Biomaterial-driven in situ cardiovascular tissue engineering : a multi-disciplinary perspective
TLDR
The main current challenges for in situ cardiovascular regeneration are pinpointed and further address, namely the achievement of tissue homeostasis, the development of predictive models for long-term performances of the implanted grafts, and the necessity for stratification for successful clinical translation.Abstract:
There is a persistent and growing clinical need for readily-available substitutes for heart valves and small-diameter blood vessels. In situ tissue engineering is emerging as a disruptive new technology, providing ready-to-use biodegradable, cell-free constructs which are designed to induce regeneration upon implantation, directly in the functional site. The induced regenerative process hinges around the host response to the implanted biomaterial and the interplay between immune cells, stem/progenitor cell and tissue cells in the microenvironment provided by the scaffold in the hemodynamic environment. Recapitulating the complex tissue microstructure and function of cardiovascular tissues is a highly challenging target. Therein the scaffold plays an instructive role, providing the microenvironment that attracts and harbors host cells, modulating the inflammatory response, and acting as a temporal roadmap for new tissue to be formed. Moreover, the biomechanical loads imposed by the hemodynamic environment play a pivotal role. Here, we provide a multidisciplinary view on in situ cardiovascular tissue engineering using synthetic scaffolds; starting from the state-of-the art, the principles of the biomaterial-driven host response and wound healing and the cellular players involved, toward the impact of the biomechanical, physical, and biochemical microenvironmental cues that are given by the scaffold design. To conclude, we pinpoint and further address the main current challenges for in situ cardiovascular regeneration, namely the achievement of tissue homeostasis, the development of predictive models for long-term performances of the implanted grafts, and the necessity for stratification for successful clinical translation.read more
Citations
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Fibrosis in tissue engineering and regenerative medicine: treat or trigger?
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What Is the Potential of Tissue-Engineered Pulmonary Valves in Children?
Simone A. Huygens,Maureen P.M.H. Rutten-van Mölken,Anahita Noruzi,Jonathan R.G. Etnel,Isaac Corro Ramos,Carlijn V. C. Bouten,Jolanda Kluin,Johanna J.M. Takkenberg +7 more
TL;DR: If tissue-engineered heart valves result in improved clinical outcomes, they are expected to be cost-effective compared with existing heart valve substitutes, and showed that there is room for improvement in clinical outcomes in children requiring RVOTR.
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Morphology and mechanisms of a novel absorbable polymeric conduit in the pulmonary circulation of sheep.
TL;DR: Experimental in vivo experience with an entirely synthetic absorbable graft designed to be replaced by tissue in-vivo by host cells, in a process termed Endogenous Tissue Restoration (ETR) leads to progressive and substantial replacement of an off-the-shelf synthetic bioabsorbable conduit by functional host tissue to one year in sheep.
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Sheep-specific immunohistochemical panel for the evaluation of regenerative and inflammatory processes in tissue-engineered heart valves
Sylvia Dekker,Daphne van Geemen,Antoon J. van den Bogaerdt,Anita Anita Driessen-Mol,Elena Aikawa,Anthal I.P.M. Smits +5 more
TL;DR: A comprehensive sheep-specific panel of antibodies could serve as a tool to study the spatiotemporal expression of proteins in remodeling tissue-engineered heart valves after implantation in a sheep model, thereby contributing to the understanding of the in vivo processes which ultimately determine long-term success or failure of tissue- engineered heart valves.
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Geometry influences inflammatory host cell response and remodeling in tissue-engineered heart valves in-vivo.
Sarah E. Motta,Emanuela S. Fioretta,Valentina Lintas,Petra E. Dijkman,Monika Hilbe,Laura Frese,Nikola Cesarovic,S Sandra Loerakker,Frank P. T. Baaijens,Volkmar Falk,Volkmar Falk,Simon P. Hoerstrup,Maximilian Y. Emmert +12 more
TL;DR: TEHV-geometry can significantly influence the host cell response by determining the infiltration and presence of macrophages and α-SMA+-cells, which play a crucial role in orchestrating TEHV remodeling.
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