Ju Young Min, Ahn Hyunhee, Arenas-Herrera Juan, Kim Cheil, Abolbashari Mehran, Atala Anthony, Yoo James J, Lee Sang Jin
Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
Acta Biomater. 2017 Sep 1;59:58-67. doi: 10.1016/j.actbio.2017.06.027. Epub 2017 Jun 19.
The strategy of vascular tissue engineering is to create a vascular substitute by combining autologous vascular cells with a tubular-shaped biodegradable scaffold. We have previously developed a novel electrospun bilayered vascular scaffold that provides proper biological and biomechanical properties as well as structural configuration. In this study, we investigated the clinical feasibility of a cellularized vascular scaffold in a preclinical large animal model. We fabricated the cellularized vascular construct with autologous endothelial progenitor cell (EPC)-derived endothelial cells (ECs) and smooth muscle cells (SMCs) followed by a pulsatile bioreactor preconditioning. This fully cellularized vascular construct was tested in a sheep carotid arterial interposition model. After preconditioning, confluent and mature EC and SMC layers in the scaffold were achieved. The cellularized constructs sustained the structural integrity with a high degree of graft patency without eliciting an inflammatory response over the course of the 6-month period in sheep. Moreover, the matured EC coverage on the lumen and a thick smooth muscle layer were formed at 6months after transplantation. We demonstrated that electrospun bilayered vascular scaffolds in conjunction with autologous vascular cells may be a clinically applicable alternative to traditional prosthetic vascular graft substitutes.
This study demonstrates the utility of tissue engineering to provide platform technologies for rehabilitation of patients recovering from severe, devastating cardiovascular diseases. The long-term goal is to provide alternatives to vascular grafting using bioengineered blood vessels derived from an autologous cell source with a functionalized vascular scaffold. This novel bilayered vascular construct for engineering blood vessels is designed to offer "off-the-shelf" availability for clinical translation.
血管组织工程的策略是通过将自体血管细胞与管状可生物降解支架相结合来创建血管替代物。我们之前开发了一种新型的电纺双层血管支架,它具有合适的生物学和生物力学特性以及结构配置。在本研究中,我们在临床前大型动物模型中研究了细胞化血管支架的临床可行性。我们用自体内皮祖细胞(EPC)衍生的内皮细胞(ECs)和平滑肌细胞(SMCs)构建细胞化血管构建体,随后进行搏动生物反应器预处理。这种完全细胞化的血管构建体在绵羊颈动脉置换模型中进行了测试。预处理后,支架中实现了汇合且成熟的EC和SMC层。在绵羊的6个月观察期内,细胞化构建体维持了结构完整性,具有高度的移植物通畅性,且未引发炎症反应。此外,移植后6个月时,在管腔内形成了成熟的EC覆盖层和厚厚的平滑肌层。我们证明,电纺双层血管支架与自体血管细胞相结合可能是传统人工血管替代物的一种临床适用替代方案。
本研究证明了组织工程为从严重、毁灭性心血管疾病中恢复的患者康复提供平台技术的实用性。长期目标是提供使用源自自体细胞源并带有功能化血管支架的生物工程血管来替代血管移植的方法。这种用于工程化血管的新型双层血管构建体旨在为临床转化提供“现货”可用性。