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Xu Y, Chen Q, Shao Z, Wei J, Zhu X, Rong A, Chen X, Ni Y, Jiang Y. Evaluation of new robust silk fibroin hydrogels for posterior scleral reinforcement in rabbits. Front Bioeng Biotechnol 2023; 11:1211688. [PMID: 37388765 PMCID: PMC10300450 DOI: 10.3389/fbioe.2023.1211688] [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: 04/25/2023] [Accepted: 06/01/2023] [Indexed: 07/01/2023] Open
Abstract
Background: Currently, there is no ideal material available for posterior scleral reinforcement (PSR) to prevent the progression of high myopia. In this study, we investigated robust regenerated silk fibroin (RSF) hydrogels as potential grafts for PSR in animal experiments to evaluate their safety and biological reactions. Methods: PSR surgery was performed on the right eye of twenty-eight adult New Zealand white rabbits, with the left eye serving as a self-control. Ten rabbits were observed for 3 months, while 18 rabbits were observed for 6 months. The rabbits were evaluated using intraocular pressure (IOP), anterior segment and fundus photography, A- and B-ultrasound, optical coherence tomography (OCT), histology, and biomechanical tests. Results: No complications such as significant IOP fluctuation, anterior chamber inflammation, vitreous opacity, retinal lesion, infection, or material exposure were observed. Furthermore, no evidence of pathological changes in the optic nerve and retina, or structural abnormalities on OCT, were found. The RSF grafts were appropriately located at the posterior sclera and enclosed in fibrous capsules. The scleral thickness and collagen fiber content of the treated eyes increased after surgery. The ultimate stress of the reinforced sclera increased by 30.7%, and the elastic modulus increased by 33.0% compared to those of the control eyes at 6 months after surgery. Conclusion: Robust RSF hydrogels exhibited good biocompatibility and promoted the formation of fibrous capsules at the posterior sclera in vivo. The biomechanical properties of the reinforced sclera were strengthened. These findings suggest that RSF hydrogel is a potential material for PSR.
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Affiliation(s)
- Yule Xu
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qiaolin Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Laborarory of Advanced Materials, Fudan University, Shanghai, China
| | - Zhengzhong Shao
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Laborarory of Advanced Materials, Fudan University, Shanghai, China
| | - Jiahong Wei
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xuyou Zhu
- Department of Pathology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ao Rong
- Department of Ophthalmology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Ophthalmology, Shanghai Xin Shi Jie Eye Hospital, Shanghai, China
| | - Xin Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Laborarory of Advanced Materials, Fudan University, Shanghai, China
| | - Yusu Ni
- Otology and Skull Base Surgery Department, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China
- Key Laboratory of Hearing Medicine of National Health and Family Planning Commission, Shanghai, China
- Otorhinolaryngology Department of Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Yi Jiang
- Department of Ophthalmology, Shanghai Xin Shi Jie Eye Hospital, Shanghai, China
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Settembrini A, Buongiovanni G, Settembrini P, Alessandrino A, Freddi G, Vettor G, Martelli E. In-vivo evaluation of silk fibroin small-diameter vascular grafts: state of art of preclinical studies and animal models. Front Surg 2023; 10:1090565. [PMID: 37304180 PMCID: PMC10254405 DOI: 10.3389/fsurg.2023.1090565] [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: 11/05/2022] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Autologous vein and artery remains the first choice for vascular grafting procedures in small-diameter vessels such as coronary and lower limb districts. Unfortunately, these vessels are often found to be unsuitable in atherosclerotic patients due to the presence of calcifications or to insufficient size. Synthetic grafts composed of materials such as expanded polytetrafluoroethylene (ePTFE) are frequently employed as second choice, because of their widespread availability and success in the reconstruction of larger arteries. However, ePTFE grafts with small diameter are plagued by poor patency rates due to surface thrombogenicity and intimal hyperplasia, caused by the bioinertness of the synthetic material and aggravated by low flow conditions. Several bioresorbable and biodegradable polymers have been developed and tested to exploit such issues for their potential stimulation to endothelialization and cell infiltration. Among these, silk fibroin (SF) has shown promising pre-clinical results as material for small-diameter vascular grafts (SDVGs) because of its favorable mechanical and biological properties. A putative advantage in graft infection in comparison with synthetic materials is plausible, although it remains to be demonstrated. Our literature review will focus on the performance of SF-SDVGs in vivo, as evaluated by studies performing vascular anastomosis and interposition procedures, within small and large animal models and different arterial districts. Efficiency under conditions that more accurately mime the human body will provide encouraging evidence towards future clinical applications.
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Affiliation(s)
- Alberto Settembrini
- Department of Vascular Surgery, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Buongiovanni
- Postgraduate School of Vascular Surgery, Università Degli Studi di Milano, Milan, Italy
| | - Piergiorgio Settembrini
- Department of Biomedical and Clinical Sciences, L. Sacco University Hospital, Università degli Studi di Milano, Milan, Italy
| | | | | | - Giulia Vettor
- Heart Rhythm Center, Department of Clinical Electrophysiology and Cardiac Pacing, IRCCS Monzino Cardiology Center, Milan, Italy
| | - Eugenio Martelli
- Department of General and Specialist Surgery, Sapienza University of Rome, Rome, Italy
- Saint Camillus International University of Health Sciences, Rome, Italy
- Division of Vascular Surgery, S. Anna and S. Sebastiano Hospital, Caserta, Italy
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Matrix Regeneration Ability In Situ Induced by a Silk Fibroin Small-Caliber Artificial Blood Vessel In Vivo. Polymers (Basel) 2022; 14:polym14183754. [PMID: 36145899 PMCID: PMC9502482 DOI: 10.3390/polym14183754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 11/17/2022] Open
Abstract
The success of a small-caliber artificial vascular graft in the host in order to obtain functional tissue regeneration and remodeling remains a great challenge in clinical application. In our previous work, a silk-based, small-caliber tubular scaffold (SFTS) showed excellent mechanical properties, long-term patency and rapid endothelialization capabilities. On this basis, the aim of the present study was to evaluate the vascular reconstruction process after implantation to replace the common carotid artery in rabbits. The new tissue on both sides of the SFTSs at 1 month was clearly observed. Inside the SFTSs, the extracellular matrix (ECM) was deposited on the pore wall at 1 month and continued to increase during the follow-up period. The self-assembled collagen fibers and elastic fibers were clearly visible in a circumferential arrangement at 6 months and were similar to autologous blood vessels. The positive expression rate of Lysyl oxidase-1 (LOXL-1) was positively correlated with the formation and maturity of collagen fibers and elastic fibers. In summary, the findings of the tissue regeneration processes indicated that the bionic SFTSs induced in situ angiogenesis in defects.
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Hu K, Li Y, Ke Z, Yang H, Lu C, Li Y, Guo Y, Wang W. History, progress and future challenges of artificial blood vessels: a narrative review. BIOMATERIALS TRANSLATIONAL 2022; 3:81-98. [PMID: 35837341 PMCID: PMC9255792 DOI: 10.12336/biomatertransl.2022.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/24/2022] [Accepted: 03/01/2022] [Indexed: 11/29/2022]
Abstract
Cardiovascular disease serves as the leading cause of death worldwide, with stenosis, occlusion, or severe dysfunction of blood vessels being its pathophysiological mechanism. Vascular replacement is the preferred surgical option for treating obstructed vascular structures. Due to the limited availability of healthy autologous vessels as well as the incidence of postoperative complications, there is an increasing demand for artificial blood vessels. From synthetic to natural, or a mixture of these components, numerous materials have been used to prepare artificial vascular grafts. Although synthetic grafts are more appropriate for use in medium to large-diameter vessels, they fail when replacing small-diameter vessels. Tissue-engineered vascular grafts are very likely to be an ideal alternative to autologous grafts in small-diameter vessels and are worthy of further investigation. However, a multitude of problems remain that must be resolved before they can be used in biomedical applications. Accordingly, this review attempts to describe these problems and provide a discussion of the generation of artificial blood vessels. In addition, we deliberate on current state-of-the-art technologies for creating artificial blood vessels, including advances in materials, fabrication techniques, various methods of surface modification, as well as preclinical and clinical applications. Furthermore, the evaluation of grafts both in vivo and in vitro, mechanical properties, challenges, and directions for further research are also discussed.
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Affiliation(s)
- Ke Hu
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yuxuan Li
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Zunxiang Ke
- Department of Emergency Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Hongjun Yang
- Key Laboratory of Green Processing and Functional New Textile Materials of Ministry of Education, Wuhan Textile University, Wuhan, Hubei Province, China
| | - Chanjun Lu
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yiqing Li
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yi Guo
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China,Clinical Centre of Human Gene Research, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China,Corresponding author: Yi Guo, ; Weici Wang,
| | - Weici Wang
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China,Corresponding author: Yi Guo, ; Weici Wang,
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Feng ZG, Fang Z, Xing Y, Wang H, Geng X, Ye L, Zhang A, Gu Y. Remodeling of Structurally Reinforced (TPU+PCL/PCL)-Hep Electro-spun Small Diameter Bilayer Vascular Grafts Interposed in Rat Ab-dominal Aorta. Biomater Sci 2022; 10:4257-4270. [DOI: 10.1039/d1bm01653a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
As the thermoplastic polyurethane (TPU) elastomer possesses good biocompatibility and mechanical properties similar to native vascular tissues as well, it is intended to co-electrospin with poly(ε-caprolactone) (PCL) onto the outer...
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Bioengineering silk into blood vessels. Biochem Soc Trans 2021; 49:2271-2286. [PMID: 34495327 DOI: 10.1042/bst20210359] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/05/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022]
Abstract
The rising incidence of cardiovascular disease has increased the demand for small diameter (<6 mm) synthetic vascular grafts for use in bypass surgery. Clinically available synthetic grafts (polyethylene terephthalate and expanded polytetrafluorethylene) are incredibly strong, but also highly hydrophobic and inelastic, leading to high rates of failure when used for small diameter bypass. The poor clinical outcomes of commercial synthetic grafts in this setting have driven significant research in search of new materials that retain favourable mechanical properties but offer improved biocompatibility. Over the last several decades, silk fibroin derived from Bombyx mori silkworms has emerged as a promising biomaterial for use in vascular applications. Progress has been driven by advances in silk manufacturing practices which have allowed unprecedented control over silk strength, architecture, and the ensuing biological response. Silk can now be manufactured to mimic the mechanical properties of native arteries, rapidly recover the native endothelial cell layer lining vessels, and direct positive vascular remodelling through the regulation of local inflammatory responses. This review summarises the advances in silk purification, processing and functionalisation which have allowed the production of robust vascular grafts with promise for future clinical application.
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Gupta P, Mandal BB. Silk biomaterials for vascular tissue engineering applications. Acta Biomater 2021; 134:79-106. [PMID: 34384912 DOI: 10.1016/j.actbio.2021.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 02/07/2023]
Abstract
Vascular tissue engineering is a rapidly growing field of regenerative medicine, which strives to find innovative solutions for vascular reconstruction. Considering the limited success of synthetic grafts, research impetus in the field is now shifted towards finding biologically active vascular substitutes bestowing in situ growth potential. In this regard, silk biomaterials have shown remarkable potential owing to their favorable inherent biological and mechanical properties. This review provides a comprehensive overview of the progressive development of silk-based small diameter (<6 mm) tissue-engineered vascular grafts (TEVGs), emphasizing their pre-clinical implications. Herein, we first discuss the molecular structure of various mulberry and non-mulberry silkworm silk and identify their favorable properties at the onset of vascular regeneration. The emergence of various state-of-the-art fabrication methodologies for the advancement of silk TEVGs is rationally appraised in terms of their in vivo performance considering the following parameters: ease of handling, long-term patency, resistance to acute thrombosis, stenosis and aneurysm formation, immune reaction, neo-tissue formation, and overall remodeling. Finally, we provide an update on the pre-clinical status of silk-based TEVGs, followed by current challenges and future prospects. STATEMENT OF SIGNIFICANCE: Limited availability of healthy autologous blood vessels to replace their diseased counterpart is concerning and demands other artificial substitutes. Currently available synthetic grafts are not suitable for small diameter blood vessels owing to frequent blockage. Tissue-engineered biological grafts tend to integrate well with the native tissue via remodeling and have lately witnessed remarkable success. Silk fibroin is a natural biomaterial, which has long been used as medical sutures. This review aims to identify several favorable properties of silk enabling vascular regeneration. Furthermore, various methodologies to fabricate tubular grafts are discussed and highlight their performance in animal models. An overview of our understanding to rationally improve the biological activity fostering the clinical success of silk-based grafts is finally discussed.
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Hong H, Lee OJ, Lee YJ, Lee JS, Ajiteru O, Lee H, Suh YJ, Sultan MT, Kim SH, Park CH. Cytocompatibility of Modified Silk Fibroin with Glycidyl Methacrylate for Tissue Engineering and Biomedical Applications. Biomolecules 2020; 11:35. [PMID: 33383963 PMCID: PMC7824185 DOI: 10.3390/biom11010035] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/21/2020] [Accepted: 12/27/2020] [Indexed: 11/23/2022] Open
Abstract
Hydrogel with chemical modification has been used for 3D printing in the biomedical field of cell and tissue-based regeneration because it provides a good cellular microenvironment and mechanical supportive ability. As a scaffold and a matrix, hydrogel itself has to be modified chemically and physically to form a β-sheet crosslinking structure for the strength of the biomaterials. These chemical modifications could affect the biological damage done to encapsulated cells or surrounding tissues due to unreacted chemical residues. Biological assessment, including assessment of the cytocompatibility of hydrogel in clinical trials, must involve testing with cytotoxicity, irritation, and sensitization. Here, we modified silk fibroin and glycidyl methacrylate (Silk-GMA) and evaluated the physical characterizations, residual chemical detection, and the biological effect of residual GMA depending on dialysis periods. Silk-GMA depending on each dialysis period had a typical β-sheet structure in the characterization analysis and residual GMA decreased from dialysis day 1. Moreover, cell proliferation and viability rate gradually increased; additionally, necrotic and apoptotic cells decreased from dialysis day 2. These results indicate that the dialysis periods during chemical modification of natural polymer are important for removing unreacted chemical residues and for the potential application of the manufacturing standardization for chemically modified hydrogel for the clinical transplantation for tissue engineering and biomedical applications.
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Affiliation(s)
- Heesun Hong
- Nano-Bio Regenrative Medical Institute, College of Medicine, Hallym University, Chuncheon 24252, Korea; (H.H.); (O.J.L.); (Y.J.L.); (J.S.L.); (O.A.); (H.L.); (Y.J.S.); (M.T.S.); (S.H.K.)
| | - Ok Joo Lee
- Nano-Bio Regenrative Medical Institute, College of Medicine, Hallym University, Chuncheon 24252, Korea; (H.H.); (O.J.L.); (Y.J.L.); (J.S.L.); (O.A.); (H.L.); (Y.J.S.); (M.T.S.); (S.H.K.)
| | - Young Jin Lee
- Nano-Bio Regenrative Medical Institute, College of Medicine, Hallym University, Chuncheon 24252, Korea; (H.H.); (O.J.L.); (Y.J.L.); (J.S.L.); (O.A.); (H.L.); (Y.J.S.); (M.T.S.); (S.H.K.)
| | - Ji Seung Lee
- Nano-Bio Regenrative Medical Institute, College of Medicine, Hallym University, Chuncheon 24252, Korea; (H.H.); (O.J.L.); (Y.J.L.); (J.S.L.); (O.A.); (H.L.); (Y.J.S.); (M.T.S.); (S.H.K.)
| | - Olatunji Ajiteru
- Nano-Bio Regenrative Medical Institute, College of Medicine, Hallym University, Chuncheon 24252, Korea; (H.H.); (O.J.L.); (Y.J.L.); (J.S.L.); (O.A.); (H.L.); (Y.J.S.); (M.T.S.); (S.H.K.)
| | - Hanna Lee
- Nano-Bio Regenrative Medical Institute, College of Medicine, Hallym University, Chuncheon 24252, Korea; (H.H.); (O.J.L.); (Y.J.L.); (J.S.L.); (O.A.); (H.L.); (Y.J.S.); (M.T.S.); (S.H.K.)
| | - Ye Ji Suh
- Nano-Bio Regenrative Medical Institute, College of Medicine, Hallym University, Chuncheon 24252, Korea; (H.H.); (O.J.L.); (Y.J.L.); (J.S.L.); (O.A.); (H.L.); (Y.J.S.); (M.T.S.); (S.H.K.)
| | - Md Tipu Sultan
- Nano-Bio Regenrative Medical Institute, College of Medicine, Hallym University, Chuncheon 24252, Korea; (H.H.); (O.J.L.); (Y.J.L.); (J.S.L.); (O.A.); (H.L.); (Y.J.S.); (M.T.S.); (S.H.K.)
| | - Soon Hee Kim
- Nano-Bio Regenrative Medical Institute, College of Medicine, Hallym University, Chuncheon 24252, Korea; (H.H.); (O.J.L.); (Y.J.L.); (J.S.L.); (O.A.); (H.L.); (Y.J.S.); (M.T.S.); (S.H.K.)
| | - Chan Hum Park
- Nano-Bio Regenrative Medical Institute, College of Medicine, Hallym University, Chuncheon 24252, Korea; (H.H.); (O.J.L.); (Y.J.L.); (J.S.L.); (O.A.); (H.L.); (Y.J.S.); (M.T.S.); (S.H.K.)
- Departments of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, School of Medicine, Hallym University, Chuncheon 24253, Korea
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Bilayer nicorandil-loaded small-diameter vascular grafts improve endothelial cell function via PI3K/AKT/eNOS pathway. Biodes Manuf 2020. [DOI: 10.1007/s42242-020-00107-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Li H, Song G, Tian W, Ding M, Sun X, Xu J, Dong F, Wang A, Ning P, Yin Y, Wang J. Motility and function of smooth muscle cells in a silk small-caliber tubular scaffold after replacement of rabbit common carotid artery. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 114:110977. [DOI: 10.1016/j.msec.2020.110977] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/06/2020] [Accepted: 04/15/2020] [Indexed: 12/17/2022]
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