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English EJ, Samolyk BL, Gaudette GR, Pins GD. Micropatterned fibrin scaffolds increase cardiomyocyte alignment and contractility for the fabrication of engineered myocardial tissue. J Biomed Mater Res A 2023; 111:1309-1321. [PMID: 36932841 PMCID: PMC11128133 DOI: 10.1002/jbm.a.37530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/09/2023] [Accepted: 03/01/2023] [Indexed: 03/19/2023]
Abstract
Cardiovascular disease is the leading cause of death in the United States, which can result in blockage of a coronary artery, triggering a myocardial infarction (MI), scar tissue formation in the myocardium, and ultimately heart failure. Currently, the gold-standard solution for total heart failure is a heart transplantation. An alternative to total-organ transplantation is surgically remodeling the ventricle with the implantation of a cardiac patch. Acellular cardiac patches have previously been investigated using synthetic or decellularized native materials to improve cardiac function. However, a limitation of this strategy is that acellular cardiac patches only reshape the ventricle and do not increase cardiac contractile function. Toward the development of a cardiac patch, our laboratory previously developed a cell-populated composite fibrin scaffold and aligned microthreads to recapitulate the mechanical properties of native myocardium. In this study, we explore micropatterning the surfaces of fibrin gels to mimic anisotropic native tissue architecture and promote cellular alignment of human induced pluripotent stem cell cardiomyocytes (hiPS-CM), which is crucial for increasing scaffold contractile properties. hiPS-CMs seeded on micropatterned surfaces exhibit cellular elongation, distinct sarcomere alignment, and circumferential connexin-43 staining at 14 days of culture, which are necessary for mature contractile properties. Constructs were also subject to electrical stimulation during culture to promote increased contractile properties. After 7 days of stimulation, contractile strains of micropatterned constructs were significantly higher than unpatterned controls. These results suggest that the use of micropatterned topographic cues on fibrin scaffolds may be a promising strategy for creating engineered cardiac tissue.
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Affiliation(s)
- Elizabeth J. English
- Biomedical Engineering Department, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
- Tessera Therapeutics, Somerville, Massachusetts, USA
| | - Bryanna L. Samolyk
- Biomedical Engineering Department, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
| | - Glenn R. Gaudette
- Biomedical Engineering Department, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
- Department of Engineering, Boston College, Newton, Massachusetts, USA
| | - George D. Pins
- Biomedical Engineering Department, Worcester Polytechnic Institute, Worcester, Massachusetts, USA
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2
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Shao R, Li J, Wang L, Li X, Shu C. Progress in the application of patch materials in cardiovascular surgery. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2023; 48:285-293. [PMID: 36999476 PMCID: PMC10930349 DOI: 10.11817/j.issn.1672-7347.2023.220560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Indexed: 04/01/2023]
Abstract
The cardiovascular patch, served as artificial graft materials to replace heart or vascular tissue defect, is still playing a key role in cardiovascular surgeries. The defects of traditional cardiovascular patch materials may determine its unsatisfactory long-term effect or fatal complications after surgery. Recent studies on many new materials (such as tissue engineered materials, three-dimensional printed materials, etc) are being developed. Patch materials have been widely used in clinical procedures of cardiovascular surgeries such as angioplasty, cardiac atrioventricular wall or atrioventricular septum repair, and valve replacement. The clinical demand for better cardiovascular patch materials is still urgent. However, the cardiovascular patch materials need to adapt to normal coagulation mechanism and durability, promote short-term endothelialization after surgery, and inhibit long-term postoperative intimal hyperplasia, its research and development process is relatively complicated. Understanding the characteristics of various cardiovascular patch materials and their application in cardiovascular surgeries is important for the selection of new clinical surgical materials and the development of cardiovascular patch materials.
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Affiliation(s)
- Rubing Shao
- Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha 410011.
- Institute of Vascular Diseases, Central South University, Changsha 410011.
| | - Jiehua Li
- Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha 410011
- Institute of Vascular Diseases, Central South University, Changsha 410011
| | - Lunchang Wang
- Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha 410011
- Institute of Vascular Diseases, Central South University, Changsha 410011
| | - Xin Li
- Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha 410011.
- Institute of Vascular Diseases, Central South University, Changsha 410011.
| | - Chang Shu
- Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha 410011.
- Institute of Vascular Diseases, Central South University, Changsha 410011.
- Vascular Surgery Center, Fuwai Hospital, Chinese Academy of Medical Sciences & National Center for Cardiovascular Diseases, Beijing 100037, China.
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3
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Biological Scaffolds for Congenital Heart Disease. BIOENGINEERING (BASEL, SWITZERLAND) 2023; 10:bioengineering10010057. [PMID: 36671629 PMCID: PMC9854830 DOI: 10.3390/bioengineering10010057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 01/05/2023]
Abstract
Congenital heart disease (CHD) is the most predominant birth defect and can require several invasive surgeries throughout childhood. The absence of materials with growth and remodelling potential is a limitation of currently used prosthetics in cardiovascular surgery, as well as their susceptibility to calcification. The field of tissue engineering has emerged as a regenerative medicine approach aiming to develop durable scaffolds possessing the ability to grow and remodel upon implantation into the defective hearts of babies and children with CHD. Though tissue engineering has produced several synthetic scaffolds, most of them failed to be successfully translated in this life-endangering clinical scenario, and currently, biological scaffolds are the most extensively used. This review aims to thoroughly summarise the existing biological scaffolds for the treatment of paediatric CHD, categorised as homografts and xenografts, and present the preclinical and clinical studies. Fixation as well as techniques of decellularisation will be reported, highlighting the importance of these approaches for the successful implantation of biological scaffolds that avoid prosthetic rejection. Additionally, cardiac scaffolds for paediatric CHD can be implanted as acellular prostheses, or recellularised before implantation, and cellularisation techniques will be extensively discussed.
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4
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Luchristt D, Weidner AC, Siddiqui NY. Urinary basement membrane graft-augmented sacrospinous ligament suspension: a description of technique and short-term outcomes. Int Urogynecol J 2022; 33:1347-1350. [PMID: 35294566 DOI: 10.1007/s00192-022-05159-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/07/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Since the discontinuation of manufacture and distribution of surgical mesh for transvaginal prolapse repair, the use of biologic grafts for transvaginal apical suspension has gained renewed attention. However, there is no FDA-approved device and minimal published data describing such an approach. The objective of this video is to describe a technique and to present limited short-term outcomes utilizing a porcine urinary basement membrane (UBM) graft to perform an augmented bilateral sacrospinous ligament suspension (SSLS). METHODS We present a step-by-step overview of our technique to perform an augmented SSLS with off-label utilization of a 7- × 10-cm porcine UBM graft. We demonstrate graft shaping and application during transvaginal repair along with data describing perioperative outcomes associated with a series of 25 cases performed at our institution using the technique described. RESULTS No perioperative complications related to the graft were observed in our cohort. The most common postoperative concern was buttock pain, which spontaneously resolved within 6 months. Two individuals (8%) developed recurrent prolapse within 1 year of surgery. CONCLUSIONS The UBM-augmented apical suspension allows for reinforced transvaginal prolapse repair without the use of permanent mesh material. We have observed good clinical success in our application of this technique, but dedicated research assessing long-term outcomes compared with a native tissue repair is needed.
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Affiliation(s)
- Douglas Luchristt
- Division of Urogynecology, Department of Obstetrics & Gynecology, Duke University, 5324 McFarland Drive, Suite 310, Durham, NC, 27707, USA.
| | - Alison C Weidner
- Division of Urogynecology, Department of Obstetrics & Gynecology, Duke University, 5324 McFarland Drive, Suite 310, Durham, NC, 27707, USA
| | - Nazema Y Siddiqui
- Division of Urogynecology, Department of Obstetrics & Gynecology, Duke University, 5324 McFarland Drive, Suite 310, Durham, NC, 27707, USA
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5
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Macrophage Response to Biomaterials in Cardiovascular Applications. Stem Cells 2021. [DOI: 10.1007/978-3-030-77052-5_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Amigo N, Zubieta C, Riganti JM, Ramirez M, Renda P, Lovera R, Pascaner A, Vigliano C, Craiem D, Young DA, Gilbert TW, Nieponice A. Biomechanical Features of Reinforced Esophageal Hiatus Repair in a Porcine Model. J Surg Res 2020; 246:62-72. [DOI: 10.1016/j.jss.2019.08.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/24/2019] [Accepted: 08/29/2019] [Indexed: 12/18/2022]
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7
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Gupta A, Francis S, Stewart R, Hobson D, Meriwether KV. Repair of colonic neovaginal stenosis using a biological graft in a male-to-female transgender patient. Int Urogynecol J 2018; 30:661-663. [DOI: 10.1007/s00192-018-3800-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/19/2018] [Indexed: 11/28/2022]
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8
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Guruswamy Damodaran R, Vermette P. Tissue and organ decellularization in regenerative medicine. Biotechnol Prog 2018; 34:1494-1505. [PMID: 30294883 DOI: 10.1002/btpr.2699] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/30/2018] [Indexed: 12/22/2022]
Abstract
The advancement and improvement in decellularization methods can be attributed to the increasing demand for tissues and organs for transplantation. Decellularized tissues and organs, which are free of cells and genetic materials while retaining the complex ultrastructure of the extracellular matrix (ECM), can serve as scaffolds to subsequently embed cells for transplantation. They have the potential to mimic the native physiology of the targeted anatomic site. ECM from different tissues and organs harvested from various sources have been applied. Many techniques are currently involved in the decellularization process, which come along with their own advantages and disadvantages. This review focuses on recent developments in decellularization methods, the importance and nature of detergents used for decellularization, as well as on the role of the ECM either as merely a physical support or as a scaffold in retaining and providing cues for cell survival, differentiation and homeostasis. In addition, application, status, and perspectives on commercialization of bioproducts derived from decellularized tissues and organs are addressed. © 2018 American Institute of Chemical Engineers Biotechnol. Prog., 34:1494-1505, 2018.
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Affiliation(s)
- Rajesh Guruswamy Damodaran
- Laboratoire de bio-ingénierie et de biophysique de l'Université de Sherbrooke, Department of Chemical and Biotechnological Engineering, Université de Sherbrooke, 2500 Boul. de l'Université, Sherbrooke, QC, J1K 2R1, Canada.,Pharmacology Institute of Sherbrooke, Faculté de médecine et des sciences de la santé, 3001 12ième Avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada.,Research Centre on Aging, Institut universitaire de gériatrie de Sherbrooke, 1036 rue Belvédère Sud, Sherbrooke, Québec, J1H 4C4, Canada
| | - Patrick Vermette
- Laboratoire de bio-ingénierie et de biophysique de l'Université de Sherbrooke, Department of Chemical and Biotechnological Engineering, Université de Sherbrooke, 2500 Boul. de l'Université, Sherbrooke, QC, J1K 2R1, Canada.,Pharmacology Institute of Sherbrooke, Faculté de médecine et des sciences de la santé, 3001 12ième Avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada.,Research Centre on Aging, Institut universitaire de gériatrie de Sherbrooke, 1036 rue Belvédère Sud, Sherbrooke, Québec, J1H 4C4, Canada
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9
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Young DA, McGilvray KC, Ehrhart N, Gilbert TW. Comparison of in vivo remodeling of urinary bladder matrix and acellular dermal matrix in an ovine model. Regen Med 2018; 13:759-773. [DOI: 10.2217/rme-2018-0091] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: Biologically derived surgical graft materials come from a variety of sources with varying mechanical properties. This study aimed to evaluate the host response and mechanical performance of two extracellular matrix devices in a large animal preclinical model. Materials & methods: Bilateral defects were created in the fascia lata of sheep and repaired with either an acellular dermal matrix (ADM) or urinary bladder matrix (UBM). After 1 or 3 months, the repair site was explanted for histological and mechanical analysis. Results & conclusion: Despite pre-implantation mechanical differences, both UBM and ADM demonstrated similar mechanical performance at 3 months. However, UBM was completely remodeled into site-appropriate tissue by 3 months, while ADM showed limited tissue incorporation.
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Affiliation(s)
| | - Kirk C McGilvray
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA
| | - Nicole Ehrhart
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Thomas W Gilbert
- ACell, Inc., Columbia, MD 21046, USA
- McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
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10
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Effects of topical applications of porcine acellular urinary bladder matrix and Centella asiatica extract on oral wound healing in a rat model. Clin Oral Investig 2018; 23:2083-2095. [DOI: 10.1007/s00784-018-2620-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 09/04/2018] [Indexed: 12/22/2022]
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11
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Young DA, Jackson N, Ronaghan CA, Brathwaite CEM, Gilbert TW. Retrorectus repair of incisional ventral hernia with urinary bladder matrix reinforcement in a long-term porcine model. Regen Med 2018; 13:395-408. [DOI: 10.2217/rme-2018-0023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aim: Not all biologically derived materials elicit the same host response when used for reinforcement of ventral hernia repairs. This study aimed to evaluate the remodeling characteristics of the abdominal wall following reinforcement with urinary bladder matrix (UBM) in a large animal preclinical model of ventral hernia repair. Materials & methods: Midline defects in 36 Yucatan minipigs were reinforced with UBM-derived surgical devices using a classic Rives–Stoppa–Wantz approach, and compared with primary repair controls. After 3 or 8 months, the abdominal wall was explanted for histological and mechanical analysis. Results & conclusion: All UBM-derived surgical devices were completely resorbed within 8 months and facilitated deposition of vascularized, biomechanically functional connective tissue in the retrorectus plane, with no evidence of hernia formation.
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Affiliation(s)
| | | | | | | | - Thomas W Gilbert
- ACell Inc., Columbia, MD 21046, USA
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15219, USA
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12
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Fetal extracellular matrix nerve wraps locally improve peripheral nerve remodeling after complete transection and direct repair in rat. Sci Rep 2018. [PMID: 29540763 PMCID: PMC5852088 DOI: 10.1038/s41598-018-22628-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In peripheral nerve (PN) injuries requiring surgical repair, as in PN transection, cellular and ECM remodeling at PN epineurial repair sites is hypothesized to reduce PN functional outcomes by slowing, misdirecting, or preventing axons from regrowing appropriately across the repair site. Herein this study reports on deriving and analyzing fetal porcine urinary bladder extracellular matrix (fUB-ECM) by vacuum assisted decellularization, fabricating fUBM-ECM nerve wraps, and testing fUB-ECM nerve wrap biocompatibility and bioactivity in a trigeminal, infraorbital nerve (ION) branch transection and direct end-to-end repair model in rat. FUB-ECM nerve wraps significantly improved epi- and endoneurial organization and increased both neovascularization and growth associated protein-43 (GAP-43) expression at PN repair sites, 28-days post surgery. However, the number of neurofilament positive axons, remyelination, and whisker-evoked response properties of ION axons were unaltered, indicating improved tissue remodeling per se does not predict axon regrowth, remyelination, and the return of mechanoreceptor cortical signaling. This study shows fUB-ECM nerve wraps are biocompatible, bioactive, and good experimental and potentially clinical devices for treating epineurial repairs. Moreover, this study highlights the value provided by precise, analytic models, like the ION repair model, in understanding how PN tissue remodeling relates to axonal regrowth, remyelination, and axonal response properties.
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13
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Talwar S, Das A, Siddarth B, Choudhary SK, Airan B. Patch materials for right ventricular outflow reconstruction: past, present, and future. Indian J Thorac Cardiovasc Surg 2018; 35:41-50. [PMID: 33060968 DOI: 10.1007/s12055-017-0621-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/16/2017] [Accepted: 11/22/2017] [Indexed: 11/26/2022] Open
Abstract
In this review, we discuss various patch materials used for reconstruction of the right ventricular outflow tract. Their relative merits and demerits are discussed. Traditional patches and their results are detailed along with a brief description of newer developments in the field.
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Affiliation(s)
- Sachin Talwar
- Cardiothoracic Center, All India Institute of Medical Sciences, New Delhi, 110029 India
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Anupam Das
- Cardiothoracic Center, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Bharath Siddarth
- Cardiothoracic Center, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Shiv Kumar Choudhary
- Cardiothoracic Center, All India Institute of Medical Sciences, New Delhi, 110029 India
| | - Balram Airan
- Cardiothoracic Center, All India Institute of Medical Sciences, New Delhi, 110029 India
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14
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Spinali KL, Schmuck EG. Natural Sources of Extracellular Matrix for Cardiac Repair. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1098:115-130. [PMID: 30238368 DOI: 10.1007/978-3-319-97421-7_6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Tissue engineering and regenerative medicine have adopted the use of extracellular matrix (ECM) as a cell delivery device and bioactive regenerative agent. To this end, many ECMs have been investigated for cardiac tissue engineering and regenerative medicine applications with variable success. Many sources of natural ECMs have been tested for cardiac applications. Typically, natural ECMs have been made from decellularized organs or tissues and processed into either sheets or injectable hydrogels. This chapter will review natural sources of ECM materials that have been tested as therapeutic agents in models of heart failure.
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Affiliation(s)
- Keith L Spinali
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin Madison, Madison, WI, USA
| | - Eric G Schmuck
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin Madison, Madison, WI, USA.
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15
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Dziki JL, Badylak SF. Extracellular Matrix for Myocardial Repair. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1098:151-171. [PMID: 30238370 DOI: 10.1007/978-3-319-97421-7_8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Multiple strategies have been investigated to restore functional myocardium following injury or disease including the local administration of cytokines or chemokines, stem/progenitor cell therapy, mechanical circulatory support, pharmacologic use, and the use of inductive biomaterials. The use of xenogeneic biologic scaffolds composed of extracellular matrix (ECM) has been shown to facilitate functional restoration of several tissues and organs including the esophagus, skeletal muscle, skin, and myocardium, among others. The present chapter describes the current understanding of specific components of biologic scaffolds composed of ECM, the mechanisms by which ECM bioscaffolds promote constructive cardiac remodeling after injury, determinants of remodeling outcome, and the versatility of ECM as a potential cardiac therapeutic.
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Affiliation(s)
- Jenna L Dziki
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Stephen F Badylak
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA. .,Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. .,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
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16
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Artificial Cardiac Muscle with or without the Use of Scaffolds. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8473465. [PMID: 28875152 PMCID: PMC5569873 DOI: 10.1155/2017/8473465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/31/2017] [Accepted: 06/27/2017] [Indexed: 12/17/2022]
Abstract
During the past several decades, major advances and improvements now promote better treatment options for cardiovascular diseases. However, these diseases still remain the single leading cause of death worldwide. The rapid development of cardiac tissue engineering has provided the opportunity to potentially restore the contractile function and retain the pumping feature of injured hearts. This conception of cardiac tissue engineering can enable researchers to produce autologous and functional biomaterials which represents a promising technique to benefit patients with cardiovascular diseases. Such an approach will ultimately reshape existing heart transplantation protocols. Notable efforts are accelerating the development of cardiac tissue engineering, particularly to create larger tissue with enhanced functionality. Decellularized scaffolds, polymer synthetics fibrous matrix, and natural materials are used to build robust cardiac tissue scaffolds to imitate the morphological and physiological patterns of natural tissue. This ultimately helps cells to implant properly to obtain endogenous biological capacity. However, newer designs such as the hydrogel scaffold-free matrix can increase the applicability of artificial tissue to engineering strategies. In this review, we summarize all the methods to produce artificial cardiac tissue using scaffold and scaffold-free technology, their advantages and disadvantages, and their relevance to clinical practice.
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17
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Liang R, Knight K, Easley D, Palcsey S, Abramowitch S, Moalli PA. Towards rebuilding vaginal support utilizing an extracellular matrix bioscaffold. Acta Biomater 2017; 57:324-333. [PMID: 28487243 PMCID: PMC5639927 DOI: 10.1016/j.actbio.2017.05.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 04/25/2017] [Accepted: 05/05/2017] [Indexed: 12/15/2022]
Abstract
As an alternative to polypropylene mesh, we explored an extracellular matrix (ECM) bioscaffold derived from urinary bladder matrix (MatriStem™) in the repair of vaginal prolapse. We aimed to restore disrupted vaginal support simulating application via transvaginal and transabdominal approaches in a macaque model focusing on the impact on vaginal structure, function, and the host immune response. In 16 macaques, after laparotomy, the uterosacral ligaments and paravaginal attachments to pelvic side wall were completely transected (IACUC# 13081928). 6-ply MatriStem was cut into posterior and anterior templates with a portion covering the vagina and arms simulating uterosacral ligaments and paravaginal attachments, respectively. After surgically exposing the correct anatomical sites, in 8 animals, a vaginal incision was made on the anterior and posterior vagina and the respective scaffolds were passed into the vagina via these incisions (transvaginal insertion) prior to placement. The remaining 8 animals underwent the same surgery without vaginal incisions (transabdominal insertion). Three months post implantation, firm tissue bands extending from vagina to pelvic side wall appeared in both MatriStem groups. Experimental endpoints examining impact of MatriStem on the vagina demonstrated that vaginal biochemical and biomechanical parameters, smooth muscle thickness and contractility, and immune responses were similar in the MatriStem no incision group and sham-operated controls. In the MatriStem incision group, a 41% decrease in vaginal stiffness (P=0.042), a 22% decrease in collagen content (P=0.008) and a 25% increase in collagen subtypes III/I was observed vs. Sham. Active MMP2 was increased in both Matristem groups vs. Sham (both P=0.002). This study presents a novel application of ECM bioscaffolds as a first step towards the rebuilding of vaginal support. STATEMENT OF SIGNIFICANCE Pelvic organ prolapse is a common condition related to failure of the supportive soft tissues of the vagina; particularly at the apex and mid-vagina. Few studies have investigated methods to regenerate these failed structures. The overall goal of the study was to determine the feasibility of utilizing a regenerative bioscaffold in prolapse applications to restore apical (level I) and lateral (level II) support to the vagina without negatively impacting vaginal structure and function. The significance of our findings is two fold: 1. Implantation of properly constructed extracellular matrix grafts promoted rebuilding of level I and level II support to the vagina and did not negatively impact the overall functional, morphological and biochemical properties of the vagina. 2. The presence of vaginal incisions in the transvaginal insertion of bioscaffolds may compromise vaginal structural integrity in the short term.
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Affiliation(s)
- Rui Liang
- Magee Women Research Institute, University of Pittsburgh, Pittsburgh, PA, USA; Department of Obstetrics, Gynecology, Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Katrina Knight
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Deanna Easley
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Stacy Palcsey
- Magee Women Research Institute, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Steven Abramowitch
- Magee Women Research Institute, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Pamela A Moalli
- Magee Women Research Institute, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Department of Obstetrics, Gynecology, Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
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18
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Pok S, Stupin IV, Tsao C, Pautler RG, Gao Y, Nieto RM, Tao ZW, Fraser CD, Annapragada AV, Jacot JG. Full-Thickness Heart Repair with an Engineered Multilayered Myocardial Patch in Rat Model. Adv Healthc Mater 2017; 6:10.1002/adhm.201600549. [PMID: 28081298 PMCID: PMC5896558 DOI: 10.1002/adhm.201600549] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 10/14/2016] [Indexed: 11/11/2022]
Abstract
In a rat model of right free wall replacement, the transplantation of an engineered multilayered myocardial patch fabricated from a polycaprolactone membrane supporting a chitosan/heart matrix hydrogel induces significant muscular and vascular remodeling and results in a significantly higher right ventricular ejection fraction compared to use of a commercially available pericardium patch.
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Affiliation(s)
- Seokwon Pok
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
- Division of Congenital Heart Surgery, Texas Children's Hospital, Houston, TX 77030, USA
| | - Igor V Stupin
- Department of Basic Radiology Research, Texas Children's Hospital, Houston, TX 77030, USA
| | - Christopher Tsao
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | - Robia G Pautler
- Department of Molecular Physiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Yang Gao
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
| | - Raymond M Nieto
- Division of Congenital Heart Surgery, Texas Children's Hospital, Houston, TX 77030, USA
| | - Ze-Wei Tao
- Department of Bioengineering, University of Colorado Denver/Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Charles D Fraser
- Division of Congenital Heart Surgery, Texas Children's Hospital, Houston, TX 77030, USA
| | - Ananth V Annapragada
- Department of Basic Radiology Research, Texas Children's Hospital, Houston, TX 77030, USA
| | - Jeffrey G Jacot
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
- Division of Congenital Heart Surgery, Texas Children's Hospital, Houston, TX 77030, USA
- Department of Bioengineering, University of Colorado Denver/Anschutz Medical Campus, Aurora, CO 80045, USA
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19
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Liang R, Knight K, Barone W, Powers RW, Nolfi A, Palcsey S, Abramowitch S, Moalli PA. Extracellular matrix regenerative graft attenuates the negative impact of polypropylene prolapse mesh on vagina in rhesus macaque. Am J Obstet Gynecol 2017; 216:153.e1-153.e9. [PMID: 27615441 DOI: 10.1016/j.ajog.2016.09.073] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/30/2016] [Accepted: 09/01/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND The use of wide pore lightweight polypropylene mesh to improve anatomical outcomes in the surgical repair of prolapse has been hampered by mesh complications. One of the prototype prolapse meshes has been found to negatively impact the vagina by inducing a decrease in smooth muscle volume and contractility and the degradation of key structural proteins (collagen and elastin), resulting in vaginal degeneration. Recently, bioscaffolds derived from extracellular matrix have been used to mediate tissue regeneration and have been widely adopted in tissue engineering applications. OBJECTIVE Here we aimed to: (1) define whether augmentation of a polypropylene prolapse mesh with an extracellular matrix regenerative graft in a primate sacrocolpopexy model could mitigate the degenerative changes; and (2) determine the impact of the extracellular matrix graft on vagina when implanted alone. STUDY DESIGN A polypropylene-extracellular matrix composite graft (n = 9) and a 6-layered extracellular matrix graft alone (n = 8) were implanted in 17 middle-aged parous rhesus macaques via sacrocolpopexy and compared to historical data obtained from sham (n = 12) and the polypropylene mesh (n = 12) implanted by the same method. Vaginal function was measured in passive (ball-burst test) and active (smooth muscle contractility) mechanical tests. Vaginal histomorphologic/biochemical assessments included hematoxylin-eosin and trichrome staining, immunofluorescent labeling of α-smooth muscle actin and apoptotic cells, measurement of total collagen, collagen subtypes (ratio III/I), mature elastin, and sulfated glycosaminoglycans. Statistical analyses included 1-way analysis of variance, Kruskal-Wallis, and appropriate post-hoc tests. RESULTS The host inflammatory response in the composite mesh-implanted vagina was reduced compared to that following implantation with the polypropylene mesh alone. The increase in apoptotic cells observed with the polypropylene mesh was blunted in the composite (overall P < .001). Passive mechanical testing showed inferior parameters for both polypropylene mesh alone and the composite compared to sham whereas the contractility and thickness of smooth muscle layer in the composite were improved with a value similar to sham, which was distinct from the decreases observed with polypropylene mesh alone. Biochemically, the composite had similar mature elastin content, sulfated glycosaminoglycan content, and collagen subtype III/I ratio but lower total collagen content when compared to sham (P = .011). Multilayered extracellular matrix graft alone showed overall comparable values to sham in aspects of the biomechanical, histomorphologic, or biochemical endpoints of the vagina. The increased collagen subtype ratio III/I with the extracellular matrix graft alone (P = .033 compared to sham) is consistent with an ongoing active remodeling response. CONCLUSION Mesh augmentation with a regenerative extracellular matrix graft attenuated the negative impact of polypropylene mesh on the vagina. Application of the extracellular matrix graft alone had no measurable negative effects suggesting that the benefits of this extracellular matrix graft occur when used without a permanent material. Future studies will focus on understanding mechanisms.
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20
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Chrobak MO, Hansen KJ, Gershlak JR, Vratsanos M, Kanellias M, Gaudette GR, Pins GD. Design of a Fibrin Microthread-Based Composite Layer for Use in a Cardiac Patch. ACS Biomater Sci Eng 2017; 3:1394-1403. [DOI: 10.1021/acsbiomaterials.6b00547] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Megan O. Chrobak
- Department
of Biomedical Engineering, Worcester Polytechnic Institute, 100 Institute Road, Worcester, Massachusetts 01609, United States
| | - Katrina J. Hansen
- Department
of Biomedical Engineering, Worcester Polytechnic Institute, 100 Institute Road, Worcester, Massachusetts 01609, United States
| | - Joshua R. Gershlak
- Department
of Biomedical Engineering, Worcester Polytechnic Institute, 100 Institute Road, Worcester, Massachusetts 01609, United States
| | - Maria Vratsanos
- Department
of Biomedical Engineering, Case Western Reserve University, 10900
Euclid Avenue, Cleveland, Ohio 44106, United States
| | - Marianne Kanellias
- Department
of Biomedical Engineering, Worcester Polytechnic Institute, 100 Institute Road, Worcester, Massachusetts 01609, United States
| | - Glenn R. Gaudette
- Department
of Biomedical Engineering, Worcester Polytechnic Institute, 100 Institute Road, Worcester, Massachusetts 01609, United States
| | - George D. Pins
- Department
of Biomedical Engineering, Worcester Polytechnic Institute, 100 Institute Road, Worcester, Massachusetts 01609, United States
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21
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Shanti RM, Smart RJ, Meram A, Kim D. Porcine Urinary Bladder Extracellular Matrix for the Salvage of Fibula Free Flap Skin Paddle: Technical Note and Description of a Case. Craniomaxillofac Trauma Reconstr 2016; 10:318-322. [PMID: 29109844 DOI: 10.1055/s-0036-1593473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 08/14/2016] [Indexed: 01/15/2023] Open
Abstract
This report establishes a novel application of a commercially available porcine urinary bladder extracellular matrix, MatriStem (ACell, Inc., Columbia, MD), in the salvage of partial loss of the skin paddle of a fibula osteoseptocutaneous free flap that was utilized for mandibular reconstruction.
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Affiliation(s)
- Rabie M Shanti
- Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Ryan J Smart
- Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - Andrew Meram
- Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
| | - David Kim
- Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana
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22
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Coakley DN, Shaikh FM, O'Sullivan K, Kavanagh EG, Grace PA, McGloughlin TM. In vitro evaluation of acellular porcine urinary bladder extracellular matrix – A potential scaffold in tissue engineered skin. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.wndm.2015.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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23
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Fleming ME, Bharmal H, Valerio I. Regenerative medicine applications in combat casualty care. Regen Med 2015; 9:179-90. [PMID: 24750059 DOI: 10.2217/rme.13.96] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
The purpose of this report is to describe regenerative medicine applications in the management of complex injuries sustained by service members injured in support of the wars in Afghanistan and Iraq. Improvements in body armor, resuscitative techniques and faster transport have translated into increased patient survivability and more complex wounds. Combat-related blast injuries have resulted in multiple extremity injuries, significant tissue loss and amputations. Due to the limited availability and morbidity associated with autologous tissue donor sites, the introduction of regenerative medicine has been critical in managing war extremity injuries with composite massive tissue loss. Through case reports and clinical images, this report reviews the application of regenerative medicine modalities employed to manage combat-related injuries. It illustrates that the novel use of hybrid reconstructions combining traditional and regenerative medicine approaches are an effective tool in managing wounds. Lessons learned can be adapted to civilian care.
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Affiliation(s)
- Mark E Fleming
- Department of Orthopaedics, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889, USA
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24
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Weiss DJ, Elliott M, Jang Q, Poole B, Birchall M. Tracheal bioengineering: the next steps. Proceeds of an International Society of Cell Therapy Pulmonary Cellular Therapy Signature Series Workshop, Paris, France, April 22, 2014. Cytotherapy 2014; 16:1601-13. [PMID: 25457172 DOI: 10.1016/j.jcyt.2014.10.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/29/2014] [Accepted: 10/30/2014] [Indexed: 11/15/2022]
Abstract
There has been significant and exciting recent progress in the development of bioengineering approaches for generating tracheal tissue that can be used for congenital and acquired tracheal diseases. This includes a growing clinical experience in both pediatric and adult patients with life-threatening tracheal diseases. However, not all of these attempts have been successful, and there is ongoing discussion and debate about the optimal approaches to be used. These include considerations of optimal materials, particularly use of synthetic versus biologic scaffolds, appropriate cellularization of the scaffolds, optimal surgical approaches and optimal measure of both clinical and biologic outcomes. To address these issues, the International Society of Cell Therapy convened a first-ever meeting of the leading clinicians and tracheal biologists, along with experts in regulatory and ethical affairs, to discuss and debate the issues. A series of recommendations are presented for how to best move the field ahead.
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Affiliation(s)
- Daniel J Weiss
- Department of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Martin Elliott
- Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, United Kingdom
| | - Queenie Jang
- International Society for Cell Therapy, Vancouver, British Columbia, Canada
| | - Brian Poole
- International Society for Cell Therapy, Vancouver, British Columbia, Canada
| | - Martin Birchall
- Royal National Throat Nose, and Ear Hospital and University College London, London, United Kingdom.
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25
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Taylor DA, Sampaio LC, Gobin A. Building new hearts: a review of trends in cardiac tissue engineering. Am J Transplant 2014; 14:2448-59. [PMID: 25293671 DOI: 10.1111/ajt.12939] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 06/26/2014] [Accepted: 07/12/2014] [Indexed: 01/25/2023]
Abstract
Cardiovascular disease (CVD) is the number one cause of death in the United States. However, few treatments for CVD provide a means to regain full cardiac function with no long-term side effects. Novel tissue-engineered products may provide a way to overcome the limitations of current CVD therapies by replacing injured myocardium with functioning tissue or by inducing more constructive forms of endogenous repair. In this review, we discuss some of the factors that should be considered in the development of tissue-engineered products, and we review the methods currently being investigated to generate more effective heart valves, cardiac patches and whole hearts.
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Affiliation(s)
- D A Taylor
- Department of Regenerative Medicine Research, Texas Heart Institute, Houston, TX
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