.biomaterials.2013.09.058] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 09/17/2013] [Indexed: 01/10/2023]
Abstract
Despite the enormous progress in the treatment of coronary artery diseases, they remain the most common cause of heart failure in the Western countries. New translational therapeutic approaches explore cardiomyogenic differentiation of various types of stem cells in combination with tissue-engineered scaffolds. In this study we fabricated PHBHV/gelatin constructs mimicking myocardial structural properties. Chemical structure and molecular interaction between material components induced specific properties to the substrate in terms of hydrophilicity degree, porosity and mechanical characteristics. Viability and proliferation assays demonstrated that these constructs allow adhesion and growth of mesenchymal stem cells (MSCs) and cardiac resident non myocytic cells (NMCs). Immunofluorescence analysis demonstrated that stem cells cultured on these constructs adopt a distribution mimicking the three-dimensional cell alignment of myocardium. qPCR and immunofluorescence analyses showed the ability of this construct to direct initial MSC and NMC lineage specification towards cardiomyogenesis: both MSCs and NMCs showed the expression of the cardiac transcription factor GATA-4, fundamental for early cardiac commitment. Moreover NMCs also acquired the expression of the cardiac transcription factors Nkx2.5 and TBX5 and produced sarcomeric proteins. This work may represent a new approach to induce both resident and non-resident stem cells to cardiac commitment in a 3-D structure, without using additional stimuli.
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44
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Boffito M, Sartori S, Ciardelli G. Polymeric scaffolds for cardiac tissue engineering: requirements and fabrication technologies. POLYM INT 2013. [DOI: 10.1002/pi.4608] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Monica Boffito
- Department of Mechanical and Aerospace Engineering; Politecnico di Torino; Corso Duca degli Abruzzi 24 10129 Turin Italy
| | - Susanna Sartori
- Department of Mechanical and Aerospace Engineering; Politecnico di Torino; Corso Duca degli Abruzzi 24 10129 Turin Italy
| | - Gianluca Ciardelli
- Department of Mechanical and Aerospace Engineering; Politecnico di Torino; Corso Duca degli Abruzzi 24 10129 Turin Italy
- CNR-IPCF UOS Pisa; Via Moruzzi 1 56124 Pisa Italy
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45
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Silvestri A, Boffito M, Sartori S, Ciardelli G. Biomimetic Materials and Scaffolds for Myocardial Tissue Regeneration. Macromol Biosci 2013; 13:984-1019. [DOI: 10.1002/mabi.201200483] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 04/23/2013] [Indexed: 12/14/2022]
Affiliation(s)
- Antonella Silvestri
- Department of Mechanical and Aerospace Engineering; Politecnico di Torino; Corso Duca degli Abruzzi 24 10129 Turin Italy
| | - Monica Boffito
- Department of Mechanical and Aerospace Engineering; Politecnico di Torino; Corso Duca degli Abruzzi 24 10129 Turin Italy
| | - Susanna Sartori
- Department of Mechanical and Aerospace Engineering; Politecnico di Torino; Corso Duca degli Abruzzi 24 10129 Turin Italy
| | - Gianluca Ciardelli
- Department of Mechanical and Aerospace Engineering; Politecnico di Torino; Corso Duca degli Abruzzi 24 10129 Turin Italy
- CNR-IPCF UOS Pisa; Via Moruzzi 1 56124 Pisa Italy
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46
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Di Felice V, Zummo G. Stem cell populations in the heart and the role of Isl1 positive cells. Eur J Histochem 2013; 57:e14. [PMID: 23807293 PMCID: PMC3794340 DOI: 10.4081/ejh.2013.e14] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 02/04/2013] [Accepted: 02/08/2013] [Indexed: 11/23/2022] Open
Abstract
Cardiac progenitor cells are multipotent stem cells isolated from both embryonic and adult hearts in several species and are able to differentiate at least into smooth muscle cells, endothelial cells and cardiomyocytes. The embryonic origin of these cells has not yet been demonstrated, but it has been suggested that these cells may derive from the first and secondary heart fields and from the neural crest. In the last decade, two diffe-rent populations of cardiac progenitor or stem cells have been identified and isolated, i.e., the Islet1 positive (Isl1+) and c-Kit positive (c-Kit+)/Stem Cell Antigen-1 positive (Sca-1+) cells. Until 2012, these two populations have been considered two separate entities with different roles and a different origin, but new evidence now suggests a con-nection between the two populations and that the two populations may represent two subpopulations of a unique pool of cardiac stem cells, derived from a common immature primitive cell. To find a common consensus on this concept is very important in furthe-ring the application of stem cells to cardiac tissue engineering.
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Affiliation(s)
- V Di Felice
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, 90127 Palermo, Italy.
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47
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Higuchi A, Ling QD, Chang Y, Hsu ST, Umezawa A. Physical Cues of Biomaterials Guide Stem Cell Differentiation Fate. Chem Rev 2013; 113:3297-328. [DOI: 10.1021/cr300426x] [Citation(s) in RCA: 335] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Akon Higuchi
- Department of Chemical and Materials
Engineering, National Central University, Jhongli, Taoyuan 32001, Taiwan
- Department of Reproductive Biology, National Research Institute for Child Health and Development, 2-10-1 Okura,
Setagaya-ku, Tokyo 157-8535, Japan
- Cathay Medical Research Institute, Cathay General Hospital, No. 32, Ln 160, Jian-Cheng Road, Hsi-Chi City, Taipei 221, Taiwan
| | - Qing-Dong Ling
- Cathay Medical Research Institute, Cathay General Hospital, No. 32, Ln 160, Jian-Cheng Road, Hsi-Chi City, Taipei 221, Taiwan
- Institute of Systems Biology
and Bioinformatics, National Central University, No. 300 Jhongda Rd., Jhongli, Taoyuan 32001, Taiwan
| | - Yung Chang
- Department of Chemical Engineering, R&D Center for Membrane Technology, Chung Yuan Christian University, 200 Chung-Bei Rd., Jhongli, Taoyuan 320, Taiwan
| | - Shih-Tien Hsu
- Taiwan Landseed Hospital, 77 Kuangtai Road, Pingjen City, Tao-Yuan
County 32405, Taiwan
| | - Akihiro Umezawa
- Department of Reproductive Biology, National Research Institute for Child Health and Development, 2-10-1 Okura,
Setagaya-ku, Tokyo 157-8535, Japan
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48
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Romanazzo S, Forte G, Ebara M, Uto K, Pagliari S, Aoyagi T, Traversa E, Taniguchi A. Substrate stiffness affects skeletal myoblast differentiation in vitro. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2012; 13:064211. [PMID: 27877538 PMCID: PMC5099771 DOI: 10.1088/1468-6996/13/6/064211] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 10/11/2012] [Indexed: 05/06/2023]
Abstract
To maximize the therapeutic efficacy of cardiac muscle constructs produced by stem cells and tissue engineering protocols, suitable scaffolds should be designed to recapitulate all the characteristics of native muscle and mimic the microenvironment encountered by cells in vivo. Moreover, so not to interfere with cardiac contractility, the scaffold should be deformable enough to withstand muscle contraction. Recently, it was suggested that the mechanical properties of scaffolds can interfere with stem/progenitor cell functions, and thus careful consideration is required when choosing polymers for targeted applications. In this study, cross-linked poly-ε-caprolactone membranes having similar chemical composition and controlled stiffness in a supra-physiological range were challenged with two sources of myoblasts to evaluate the suitability of substrates with different stiffness for cell adhesion, proliferation and differentiation. Furthermore, muscle-specific and non-related feeder layers were prepared on stiff surfaces to reveal the contribution of biological and mechanical cues to skeletal muscle progenitor differentiation. We demonstrated that substrate stiffness does affect myogenic differentiation, meaning that softer substrates can promote differentiation and that a muscle-specific feeder layer can improve the degree of maturation in skeletal muscle stem cells.
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Affiliation(s)
- Sara Romanazzo
- Cell–Materials Interaction Group, Biomaterials Unit, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Tsukuba, Japan
- Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Giancarlo Forte
- Smart Biomaterials Laboratory, Biomaterials Unit, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Tsukuba, Japan
| | - Mitsuhiro Ebara
- Smart Biomaterials Laboratory, Biomaterials Unit, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Tsukuba, Japan
| | - Koichiro Uto
- Smart Biomaterials Laboratory, Biomaterials Unit, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Tsukuba, Japan
| | - Stefania Pagliari
- Smart Biomaterials Laboratory, Biomaterials Unit, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Tsukuba, Japan
| | - Takao Aoyagi
- Smart Biomaterials Laboratory, Biomaterials Unit, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Tsukuba, Japan
| | - Enrico Traversa
- Department of Chemical Science and Technology, University of Rome ‘Tor Vergata’, Italy
| | - Akiyoshi Taniguchi
- Cell–Materials Interaction Group, Biomaterials Unit, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), Tsukuba, Japan
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49
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Van Tam JK, Uto K, Ebara M, Pagliari S, Forte G, Aoyagi T. Mesenchymal stem cell adhesion but not plasticity is affected by high substrate stiffness. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2012; 13:064205. [PMID: 27877532 PMCID: PMC5099765 DOI: 10.1088/1468-6996/13/6/064205] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 10/01/2012] [Indexed: 06/06/2023]
Abstract
The acknowledged ability of synthetic materials to induce cell-specific responses regardless of biological supplies provides tissue engineers with the opportunity to find the appropriate materials and conditions to prepare tissue-targeted scaffolds. Stem and mature cells have been shown to acquire distinct morphologies in vitro and to modify their phenotype when grown on synthetic materials with tunable mechanical properties. The stiffness of the substrate used for cell culture is likely to provide cells with mechanical cues mimicking given physiological or pathological conditions, thus affecting the biological properties of cells. The sensitivity of cells to substrate composition and mechanical properties resides in multiprotein complexes called focal adhesions, whose dynamic modification leads to cytoskeleton remodeling and changes in gene expression. In this study, the remodeling of focal adhesions in human mesenchymal stem cells in response to substrate stiffness was followed in the first phases of cell-matrix interaction, using poly-ε-caprolactone planar films with similar chemical composition and different elasticity. As compared to mature dermal fibroblasts, mesenchymal stem cells showed a specific response to substrate stiffness, in terms of adhesion, as a result of differential focal adhesion assembly, while their multipotency as a bulk was not significantly affected by matrix compliance. Given the sensitivity of stem cells to matrix mechanics, the mechanobiology of such cells requires further investigations before preparing tissue-specific scaffolds.
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Affiliation(s)
| | | | | | | | - Giancarlo Forte
- Biomaterials Unit, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan
| | - Takao Aoyagi
- Biomaterials Unit, International Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science (NIMS), 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan
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50
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Bayomy AF, Bauer M, Qiu Y, Liao R. Regeneration in heart disease-Is ECM the key? Life Sci 2012; 91:823-7. [PMID: 22982346 DOI: 10.1016/j.lfs.2012.08.034] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 08/21/2012] [Accepted: 08/30/2012] [Indexed: 12/17/2022]
Abstract
The heart possesses a regeneration potential derived from endogenous and exogenous stem and progenitor cell populations, though baseline regeneration appears to be sub-therapeutic. This limitation was initially attributed to a lack of cells with cardiomyogenic potential following an insult to the myocardium. Rather, recent studies demonstrate increased numbers of cardiomyocyte progenitor cells in diseased hearts. Given that the limiting factor does not appear to be cell quantity but rather repletion of functional cardiomyocytes, it is crucial to understand potential mechanisms inhibiting progenitor cell differentiation. One of the extensively studied areas in heart disease is extracellular matrix (ECM) remodeling, with both the composition and mechanical properties of the ECM undergoing changes in diseased hearts. This review explores the influence of ECM properties on cardiomyogenesis and adult cardiac progenitor cells.
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Affiliation(s)
- Ahmad F Bayomy
- Cardiac Muscle Research Laboratory, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA 02115, USA
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