Fabrication of Chitosan Silk-based Tracheal Scaffold Using Freeze-Casting Method

Challenges and Opportunities in Developing Tracheal Substitutes for the Recovery of Long-Segment Defects

Tracheal resection and reconstruction procedures are necessary when stenosis, tracheomalacia, tumors, vascular lesions, or tracheal injury cause a tracheal blockage. Replacement with a tracheal substitute is often recommended when the trauma exceeds 50% of the total length of the trachea in adults and 30% in children. Recently, tissue engineering and other advanced techniques have shown promise in fabricating biocompatible tracheal substitutes with physical, morphological, biomechanical, and biological characteristics similar to native trachea. Different polymers and biometals are explored. Even with limited success with tissue-engineered grafts in clinical settings, complete healing of tracheal defects remains a substantial challenge due to low mechanical strength and durability of the graft materials, inadequate re-epithelialization and vascularization, and restenosis. This review has covered a range of reconstructive and regenerative techniques, design criteria, the use of bioprostheses and synthetic grafts for the recovery of tracheal defects, as well as the traditional and cutting-edge methods of their fabrication, surface modification for increased immuno- or biocompatibility, and associated challenges.

Preparation and evaluation of antibacterial wound dressing based on vancomycin-loaded silk/dialdehyde starch nanoparticles

One of the main reasons infected wounds go untreated is that antibiotic-resistant bacteria mainly cause infection. Vancomycin is an antibiotic used against Gram-positive bacteria, such as MRSA, but it has limited intravenous use due to its toxicity. This study describes using a local drug delivery approach at the wound site. The aim is to prepare a silk dressing containing dialdehyde starch nanoparticles loaded with vancomycin that can cure infection through the controlled release of antibiotics. First, the starch was oxidized by sodium periodate solution and converted to dialdehyde starch. Dialdehyde starch was converted into nanoparticles by the microemulsion method. Simultaneously, with nanoparticle formation, the antibiotic vancomycin (VAN), added to the solution, was loaded into the dialdehyde starch nanoparticles (DASNP). The wound dressing (SF/DASNP/VAN) was prepared by adding nanoparticles containing antibiotics to the silk fibroin (SF) solution, and then, the solution containing the nanoparticles was freeze-dried, and the nanoparticles were placed inside the silk matrix. Drug release of dressings was performed by immersion in phosphate-buffered saline, and cytotoxicity by MTT assay and antibacterial properties of dressings were investigated by the inhibition zone method. The morphology of the SF/DASNP/VAN dressing, its biocompatibility, antibacterial efficiency, and antibiotic release kinetics were assessed. The synthesized dressing has the desired biocompatibility with 69% cell viability and shows antibacterial properties against MRSA with a growth inhibition zone diameter of 12 mm. Also, VAN was successfully incorporated into the dressing, resulting in a 144-h continuous release profile. It may be concluded that the fabricated dressing based on silk and dialdehyde starch nanoparticles opens up a new option for topical administration of antibiotics. We believe its properties can be considered a new dressing for infectious wounds by reducing infection associated with controlled drug delivery.

Non-Mulberry Silk Fiber-Based Composite Scaffolds Containing Millichannels for Auricular Cartilage Regeneration

Tissue engineering has made significant progress as a cartilage repair alternative. It is crucial to promote cell proliferation and migration within three-dimensional (3D) bulk scaffolds for tissue regeneration through either chemical gradients or physical channels. In this study, by developing optimized silk fiber-based composite scaffolds, millimeter-scaled channels were created in the corresponding scaffolds via facile physical percussive drilling and subsequently utilized for auricular cartilage regeneration. We found that by the introduction of poly-l-lactic acid porous microspheres (PLLA PMs), the channels incorporated into the Antheraea pernyi (Ap) silk fiber-based scaffolds were reinforced, and the mechanical features were well maintained. Moreover, Ap silk fiber-based scaffolds reinforced by PLLA PMs containing channels (CMAF) exhibited excellent chondrocyte proliferation, migration, and synthesis of cartilage-specific extracellular matrix (ECM) in vitro. The biological evaluation in vivo revealed that CMAF had a higher chondrogenic capability for an even deposition of the specific ECM component. This study suggested that multihierarchical CMAF may have potential application for auricular cartilage regeneration.

Emerging Paradigms in Bioengineering the Lungs

In end-stage lung diseases, the shortage of donor lungs for transplantation and long waiting lists are the main culprits in the significantly increasing number of patient deaths. New strategies to curb this issue are being developed with the help of recent advancements in bioengineering technology, with the generation of lung scaffolds as a steppingstone. There are various types of lung scaffolds, namely, acellular scaffolds that are developed via decellularization and recellularization techniques, artificial scaffolds that are synthesized using synthetic, biodegradable, and low immunogenic materials, and hybrid scaffolds which combine the advantageous properties of materials in the development of a desirable lung scaffold. There have also been advances in the design of bioreactors in terms of providing an optimal regenerative environment for the maturation of functional lung tissue over time. In this review, the emerging paradigms in the field of lung tissue bioengineering will be discussed.

Tissue Engineering for Tracheal Replacement: Strategies and Challenges

The critical feature in trachea replacement is to provide a hollow cylindrical framework that is laterally stable and longitudinally flexible, facilitating cartilage and epithelial tissue formation. Despite advanced techniques and sources of materials used, most inherent challenges are related to the complexity of its anatomy. Limited blood supply leads to insufficient regenerative capacity for cartilage and epithelium. Natural and synthetic scaffolds, different types of cells, and growth factors are part of tissue engineering approaches with varying outcomes. Pre-vascularization remains one of the crucial factors to expedite the regenerative process in tracheal reconstruction. This review discusses the challenges and strategies used in tracheal tissue engineering, focusing on scaffold implantation in clinical and preclinical studies conducted in recent decades.

Advanced Hydrogels for Cartilage Tissue Engineering: Recent Progress and Future Directions

Cartilage is a tension- and load-bearing tissue and has a limited capacity for intrinsic self-healing. While microfracture and arthroplasty are the conventional methods for cartilage repair, these methods are unable to completely heal the damaged tissue. The need to overcome the restrictions of these therapies for cartilage regeneration has expanded the field of cartilage tissue engineering (CTE), in which novel engineering and biological approaches are introduced to accelerate the development of new biomimetic cartilage to replace the injured tissue. Until now, a wide range of hydrogels and cell sources have been employed for CTE to either recapitulate microenvironmental cues during a new tissue growth or to compel the recovery of cartilaginous structures via manipulating biochemical and biomechanical properties of the original tissue. Towards modifying current cartilage treatments, advanced hydrogels have been designed and synthesized in recent years to improve network crosslinking and self-recovery of implanted scaffolds after damage in vivo. This review focused on the recent advances in CTE, especially self-healing hydrogels. The article firstly presents the cartilage tissue, its defects, and treatments. Subsequently, introduces CTE and summarizes the polymeric hydrogels and their advances. Furthermore, characterizations, the advantages, and disadvantages of advanced hydrogels such as multi-materials, IPNs, nanomaterials, and supramolecular are discussed. Afterward, the self-healing hydrogels in CTE, mechanisms, and the physical and chemical methods for the synthesis of such hydrogels for improving the reformation of CTE are introduced. The article then briefly describes the fabrication methods in CTE. Finally, this review presents a conclusion of prevalent challenges and future outlooks for self-healing hydrogels in CTE applications.

Biocompatibility of Alginate -Graphene Oxide Film for Tissue Engineering Applications

The present paper indicates promising potential of Sodium Alginate) Alg)/Graphene oxide (Go) films in fields bone tissue engineering (TE). The Sodium Alginate (Alg)/Graphene oxide (Go) films, were fabricated via (solvent casting method). The interaction of Sodium Alginate (Alg) with Graphene oxide (Go) via hydrogen bonding was confirmed by FTIR analysis. The swelling degree of Sodium Alginate (Alg)/Graphene oxid (Go) films was also studied. Furthermore, the biocompatibility of Sodium Alginate (Alg)/Graphene oxide (Go) films disclosed its non-cytotoxic effect on the cell lines (MG-63) in-vitro test, the viability of cell lines on the films, and hence its appropriateness as potent biomaterial for tissue engineering.

Advanced Multi-Dimensional Cellular Models as Emerging Reality to Reproduce In Vitro the Human Body Complexity

A hot topic in biomedical science is the implementation of more predictive in vitro models of human tissues to significantly improve the knowledge of physiological or pathological process, drugs discovery and screening. Bidimensional (2D) culture systems still represent good high-throughput options for basic research. Unfortunately, these systems are not able to recapitulate the in vivo three-dimensional (3D) environment of native tissues, resulting in a poor in vitro–in vivo translation. In addition, intra-species differences limited the use of animal data for predicting human responses, increasing in vivo preclinical failures and ethical concerns. Dealing with these challenges, in vitro 3D technological approaches were recently bioengineered as promising platforms able to closely capture the complexity of in vivo normal/pathological tissues. Potentially, such systems could resemble tissue-specific extracellular matrix (ECM), cell–cell and cell–ECM interactions and specific cell biological responses to mechanical and physical/chemical properties of the matrix. In this context, this review presents the state of the art of the most advanced progresses of the last years. A special attention to the emerging technologies for the development of human 3D disease-relevant and physiological models, varying from cell self-assembly (i.e., multicellular spheroids and organoids) to the use of biomaterials and microfluidic devices has been given.

Fabrication and characterization of mechanically competent 3D printed polycaprolactone-reduced graphene oxide scaffolds

The ability to produce constructs with a high control over the bulk geometry and internal architecture has situated 3D printing as an attractive fabrication technique for scaffolds. Various designs and inks are actively investigated to prepare scaffolds for different tissues. In this work, we prepared 3D printed composite scaffolds comprising polycaprolactone (PCL) and various amounts of reduced graphene oxide (rGO) at 0.5, 1, and 3 wt.%. We employed a two-step fabrication process to ensure an even mixture and distribution of the rGO sheets within the PCL matrix. The inks were prepared by creating composite PCL-rGO films through solvent evaporation casting that were subsequently fed into the 3D printer for extrusion. The resultant scaffolds were seamlessly integrated, and 3D printed with high fidelity and consistency across all groups. This, together with the homogeneous dispersion of the rGO sheets within the polymer matrix, significantly improved the compressive strength and stiffness by 185% and 150%, respectively, at 0.5 wt.% rGO inclusion. The in vitro response of the scaffolds was assessed using human adipose-derived stem cells. All scaffolds were cytocompatible and supported cell growth and viability. These mechanically reinforced and biologically compatible 3D printed PCL-rGO scaffolds are a promising platform for regenerative engineering applications.

Effects of lamellar microstructure of retinoic acid loaded-matrixes on physicochemical properties, migration, and neural differentiation of P19 embryonic carcinoma cells

In this study, retinoic acid loaded-PLGA-gelatin matrixes were prepared with both freeze-casting and freeze-drying techniques. Herein, the effect of unidirectional microstructure with tunable pores on release profile, cellular adhesion, migration, and differentiation was compared. Morphological observation determined that highly interconnected porous structure can be formed, but lamellar pore channels were observed in freeze-casting prepared constructs. The absorption ratio was increased, and the biodegradation rate was decreased as a function of the orientation of microstructure. The in-vitro release study illustrated non-Fickian release mechanism in both methods, so that erosion has predominated over diffusion. Accordingly, PLGA-gelatin scaffolds prepared with freeze-drying technique showed no adequate erosion due to the rigid structure, while freeze-casting one presented more favorable erosion. Microscopic observations of adhered P19 embryonic cells on the scaffolds showed that the freeze-casting matrixes with unidirectional pores provide a more compatible microenvironment for cell attachments and spreading. Besides, it facilitated cell migration and penetration inside the structure and may act as guidance for neuron growth. Improvement in the expression of neural genes in unidirectionally oriented pores proved the decisive role of contact guidance for nerve healing. It seems that the freeze-cast PLGA-gelatin-retinoic acid scaffolds have initial features for nerve tissue regeneration studies.

Tissue engineering applications in otolaryngology-The state of translation

While tissue engineering holds significant potential to address current limitations in reconstructive surgery of the head and neck, few constructs have made their way into routine clinical use. In this review, we aim to appraise the state of head and neck tissue engineering over the past five years, with a specific focus on otologic, nasal, craniofacial bone, and laryngotracheal applications. A comprehensive scoping search of the PubMed database was performed and over 2000 article hits were returned with 290 articles included in the final review. These publications have addressed the hallmark characteristics of tissue engineering (cellular source, scaffold, and growth signaling) for head and neck anatomical sites. While there have been promising reports of effective tissue engineered interventions in small groups of human patients, the majority of research remains constrained to in vitro and in vivo studies aimed at furthering the understanding of the biological processes involved in tissue engineering. Further, differences in functional and cosmetic properties of the ear, nose, airway, and craniofacial bone affect the emphasis of investigation at each site. While otolaryngologists currently play a role in tissue engineering translational research, continued multidisciplinary efforts will likely be required to push the state of translation towards tissue-engineered constructs available for routine clinical use.

LEVEL OF EVIDENCE

NA.

Mussel-inspired polydopamine induced the osteoinductivity to ice-templating PLGA-gelatin matrix for bone tissue engineering application

In this study, poly(lactic-co-glycolic acid) (PLGA)-gelatin scaffolds were fabricated using the freeze-casting technique. Polydopamine (PDA) coating was applied on the surface of scaffolds to enhance the hydrophilicity, bioactivity, and cellular behavior of the composite constructs. Further, the synergistic effect of PDA coating and lamellar microstructure of scaffolds was evaluated on the promotion of properties. Based on morphological observations, freeze-casting constructs showed lamellar pore channels while the uniformity and pore size were slightly affected by deposition of PDA. The hydrophilicity and swelling capacity of the scaffolds were assessed using contact angle measurement and phosphate buffered saline absorption ratio. The results indicated a significant increment in water-matrix interactions following surface modification. The evaluation of the biodegradation ratio revealed the higher degree of degradation in PDA-coated samples owing to the presence of hydrophilic functional groups in the chemical structure of PDA. On the other hand, the bioactivity potential of PDA in the simulated body fluid solution confirmed the possibility of using coated constructs as a bone reconstructive substitute. The improvement of cellular attachment and filopodia formation in PDA-contained matrixes was the other benefit of the coating process. Furthermore, cellular proliferation and ALP activity were enhanced after PDA coating. The suggested PDA-coated PLGA-gelatin scaffolds can be applied in bone tissue regeneration.

Preparation and characterization of human size whole heart for organ engineering: scaffold microangiographic imaging

Definitive treatment for end-stage heart failure is heart transplantation, however, this is associated with several limitations. Aim: We decellularized and assessed ovine hearts through coronary perfusion. To evaluate in situ recellularization, a decellular graft was transplanted hetrotopically into the omental wrap. Results: Cell removal was confirmed by DNA count (11.68 ± 3.42 ng/mg dry weight). Elastic, reticular and collagen fiber were well preserved. There was a slight change in both glycosaminoglycan (7.01 ± 1.36 to 8.37 ± 0.32 μg/mg) and collagen (32.37 ± 2.3 to 36.31 ± 2.1) μg/mg (p > 0.05). Angiography and blood circulation revealed an intact vascular network. Implantation led to proper vascularization. Image J indicated CD31: 23.98 ± 12.3; CD34: 48.67 ± 19.5 and αSMA: 78.33 ± 27.8 inch/cm. Conclusion: Bio-scaffold of human size heart is achievable for future steps employing this technique.

Bombyx mori derived scaffolds and their use in cartilage regeneration: a systematic review

For the last two decades, silk has been extensively used as scaffolds in tissue engineering because of its remarkable properties. Unfortunately, the aneural property of cartilage limits its regenerative potential which can be achieved using tissue engineering approach. A lot of research has been published searching for the optimization of silk fibroin (SF) and its blends in order to get the best cartilage mimicking properties. However, according to our best knowledge, there is no systematic review available regarding the use of Bombyx mori derived biomaterials limited to cartilage related studies. This systematic review highlights the in vitro and in vivo work done for the past 7 years on structural and functional properties of B. mori derived biomaterials together with different parameters for cartilage regeneration. PubMed database was searched focusing on in vitro and in vivo studies using the search thread "silk fibroin" and "cartilage". A total of 40 articles met the inclusion criteria. All the articles were deeply studied for cell types, scaffold types and animal models used along with study design and results. Five types of cells were used for in vitro while seven types of cells were used for in vivo studies. Three types of animal models were used for scaffold implantation purpose. Moreover, different types of scaffolds either seeded with cells or supplemented with various factors were explored and discussed in detail. Results suggest the suitability of silk as a better biomaterial because of its cartilage mimicking properties.

Evaluation of Acellular Bilayer Silk Fibroin Grafts for Onlay Tracheoplasty in a Rat Defect Model

OBJECTIVE

To assess the efficacy of acellular bilayer silk fibroin (BLSF) grafts to repair full-thickness tracheal defects and to compare the performance with conventional porcine small intestinal submucosa (SIS) implants.

STUDY DESIGN

A prospective controlled animal trial in a rat model of onlay tracheoplasty.

SETTING

Pediatric medical center.

SUBJECTS AND METHODS

Tracheal reconstruction of adult Sprague-Dawley rats was performed with BLSF (n = 38) or SIS (n = 32) matrices for up to 3 months of implantation. Functional evaluations of repaired conduits as well as histologic, immunohistochemical, and histomorphometric analyses of neotissues were assessed.

RESULTS

Prior to scheduled euthanasia, survival rates of rats receiving BLSF or SIS grafts were ≥94%, with no clinical signs of airway obstruction observed over the course of the study. Micro-computed tomography analysis revealed that the mean percentage of stenosis was <20% in both implant groups. BLSF and SIS grafts supported formation of pseudostratified ciliated columnar epithelium by 1 week postoperatively; however, each matrix failed to promote de novo chondrogenesis by 3 months following repair.

CONCLUSIONS

BLSF scaffolds can be used for reconstruction of rat tracheal patch defects with functional outcomes comparable to those of SIS matrices.

How to build a lung: latest advances and emerging themes in lung bioengineering

Chronic respiratory diseases remain a major cause of morbidity and mortality worldwide. The only option at end-stage disease is lung transplantation, but there are not enough donor lungs to meet clinical demand. Alternative options to increase tissue availability for lung transplantation are urgently required to close the gap on this unmet clinical need. A growing number of tissue engineering approaches are exploring the potential to generate lung tissue ex vivo for transplantation. Both biologically derived and manufactured scaffolds seeded with cells and grown ex vivo have been explored in pre-clinical studies, with the eventual goal of generating functional pulmonary tissue for transplantation. Recently, there have been significant efforts to scale-up cell culture methods to generate adequate cell numbers for human-scale bioengineering approaches. Concomitantly, there have been exciting efforts in designing bioreactors that allow for appropriate cell seeding and development of functional lung tissue over time. This review aims to present the current state-of-the-art progress for each of these areas and to discuss promising new ideas within the field of lung bioengineering.