An artificial blood vessel with an endothelial-cell monolayer

Cryopreservation-induced delayed injury and cell-type-specific responses during the cryopreservation of endothelial cell monolayers

The cryopreservation of endothelial cell monolayers is an important step that bridges the cryopreservation of cells in suspension to that of tissues. Previous studies have identified clear distinctions in freezing mechanisms between cells in suspension and in monolayers, as well as developed novel protocols for monolayer cryopreservation. Recently, our group has shown that human umbilical vein endothelial cell (HUVEC) and porcine corneal endothelial cell (PCEC) monolayers grown on Rinzl plastic substrate can be cryopreserved in 5% dimethyl sulfoxide, 6% hydroxyethyl starch, and 2% chondroitin sulfate, following a slow-cooling protocol (-1 °C/min) with rapid plunge into liquid nitrogen from -40 °C. However, membrane integrity assessments were done immediately post thaw, which may result in an overestimation of cell viability due to possible delayed injury responses. Here, we show that for the optimal protocol condition of plunge at the -40 °C interrupt temperature, HUVEC and PCEC monolayers exhibited no significant immediate post-thaw injuries nor delayed injury responses during the 24-h post-thaw overnight culture period. HUVEC monolayers experienced no significant impact to their natural growth rate during the post-thaw culture, while PCEC monolayers experienced significantly higher growth than the unfrozen controls. The difference in the low-temperature responses between HUVEC and PCEC monolayers was further shown under high temperature plunge conditions. At these suboptimal plunge temperatures, HUVEC monolayers exhibited moderate immediate membrane injury but a pronounced delayed injury response during the 24-h post-thaw culture, while PCEC monolayers showed significant immediate membrane injury but no additional delayed injury response during the same period. Therefore, we provide further validation of our group's previously designed endothelial monolayer cryopreservation protocol for HUVEC and PCEC monolayers, and we identify several cell-type-specific responses to the freezing process.

CASIN and AMD3100 enhance endothelial cell proliferation, tube formation and sprouting

Endothelial dysfunction is prominent in atherosclerosis, hypertension, diabetes, peripheral and cardiovascular diseases, and stroke. Novel therapeutic approaches to these conditions often involve development of tissue-engineered veins with ex vivo expanded endothelial cells. However, high cell number requirements limit these approaches to become applicable to clinical applications and highlight the requirement of technologies that accelerate expansion of vascular-forming cells. We have previously shown that novel small molecules could induce hematopoietic stem cell expansion ex vivo. We hypothesized that various small molecules targeting hematopoietic stem cell quiescence and mobilization could be used to induce endothelial cell expansion and angiogenesis due to common origin and shared characteristics of endothelial and hematopoietic cells. Here, we have screened thirty-five small molecules and found that CASIN and AMD3100 increase endothelial cell expansion up to two-fold and induce tube formation and ex vivo sprouting. In addition, we have studied how CASIN and AMD3100 affect cell migration, apoptosis and cell cycle of endothelial cells. CASIN and AMD3100 upregulate key endothelial marker genes and downregulate a number of cyclin dependent kinase inhibitors. These findings suggest that CASIN and AMD3100 could be further tested in the development of artificial vascular systems and vascular gene editing technologies. Furthermore, these findings may have potential to contribute to the development of alternative treatment methods for diseases that cause endothelial damage.

Endothelial outgrowth cells regulate coagulation, platelet accumulation, and respond to tumor necrosis factor similar to carotid endothelial cells

Endothelial cells (ECs) are central regulators of hemostasis, inflammation, and other vascular processes. ECs have been used to cover vascular graft materials in an attempt to improve the biological integration of the grafts with the surrounding tissue. Although EC seeded grafts demonstrated improved patency, the invasive nature of EC harvest has limited the clinical translation of this technique. Endothelial outgrowth cells (EOCs) can be derived from circulating endothelial progenitor cells, which are noninvasively isolated from a peripheral blood draw. Although EOCs have been presumed to regulate hemostasis and inflammation similarly to arterial ECs, there has been limited research that directly compares EOCs to arterial ECs, particularly using pairs of donor-matched cells. This study provides a multifaceted characterization of hemostasis regulation by baboon EOCs and carotid ECs, both in the presence and absence of an inflammatory stimulus, tumor necrosis factor α (TNFα). The expression of genes involved in thrombosis and inflammation was highly similar between ECs and EOCs at a basal state and following TNFα stimulation. ECs and EOCs activated similar levels of protein C and Factor X (FX) at a basal state. Following TNFα treatment, EOCs had less of an increase in tissue factor activity than ECs. Cell-seeded expanded polytetrafluoroethylene vascular grafts demonstrated no significant differences between ECs and EOCs in platelet accumulation or fibrinogen incorporation in a baboon femoral arteriovenous shunt loop. This work demonstrates that EOCs regulate thrombus formation and respond to an inflammatory stimulus similar to ECs, and supports utilizing EOCs as a source for an autologous endothelium in tissue engineering applications.

Endothelial outgrowth cells: function and performance in vascular grafts

The clinical need for vascular grafts continues to grow. Tissue engineering strategies have been employed to develop vascular grafts for patients lacking sufficient autologous vessels for grafting. Restoring a functional endothelium on the graft lumen has been shown to greatly improve the long-term patency of small-diameter grafts. However, obtaining an autologous source of endothelial cells for in vitro endothelialization is invasive and often not a viable option. Endothelial outgrowth cells (EOCs), derived from circulating progenitor cells in peripheral blood, provide an alternative cell source for engineering an autologous endothelium. This review aims at highlighting the role of EOCs in the regulation of processes that are central to vascular graft performance. To characterize EOC performance in vascular grafts, this review identifies the characteristics of EOCs, defines functional performance criteria for EOCs in vascular grafts, and summarizes the existing work in developing vascular grafts with EOCs.

Development of a YIGSR-peptide-modified polyurethaneurea to enhance endothelialization

Polyurethanes have been investigated for use as vascular grafts due to their excellent mechanical properties and relatively good biocompatibility. However, poor retention of endothelial cells and thrombogenicity in vivo remain problematic for vascular graft applications. The peptide YIGSR has been shown to increase endothelial cell adhesion but not attachment of platelets, suggesting its possible utility for vascular graft applications. In this study, a bioactive polyurethaneurea has been synthesized by incorporating GGGYIGSRGGGK peptide sequences into the polymer backbone. Successful incorporation of the peptides was confirmed by NMR, contact angle measurement and ESCA. Uniform distribution of peptides on the surface was observed using a fluorescent probe capable of reacting with tyrosine residues on the peptides. Hard segment domains were visualized using tapping mode AFM. Endothelial cell adhesion, spreading, proliferation, migration and extra-cellular matrix production were improved on bioactive polyurethaneurea compared to control polyurethaneurea. Competitive inhibition of endothelial cell attachment and spreading by soluble YIGSR peptides indicated that cell adhesion and spreading were specifically mediated by YIGSR-sensitive cell adhesion receptor, not just by changed surface properties. There was no significant difference in the number of adherent platelets. Therefore, this bioactive polyurethanurea may improve vascular graft endothelialization without increasing thrombogenicity.

Cytocompatibility of electrospun nanofiber tubular scaffolds for small diameter tissue engineering blood vessels

A tubular scaffold was fabricated by using electrospun polymer solution blends of pNSR32 (recombinant spider silk protein), PCL (polycaprolactone) and Gt (gelatin). The physicochemical properties and cytocompatibility of these scaffolds were investigated. Afterwards, the pNSR32/PCL/Gt tubular scaffold (inner diameter=3mm) showed high porosity of 86.2 ± 2.9%, pore size of 2423 ± 979nm and average fibre diameter of 166 ± 85nm. Water uptake and contact angle of the scaffolds reached 112.0 ± 4.4% and 45.7 ± 13.7°, respectively. SDRAECs (Sprague Dawley Rat Aortic Endothelial Cells) grew and proliferated well and phenotype could be maintained on the composite scaffolds after they had been cultured on the composite scaffolds for 7 days. Compared with pure PCL scaffolds a greater density of viable cells was seen on the composites, especially the pNSR32/PCL/Gt scaffolds.

Animal models for the assessment of novel vascular conduits

The development of an ideal small-diameter conduit for use in vascular bypass surgery has yet to be achieved. The ongoing innovation in biomaterial design generates novel conduits that require preclinical assessment in vivo, and a number of animal models have been used for this purpose. This article examines the rationale behind animal models used in the assessment of small-diameter vascular conduits encompassing the commonly used species: baboons, sheep, pigs, dogs, rabbits, and rodents. Studies on the comparative hematology for these species relative to humans are summarized, and the hydrodynamic values for common implant locations are also compared. The large- and small-animal models are then explored, highlighting the characteristics of each that determine their relative utility in the assessment of vascular conduits. Where possible, the performance of expanded polytetrafluoroethylene is given in each animal and in each location to allow direct comparisons between species. New challenges in animal modeling are outlined for the assessment of tissue-engineered graft designs. Finally, recommendations are given for the selection of animal models for the assessment of future vascular conduits.

The use of animal models in developing the discipline of cardiovascular tissue engineering: a review

Cardiovascular disease remains one of the major causes of death and disability in the Western world. Tissue engineering offers the prospect of being able to meet the demand for replacement of heart valves, vessels for coronary and lower limb bypass surgery and the generation of cardiac tissue for addition to the diseased heart. In order to test prospective tissue-engineered devices, these constructs must first be proven in animal models before receiving CE marking or FDA approval for a clinical trial. The choice of animal depends on the nature of the tissue-engineered construct being tested. Factors that need to be considered include technical requirements of implanting the construct, availability of the animal, cost and ethical considerations. In this paper, we review the history of animal studies in cardiovascular tissue engineering and the uses of animal tissue as sources for tissue engineering.

Modification of polyurethaneurea with PEG and YIGSR peptide to enhance endothelialization without platelet adhesion

Improved endothelialization without platelet adhesion is essential to enhance the long-term patency of synthetic vascular grafts and other blood-contacting devices. We have developed a dually modified polyurethaneurea by incorporating endothelial cell adhesive YIGSR peptide sequences as chain extenders and nonthrombogenic PEG as a soft segment (PUUYIGSR-PEG) in the polymer backbone. PUUYIGSR-PEG was successfully synthesized and characterized by proton NMR, FTIR, GPC, DSC, ESCA, and contact angle measurement. Despite having similar molecular weight, the peptide/PEG-modified polyurethaneurea (PUUYIGSR-PEG) showed superior mechanical properties compared to the control PEG-modified polyurethaneurea (PUUPPD-PEG). Virtually no platelet adhesion was observed on PUUYIGSR-PEG, while endothelial cell adhesion, spreading, and migration were significantly greater on PUUYIGSR-PEG compared to PUUPPD-PEG. Thus, this bioactive polymer may be an appropriate biomaterial for small diameter vascular grafts.

A biologically active VEGF construct in vitro: implications for bioengineering-improved prosthetic vascular grafts

Prosthetic arterial grafts are unable to develop an intact endothelial lining after implantation, predisposing them to fail. Strategies have been sought to enhance endothelialization using growth factors and cytokines. This study assessed the biologic activity of vascular endothelial growth factor (VEGF) covalently linked to bovine serum albumin (BSA). Native and modified VEGF were assayed for endothelial cell migration and proliferation. Migration assays were performed comparing the effects of 2% fetal bovine serum (FBS), 50 ng/mL, 100 ng/mL, and 200 ng/mL of native VEGF and VEGF-BSA. Proliferation assays were performed by using Alamar Blue comparing cellular growth in 1% FBS, 10% FBS, 100 ng/mL unbound VEGF, and 100 ng/mL VEGF-BSA. VEGF is a potent chemotactic agent for endothelial cells in both unbound and bound states. Native VEGF solutions (50 ng/mL, 100 ng/mL, and 200 ng/mL) stimulated 23.9 cells/high power field (HPF), 35.3 cells/HPF, and 49.1 cells/HPF (p < 0.005). VEGF-BSA solutions stimulated 25.9 cells/HPF, 39.1 cells/HPF, and 69.0 cells/HPF (p < 0.001). VEGF-BSA and native VEGF supported similar increased cellular proliferation compared with 1% FBS media (p < 0.002). Modified VEGF retains its chemotactic and proliferative properties in vitro. These findings suggest that bare prosthetic surfaces lined with VEGF bound to a "basecoat" albumin may support endothelial cell proliferation and migration and thereby offer new strategies to improve graft patency.

Endothelial-cell injury of the basilar artery caused by ethanol infusion in dogs

This study in mongrel dogs was designed to observe the effects of ethanol on both endothelial cells of the basilar artery and brain function. By use of sterile surgical technique, a super-selective catheter was placed in the proximal portion of the basilar artery in the dogs. Five dogs received 3 ml of 25% ethanol and 5 dogs received 3 ml of 50% of ethanol through the catheter over 2 minutes. The remaining 5 dogs received 3 ml of saline as a control. Auditory brain stem response (ABR) was monitored for 2 hours after ethanol infusion, and then perfusion-fixation was performed from the heart with 4% paraformaldehyde. The basilar artery was observed with scanning electron microscopy after routine procedures. The endothelial cells were intact in the control group. The 50% group showed a higher level of injury to the endothelium as well as a higher degree of platelet adhesion and fibrin clot formation compared with the 25% group. The extensive endothelial-cell damage subsequently caused thrombus formation. The ABR disappeared immediately after ethanol infusion in both ethanol groups, and recovered gradually in the 25% group, but did not re-appear during the time course of 2 hours in the 50% group. The ethanol less than 25% in concentration near the endothelium is considered to be safe as a transcatheter embolic agent with the attention to the central toxicity.

New bioactivation mode for vascular prostheses made of Dacron polyester

The performance of vascular prostheses, especially those of small calibre, still presents several problems. The use of polyesters such as the well-known poly(ethylene terephthalate) (Dacron) and, more recently, poly(tetrafluoroethylene) and polyurethanes provides a marked improvement. We have developed a process to increase the efficiency of such prostheses, using the ability of the Dacron polyester to be covalently modified by proteins under mild chemical conditions. The biomaterial is obtained from the particular interaction of elastin-solubilized peptides with type I + III collagens under very precise conditions. We have obtained an irreversible covalent bonding on Dacron. These biological conditions and the addition of connective proteins and glycosaminoglycans conferred on the resulting material a composition and a three-dimensional structure equivalent to the subendothelium, providing bioactive properties suitable for the development of a vascular prosthesis.

Endothelial lined skeletal muscle ventricles: open and percutaneous seeding techniques

Twelve bilateral skeletal muscle ventricles (SMVs) were constructed in six dogs by wrapping each latissimus dorsi muscle around a cylindrical, plastic mandrel (volume 30 cc). After 6 to 10 weeks, five dogs had one of their SMVs seeded with allogeneic cultured canine endothelial cells (8 x 10(6) cells/pouch) via an open technique, whil the contralateral SMV was seeded by percutaneous injection of cells into the space around the mandrel. After 1 week, the SMVs were excised. Viable, adherent endothelial cells were present in all seeded pouches; this was confirmed via fluorescent microscopy with several endothelial cell markers; KLH-2, dilacetylated low-density lipoprotein and antibodies to von Willebrand factor. The inner lining of the SMVs were also examined with scanning and transmission electron microscopy; the highest concentration of cells were seen at the apex where a continuous endothelial monolayer was observed. No significant difference in the distribution or the morphology of the endothelial lining was noted between the open and percutaneous seeding techniques. These data show that SMVs can be seeded with an endothelial monolayer using both open and percutaneous techniques.