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Functional tissue engineering of chondral and osteochondral constructs.

Due to the prevalence of osteoarthritis (OA) and damage to articular cartilage, coupled with the poor intrinsic healing capacity of this avascular connective tissue, there is a great demand for an articular cartilage substitute. As the bearing material of diarthrodial joints, articular cartilage has remarkable functional properties that have been difficult to reproduce in tissue-engineered constructs. We have previously demonstrated that by using a functional tissue engineering approach that incorporates mechanical loading into the long-term culture environment, one can enhance the development of mechanical properties in chondrocyte-seeded agarose constructs. As these gel constructs begin to achieve material properties similar to that of the native tissue, however, new challenges arise, including integration of the construct with the underlying native bone. To address this issue, we have developed a technique for producing gel constructs integrated into an underlying bony substrate. These osteochondral constructs develop cartilage-like extracellular matrix and material properties over time in free swelling culture. In this study, as a preliminary to loading such osteochondral constructs, finite element modeling (FEM) was used to predict the spatial and temporal stress, strain, and fluid flow fields within constructs subjected to dynamic deformational loading. The results of these models suggest that while chondral ("gel alone") constructs see a largely homogenous field of mechanical signals, osteochondral ("gel bone") constructs see a largely inhomogeneous distribution of mechanical signals. Such inhomogeneity in the mechanical environment may aid in the development of inhomogeneity in the engineered osteochondral constructs. Together with experimental observations, we anticipate that such modeling efforts will provide direction for our efforts aimed at the optimization of applied physical forces for the functional tissue engineering of an osteochondral articular cartilage substitute.

Biocompatible Materials↗

[Tissue engineering applications: cartilage lesions repair by the use of autologous chondrocytes].

Promising new therapies based on tissue engineering have been recently developed for cartilage repair. The association of biomaterials with autologous chondrocytes expanded in vitro can represent a useful tool to regenerate this tissue. The scaffolds utilised in such therapeutical applications should provide a pre-formed three-dimensional shape, prevent cells from floating out of the defect, have sufficient mechanical strength, facilitate uniform spread of cells and stimulate the phenotype of transplanted cells. Hyaff-11 is a hyaluronic-acid based biodegradable polymer, that has been shown to provide successful cell carrier for tissue-engineered repair. From our findings we can state that human chondrocytes seeded on Hyaff-11 are able to maintain in vitro the characteristic of differentiated cells, expressing and producing collagen type II and aggrecan which are the main markers of cartilage phenotype, down-regulating collagen type I. Moreover, it seems to be a useful scaffold for cartilage repair both in animal models and clinical trials in humans, favouring the formation of a hyaline-like tissue. In the light of these data, we can hypothesise, for the future, the use of autologous chondrocyte transplantation together with gene therapy as a treatment for rheumatic diseases such as osteoarthritis.

Animals↗

Hydrogels for tissue engineering: scaffold design variables and applications.

Polymer scaffolds have many different functions in the field of tissue engineering. They are applied as space filling agents, as delivery vehicles for bioactive molecules, and as three-dimensional structures that organize cells and present stimuli to direct the formation of a desired tissue. Much of the success of scaffolds in these roles hinges on finding an appropriate material to address the critical physical, mass transport, and biological design variables inherent to each application. Hydrogels are an appealing scaffold material because they are structurally similar to the extracellular matrix of many tissues, can often be processed under relatively mild conditions, and may be delivered in a minimally invasive manner. Consequently, hydrogels have been utilized as scaffold materials for drug and growth factor delivery, engineering tissue replacements, and a variety of other applications.

Biocompatible Materials↗

Fetal tissue engineering: in utero tracheal augmentation in an ovine model.

BACKGROUND/PURPOSE: This study was aimed at comparing fetal tissue engineering with autologous free grafting in an ovine model of in utero tracheal repair. METHODS: Chondrocytes were isolated from both elastic and hyaline cartilage specimens harvested from fetal lambs and expanded in vitro. Cells were seeded dynamically onto biodegradable scaffolds, which then were maintained in a rotating bioreactor for 6 to 8 weeks. Constructs subsequently were implanted into fetal tracheas (n = 15), in a heterologous fashion (group I). In group II, fetuses (n = 5) received autologous free grafts of elastic cartilage harvested from the ear as tracheal implants. In vivo specimens were harvested for histologic analysis at different time-points postimplantation. RESULTS: In the 12 of 15 surviving fetuses of group I, all constructs were found to resemble normal hyaline cartilage, engraft well despite their heterologous origin, and display time-dependent epithelialization derived from the native trachea. All autologous free grafts were engrafted and epithelialized at birth, retaining histologic characteristics of elastic cartilage, but were more deformed than engineered constructs. Of the lambs allowed to reach term, 5 of 5 in the engineered group and 4 of 5 in the free graft group could breathe spontaneously. CONCLUSIONS: (1) Tissue-engineered cartilage, as well as autologous free grafts, can be implanted successfully into the fetal trachea, resulting in engraftment and function. (2) Engineered cartilage provides enhanced structural support after implantation into the fetal trachea when compared with free grafts. Prenatal tracheoplasty may prove useful for the treatment of severe congenital tracheal malformations.

Animals↗

[Amniotic fluid: a novel source for tissue engineering].

OBJECTIVE: To investigate the possibility of using amniotic fluid cells as seed cells for tissue engineering. METHODS: Amniotic fluid was obtained by ultrasound-guided amniocentesis performed on pregnant women with a gestational age ranging from 16(th) approximately 23(rd) weeks. The cells isolated from the amniotic fluid were cultured in F10 culture fluid with 10% FBS. Immunocytochemistry was used to examine the standard intermediate filaments. After 3 passages of subculture, the cells were harvested and seeded onto PGA polymer scaffold. The cellular morphology, structure and adhesion with scaffold were evaluated by contrast microscope and scanning electronic microscope. RESULTS: The amniocytes expanded rapidly in culture media. Immunocytochemistry revealed positive signals for vimentin, smooth muscle action (SMA), and pan cytokeratin, and negative signals for desmin. Amniocytes-polymer complex analysis showed confluent cells firmly attached to the scaffold, with no evidence of cell death. CONCLUSION: The expansion potential of amniotic fluid cells is active. They express the characteristics of mesenchymal cells. The cells on PGA polymer scaffold can grow rapidly and maintain its morphological property. So the amniotic fluid may be a practical cell source for tissue engineering.

Actins↗

Tissue-engineered bone repair of goat-femur defects with osteogenically induced bone marrow stromal cells.

Tissue engineering can generate bone tissue and has been shown to provide a better means of repairing weight-bearing bone defect. Previous studies, however, have heretofore been limited to the use of nonosteogenically induced bone marrow stromal cells (BMSCs) or the application of slow-degradation scaffolds. In this study, weight-bearing bone was engineered using osteogenically induced BMSCs. In addition, coral was used as a scaffold material, due to its proper degradation rate for the engineering and repair of a goat femur defect. A 25 mm long defect was created at the middle of the right femur in each of 10 goats. The rates of defect repair were compared in an experimental group of ten goats receiving implants containing osteogenically induced BMSCs and in the control group of goats (n = 10) receiving just coral cylinders. In the experimental group, bony union was observed by radiographic and gross view at 4 months, and engineered bone was further remodeled into newly formed cortexed bone at 8 months. There was increased gray density of radiographic rays in the repaired area, which was significantly different (p < 0.05) from that of the control group. H&E staining demonstrated that trabecular bone was formed at 4 months. Moreover, irregular osteon was observed at 8 months. Most importantly, the tissue-engineered bone segment revealed a similarity to the left-side normal femur in terms of bend load strength and bend rigidity, showing no significant difference (p > 0.05). In contrast, the coral cylinders of the control group showed no bone formation. Furthermore, almost complete resorption of the carrier had occurred, being evident at 2 months in the control group. H&E staining demonstrated that a small amount of residual coral particle was surrounded by fibrous tissue at 4 months whereas the residues disappeared at 8 months. Based on these results, we conclude that engineered bone from osteogenically induced BMSCs and coral can ideally heal critical-sized segmental bone defects in the weight-bearing area of goats.

Animals↗

[Preliminary study of cryopreservation of tissue engineered tendon].

OBJECTIVE: To investigate a cryophylactic agent (CPA) to protect tissue engineered tendon (TET) in deep low temperature. METHODS: Sixty-four BALB/C inbred nude mice were chosen, which included 4 as blank control group, left sides of 60 as experimental group and their right sides as control group. Transformed human embryonic tendon cells of the 54th passage and artificial materials of carbon fiber (CF) and polyglycolic acid (PGA) were co-cultured in vitro to construct TET. TET was frozen in liquid nitrogen with four kinds of CPA (groups A, B, C, and D) for 2 months. They were thawed quickly and transplanted into hind limbs of nude mice to repair the defects of Achilles tendon, which was 5 mm in length and 65.7% of total Achilles tendon. In control group, no cryopreservation treatment was taken. The morphological, histological, ultrastructure, and immunohistochemistry examinations were made and short tandem repeat loci were detected 2, 4, 6, 8, and 12 weeks later. RESULTS: In the experimental group, the morphological properties of tendon cells resumed gradually and the capability of synthesizing collagen enhanced by degrees. Tendon cells survived and could secret type I collagen and there was less difference between experimental and control groups 12 weeks after transplantation. In group A, vacuole in mitochondrion of tendon cell decreased, tendon cell arranged in order and abundant collagen fibers were found and linked. CONCLUSION: The cryopreservation agent in group A can protect TET in deep low temperature.

Achilles Tendon↗

Tissue engineering for meniscus repair.

Meniscus injury is common in today's active society. Despite the frequent presentation of meniscus injury, the decision to repair or resect a torn meniscus is not always straightforward. Current repair techniques are effective in the peripheral vascularized meniscus, but their success is not dependable in the avascularized zone. Tissue engineering, a discipline that combines the technologies of cell culture and biodegradable scaffolds to deliver a cellular repair, may be one future answer to this problem. The concept of using cell-based repair for torn menisci could improve healing of lesions in the avascular zone and broadly expand the indication for repair rather than removal, obviating the need for meniscectomy. This article reviews current advances in the relatively new field of tissue engineering toward the development of a tissue-engineered meniscal repair technique.

Chondrocytes↗

Tissue-engineered vessel strengthens quickly under physiological deformation: application of a new perfusion bioreactor with machine vision.

In order to develop a patent tissue-engineered blood vessel that grossly resembles native tissue, required culture times in most studies exceed 8 weeks. For the sake of shortening the maturation period of the constructs, we have used deformation as the basic index for mechanical environment control. A new bioreactor with a machine vision identifier was developed to accurately control the deformation of the construct during the perfusion process. Two groups of seeded constructs (n = 4 per group) were investigated in this study, with one group stimulated by a cyclic deformation of 10% and the other by a pulsatile pressure that gradually increased to 120 mm Hg (the control group). After 21 days of culture, the mechanical properties of the constructs were examined. The average burst strength and suture retention strength in the two groups were significantly different (t test, p < 0.05). For the experimental group, the average burst strength and suture retention strength were higher than those of the control group, by 31.6 and 23.4%, respectively. Specifically, the average burst strength of the constructs reached 1,402 mm Hg (close to that of the native vessel, i.e. 1,680 mm Hg) within a relatively short period of 21 days. In conclusion, deformation is an observable, controllable and very valuable index for mechanical environment control in vascular tissue engineering. It makes the control of mechanical stimuli more essential and experiments more comparable.

Animals↗

The roles of tissue engineering and vascularisation in the development of micro-vascular networks: a review.

The construction of tissue-engineered devices for medical applications is now possible in vitro using cell culture and bioreactors. Although methods of incorporating them back into the host are available, current constructs depend purely on diffusion which limits their potential. The absence of a vascular network capable of distributing oxygen and other nutrients within the tissue-engineered device is a major limiting factor in creating vascularised artificial tissues. Though bio-hybrid prostheses such as vascular bypass grafts and skin substitutes have already been developed and are being used clinically, the absence of a capillary bed linking the two systems remains the missing link. In this review, the different approaches currently being or that have been applied to vascularise tissues are identified and discussed.

Animals↗

A structural model for the flexural mechanics of nonwoven tissue engineering scaffolds.

The development of methods to predict the strength and stiffness of biomaterials used in tissue engineering is critical for load-bearing applications in which the essential functional requirements are primarily mechanical. We previously quantified changes in the effective stiffness (E) of needled nonwoven polyglycolic acid (PGA) and poly-L-lactic acid (PLLA) scaffolds due to tissue formation and scaffold degradation under three-point bending. Toward predicting these changes, we present a structural model for E of a needled nonwoven scaffold in flexure. The model accounted for the number and orientation of fibers within a representative volume element of the scaffold demarcated by the needling process. The spring-like effective stiffness of the curved fibers was calculated using the sinusoidal fiber shapes. Structural and mechanical properties of PGA and PLLA fibers and PGA, PLLA, and 50:50 PGA/PLLA scaffolds were measured and compared with model predictions. To verify the general predictive capability, the predicted dependence of E on fiber diameter was compared with experimental measurements. Needled nonwoven scaffolds were found to exhibit distinct preferred (PD) and cross-preferred (XD) fiber directions, with an E ratio (PD/XD) of approximately 3:1. The good agreement between the predicted and experimental dependence of E on fiber diameter (R2 = 0.987) suggests that the structural model can be used to design scaffolds with E values more similar to native soft tissues. A comparison with previous results for cell-seeded scaffolds (Engelmayr, G. C., Jr., et al., 2005, Biomaterials, 26(2), pp. 175-187) suggests, for the first time, that the primary mechanical effect of collagen deposition is an increase in the number of fiber-fiber bond points yielding effectively stiffer scaffold fibers. This finding indicated that the effects of tissue deposition on needled nonwoven scaffold mechanics do not follow a rule-of-mixtures behavior. These important results underscore the need for structural approaches in modeling the effects of engineered tissue formation on nonwoven scaffolds, and their potential utility in scaffold design.

Biocompatible Materials↗

Computational fluid dynamics modeling of steady-state momentum and mass transport in a bioreactor for cartilage tissue engineering.

Computational fluid dynamics (CFD) models to quantify momentum and mass transport under conditions of tissue growth will aid bioreactor design for development of tissue-engineered cartilage constructs. Fluent CFD models are used to calculate flow fields, shear stresses, and oxygen profiles around nonporous constructs simulating cartilage development in our concentric cylinder bioreactor. The shear stress distribution ranges from 1.5 to 12 dyn/cm(2) across the construct surfaces exposed to fluid flow and varies little with the relative number or placement of constructs in the bioreactor. Approximately 80% of the construct surface exposed to flow experiences shear stresses between 1.5 and 4 dyn/cm(2), validating the assumption that the concentric cylinder bioreactor provides a relatively homogeneous hydrodynamic environment for construct growth. Species mass transport modeling for oxygen demonstrates that fluid-phase oxygen transport to constructs is uniform. Some O(2) depletion near the down stream edge of constructs is noted with minimum pO(2) values near the constructs of 35 mmHg (23% O(2) saturation). These values are above oxygen concentrations in cartilage in vivo, suggesting that bioreactor oxygen concentrations likely do not affect chondrocyte growth. Scale-up studies demonstrate the utility and flexibility of CFD models to design and characterize bioreactors for growth of tissue-engineered cartilage.

Bioreactors↗

New murine model of spontaneous autologous tissue engineering, combining an arteriovenous pedicle with matrix materials.

The authors previously described a model of tissue engineering in rats that involves the insertion of a vascular pedicle and matrix material into a semirigid closed chamber, which is buried subcutaneously. The purpose of this study was to develop a comparable model in mice, which could enable genetic mutants to be used to more extensively study the mechanisms of the angiogenesis, matrix production, and cellular migration and differentiation that occur in these models. A model that involves placing a split silicone tube around blood vessels in the mouse groin was developed and was demonstrated to successfully induce the formation of new vascularized tissue. Two vessel configurations, namely, a flow-through pedicle (n = 18 for three time points) and a ligated vascular pedicle (n = 18), were compared. The suitability of chambers constructed from either polycarbonate or silicone and the effects of incorporating either Matrigel equivalent (n = 18) or poly(DL-lactic-co-glycolic acid) (n = 18) on angiogenesis and tissue production were also tested. Empty chambers, chambers with vessels only, and chambers with matrix only served as control chambers. The results demonstrated that a flow-through type of vascular pedicle, rather than a ligated pedicle, was more reliable in terms of patency, angiogenesis, and tissue production, as were silicone chambers, compared with polycarbonate chambers. Marked angiogenesis occurred with both types of extracellular matrix scaffolds, and there was evidence that native cells could migrate into and survive within the added matrix, generating a vascularized three-dimensional construct. When Matrigel was used as the matrix, the chambers filled with adipose tissue, creating a highly vascularized fat flap. In some cases, new breast-like acini and duct tissue appeared within the fat. When poly(dl-lactic-co-glycolic acid) was used, the chambers filled with granulation and fibrous tissue but no fat or breast tissue was observed. No significant amount of tissue was generated in the control chambers. Operative times were short (25 minutes), and two chambers could be inserted into each mouse. In summary, the authors have developed an in vivo murine model for studying angiogenesis and tissue-engineering applications that is technically simple and quick to establish, has a high patency rate, and is well tolerated by the animals.

Animals↗

[Decellularized human tissue engineering aortic valves conduit].

OBJECTIVE: To explore the suitable method to create a decellularized human tissue engineering homograft aortic valves conduit and to study its biologic, immol/Lunological, and biomechanical properties. METHODS: Human homograft aortic valves conduits donated by healthy adult males undergoing brain death preserved in liquid nitrogen were treated with pH 8.0 hypotonic Tris buffer for 12 hours; then pH 8.0 isotonic buffer with 0.5% DOA, 1% DOA or 1% Triton for 12 hours-24 h; l and then pH 7.6 isotonic buffer with DNAase 200 micro g/ml, RNAase 20 micro g/ml for 2 hours. the histology, HLA-DR antigen, water content, thinkness, denaturation temperature, DNA content, Collagen Contents, stress-strain, destroying stress were examined. RESULTS: In comparison with the standard cryopreserved human homograft aortic valves conduit, the valves, wall and muscle of the homograft aorta treated by 1% DOA for 24 hours were decellularized completely, and the 3-dimensional network structure of elastic fibers and collagenous fibers remained intact. Immol/Lunohistochemistry showed a remarkable decrease of expression of tissue genome DNA contents, a decrease by 91.14% in the valves, and by 91.53% in the wall, and a remarkable decrease of the expression of HLA-DR antigens. However, the water content in the decellular aortic wall was increased significantly (75.4 +/- 1.8 vs 82.0 +/- 0.7, P < 0.05). No significant differences were found in the denaturation temperature, stress-strain, destroying stress parameter, and tissue extension ratio in the decellular human homograft aortic valves conduits. CONCLUSION: The decellularization method by isotonic buffer with 1% DOA-DNAase is effective. The decellularized human homograft aortic valves conduits are unaltered in biologic, biomechanical, and physical properties with lowered immol/Lunogenicity, It can be used as an ideal valve for patients or as a homograft stent for developing tissue engineering valve by host recellularization.

Adult↗

Tissue engineering of cardiac valve prostheses I: development and histological characterization of an acellular porcine scaffold.

BACKGROUND AND AIMS OF THE STUDY: Several deficiencies in current heart valve prostheses make them problematic for use in younger patients. Tissue valve substitutes are non-viable with a life expectancy of only 10-15 years, while mechanical valves require long-term anti-coagulation therapy. A solution to these problems would be to develop a tissue-engineered heart valve containing autologous cells, enabling the valve to maintain its biochemical and mechanical properties, yet grow with the patient. The study aim was to optimize a protocol to produce a porcine acellular matrix scaffold for use in developing a tissue-engineered heart valve. METHODS: Fresh porcine aortic valve leaflets were treated with Triton X-100, sodium dodecyl sulfate (SDS), sodium deoxycholate, MEGA 10, TnBP, CHAPS, and Tween 20, over a range of concentrations, in the presence of protease inhibitors for up to 72 h. Histological analysis was used to detect the major structural proteins of the heart valve, collagen I, elastin and glycosaminoglycans. RESULTS: After 72 h, most protocols resulted in the retention of large numbers of whole cells and cell fragments. Only SDS (0.03-1%) or sodium deoxycholate (0.5-2%) resulted in total decellularization at 24 h. Histological analysis of acellular matrices showed that the major structural proteins had been retained and appeared to be intact. CONCLUSION: Protocols utilizing SDS or sodium deoxycholate were successful for leaflet decellularization, and histological analysis showed that the major structural components of the valve matrix had been maintained. These methods are being developed further with a view to reseeding with autologous cells to produce tissue-engineered solutions for clinical implantation.

Animals↗

[Reconstruction of rabbit corneal stroma using tissue engineering technique].

OBJECTIVE: Reconstruct corneal stroma by tissue engineering. METHODS: Primary corneal stromal cells were isolated from newborn rabbit cornea. When the cultured cells reaching confluence, the stromal cells were mixed with polyglycolic acid (PGA) to form a cell-scaffold construct. After 1 week in vitro culture, the constructs were implanted into mother rabbit corneal stroma. Parts of corneal stromal cells were transfected with GFP gene as mark of transplanted cells. Tissues were harvested at 8 weeks for transmission electron microscopy (TEM), histology and Western blot evaluation. In control, PGA alone was implanted into the other cornea. RESULTS: The engineered corneal stroma became transparent gradually over a period of 8 weeks. The histology of engineered stromal lamellar was relatively similar to that of natural one, no significant differences were found in the diameter of cornea collagen fiber [(29.4 +/- 4.7) nm] in experimental rabbits compared with control [(28.5 +/- 3.5) nm], Student's t-test: P = 0.1316 > 0.05. TEM demonstrated that collagen fibrils deposited in engineered stroma had a similar diameter compared to that of normal counterpart. In addition, Western blot showed the positive expression of type I collagen in the collagen fibrils. In contrast, no new stroma tissue was formed when PGA alone implanted. A green colored stroma was observed when engineered with GFP-labeled cells under fluorescence light microscope. CONCLUSION: The results demonstrate that nearly transparent corneal stroma can be obtained by the technique of cornea engineering.

Animals↗

[Artificial cornea, cell culture and tissue engineering].

The cornea, the fibrous transparent layer of the eye ball, is becoming a target of tissue engineering research because of the scarcity of donors. We report our experience in developing a mechanism to build a full-thickness corneal substitute using cell culture and protocols of tissue engineering. Isolation of keratocytes, epithelial and endothelial cells was accomplished by culturing denuded corneal stroma, limbal explant and enzymatically detached endothelium. Each type of cell was cultured in selective medium. Microanalytical quality control of cell viability was carried out. A multilayered cornea construct was built by sequential deposition of endothelium, keratocytes immersed a gel of human fibrin and epithelium in a manner that reproduce the normal histological structure.

Artificial Organs↗

[Repair of meniscal defects with autologous tissue-engineered fibrocartilage].

OBJECTIVE: To repair critical-sized meniscal defects in an immunocompetent mammal by tissue engineering approach. METHODS: 15 45-day-old Changfeng crossbred pigs were selected as experimental animals. Autologous fibrochondrocytes were obtained from left knee menisci by modified Klagsbrun's method and were proliferated in vitro to a proper amount. A 1-cm-long full-layer defect of right medial meniscus was created anterior to the medial collateral ligament. PGA-fibrochondrocyte-Pluronic complex, fibrochondrocyte-Pluronic complex or PGA only was respectively implanted into the defects. We used intact menisci and untreated meniscal defects as controls. Samples respectively obtained in 9 w, 16 w and 25 w were appraised by general observation, histology, biochemistry and biomechanics. RESULTS: From the sights of general morphology, histological structure and Young's Modulus (59.7% of that in normal meniscus at 25 w), the PGA-cell-Pluronic complex can form the best quality tissue, which can stabilize the GAG ratio (74.5% of that in normal cartilage at 25 w) of femoral entocondyle cartilage. CONCLUSION: Autologous tissue-engineered fibrocartilage is a promising feasible method to regenerate or reconstruct menisci so as to hold back the degenerative changes of the knee.

Animals↗