Clemson University, Department of Bioengineering, United States.
Clemson University, Department of Bioengineering, United States.
Acta Biomater. 2018 Apr 1;70:25-34. doi: 10.1016/j.actbio.2018.01.008. Epub 2018 Feb 1.
Hyperglycemia and dyslipidemia coexist in diabetes and result in inflammation, degeneration, and impaired tissue remodeling, processes which are not conducive to the desired integration of tissue engineered products into the surrounding tissues. There are several challenges for vascular tissue engineering such as non-thrombogenicity, adequate burst pressure and compliance, suturability, appropriate remodeling responses, and vasoactivity, but, under diabetic conditions, an additional challenge needs to be considered: the aggressive oxidative environment generated by the high glucose and lipid concentrations that lead to the formation of advanced glycation end products (AGEs) in the vascular wall. Extracellular matrix-based scaffolds have adequate physical properties and are biocompatible, however, these scaffolds are altered in diabetes by the formation AGEs and impaired collagen degradation, consequently increasing vascular wall stiffness. In addition, vascular cells detect and respond to altered stimuli from the matrix by pathological remodeling of the vascular wall. Due to the immunomodulatory effects of mesenchymal stem cells (MSCs), they are frequently used in tissue engineering in order to protect the scaffolds from inflammation. MSCs together with antioxidant treatments of the scaffolds are expected to protect the vascular grafts from diabetes-induced alterations. In conclusion, as one of the most daunting environments that could damage the ECM and its interaction with cells is progressively built in diabetes, we recommend that cells and scaffolds used in vascular tissue engineering for diabetic patients are tested in diabetic animal models, in order to obtain valuable results regarding their resistance to diabetic adversities.
Almost 25 million Americans have diabetes, characterized by high levels of blood sugar that binds to tissues and disturbs the function of cardiovascular structures. Therefore, patients with diabetes have a high risk of cardiovascular diseases. Surgery is required to replace diseased arteries with implants, but these fail after 5-10 years because they are made of non-living materials, not resistant to diabetes. New tissue engineering materials are developed, based on the patients' own stem cells, isolated from fat, and added to extracellular matrix-based scaffolds. Our main concern is that diabetes could damage the tissue-like implants. Thus we review studies related to the effect of diabetes on tissue components and recommend antioxidant treatments to increase the resistance of implants to diabetes.
高血糖和血脂异常在糖尿病中并存，导致炎症、变性和组织重塑受损，这些过程不利于组织工程产品与周围组织的理想整合。血管组织工程面临着几个挑战，如非血栓形成性、足够的爆破压和顺应性、可缝合性、适当的重塑反应和血管活性，但在糖尿病条件下，还需要考虑一个额外的挑战：由高血糖和脂质浓度产生的侵袭性氧化环境导致血管壁中晚期糖基化终产物 (AGEs) 的形成。基于细胞外基质的支架具有足够的物理性能和生物相容性，然而，在糖尿病中，这些支架会因 AGEs 的形成和胶原蛋白降解受损而改变，从而增加血管壁的僵硬度。此外，血管细胞通过血管壁的病理性重塑来检测和响应基质中改变的刺激。由于间充质干细胞 (MSCs) 的免疫调节作用，它们经常被用于组织工程中，以保护支架免受炎症的影响。MSCs 与支架的抗氧化治疗一起，有望保护血管移植物免受糖尿病引起的改变。总之，由于在糖尿病中逐渐建立了最令人生畏的环境之一，即有可能破坏细胞外基质及其与细胞的相互作用，我们建议在糖尿病动物模型中测试用于糖尿病患者的血管组织工程中的细胞和支架，以获得关于其对糖尿病逆境的抵抗力的有价值的结果。
近 2500 万美国人患有糖尿病，其特征是血糖水平高，与组织结合并扰乱心血管结构的功能。因此，糖尿病患者患心血管疾病的风险很高。需要手术用植入物代替患病的动脉，但这些植入物在 5-10 年后会失效，因为它们是由非活体材料制成的，无法抵抗糖尿病。新的组织工程材料是基于患者自身的干细胞开发的，这些干细胞从脂肪中分离出来，并添加到基于细胞外基质的支架中。我们主要关心的是糖尿病可能会损害类似组织的植入物。因此，我们回顾了与糖尿病对组织成分影响相关的研究，并建议进行抗氧化治疗，以提高植入物对糖尿病的抵抗力。
