Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine, New Haven, Connecticut 06510, USA.
Tissue Eng Part C Methods. 2011 Oct;17(10):993-8. doi: 10.1089/ten.TEC.2011.0110. Epub 2011 Jul 1.
We created the first tissue-engineered vascular graft (TEVG) to be successfully used in humans. The TEVG is made by seeding autologous bone marrow-derived mononuclear cells (BM-MNCs) onto a biodegradable tubular scaffold fabricated from polyglycolic-acid mesh coated with a 50:50 copolymer of poly-L-lactide and-ɛ-caprolactone. In the initial clinical study, the BM-MNCs were isolated using a Ficoll density centrifugation method. Use of this cell isolation technique is problematic in that it is performed using an open system and therefore is susceptible to contamination. As a first step toward creating a closed system for assembling a TEVG, we evaluated the use of a filter-based method for isolating BM-MNCs and compared it to density centrifugation in Ficoll.
BM-MNCs were isolated from human BM using density centrifugation in Ficoll or a filter-based method. BM-MNCs were seeded onto biodegradable tubular scaffold and incubated for 24 h before implantation. The TEVG were implanted as inferior vena cava interposition grafts in SCID/bg mice (n=24) using microsurgical technique. Grafts were followed with ultrasonography and computed tomography-angiography. Ten weeks after implantation the TEVG were explanted and examined using histology and immunohistochemistry.
Both methods isolated similar number of cells (Ficoll: 8.5±6.6×10(6)/mL, Filter: 6.6±3.5×10(6)/mL; p=0.686) with similar viability as assayed using fluorescence-activated cell sorting (FACS) (Ficoll: 97.0%±1.5%, Filter: 95.9%±3.0%; p=0.339). FACS analysis demonstrated that the fraction of lymphocytes and monocytes to total cells was lower in the filter group (CD4 in Ficoll: 8.9%±1.1%, CD4 in Filter: 3.5%±0.8%; p=0.002, CD8 in Ficoll: 9.4%±2.1%, CD8 in Filter: 3.9%±1.4%; p=0.021, Monocyte in Ficoll: 6.9%±1.0%, Monocyte in Filter: 2.7%±1.0%; p=0.008), consistent with granulocyte contamination (Ficoll: 46.6±2.7×10(6)/mL, Filter: 58.1±5.2×10(6)/mL; p<0.001). The ratio of stem cells to BM-MNCs was comparable between groups. There were no statistically significant differences with regard to TEVG patency and morphology between groups. Both methods of cell isolation produced neovessels with similar histology.
Filter-based BM-MNC isolation is comparable to BM-MNC isolation using density centrifugation in Ficoll for TEVG assembly. The filter-based cell isolation technique has the added advantage of the potential to create a closed disposable system.
我们成功地将首个组织工程血管移植物(TEVG)应用于人体。该 TEVG 是通过将自体骨髓来源的单核细胞(BM-MNC)接种到由聚乙二醇酸网制成的可生物降解的管状支架上制成的,该支架涂有聚 L-乳酸和-ε-己内酯的 50:50 共聚物。在最初的临床研究中,BM-MNC 是使用菲可密度离心法分离的。使用这种细胞分离技术存在问题,因为它是在开放系统中进行的,因此容易受到污染。作为创建用于组装 TEVG 的封闭系统的第一步,我们评估了使用基于过滤器的方法分离 BM-MNC 的方法,并将其与菲可密度离心法进行了比较。
使用菲可密度离心法或基于过滤器的方法从人骨髓中分离 BM-MNC。将 BM-MNC 接种到可生物降解的管状支架上,并在植入前孵育 24 小时。使用显微外科技术将 TEVG 作为下腔静脉间置移植物植入 SCID/bg 小鼠(n=24)中。使用超声和计算机断层血管造影术对移植物进行随访。植入 10 周后,取出 TEVG 并进行组织学和免疫组织化学检查。
两种方法分离的细胞数量相似(菲可密度离心法:8.5±6.6×10(6)/mL,过滤器:6.6±3.5×10(6)/mL;p=0.686),使用荧光激活细胞分选(FACS)测定的存活率也相似(菲可密度离心法:97.0%±1.5%,过滤器:95.9%±3.0%;p=0.339)。FACS 分析表明,过滤器组的淋巴细胞和单核细胞与总细胞的比例较低(菲可密度离心法:CD4 为 8.9%±1.1%,CD4 为 3.5%±0.8%;p=0.002,CD8 为 9.4%±2.1%,CD8 为 3.9%±1.4%;p=0.021,单核细胞为 6.9%±1.0%,单核细胞为 2.7%±1.0%;p=0.008),与粒细胞污染一致(菲可密度离心法:46.6±2.7×10(6)/mL,过滤器:58.1±5.2×10(6)/mL;p<0.001)。两组之间 BM-MNC 中干细胞的比例无统计学差异。两组之间 TEVG 通畅率和形态无统计学差异。两种细胞分离方法均产生具有相似组织学的新生血管。
基于过滤器的 BM-MNC 分离与使用菲可密度离心法分离 BM-MNC 用于 TEVG 组装相当。基于过滤器的细胞分离技术具有潜在的优势,可以创建封闭的一次性系统。